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1.
Medicine (Baltimore) ; 99(19): e19763, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384426

RESUMO

INTRODUCTION: Pendred syndrome (PDS)/DFNB 4 is a disorder with fluctuating and progressive hearing loss, vertigo, and thyroid goiter. We identified pathophysiology of a neurodegenerative disorder in PDS patient derived cochlear cells that were induced via induced pluripotent stem cells and found sirolimus, an mTOR inhibitor, as an inhibitor of cell death with the minimum effective concentration less than 1/10 of the approved dose for other diseases. Given that there is no rational standard therapy for PDS, we planned a study to examine effects of low dose oral administration of sirolimus for the fluctuating and progressive hearing loss, and the balance disorder of PDS by daily monitor of their audio-vestibular symptoms. METHODS AND ANALYSIS: This is a phase I/IIa double blind parallel-group single institute trial in patient with PDS/DFNB4. Sixteen of outpatients with fluctuating hearing diagnosed as PDS in SLC26A4 genetic testing aged in between 7 and 50 years old at the time of consent are given either placebo or sirolimus tablet (NPC-12T). In NPC-12T placebo arm, placebo will be given for 36 weeks; in active substance arm, placebo will be given for 12 weeks and the NPC-12T for 24 weeks. Primary endpoints are safety and tolerability. The number of occurrences and types of adverse events and of side effects will be sorted by clinical symptoms and by abnormal change of clinical test results. A 2-sided 95% confidence interval of the incidence rate by respective dosing arms will be calculated using the Clopper-Pearson method. Clinical effects on audio-vestibular tests performed daily and precise physiological test at each visit will also be examined as secondary and expiratory endpoints. TRIAL REGISTRATION NUMBER: JMA-IIA00361; Pre-results.


Assuntos
Bócio Nodular/tratamento farmacológico , Perda Auditiva Neurossensorial/tratamento farmacológico , Sirolimo/administração & dosagem , Aqueduto Vestibular/anormalidades , Adolescente , Adulto , Audiometria , Criança , Método Duplo-Cego , Feminino , Bócio Nodular/genética , Perda Auditiva Neurossensorial/genética , Humanos , Masculino , Pessoa de Meia-Idade , Transportadores de Sulfato/genética , Resultado do Tratamento , Testes de Função Vestibular , Adulto Jovem
2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(3. Vyp. 2): 16-22, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32307425

RESUMO

Cognitive impairment is common in poststroke patients. Today in rehabilitation programs the specialists use the vestibular stimulation including biological feedback to supporting reaction for treatment poststroke cognitive impairment. These studies show the relationship of vestibular function with memory, attention, spatial orientation, navigation, mental representation of three-dimensional space and other cognitive functions. It makes possible to build rehabilitation programs for patients with stroke.


Assuntos
Biorretroalimentação Psicológica , Disfunção Cognitiva/complicações , Disfunção Cognitiva/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Testes de Função Vestibular , Atenção , Cognição , Humanos , Memória , Percepção Espacial , Navegação Espacial
3.
Nat Commun ; 11(1): 63, 2020 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-31896743

RESUMO

Each vestibular sensory epithelium in the inner ear is divided morphologically and physiologically into two zones, called the striola and extrastriola in otolith organ maculae, and the central and peripheral zones in semicircular canal cristae. We found that formation of striolar/central zones during embryogenesis requires Cytochrome P450 26b1 (Cyp26b1)-mediated degradation of retinoic acid (RA). In Cyp26b1 conditional knockout mice, formation of striolar/central zones is compromised, such that they resemble extrastriolar/peripheral zones in multiple features. Mutants have deficient vestibular evoked potential (VsEP) responses to jerk stimuli, head tremor and deficits in balance beam tests that are consistent with abnormal vestibular input, but normal vestibulo-ocular reflexes and apparently normal motor performance during swimming. Thus, degradation of RA during embryogenesis is required for formation of highly specialized regions of the vestibular sensory epithelia with specific functions in detecting head motions.


