Chen Gang, Dai Xiaoyan, Ren Xiuping, Lin Naifen, Zhang Min, Du Zhaolin, Zhang Endong
Department of Otolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Front Neurol. 2020 Oct 26;11:596454. doi: 10.3389/fneur.2020.596454. eCollection 2020.
To compare utricular dysfunction with saccular dysfunction in benign paroxysmal positional vertigo (BPPV), based on ocular vestibular evoked myogenic potentials (oVEMP) and cervical VEMP (cVEMP), respectively. We performed a literature search exploring utricular and saccular dysfunction in BPPV patients through June 2020 using oVEMP and cVEMP, respectively. The databases included Pubmed, Embase, CENTRAL, CNKI, Wan Fang Data, and CBM. The literatures were limited to Chinese and English. Inclusion criteria and exclusion criteria were defined. We adopted abnormal rate as the outcome. All statistical processes were conducted through software Review Manager. Considering the air-conducted sound (ACS) and bone conducted vibration (BCV) may have different mechanisms, and three types of diagnostic criteria for abnormal VEMP were available, sub-group analysis was performed simultaneously according to the sound stimuli and the diagnostic criteria of abnormal VEMP. We retrieved 828 potentially relevant literatures, and finally 12 studies were included for meta-analysis of abnormal rate after duplication removal, titles and abstracts screening, and full-text reading. The abnormal rate of oVEMP was not significantly different from cVEMP (OR = 1.59, 95% CI = 0.99-2.57). But the abnormal rate was obviously different between the subgroups adopting ACS oVEMP and BCV oVEMP. In studies adopting ACS oVEMP, the abnormal rate of oVEMP was higher than cVEMP (OR = 1.85, 95% CI = 1.38-2.49). The abnormal rate of oVEMP was also higher than cVEMP when adopting asymmetry ratio (AR) and no response (NR) as diagnostic criteria (OR = 2.16, 95% CI = 1.61-2.89). The meta-analysis reveals that utricular dysfunction may be more predominant in BPPV compared with saccular dysfunction.
为了基于眼前庭诱发肌源性电位（oVEMP）和颈肌前庭诱发肌源性电位（cVEMP），比较良性阵发性位置性眩晕（BPPV）中的椭圆囊功能障碍和球囊功能障碍。我们进行了一项文献检索，分别通过oVEMP和cVEMP探索截至2020年6月的BPPV患者的椭圆囊和球囊功能障碍。数据库包括PubMed、Embase、CENTRAL、中国知网、万方数据和中国生物医学文献数据库。文献限于中文和英文。定义了纳入标准和排除标准。我们采用异常率作为结局指标。所有统计过程均通过Review Manager软件进行。考虑到气导声音（ACS）和骨导振动（BCV）可能具有不同机制，且有三种异常VEMP的诊断标准可用，因此根据声音刺激和异常VEMP诊断标准同时进行亚组分析。我们检索到828篇潜在相关文献，最终纳入12项研究进行重复文献去除、标题和摘要筛选以及全文阅读后的异常率荟萃分析。oVEMP异常率与cVEMP无显著差异（OR = 1.59, 95% CI = 0.99 - 2.57）。但采用ACS oVEMP和BCV oVEMP亚组之间的异常率明显不同。在采用ACS oVEMP的研究中，oVEMP异常率高于cVEMP（OR = 1.85, 95% CI = 1.38 - 2.49）。当采用不对称率（AR）和无反应（NR）作为诊断标准时，oVEMP异常率也高于cVEMP（OR = 2.16, 95% CI = 1.61 - 2.89）。荟萃分析表明，与球囊功能障碍相比，椭圆囊功能障碍在BPPV中可能更为主导。
