Dyball Alyssa C, Wu Xiao Ping, Kwok Belinda Y C, Wang Chao, Nham Benjamin, Pogson Jacob M, Kong Jonathan H K, Taylor Rachael L, Weber Konrad P, Welgampola Miriam S, Rosengren Sally M
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Audiology Department, Macquarie University, Sydney, Australia.
Exp Brain Res. 2024 Dec 2;243(1):10. doi: 10.1007/s00221-024-06947-z.
The ocular vestibular evoked myogenic potential (oVEMP) is a measure of otolith function. The initial n10 peak follows a contralateral pathway from ipsilateral utricle to contralateral inferior oblique muscle. Following the n10, a series of positive and negative waves are elicited in the inferior oblique, but their characteristics and generators are unknown. This paper therefore investigated the latency, amplitude, and laterality of these late peaks in patients with hearing or vestibular loss compared to healthy volunteers. oVEMPs were elicited to bone-conducted (BC) square wave pulses and air-conducted (AC) clicks in 63 healthy volunteers, 15 patients with profound hearing loss (HL), 45 patients with unilateral vestibular loss (uVL), and 10 patients with bilateral vestibular loss (bVL). In healthy volunteers, up to 5 peaks and troughs were elicited to BC bilaterally. The first two peaks were largest, and amplitude decreased linearly thereafter. In healthy volunteers stimulated with AC clicks and patients with uVL stimulated with either stimulus, the first 2-3 oVEMP waves were significantly larger on the side opposite the healthy/stimulated ear, while the later waves were smaller and had similar amplitude bilaterally. All peaks were absent stimulating ears with no measurable vestibular function. Late peaks were elicited in patients with intact vestibular function regardless of hearing status, demonstrating the vestibular origin of all peaks. Like the clinical n10-p15 waves, the second waves followed a dominant contralateral pathway, while waves 3 onwards appear to have a separate origin and may represent bilateral projections to the extra-ocular muscles.
眼前庭诱发肌源性电位（oVEMP）是一种耳石功能的测量方法。最初的n10波峰沿从同侧椭圆囊到对侧下斜肌的对侧通路传导。在n10之后，下斜肌会引出一系列正负波，但它们的特征和产生源尚不清楚。因此，本文研究了与健康志愿者相比，听力或前庭功能丧失患者这些晚期波峰的潜伏期、振幅和偏侧性。对63名健康志愿者、15名重度听力损失（HL）患者、45名单侧前庭功能丧失（uVL）患者和10名双侧前庭功能丧失（bVL）患者进行骨传导（BC）方波脉冲和气传导（AC）短声诱发oVEMP检查。在健康志愿者中，双侧BC刺激可引出多达5个波峰和波谷。前两个波峰最大，此后振幅呈线性下降。在接受AC短声刺激的健康志愿者和接受任何一种刺激的uVL患者中，前2 - 3个oVEMP波在健康/受刺激耳对侧的一侧明显更大，而后期波更小且双侧振幅相似。刺激前庭功能不可测的耳朵时，所有波峰均消失。无论听力状况如何，前庭功能完整的患者均可引出晚期波峰，表明所有波峰均起源于前庭。与临床n10 - p15波一样，第二个波沿主要的对侧通路传导，而从第3个波开始似乎有独立的起源，可能代表着眼外肌的双侧投射。
