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帕金森病中前庭诱发肌源性电位与不同头晕状态的关联:一项对照研究。

Association between vestibular evoked myogenic potentials and different dizziness status in Parkinson's disease: A controlled study.

作者信息

Li Xingyue, Du Xiaoyan, Zhao Rui, Du Hongheng, Zhao Libo

机构信息

Department of Neurology, Yongchuan Hospital of Chongqing Medical University, 439# Xuanhua Road, Yongchuan, Chongqing 402160, China; Chongqing Key Laboratory of Cerebrovascular Disease Research, 439# Xuanhua Road, Yongchuan, Chongqing 402160, China; Department of Encephalopathy, Yongchuan District Hospital of Traditional Chinese Medicine, 2# Yingbin Avenue, Yongchuan, Chongqing 402160, China.

Department of Neurology, Yongchuan Hospital of Chongqing Medical University, 439# Xuanhua Road, Yongchuan, Chongqing 402160, China; Chongqing Key Laboratory of Cerebrovascular Disease Research, 439# Xuanhua Road, Yongchuan, Chongqing 402160, China.

出版信息

Clin Neurol Neurosurg. 2025 Feb;249:108711. doi: 10.1016/j.clineuro.2024.108711. Epub 2024 Dec 24.

Abstract

OBJECTIVE

This study compared ocular and cervical vestibular evoked myogenic potentials (oVEMP and cVEMP) among individuals with Parkinson's disease (PD) without dizziness, with nonspecific dizziness (dizziness without orthostatic hypotension), or with dizziness combined with orthostatic hypotension.

MATERIALS AND METHODS

We prospectively analyzed 30 of each of the three types of individuals who were admitted to Yongchuan Hospital of Chongqing Medical University (Chongqing, China) between June 2022 and April 2023. The three groups received oVEMP and cVEMP measurements using an electromyography-evoked potential system. For oVEMP, the N10 latency, P16 latency, and amplitude were compared between the three groups and the reference values. For cVEMP, the P13 latency, N23 latency, and amplitude were compared between the three groups and the reference values. Overall characteristics of oVEMP and cVEMP were also assessed using a previously published scoring scale originally developed for individuals with multiple sclerosis between the three groups included. The correlation between VEMP parameters (the latency and amplitude) and VEMP scores were simultaneously analyzed using Pearson's bivariate correlation analysis.

RESULTS

When compared with reference values, the oVEMP and cVEMP parameters of all three groups were found to be slightly different from the reference values. When the three groups included were compared with each other, in terms of oVEMP, the average amplitude in the left eye was significantly higher in those with nonspecific dizziness than in the other two groups. In terms of cVEMP, the average N23 latency on both the right and left sides of the neck and average amplitude on the right side of the neck were significantly higher in those with nonspecific dizziness than in the other two groups. Scores for oVEMP and cVEMP were also significantly higher for those with nonspecific dizziness than for the other two groups. There were no significant differences in oVEMP and cVEMP parameters, and scores for oVEMP and cVEMP between patients with dizziness combined with orthostatic hypotension and those without dizziness. In terms of correlation analysis, the N23 latency of left neck (r = 0.509, p < 0.001), the N23 latency of right neck (r = 0.495, p < 0.001), and the amplitude of right neck (r = 0.304, p = 0.004) correlated positively with cVEMP score.

CONCLUSIONS

Patients with PD without dizziness, with dizziness attributable to orthostatic hypotension, and with nonspecific dizziness may be all associated with vestibular dysfunction. The VEMP scores were highest in patients with nonspecific dizziness, so vestibular function is more severely affected in patients with nonspecific dizziness. The VEMP especially cVEMP may be useful for early diagnosis of nonspecific dizziness in PD.

摘要

目的

本研究比较了无头晕的帕金森病(PD)患者、非特异性头晕(无直立性低血压的头晕)患者以及伴有直立性低血压的头晕患者的眼性和颈性前庭诱发肌源性电位(oVEMP和cVEMP)。

材料与方法

我们前瞻性分析了2022年6月至2023年4月期间入住重庆医科大学附属永川医院(中国重庆)的上述三种类型患者各30例。三组患者均使用肌电图诱发电位系统进行oVEMP和cVEMP测量。对于oVEMP,比较三组患者与参考值之间的N10潜伏期、P16潜伏期和波幅。对于cVEMP,比较三组患者与参考值之间的P13潜伏期、N23潜伏期和波幅。还使用先前为多发性硬化症患者制定的评分量表评估了三组患者中oVEMP和cVEMP的总体特征。使用Pearson双变量相关分析同时分析VEMP参数(潜伏期和波幅)与VEMP评分之间的相关性。

结果

与参考值相比,发现所有三组患者的oVEMP和cVEMP参数均与参考值略有不同。在三组之间进行比较时,就oVEMP而言,非特异性头晕患者左眼的平均波幅显著高于其他两组。就cVEMP而言,非特异性头晕患者颈部左右两侧的平均N23潜伏期和颈部右侧的平均波幅显著高于其他两组。非特异性头晕患者的oVEMP和cVEMP评分也显著高于其他两组。伴有直立性低血压的头晕患者与无头晕患者的oVEMP和cVEMP参数以及oVEMP和cVEMP评分之间无显著差异。在相关性分析方面,左颈部N23潜伏期(r = 0.509,p < 0.001)、右颈部N23潜伏期(r = 0.495,p < 0.001)和右颈部波幅(r = 0.304,p = 0.004)与cVEMP评分呈正相关。

结论

无头晕的PD患者、由直立性低血压引起头晕的患者以及非特异性头晕患者可能均与前庭功能障碍有关。非特异性头晕患者的VEMP评分最高,因此非特异性头晕患者的前庭功能受影响更严重。VEMP尤其是cVEMP可能有助于PD中非特异性头晕的早期诊断。

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