Kobel Megan J, Wagner Andrew R, Merfeld Daniel M, Mattingly Jameson K
Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, United States.
Front Neurol. 2021 Feb 19;12:643634. doi: 10.3389/fneur.2021.643634. eCollection 2021.
Vestibular disorders pose a substantial burden on the healthcare system due to a high prevalence and the severity of symptoms. Currently, a large portion of patients experiencing vestibular symptoms receive an ambiguous diagnosis or one that is based solely on history, unconfirmed by any objective measures. As patients primarily experience perceptual symptoms (e.g., dizziness), recent studies have investigated the use of vestibular perceptual thresholds, a quantitative measure of vestibular perception, in clinical populations. This review provides an overview of vestibular perceptual thresholds and the current literature assessing use in clinical populations as a potential diagnostic tool. Patients with peripheral and central vestibular pathologies, including bilateral vestibulopathy and vestibular migraine, show characteristic changes in vestibular thresholds. Vestibular perceptual thresholds have also been found to detect subtle, sub-clinical declines in vestibular function in asymptomatic older adults, suggesting a potential use of vestibular thresholds to augment or complement existing diagnostic methods in multiple populations. Vestibular thresholds are a reliable, sensitive, and specific assay of vestibular precision, however, continued research is needed to better understand the possible applications and limitations, especially with regard to the diagnosis of vestibular disorders.
前庭疾病由于其高患病率和症状的严重性,给医疗系统带来了沉重负担。目前,很大一部分出现前庭症状的患者得到的是模糊诊断,或者仅仅基于病史的诊断,没有任何客观测量的证实。由于患者主要经历感知症状(如头晕),最近的研究调查了在前庭临床人群中使用前庭感知阈值(一种前庭感知的定量测量方法)的情况。本综述概述了前庭感知阈值以及目前评估其作为潜在诊断工具在临床人群中使用情况的文献。患有外周和中枢前庭病变的患者,包括双侧前庭病和前庭性偏头痛,在前庭阈值方面表现出特征性变化。还发现前庭感知阈值能够检测无症状老年人前庭功能细微的亚临床下降,这表明前庭阈值有可能在多人群中增强或补充现有的诊断方法。前庭阈值是一种可靠、敏感且特异的前庭精度检测方法,然而,仍需要持续研究以更好地理解其可能的应用和局限性,特别是在前庭疾病的诊断方面。