Assuntos
Membrana dos Otólitos/embriologia , Ácido Retinoico 4 Hidroxilase/metabolismo , Tretinoína/metabolismo , Animais , Potenciais Evocados/genética , Potenciais Evocados/fisiologia , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Cabeça/fisiopatologia , Camundongos Endogâmicos C57BL , Camundongos Knockout , Osteopontina/metabolismo , Membrana dos Otólitos/citologia , Membrana dos Otólitos/metabolismo , Retinal Desidrogenase/genética , Retinal Desidrogenase/metabolismo , Ácido Retinoico 4 Hidroxilase/genética , Sáculo e Utrículo/citologia , Sáculo e Utrículo/embriologia , Tremor/genética , Tremor/fisiopatologia , Testes de Função Vestibular , Vestíbulo do Labirinto/embriologia , Vestíbulo do Labirinto/metabolismo
4.
J Laryngol Otol ; 134(1): 86-89, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31843038

RESUMO

BACKGROUND: Periodic alternating nystagmus is a rare condition characterised by spontaneous horizontal nystagmus that periodically reverses direction, indicating an alteration of the velocity storage mechanism. Windmill nystagmus is a peculiar and rare variant of periodic alternating horizontal nystagmus with a superimposed periodic alternating vertical nystagmus. It is generally observed in blind patients. CASE REPORT: This paper presents the unique case of a normally sighted patient with a windmill nystagmus triggered by an episode of benign paroxysmal positional vertigo due to bilateral posterior canalolithiasis. Videonystagmography revealed an anticlockwise up-beating nystagmus followed by a clockwise down-beating nystagmus with a cycle lasting 2 minutes, followed by a brief burst of horizontal left-beating nystagmus. CONCLUSION: This case report represents the first observation of a new type of windmill nystagmus, probably provoked by a malfunction of the velocity storage mechanism, gaze-stabilisation and short-adaptation networks, with a loss of cerebellar inhibition.


Assuntos
Vertigem Posicional Paroxística Benigna/diagnóstico , Nistagmo Patológico/diagnóstico , Canais Semicirculares/fisiopatologia , Idoso de 80 Anos ou mais , Vertigem Posicional Paroxística Benigna/fisiopatologia , Feminino , Humanos , Nistagmo Patológico/fisiopatologia , Testes de Função Vestibular , Gravação em Vídeo
5.
Ideggyogy Sz ; 72(11-12): 419-425, 2019 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-31834686

RESUMO

Background and purpose: - Our objectives were to determine the differences in the vestibular evoked myogenic potential (VEMP) responses in patients diagnosed with early staged idiopathic Parkinson's disease (PD) compared to the normal population and evaluate the vestibular system disorder causing balance-posture disorders. Second aim of this study was to investigate caloric test responses particularly in early staged PD compared to normal popu-lation. Methods: Thirty patients (14 females and 16 males; mean age, 60.6 ± 13.1 years) diagnosed with idiopathic PD and 28 healthy subjects (20 males and 8 females; mean age, 59.1 ± 6.4 years) were included. The patient and control groups were subdivided according to their age, gender and the patient group was subdivided according to onset time of the Parkinson symptoms, Hoehn-Yahr staging. The subgroups were compared for VEMP and caloric test responses. Results: There were no significant differences between the study and control groups for right and left VEMP measurements. Patients over 60 years and under 60 years did not show significant differences in terms of right and left mean VEMP measurements. However, P1 amplitude was significantly lower in patients over 60 years old (P = .004). Gender, disease duration, BERG balance scale and Hoehn-Yahr stage had no effect on the VEMP amplitudes. There was no significant correlation with the side of Parkinsonian symptoms to the side of canal paresis (P = .566) and the side on which no VEMP response was obtained in caloric test. Conclusion: VEMP responses were not different between PD and healthy subjects. VEMP P1 amplitude was decreased with age in PD group. Canal paresis and symptoms side were not statistically correlated in caloric test.


Assuntos
Testes Calóricos , Doença de Parkinson/diagnóstico , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Testes de Função Vestibular/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Equilíbrio Postural
6.
Artigo em Chinês | MEDLINE | ID: mdl-31623053

RESUMO

SummaryAnalyze 2 cases of horizontal semicircular canals light cupulopathy patient history, clinical manifestations, vestibular function and hearing test results, summarize the clinical features of the disease. All of the 2 patients showed a typicaln light cupulopathy nystagmus. That is, the nystagmus of the Roll-Test test is sustained to the ground, and there is no latency and attenuation with null plane. When the patient's nystagmus is characterized by direction changing positional nystagmus and head deflection nystagmus disappearance(null plane), the possibility of horizontal semicircular canals light cupulopathy is to be thought of. In this paper, 2 cases of horizontal semicircular canals light cupulopathy received in our hospital are reported as follows.


