重度阻塞性睡眠呼吸暂停患者持续气道正压通气治疗前后的前庭诱发肌源性电位反应评估。

Evaluation of vestibular evoked myogenic potentials responses in patients with severe obstructive sleep apnea before and after continuous positive airway pressure therapy.

作者信息

Arslan İbrahim, Güneş Mesut, Selçuk Ömer Tarık, Eyigör Hülya

机构信息

Department of Ear, Nose, and Throat, Antalya Education and Research Hospital, Antalya, Turkey.

出版信息

J Clin Sleep Med. 2025 Sep 1;21(9):1547-1556. doi: 10.5664/jcsm.11772.

DOI:10.5664/jcsm.11772

PMID:40415352

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12406845/

Abstract

STUDY OBJECTIVES

We investigated the diagnostic role of vestibular evoked myogenic potential (VEMP) in detecting potential damage to the otolithic organs and brainstem in patients with obstructive sleep apnea syndrome (OSAS) and evaluated the effect of continuous positive airway pressure therapy on the vestibular system through VEMP measurements.

METHODS

This single-center, prospective study included 51 patients with severe OSAS (102 ears) and 20 controls without OSAS (40 ears). Cervical and ocular VEMP tests were administered to both groups. For patients with OSAS, VEMP tests were repeated after 3-month continuous positive airway pressure therapy. Pre- and posttreatment VEMP data were compared between the groups.

RESULTS

Patients with OSAS had significantly lower response rates of both ocular and cervical VEMP compared to controls ( = .003 and = .027, respectively). In ocular VEMP, prolonged p1 and n1 latencies, shortened p1-n1 interpeak latencies, and decreased amplitudes were observed ( < .0001 for all). In cervical VEMP, prolonged n1 and p1-n1 interpeak latencies and reduced amplitudes were noted ( < .0001 for all), whereas no significant changes were observed in p1 latency. Significant posttreatment improvements were detected in ocular VEMP parameters, including n1 latency, p1-n1 latency, and amplitudes ( < .0001, = .001, and = .001, respectively). Similarly, significant posttreatment improvements were observed in cervical VEMP parameters, namely n1 latency, p1-n1 latency, and amplitudes ( < .0001, < .0001, and = .003, respectively). There was no significant change in p1 latency.

CONCLUSIONS

Subclinical abnormalities in otolithic organs and the brainstem in severe OSAS could be detected early using noninvasive VEMP testing. VEMP tests also revealed that a 3-month continuous positive airway pressure therapy ameliorated these vestibular system abnormalities.

CITATION

Arslan İ, Güneş M, Selçuk ÖT, Eyigör H. Evaluation of vestibular evoked myogenic potentials responses in patients with severe obstructive sleep apnea before and after continuous positive airway pressure therapy. 2025;21(9):1547-1556.

摘要

研究目的

我们研究了前庭诱发肌源性电位（VEMP）在检测阻塞性睡眠呼吸暂停综合征（OSAS）患者耳石器官和脑干潜在损伤中的诊断作用，并通过VEMP测量评估持续气道正压通气治疗对前庭系统的影响。

方法

这项单中心前瞻性研究纳入了51例重度OSAS患者（102耳）和20例无OSAS的对照者（40耳）。两组均进行了颈肌和眼肌VEMP测试。对于OSAS患者，在持续气道正压通气治疗3个月后重复进行VEMP测试。比较两组治疗前后的VEMP数据。

结果

与对照组相比，OSAS患者的眼肌和颈肌VEMP反应率均显著降低（分别为P = .003和P = .027）。在眼肌VEMP中，观察到p1和n1潜伏期延长、p1 - n1峰间潜伏期缩短以及波幅降低（所有P < .0001）。在颈肌VEMP中，观察到n1和p1 - n1峰间潜伏期延长以及波幅降低（所有P < .0001），而p1潜伏期无显著变化。治疗后眼肌VEMP参数有显著改善，包括n1潜伏期、p1 - n1潜伏期和波幅（分别为P < .0001、P = .001和P = .001）。同样，治疗后颈肌VEMP参数也有显著改善，即n1潜伏期、p1 - n1潜伏期和波幅（分别为P < .0001、P < .0001和P = .003）。p1潜伏期无显著变化。