眼性前庭诱发肌源性电位反应模式用于表征外周前庭疾病中的前庭功能障碍

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中文摘要

背景： 眼性前庭诱发肌源性电位（oVEMP）检测可提供关于耳石器和前庭上通路功能的电生理信息，但其临床解读常局限于正常或异常的二元判断。本研究开发并应用了一种结构化的oVEMP反应模式方案，以及一个探索性的、研究特定的复合异常负荷分级，以表征外周前庭疾病患者的前庭功能障碍。方法：2024年2月至2025年12月，110名患有梅尼埃病、良性阵发性位置性眩晕、伴眩晕的突发性感音神经性听力损失、前庭神经炎或其他外周前庭损伤的成人接受了标准化临床评估和双侧oVEMP检测。参数包括N10潜伏期、P15潜伏期、N10-P15波幅、反应阈值、耳间波幅不对称比、1000/500 Hz波幅比、波形缺失以及复合分级。结果：62.7%的患者发现oVEMP反应异常。梅尼埃病显示更高的1000/500 Hz波幅比，而较小的异质性前庭神经炎/其他外周前庭损伤复合组显示更多反应缺失和更高的复合分级。在所有四个分析组中，反应模式和分级分布存在差异；然而，仅限于三个较大的诊断同质性组的敏感性分析减弱了这些组间差异。在4周时，异常的oVEMP反应、显著耳间不对称和较高的探索性分级与残余头晕相关。结论：这些发现支持将结构化oVEMP反应模式分析作为一种功能性描述框架，但并未确立诊断准确性，也未验证所提出的分级作为通用严重程度量表。

英文摘要

Ocular vestibular evoked myogenic potential (oVEMP) testing provides electrophysiological information on otolithic and superior vestibular pathway function, but its clinical interpretation often remains limited to a binary normal-or-abnormal judgment. This study developed and applied a structured oVEMP response-pattern protocol, together with an exploratory, study-specific composite abnormality-burden grade, to characterize vestibular dysfunction in patients with peripheral vestibular disorders. From February 2024 to December 2025, 110 adults with Ménière's disease, benign paroxysmal positional vertigo, sudden sensorineural hearing loss with vertigo, vestibular neuritis, or other peripheral vestibular injury underwent standardized clinical assessment and bilateral oVEMP testing. Parameters included N10 latency, P15 latency, N10-P15 amplitude, response threshold, interaural amplitude asymmetry ratio, 1,000/500 Hz amplitude ratio, waveform absence, and the composite grade. Abnormal oVEMP responses were found in 62.7% of patients. Ménière's disease showed a higher 1,000/500 Hz amplitude ratio, while the small heterogeneous vestibular neuritis/other peripheral vestibular injury composite group showed more absent responses and higher composite grades. Across all four analytical groups, response-pattern and grade distributions differed; however, sensitivity analyses restricted to the three larger diagnostically homogeneous groups attenuated these between-group differences. At 4 weeks, abnormal oVEMP responses, marked interaural asymmetry, and higher exploratory grades were associated with residual dizziness. These findings support structured oVEMP response-pattern analysis as a functional descriptive framework, but they do not establish diagnostic accuracy or validate the proposed grade as a universal severity scale.