Assuntos
Nistagmo Patológico , Canais Semicirculares , Humanos , Nistagmo Fisiológico , Testes de Função Vestibular , Vestíbulo do Labirinto
7.
Int J Occup Med Environ Health ; 32(5): 723-733, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31589211

RESUMO

OBJECTIVES: The aim of this study was to investigate whether the restriction in neck rotation and increased neck muscle tension could be causally related to vertigo and dizziness. MATERIAL AND METHODS: Seventy-one patients reporting vertigo and/or imbalance were divided into 2 groups: 45 subjects with unilateral restriction (R+) and 26 without restriction (R-) of cervical rotation and muscle tension in the clinical flexion-rotation test. The normal caloric test was the inclusion criterion. The control group comprised 36 healthy volunteers with no history of vertigo. The vestibulo-ocular reflex (VOR) and the cervico-occular reflex (COR) were measured through the videonystagmography (VNG) sinusoidal pendular kinetic test in the conditions of not inactivated head and immobilized head, respectively. The VNG-head torsion test (VNG-HTT) nystagmus was recorded. RESULTS: Among the reported complaints, neck stiffness, headaches and blurred vision were more frequent in the R+ group than in both the R- group and the control group. VNG revealed an increased COR gain and the presence of VNG-HTT nystagmus in the R+ group only. Similarly, only in the R+ group a positive relationship between COR and VOR was observed. CONCLUSIONS: Patients with asymmetric restriction in neck rotation and increased neck muscle tension reveal the tendency to have an increased response of the vestibular system, along with co-existing COR upregulation. Further research is needed to investigate the relationships between the activation of cervical mechanoreceptors and dizziness pathomechanisms. Int J Occup Med Environ Health. 2019;32(5):723-33.


Assuntos
Tontura/fisiopatologia , Pescoço/fisiopatologia , Vertigem/fisiopatologia , Adulto , Estudos de Casos e Controles , Feminino , Cefaleia , Humanos , Masculino , Pessoa de Meia-Idade , Tono Muscular , Músculos do Pescoço/patologia , Reflexo Vestíbulo-Ocular , Testes de Função Vestibular
8.
Braz J Otorhinolaryngol ; 85(6): 788-798, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31606334

RESUMO

INTRODUCTION: People with vestibular loss present a deficit in the vestibular system, which is primarily responsible for promoting postural control, gaze stabilization, and spatial orientation while the head moves. There is no effective treatment for a bilateral loss of vestibular function. Recently, a vestibular implant was developed for people with bilateral loss of vestibular function to improve this function and, consequently, the quality of life of these patients. OBJECTIVE: To identify in the scientific literature evidence that vestibular implants in people with vestibular deficit improves vestibular function. METHODS: One hundred and forty six articles were found from five databases and 323 articles from the gray literature mentioning the relationship between vestibular implant and vestibular function in humans. The PICOS strategy (Population, Intervention, Comparison and Outcome) was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed according to the bias risk assessment of the Joanna Briggs Institute through the critical assessment checklist Joanna Briggs institute for quasi-experimental studies and the Joanna Briggs institute critical assessment checklist for case reports. RESULTS: Of the 21 articles included in reading the full text, 10 studies were selected for the qualitative analysis in the present systematic review. All ten articles analyzed through the critical assessment checklist Joanna Briggs institute showed a low risk of bias. The total number of samples in the evaluated articles was 18 patients with vestibular implants. CONCLUSIONS: Taken together, these findings support the feasibility of vestibular implant for restoration of the vestibulo-ocular reflex in a broad frequency range and illustrate new challenges for the development of this technology.


Assuntos
Implante Coclear , Doenças Vestibulares/cirurgia , Vestíbulo do Labirinto/fisiologia , Adulto , Distribuição por Idade , Idoso , Potenciais Evocados , Feminino , Humanos , Masculino , Doença de Meniere/fisiopatologia , Pessoa de Meia-Idade , Qualidade de Vida , Distribuição por Sexo , Doenças Vestibulares/fisiopatologia , Testes de Função Vestibular
9.
Int Tinnitus J ; 23(1): 42-46, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31469527

