Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences, Ellen Wilkinson Building, The University of Manchester, Manchester, UK.
Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences, Ellen Wilkinson Building, The University of Manchester, Manchester, UK
BMJ Open. 2022 Aug 17;12(8):e060540. doi: 10.1136/bmjopen-2021-060540.
Systematically investigate the effects of multiple sclerosis (MS) on the audio-vestibular system.
Systematic review of literature investigating audio-vestibular conditions in persons with MS (PwMS) aged ≥18 years. PubMed, Scopus, NICE and Web of Science were searched. Randomised controlled trials, and cohort, case-control, observational and retrospective studies in English, published from 2000 to 21 November 2021, evaluated PwMS with at least one outcome (pure tone audiometry, auditory brainstem response, otoacoustic emissions, cortical auditory evoked potentials, functional MRI assessing auditory function, vestibular evoked myogenic potentials, videonystagmography, electronystagmography, posturography, rotary chair, gaps in noise, word discrimination scores, duration pattern sequence test), were included. Study selection and assessments of bias were independently conducted by two reviewers using the Risk of Bias Assessment Tool for Non-randomized Studies, Newcastle-Ottawa Scale (NOS) and the NOS adapted for cross-sectional studies.
35 studies were included. Auditory function was evaluated in 714 PwMS and 501 controls, vestibular function was evaluated in 682 PwMS and 446 controls. Peripheral auditory function results were contradictory between studies; some found abnormalities in PwMS, and others found no differences. Tests of brainstem and central auditory functions were more consistently found to be abnormal in PwMS. Most vestibular tests were reported as abnormal in PwMS, abnormalities were either peripheral or central or both. However, quantitative analyses could not be performed due to discrepancies between studies in results reporting, test stimulus and recording parameters.
Although abnormal results on auditory and vestibular tests were noted in PwMS, specific effects of MS on the audio-vestibular system could not be determined due to the heterogeneity between studies that restricted the ability to conduct any quantitative analyses. Further research with consistent reporting, consistent stimulus and consistent recording parameters is needed in order to quantify the effects of MS on the auditory and vestibular systems.
CRD42020180094.
系统研究多发性硬化症（MS）对听觉-前庭系统的影响。
对 2000 年 11 月 21 日之前以英文发表的、评估年龄≥18 岁的多发性硬化症患者（PwMS）听觉-前庭状况的文献进行系统综述。检索了 PubMed、Scopus、NICE 和 Web of Science。纳入了随机对照试验以及队列、病例对照、观察性和回顾性研究，这些研究评估了至少有一个结局（纯音听阈测试、听觉脑干反应、耳声发射、皮质听觉诱发电位、功能磁共振成像评估听觉功能、前庭诱发肌源性电位、视频眼震图、眼震电图、姿势描记术、噪声中的间隙、单词辨别评分、时长模式序列测试）的 PwMS。两名评审员独立使用非随机研究风险偏倚评估工具、纽卡斯尔-渥太华量表（NOS）和适用于横断面研究的 NOS 评估研究选择和偏倚。
共纳入 35 项研究。714 名 PwMS 和 501 名对照者接受了听觉功能评估，682 名 PwMS 和 446 名对照者接受了前庭功能评估。研究之间的外周听觉功能结果存在差异；一些研究发现 PwMS 存在异常，而另一些研究则发现无差异。脑干和中枢听觉功能测试更一致地发现 PwMS 异常。大多数前庭测试均报告 PwMS 异常，异常可能是外周或中枢或两者兼有。但是，由于研究之间在结果报告、测试刺激和记录参数方面存在差异，因此无法进行定量分析。
尽管在 PwMS 中观察到听觉和前庭测试异常，但由于研究之间存在异质性，限制了进行任何定量分析的能力，因此无法确定 MS 对听觉-前庭系统的确切影响。需要进一步开展具有一致报告、一致刺激和一致记录参数的研究，以量化 MS 对听觉和前庭系统的影响。
PROSPERO 注册号：CRD42020180094。
