Murofushi Toshihisa, Goto Fumiyuki, Tsubota Masahito
Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, Kawasaki, Japan.
Department of Otolaryngology, Tokai University School of Medicine, Isehara, Japan.
Front Neurol. 2020 Feb 20;11:24. doi: 10.3389/fneur.2020.00024. eCollection 2020.
To compare habituation in auditory middle latency response (AMLR) to repetitive stimuli of vestibular migraine (VM) patients with Meniere's disease (MD) patients and healthy controls (HC) and to assess usefulness of AMLR for diagnosis of VM. Thirteen unilateral definite MD patients (2 men, 11 women, mean age 50.6), 13 definite VM patients (3 men, 10 women, mean age 45.5), and 8 HC subjects (2 men, 6 women, mean age 37.1) were enrolled. The electrodes were placed on the vertex and the spinal process of the fifth cervical vertebra. Binaural click stimulation (0.1 ms, 70 dBnHL) was presented. A total of 800 responses were averaged. Averaged responses were divided into four sets (S1 to S4) according to the temporal order. No, Po, Na, and Pa were identified, and amplitudes and latencies were measured. Concerning latencies, HC subjects showed a tendency of shorter latencies. However, there was no clear effect of repetitive stimulation. Concerning No-Po amplitudes, no significant differences were observed. Raw amplitudes of Na-Pa showed statistically significant differences in S1 and S2 among the groups ( < 0.01 one-way ANOVA). Differences were shown in MD vs. VM and HC vs. VM in S1 (smaller in VM) ( < 0.01 Bonferroni's test) and in MD vs. VM in S2 (smaller in VM) ( < 0.01 Bonferroni test). Relative amplitudes of Na-Pa to S1 showed statistically significant differences in S4 ( < 0.01 one-way ANOVA). Differences were shown in MD vs. VM and HC vs. VM (larger in VM) ( < 0.01 Bonferroni's test). Differences of Na-Pa amplitudes in S2 to S4 from Na-Pa amplitude in S1 were significant in S4 of VM patients (Dunnett's test). VM patients showed lack of habituation (potentiation) of Na-Pa amplitude in AMLR to repetitive stimuli while MD patients and HC subjects showed habituation. Observation of lack of habituation has high diagnostic accuracy for differential diagnosis of VM from MD.
比较梅尼埃病（MD）患者、前庭性偏头痛（VM）患者及健康对照（HC）对重复性刺激的听觉中潜伏期反应（AMLR）的习惯化情况，并评估AMLR对VM诊断的有用性。纳入13例单侧明确的MD患者（2例男性，11例女性，平均年龄50.6岁）、13例明确的VM患者（3例男性，10例女性，平均年龄45.5岁）和8例HC受试者（2例男性，6例女性，平均年龄37.1岁）。电极置于头顶和第五颈椎棘突处。进行双耳短声刺激（0.1毫秒，70分贝听力级）。共平均800次反应。根据时间顺序将平均反应分为四组（S1至S4）。识别出No、Po、Na和Pa，并测量其振幅和潜伏期。关于潜伏期，HC受试者显示出潜伏期较短的趋势。然而，重复性刺激没有明显影响。关于No-Po振幅，未观察到显著差异。Na-Pa的原始振幅在各组的S1和S2中显示出统计学显著差异（单因素方差分析，P<0.01）。在S1中，MD与VM以及HC与VM之间存在差异（VM中较小）（Bonferroni检验，P<0.01），在S2中MD与VM之间存在差异（VM中较小）（Bonferroni检验，P<0.01）。Na-Pa相对于S1的相对振幅在S4中显示出统计学显著差异（单因素方差分析，P<0.01）。MD与VM以及HC与VM之间存在差异（VM中较大）（Bonferroni检验，P<0.01）。VM患者S2至S4中Na-Pa振幅与S1中Na-Pa振幅的差异在VM患者的S4中具有显著性（Dunnett检验）。VM患者对重复性刺激的AMLR中Na-Pa振幅缺乏习惯化（增强），而MD患者和HC受试者表现出习惯化。观察到缺乏习惯化对VM与MD的鉴别诊断具有较高的诊断准确性。