RESUMO

BACKGROUND AND OBJECTIVE: Whiplash associated syndrome is one of the neck disorders that is accompanied by several chronic symptoms. Balancing problems arising from common disorders and dizziness are considered as manifestations that are time-consuming to evaluate and treat. The present study aims to investigate the effect of vestibular-balance rehabilitation using a test that can be used for differential diagnosis of these lesions by comparing dizziness handicap inventory (DHI) and Smooth Pursuit Neck Torsion (SPNT) scores. METHOD: This was an analytical cross-sectional study with a two-stage design. Forty patients with whiplash-associated disorders were randomly divided into control and intervention groups. SPNT test and DHI evaluation were performed for both groups. For twenty people selected randomly in the intervention group, vestibular-balance rehabilitation was performed during 12 sessions. Finally, the SPNT and DHI tests were performed again to examine and compare the results. RESULTS: The results of this study showed that there was a statistically significant difference between the scores of smooth pursuit neck torsion gain in the SPNT test, the total score of DHI, the functional components of this questionnaire between the control and intervention groups after the implementation of the rehabilitation, and the differences in the physical, functional, and emotional components of the questionnaires of the control and intervention groups after rehabilitation exercises. CONCLUSION: Vestibular-balance rehabilitation exercises can be an effective treatment for dizziness and improving the quality of life of a person suffering from whiplash-associated disorder, followed by the reduction in dizziness caused by disability.


Assuntos
Avaliação da Deficiência , Tontura/reabilitação , Terapia por Exercício/métodos , Doenças Vestibulares/reabilitação , Traumatismos em Chicotada/complicações , Adulto , Estudos Transversais , Tontura/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Prognóstico , Resultado do Tratamento , Doenças Vestibulares/etiologia , Testes de Função Vestibular , Traumatismos em Chicotada/diagnóstico
10.
Int Tinnitus J ; 23(1): 58-63, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31469530

RESUMO

The aim the present study is to evaluate ocular and cervical Vestibular Evoked Myogenic Potentials (VEMPs) of adult individuals with and without tinnitus who have normal hearing. Thirty one patients who have normal hearing, complaining about unilateral or bilateral subjective tinnitus and 30 volunteers who without tinnitus and vestibular complains were enrolled into the present study. Following examination by of Ear Nose Throat (ENT) physician, Tinnitus Disability Questionnaire (TDQ), pure tone audiometry (125-16.000 Hz) speech tests, oVEMP and cVEMP tests were applied to all participants. Fourteen individuals with normal hearing and tinnitus were male (44%) and 17 (56%) were female with an age average of 35.8 ± 10.2.30 years; the control group consisted of 16 males (53%) and 14 females (47%) with an age average of 37.5 ± 12 years. Two individuals of the tinnitus group had bilateral tinnitus and 29 individuals had unilateral tinnitus. A statistically significant difference in individuals without tinnitus and tinnitus must be normal at work between test answers that are not available 125-16000 Hz range Air Conduction (AC) hearing thresholds, speech tests, cVEMP and oVEMP responses. Tinnitus may appear due to many reasons. Vestibular system is one of the conditions that can cause tinnitus. According to the findings obtained from adult individuals with normal hearing, the vestibular system does not cause tinnitus.


Assuntos
Estimulação Acústica/métodos , Avaliação da Deficiência , Zumbido/diagnóstico , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Adulto , Audiometria de Tons Puros/métodos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Padrões de Referência , Medição de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários , Testes de Função Vestibular
11.
Undersea Hyperb Med ; 46(3): 227-241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31394594

RESUMO

Background: Audiology clinics have many tools available to evaluate auditory and vestibular complaints. However, many tools lack established normative ranges across the life span. We conducted this study to establish reference ranges across the life span for audiology/vestibular measures commonly used to evaluate patients with traumatic brain injury. Materials and Methods: In this repeated measures study, 75 adults, ages 18-65 years, without a history of traumatic brain injury, underwent robust auditory/vestibular evaluations three times over six months, including rotational chair, videonystagmography, computerized dynamic posturography, vestibular evoked myogenic potentials, and retinal fundoscopy. Results: Age effect was notable for transient evoked otoacoustic emissions, pure-tone audiometry, auditory brainstem response, auditory middle latency response, and auditory-steady state response at 4000 hertz (Hz). Older participants (50-65 years) were more likely to have delayed latency horizontal saccades, positional nystagmus, slowed lower-extremity motor control responses, and delayed latency ocular vestibular evoked myogenic potentials. Low to mid-frequency horizontal (0.003-4 Hz) and mid-frequency vertical (1-3 Hz) vestibulo-ocular reflex, otolith-mediated reflexes, dynamic visual acuity and balance measures were generally not influenced by age. Females had larger static subjective visual testing offset angles, longer cervical vestibular evoked myogenic potential P1 latency, faster velocity horizontal saccades, and quicker motor control latency for large backward translations than age-matched males. Conclusion: These reference ranges can be used to discern impairment within the auditory and vestibular pathway following traumatic brain injury in young to middle-aged adults. ID: TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT01925963.


