Pyykkö I, Aalto H, Starck J, Ishizaki H
Department of Otolaryngology, University Hospital of Helsinki.
Acta Otolaryngol Suppl. 1995;520 Pt 1:19-21. doi: 10.3109/00016489509125178.
We investigated the effect of visual control on postural stability on a moving platform in 36 patients with Menière's disease (MD) in 25 patients with operated acoustic neurinoma (AN) and in 19 healthy controls. The force platform was placed on rails and oscillated linearly at frequencies from 0.2 to 5 Hz at a constant velocity of 30 mm/s. In all subjects, the support surface oscillation produced postural instability that differed significantly from the base line stability. The body sway velocity increased almost linearly with the increase of stimulation frequency. The MD patients swayed more than the AN patients at base line measurements in non-visual conditions but not during platform movement. In visual conditions the AN patients stabilized their posture significantly better than the MD patients, who showed deteriorating visual control of posture during platform movement. The controls differed from the patients in all test conditions except 5 Hz stimulation, which causes the body segment to fall into resonance. The Romberg quotients (RQ) in MD patients was significantly poorer during platform movement than in controls, except at 5 Hz stimulation. The AN patients had higher RQ values than controls, and mainly used vision to compensate their vestibular deficit. Thus, patients with MD fail to control their posture efficiently with vision during movement which may explain the visually induced dizziness in MD patients.
我们研究了视觉控制对36例梅尼埃病（MD）患者、25例接受手术的听神经瘤（AN）患者以及19名健康对照者在移动平台上姿势稳定性的影响。测力平台放置在轨道上，以30毫米/秒的恒定速度在0.2至5赫兹的频率下做线性振荡。在所有受试者中，支撑面的振荡都会导致姿势不稳定，这与基线稳定性有显著差异。身体摆动速度几乎随刺激频率的增加而呈线性增加。在非视觉条件下的基线测量中，MD患者的摆动比AN患者更明显，但在平台移动期间并非如此。在视觉条件下，AN患者的姿势稳定性明显优于MD患者，MD患者在平台移动期间姿势的视觉控制能力恶化。除了在5赫兹刺激（此时身体节段会发生共振）外，在所有测试条件下，对照组与患者均存在差异。在平台移动期间，MD患者的罗姆伯格商（RQ）明显低于对照组，但在5赫兹刺激时除外。AN患者的RQ值高于对照组，且主要利用视觉来弥补其前庭功能缺陷。因此，MD患者在运动过程中无法有效地利用视觉来控制姿势，这可能解释了MD患者的视觉性眩晕。
