不同血清25(OH)D水平下的功能性和增益性前庭眼动测量：fHIT表现与vHIT增益之间的分离
Functional and gain-based vestibulo-ocular measures across serum 25(OH)D categories: a dissociation between fHIT performance and vHIT gain.
文献信息
| PMID | 42969303 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Nazli Akkaya Kurt |
| 作者单位 | Faculty of Health Sciences, Department of Audiology, Istanbul Gelisim University, Istanbul, Türkiye. |
| 期刊 | Acta oto-laryngologica |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 传统前庭检查量化半规管和耳石功能，而功能性头脉冲试验（fHIT）测量前庭眼反射在高加速度头部运动期间稳定视力的有效性。低25-羟基维生素D[25(OH)D]水平与耳石功能障碍相关，但其与功能表现的关系尚不清楚。
目的： 在无明确前庭疾病的成人中，比较不同血清25(OH)D水平类别下的耳石、半规管和功能性测量指标。
材料与方法： 39名年龄18-65岁、听力正常的成人按血清25(OH)D水平分层为三组，每组13人（<20、20-29.9、≥30 ng/mL）。所有人均接受听力检查、视频眼震图、cVEMP、oVEMP、vHIT和fHIT。采用Kruskal-Wallis检验和Mann-Whitney U检验。
结果： fHIT正确反应率在后半规管（p = 0.001）和前半规管（p = 0.019）存在差异，在<20 ng/mL时最低；水平半规管表现保持（p = 0.234）。所有vHIT增益均在可接受范围内，仅前半规管增益存在差异（p = 0.001）。VEMP潜伏期相当；cVEMP振幅不对称性存在差异（p = 0.023），但与预期相反且处于正常范围内。
结论与意义： 低25(OH)D水平伴随垂直半规管平面功能性前庭眼动表现降低，尽管增益正常。fHIT可能捕捉到vHIT增益未能反映的亚临床变化。
英文摘要
BACKGROUND: Conventional vestibular tests quantify canal and otolith function, whereas the functional head impulse test (fHIT) measures how effectively the vestibulo-ocular reflex stabilizes vision during high-acceleration head motion. Low 25-hydroxyvitamin D [25(OH)D] has been linked to otolith dysfunction, but its relation to functional performance is unknown.
OBJECTIVES: To compare otolith, canal and functional measures across serum 25(OH)D categories in adults without overt vestibular disease.
MATERIALS AND METHODS: Thirty-nine adults aged 18-65 years with normal hearing were stratified by serum 25(OH)D into three groups of 13 (<20, 20-29.9, ≥30 ng/mL). All underwent audiometry, videonystagmography, cVEMP, oVEMP, vHIT and fHIT. Kruskal-Wallis and Mann-Whitney U tests were used.
RESULTS: fHIT correct response rates differed for posterior (p = 0.001) and anterior canals (p = 0.019), being lowest at <20 ng/mL; lateral performance was preserved (p = 0.234). All vHIT gains remained within acceptable limits and only anterior canal gain differed (p = 0.001). VEMP latencies were comparable; cVEMP amplitude asymmetry differed (p = 0.023) but opposite to expectation and within normal range.
CONCLUSIONS AND SIGNIFICANCE: Low 25(OH)D was accompanied by reduced functional vestibulo-ocular performance in the vertical canal planes despite normal gains. fHIT may capture subclinical change that vHIT gain does not.