Assuntos
Lesões Encefálicas Traumáticas/fisiopatologia , Testes Auditivos/normas , Testes de Função Vestibular/normas , Adolescente , Adulto , Fatores Etários , Idoso , Audiometria de Resposta Evocada/normas , Audiometria de Tons Puros/normas , Lesões Encefálicas Traumáticas/complicações , Potenciais Evocados Auditivos do Tronco Encefálico , Feminino , Fundo de Olho , Testes Auditivos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Nistagmo Fisiológico , Otoscopia/métodos , Equilíbrio Postural , Estudos Prospectivos , Valores de Referência , Reflexo Acústico , Rotação , Movimentos Sacádicos , Fatores Sexuais , Fatores de Tempo , Potenciais Evocados Miogênicos Vestibulares , Testes de Função Vestibular/métodos , Acuidade Visual , Adulto Jovem
12.
Undersea Hyperb Med ; 46(3): 261-269, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31394597

RESUMO

Auditory processing disorders are common following mild traumatic brain injury (mTBI), but the neurocircuitry involved is not well understood. The present study used functional MRI to examine auditory cortex activation patterns during a passive listening task in a normative population and mTBI patients with and without clinical central auditory processing deficits (APD) as defined by the SCAN-3:A clinical battery. Patients with mTBI had overall patterns of lower auditory cortex activation during the listening tasks as compared to normative controls. A significant lateralization pattern (pairwise t-test; p⟨0.05) was observed in normative controls and in those with mTBI and APD during single-side stimulation. Additionally, baseline connectivity between left and right auditory cortices was lower in mTBI patients than in controls (p=0.01) and significantly reduced in the mTBI with APD group (p=0.008). Correlation was also observed between bilateral task-related activation and competing words subscore of the SCAN-3:A. These findings suggest the passive listening task is well suited to probe auditory function in military personnel with an mTBI diagnosis. Further, the study supports the use of multiple approaches for detecting and assessing central auditory deficits to improve monitoring of short- and long-term outcomes.


Assuntos
Córtex Auditivo/fisiopatologia , Doenças Auditivas Centrais/fisiopatologia , Vias Auditivas/fisiopatologia , Concussão Encefálica/fisiopatologia , Imagem por Ressonância Magnética , Adolescente , Adulto , Idoso , Análise de Variância , Córtex Auditivo/diagnóstico por imagem , Doenças Auditivas Centrais/diagnóstico , Doenças Auditivas Centrais/etiologia , Vias Auditivas/lesões , Concussão Encefálica/complicações , Estudos de Casos e Controles , Feminino , Audição/fisiologia , Testes Auditivos , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Militares , Testes de Função Vestibular , Veteranos , Adulto Jovem
13.
J Athl Train ; 54(9): 939-944, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31454287

RESUMO

CONTEXT: High school athletes with a history of motion sickness susceptibility exhibit higher baseline vestibular and ocular-motor scores than those without a history of motion sickness susceptibility. OBJECTIVE: To examine the effects of motion sickness susceptibility on baseline vestibular and ocular-motor functioning, neurocognitive performance, and symptom scores. DESIGN: Cross-sectional study. SETTING: Preseason concussion testing. PATIENTS OR OTHER PARTICIPANTS: A convenience sample of high school athletes (N = 308, age = 15.13 ± 1.21 years) involved in a variety of sports. MAIN OUTCOME MEASURE(S): Vestibular/Ocular Motor Screening, computerized neurocognitive assessment, symptom scale, and Motion Sickness Susceptibility Questionnaire-Short Form (MSSQ-S). RESULTS: Participants were categorized into 3 groups based on a median split of the scores (eg, NONE, LOW, and HIGH). The LOW (n = 95) and HIGH (n = 92) groups (ie, MSSQ-S score > 0) were 2.64 times more likely (χ21,257 = 7.94, P = .01, 95% confidence interval = 1.32, 5.26) to have baseline Vestibular/Ocular Motor Screening scores larger than the clinical cutoffs for the NONE group (n = 70). No between-groups main effects were present for the NONE (n = 52), LOW (n = 89), and HIGH (n = 90) MSSQ-S groups for verbal (F2,230 = .09, P = .91, η2 = .001) and visual (F2,230 = .15, P = .86, η2 = .001) memory, processing speed (F2,230 = .78, P = .46, η2 = .007), or reaction time (F2,230 = 2.21, P = .11, η2 = .002). The HIGH group exhibited higher total baseline symptom scores than the LOW (U = 3325.50, z = -1.99, P = .05, r = .15) and NONE (U = 1647.50, z = -2.83, P = .005, r = .24) groups. CONCLUSIONS: Motion sickness should be considered a preexisting risk factor that might influence specific domains of the baseline concussion assessment and postinjury management.


