视频头脉冲试验在帕金森病患者前庭眼反射评估中的作用。
Role of the video head impulse test in the evaluation of vestibulo-ocular reflex in individuals with Parkinson's disease.
机构信息
University of Health Sciences, Gulhane Faculty of Medicine, Department of Neurology, Ankara, Turkey.
University of Health Sciences, Department of Audiology, Ankara, Turkey.
出版信息
Ideggyogy Sz. 2024 Sep 30;77(9-10):295-301. doi: 10.18071/isz.77.0295.
BACKGROUND AND PURPOSE
Parkinson’s disease (PD) is the most common movement disorder and the second most common neurodegenerative disease of the central nervous system. Dizziness is frequently reported by PD patients, yet there is a paucity of research focusing on the vestibulo-ocular reflex (VOR) in this population using high-frequency vestibular testing. This study aims to investigate the VOR in individuals with PD using the video head thrust test with and without suppression.
.METHODS
Forty individuals with PD and 40 healthy individuals were included in the study. According to the Hoehn-Yahr Scale, individuals with PD were defined as early stage with a score of 1–2.5 and middle to late stage with a score of 3 to 5. The Head Impulse Testing Paradigm (HIMP) and Suppression Head Impulse Testing Paradigm (SHIMP) were applied to all individuals.
.RESULTS
No statistically significant difference was observed between the PD group and the control group in terms of semicircular canal (SCC) gains in both HIMP and SHIMP tests. No catch-up saccades were observed in the right anterior, right posterior, left anterior, and left posterior SCC planes in the PD and control groups. However, in the right lateral SCC plane 32 patients in the PD group had saccades, while 8 patients in the control group had saccades. In the left lateral SCC plane, 32 patients in the PD group and 9 patients in the control group had catch-up saccades. A statistically significant difference was observed in the number and amplitude of saccades in the right and left lateral SCC planes compared to the control group (p<0.05). In addition, in the PD group, the amplitude, peak velocity, and latency of the anticompensatory saccades seen in SHIMP showed a statistically significant difference compared to the control group (p<0.05).
.CONCLUSION
VOR in the vertical SCC plane was not affected in individuals with PD. However, VOR in the lateral SCC plane was affected. It was concluded that when evaluating VOR with both HIMP and SHIMP in individuals with PD, the presence of catch-up saccades should be focused on and evaluated for possible vestibular dysfunction, even though SCC gains are normal. This study will contribute to a deeper understanding of vestibular function in PD, potentially informing better management strategies for dizziness in this population.
.背景与目的
帕金森病（PD）是最常见的运动障碍，也是中枢神经系统中第二常见的神经退行性疾病。头晕是 PD 患者经常报告的症状，但针对该人群使用高频前庭测试研究前庭眼反射（VOR）的研究却很少。本研究旨在使用视频头脉冲试验（VHT）结合和不结合抑制法来研究 PD 个体的 VOR。
方法
本研究纳入了 40 名 PD 患者和 40 名健康个体。根据 Hoehn-Yahr 量表，PD 患者被定义为早期（评分 1-2.5）和中晚期（评分 3-5）。所有个体均接受了 Head Impulse Testing Paradigm（HIMP）和 Suppression Head Impulse Testing Paradigm（SHIMP）测试。
结果
在 HIMP 和 SHIMP 测试中，PD 组和对照组的半规管（SCC）增益均无统计学差异。在 PD 组和对照组中，右侧前、后、左侧前、后 SCC 平面均未观察到代偿性扫视。然而，在右侧外侧 SCC 平面，32 名 PD 患者有扫视，而 8 名对照组患者有扫视。在左侧外侧 SCC 平面，32 名 PD 患者和 9 名对照组患者有代偿性扫视。与对照组相比，右侧和左侧外侧 SCC 平面的扫视数量和幅度存在统计学差异（p<0.05）。此外，在 PD 组中，SHIMP 中观察到的代偿性扫视的振幅、峰值速度和潜伏期与对照组相比有统计学差异（p<0.05）。
结论
PD 患者垂直 SCC 平面的 VOR 不受影响，但外侧 SCC 平面的 VOR 受到影响。因此，在评估 PD 患者的 VOR 时，即使 SCC 增益正常，也应关注并评估代偿性扫视的存在，以评估可能存在的前庭功能障碍。本研究将有助于深入了解 PD 中的前庭功能，可能为该人群的头晕管理提供更好的策略。
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