Salvago Pietro, Vaccaro Davide, Plescia Fulvio, Alberti Giuseppe, Bianco Antonino, Cirrincione Luigi, Evola Lucrezia, Martines Francesco
Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), Sezione di Audiologia, Università degli Studi di Palermo, Via del Vespro 129, Palermo, 90127, Italy.
UOSD Audiologia, A.O.U.P. "Paolo Giaccone", Via del Vespro 129, Palermo, 90127, Italy.
Eur Arch Otorhinolaryngol. 2025 May 29. doi: 10.1007/s00405-025-09490-x.
To analyze the relationship between normal horizontal vestibular-ocular reflex (VOR) gain with catch-up saccades (CS) in patients reporting recurrent or chronic vestibular symptoms of unknown causes.
A prospective study involving 34 patients suffering from vestibular symptoms of unknown origin; all subjects presented bilateral normal horizontal VOR gain and CS on at least one side. Data collection regarded onset and duration of vestibular symptoms. vHIT parameters were analyzed.
Patients complained of episodic spontaneous vertigo in 54.54% of cases, dizziness in 12.12%, and unsteadiness in 33.33% respectively. The study of VOR gain evidenced a mean gain of 0.92 ± 0.08 for the right and of 0.89 ± 0.07 for the left horizontal semicircular canal (HSC) (p = 0.11). A weak inverse correlation between age and VOR gain (r=-0.007232, p = 0.954) was found. CS were observed bilaterally in 66.66% of subjects, with overt saccades in 78.78% of HSC. All detected CS presented a peak velocity between 100 and 200 °/s with a scattered pattern of saccade distribution in 75.86% of cases. HSC with a VOR gain between 0.8 and 0.89 exhibited the highest prevalence (84.37%) of overt saccades (p = 0.01). No relationship was found between CS laterality, the clusterization of saccades, and different vertigo symptoms.
Patients suffering from vertigo of unknown origin with a normal VOR gain and CS displayed a CS pattern that was mainly represented by overt saccades with a scattered pattern that may be an indirect sign of an underlying vestibular dysfunction; clinicians should include a careful analysis of CS patterns and metrics to better explore vestibular function.
分析原因不明的复发性或慢性前庭症状患者的正常水平前庭眼反射（VOR）增益与视动性眼震（CS）之间的关系。
一项前瞻性研究，纳入34例病因不明的前庭症状患者；所有受试者至少一侧的双侧水平VOR增益和CS均正常。收集前庭症状的发作情况和持续时间，并分析视频头脉冲试验（vHIT）参数。
患者分别有54.54%出现发作性自发性眩晕，12.12%出现头晕，33.33%出现不稳感。VOR增益研究显示，右侧水平半规管（HSC）的平均增益为0.92±0.08，左侧为0.89±0.07（p = 0.11）。发现年龄与VOR增益之间存在弱负相关（r = -0.007232，p = 0.954）。66.66%的受试者双侧观察到CS，78.78%的HSC出现明显眼震。所有检测到的CS的峰值速度在100至200°/秒之间，75.86%的病例中眼震分布呈散在模式。VOR增益在0.8至0.89之间的HSC出现明显眼震的患病率最高（84.37%）（p = 0.01）。未发现CS的侧别、眼震聚集与不同眩晕症状之间存在关联。
VOR增益和CS正常的不明原因眩晕患者表现出的CS模式主要以明显眼震和散在模式为特征，这可能是潜在前庭功能障碍的间接征象；临床医生应仔细分析CS模式和指标，以更好地评估前庭功能。