Assuntos
Atletas , Concussão Encefálica/diagnóstico , Movimentos Oculares/fisiologia , Percepção de Movimento/fisiologia , Enjoo devido ao Movimento/fisiopatologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Tempo de Reação/fisiologia , Fatores de Risco , Testes de Função Vestibular
14.
Artigo em Chinês | MEDLINE | ID: mdl-31446722

RESUMO

Objective:The aim of this study is to evaluate the diagnostic value of vestibular-evoked myogenic potential (cVEMP and oVEMP), caloric test, and cochlear electrogram (EcochG) in patients with Meniere's disease (MD) and non-Meniere's disease. Method:Sixty-four patients (64 ears) with Unilateral Meniere's disease were enrolled in the study group (MD group), and 127 cases(254 ears) of non-Meniere's disease patients as non-MD group, including vertigo migraine in 40 cases, benign paroxysmal positional vertigo in 48 cases, benign recurrent vertigo in 13 cases, vestibular paroxysmia in 3 cases, vestibular neuritis in 5 cases and other undiagnosed vertigo in 18 cases. Both group undertake cVEMP, oVEMP, caloric test and ECochG. Use Medcale software to draw ROC curve of ECochG and calculate the area under curve(AUC), Jordan index and optimal diagnostic cut-off points. Make the cut-off point as the point of -SP/AP, then evaluate the sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and diagnostic accuracy of cVEMP, oVEMP, caloric test and ECochG in MD group and non-MD group. Result:The AUC of ECochG ROC curve was 0.74, the Jordan index was 0.47 and the cut-off point was 0.4. The sensitivity and specificity of cVEMP(62% and 68%), oVEMP(61% and 53%) and caloric test(53% and 57%) were all below ECochG(65% and 78%). The positive predictive value and of ECochG was the highest(61.9%), the negative predictive value of cVEMP was highest(87.5%). The diagnostic accuracy of ECochG was highest(74%), followed with cVEMP(67%), oVEMP(55%) and caloric test(56%). Conclusion:Compared with the vestibular function tests, the sensitivity, specificity, diagnostic accuracy and NPV were all higher in ECochG, and the diagnostic benefit can be maximized when -SP/AP value>0.4. So the value of single vestibular function examination in the diagnosis of Meniere's disease is limited. The diagnosis of MD still requires a comprehensive evaluation in combination with medical history, audiological tests and vestibular function examinations.


Assuntos
Testes Calóricos , Doença de Meniere/diagnóstico , Potenciais Evocados Miogênicos Vestibulares , Humanos , Sensibilidade e Especificidade , Testes de Função Vestibular
15.
Artigo em Chinês | MEDLINE | ID: mdl-31446732

RESUMO

Objective:The aim of this study is to analyze the results of vestibular function tests and clinical value of patients with sudden sensorineural hearing loss (SSHL) and vertigo. Method:Twelve cases(24 ears) of unilateral SSHL with vertigo were included in the study group. 11 age and sex matched normal subjects(22 ears) were recruited as the normal control group. Both patients and normal subjects underwent carolic tests, ocular vestibular evoked myogenic potential (oVEMP), and cervical vestibular evoked myogenic potential (cVEMP) in bilateral ears. The results were compared between the subjects and the normal control group. Result: The rate of positive oVEMP was 25.0% in the affected ear and 50.0% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects; while the rate of positive cVEMP was 58.3% in the affected ear and 58.3% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects. There were no significant differences between the affected and contralateral ears (P>0.05). Compared to normal subjects, oVEMP and cVEMP in both the affected and contralateral ears were significantly reduced (P<0.05). The parameters of oVEMP and cVEMP (N1 latency, P1 latency, amplitudes) were not significantly different among the groups(P<0.05). Compared to normal subjects, the threshold difference of oVEMP and cVEMP in both the affected and contralateral ears werehigher than the normal subjects(P<0.05). Among 12 SSHL patients who underwent caloric test, 9 were found with unilateral semicircular canal weakness(CP>25%), and the abnormal rate was 75% (9/12). Conclusion:Patients with vertigo with vertigo have impaired conduction function in the ipsilateral and contralateral vestibular pathways, mainly due to decreased vestibular evoked myogenic potential, increased threshold, and abnormal cold and heat tests. The vestibular function test provides an objective basis for assessing the inner ear injury in patients with vertigo.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Súbita/diagnóstico , Potenciais Evocados Miogênicos Vestibulares , Testes de Função Vestibular , Testes Calóricos , Estudos de Casos e Controles , Humanos , Vertigem
16.
Am J Audiol ; 28(2S): 422-427, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31461335

RESUMO

Purpose Interfrequency amplitude ratio (IFAR), the ratio of amplitude between ocular vestibular evoked myogenic potentials (oVEMPs) for tone bursts of 500 and 1000 Hz, aids in identification of Ménière's disease with high sensitivity and specificity. However, it requires recording of oVEMP for 2 frequencies, which doubles the time of recording. Use of simultaneous recording of responses for both frequencies could potentially bring down testing time. Simultaneous recording might be possible by modifying the oddball paradigm and using a ratio of 1:1 for the 2 frequencies. This might also reduce variation in oVEMP amplitude between frequencies due to changes in gaze angle between the recordings. However, it remains to be explored whether or not the use of modified oddball paradigm to record oVEMP (MoVEMP) will produce comparable responses to conventional sequential recording of oVEMP (CoVEMP) for obtaining IFAR. Hence, the study aimed to compare MoVEMP and CoVEMP on various measures of oVEMP. Method The study included 29 healthy adults in the age range of 18-30 years, 23 of which were used for validation and 6 for finding test-retest reliability. All participants underwent contralateral oVEMP recording using 500- and 1000-Hz tone bursts presented using MoVEMP and CoVEMP paradigms. Results Comparable outcomes on latencies, amplitude, and IFAR were obtained between CoVEMP and MoVEMP. Furthermore, MoVEMP took significantly lesser time per ear and also produced better test-retest reliability than CoVEMP. Conclusion MoVEMP is a quicker and more reliable clinical stimulation paradigm for obtaining IFAR than CoVEMP.


Assuntos
Potenciais Evocados Miogênicos Vestibulares/fisiologia , Testes de Função Vestibular/métodos , Adolescente , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino , Adulto Jovem
17.
Am J Audiol ; 28(2S): 414-421, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31461337

RESUMO

Purpose Simultaneous recording of cervical (cVEMP) and ocular (oVEMP) vestibular evoked myogenic potentials aids in reducing the testing time when compared to conventional sequential recordings. The purpose of this study was to examine the test-retest reliability of sequential and simultaneous acquisitions of cVEMP and oVEMP. Method cVEMP and oVEMP were recorded in 35 normal-hearing individuals. The cVEMP and oVEMP were obtained using sequential and simultaneous methods. The VEMP recordings were performed across 3 sessions. The 1st 2 recording sessions were consecutive with a gap of 5 min between sessions. The 3rd recording session was after a gap of 3-5 days. Results Both simultaneous and sequential recordings showed fair-to-good test-retest reliability for latencies and amplitude of cVEMP and oVEMP. Conclusion Simultaneous cVEMP and oVEMP recordings can be used to obtain fast VEMP recording with test-retest reliability comparable with that of sequential recording.


Assuntos
Potenciais Evocados Miogênicos Vestibulares/fisiologia , Testes de Função Vestibular/métodos , Testes de Impedância Acústica , Adulto , Audiometria de Tons Puros , Feminino , Voluntários Saudáveis , Humanos , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
18.
Acta Otolaryngol ; 139(10): 854-859, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31282790

RESUMO

Background: The treatments of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) have low remission rates ranging between 60% and 90%, connected to the difficulty in correctly identifying the affected side of HSC-BPPV. Objective: To propose and compare the efficacy of the latency test (LT) in identifying the affected ear in patients with HSC-BPPV. Materials and methods: Twenty-one subjects diagnosed with HSC-BPPV, as ascertained by head rolling test (HRT), were prospectively identified. Lateralization was assessed with pseudo-spontaneous nystagmus, lying-down nystagmus, bow and lean (BLT), HRT and LT tests. LT is a novel technique involving a 180° movement of the head and the analysis of the time required to reverse the nystagmus. Results: About 57% of patients were diagnosed with geotropic, and 43% with apogeotropic type HSC-BPPV. LT achieved a correct side diagnosis in 86%. Efficacy analysis of the tests compared to HRT revealed a substantial fair level of agreement for lying-down test (κ = 0.32, p < .05), a slight level of agreement for BLT (κ = 0.19, p < .05) and a substantial level of agreement for LT (κ = 0.071, p < .001). Conclusions and significance: LT was proven to show a substantial level of agreement compared to HRT in identifying the affected ear in patients with HSC-BPPV in this pilot study.


Assuntos
Vertigem Posicional Paroxística Benigna/diagnóstico , Canais Semicirculares , Testes de Função Vestibular , Adulto , Idoso , Idoso de 80 Anos ou mais , Vertigem Posicional Paroxística Benigna/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nistagmo Fisiológico , Projetos Piloto , Valor Preditivo dos Testes , Estudos Prospectivos
19.
Acta Otolaryngol ; 139(9): 727-733, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31268396

RESUMO

Background: So far, there has been a controversy surrounding repositioning difficulty and recurrence rate between traumatic benign paroxysmal positional vertigo (t-BPPV) and idiopathic BPPV (i-BPPV). Objectives: This meta-analysis was aimed to explore whether or not the differences between t-BPPV and i-BPPV in the repositioning difficulty and recurrence rate existed. Material and methods: A literature search was performed in the databases including Pubmed, Embase, CENTRAL, which completed in 21 January 2019, with no restriction of publication language. Relative risk (RR) of number of repositioning maneuvers and the recurrence rate was calculated with its 95% confidence interval. Sensitive analysis was performed simultaneously. Results: Six retrospective cohort studies were included in our meta-analysis, including 865 t-BPPV patients and 3027 i-BPPV patients. All studies were high quality according to Newcastle-Ottawa Scale (NOS) assessment. Patients with t-BPPV required more repositioning maneuvers for resolution than those with i-BPPV (RR = 3.27, 95% CI = 1.88-5.69, p < .0001), and the recurrence rate of t-BPPV was higher than that of i-BPPV (RR = 2.91, 95% CI = 2.04-4.14, p < .00001). Conclusions and significance: Compared with i-BPPV, patients with t-BPPV require more repositioning maneuvers to resolve, and the recurrence of t-BPPV was more frequent.


Assuntos
Vertigem Posicional Paroxística Benigna/etiologia , Vertigem Posicional Paroxística Benigna/terapia , Posicionamento do Paciente/métodos , Ferimentos e Lesões/complicações , Idoso , Vertigem Posicional Paroxística Benigna/fisiopatologia , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Recidiva , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Testes de Função Vestibular
20.
Codas ; 31(3): e20180111, 2019 Jun 27.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31271579

RESUMO

PURPOSE: to analyze the occurrence of psychiatric diagnosis and the use of psychotropics medications in subjects with vestibular complaints and to relate the presence of these conditions to the results of vestibulometry. METHODS: quantitative, observational, cross-sectional study with 131 patients, treated in a university hospital. They were submitted to anamnesis, visual inspection of the external ear canal, static and dynamic balance tests, Foam laser dynamic posturography and Computerized Vectoelectronystagmography. RESULTS: sample composed of 109 women and 22 men, with average age of 55 years and nine months. The most common type of dizziness was vertigo, with the presence of neurovegetative signals. A significant percentage of psychiatric complaint/diagnosis was observed, as well as the use of psychotropic medications, mainly serotonin uptake inhibitors, followed by benzodiazepines. There was a relation between the presence of psychiatric complaints with the female gender, alterations of the static balance and alterations in the Sensorial Organization Test positions III and VI. In the Vectoelectronystagmography, there was a relation between age and the presence of spontaneous nystagmus. CONCLUSION: There was a high occurrence of psychiatric complaint/diagnosis among patients with dizziness, with use of psychotropic medications substantially greater than the general population. The evaluation of postural balance revealed an association between anxiety/depression and alterations visual overload positions in the foam laser dynamic posturography. However, no relationship was found between these conditions and alterations in the Vectoelectronystagmography tests.


Assuntos
Tontura/induzido quimicamente , Transtornos do Humor/tratamento farmacológico , Equilíbrio Postural/efeitos dos fármacos , Psicotrópicos/efeitos adversos , Vertigem/induzido quimicamente , Testes de Função Vestibular/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Psicotrópicos/classificação , Estudos Retrospectivos , Adulto Jovem
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