前庭代偿中神经系统可塑性机制的研究进展

doi:10.6040/j.issn.1673-3770.0.2023.279

摘要/Abstract

摘要： 前庭疾病会导致眩晕、平衡丧失等一系列症状,严重影响人们的生活质量和健康。当前庭功能受损时,一种称为前庭代偿(vestibular compensation, VC)的现象会在受伤后的几个小时或几天内发生。VC是涉及神经系统中一系列重排的神经可塑性过程,其分为快速而完全的静态代偿和缓慢而不完全的动态代偿。双侧前庭核团电生理的再平衡是静态代偿的主要机制,而动态代偿包括前庭适应、替代、习服三种机制,涉及全脑中枢神经系统的整体重组。本文现综述VC中神经系统可塑性机制的研究进展,从前庭核中分子的改变、细胞增殖和兴奋、突触的可塑性和传递以及神经环路的改变等一系列可塑性变化来解释静态代偿机制;通过全脑中枢神经系统的重组来解释动态代偿机制。以期为今后国内前庭疾病患者的临床治疗策略进一步改进提供思路和参考。

关键词: 前庭疾病, 前庭代偿, 动态症状, 静态症状, 动态代偿, 静态代偿

Abstract: Vestibular disorders may cause vertigo, balance disturbance, nausea, vomiting, and other symptoms that can adversely affect an individual's quality of life and health. When peripheral vestibular inputs are partially or completely lost, a phenomenon known as vestibular compensation occurs in the hours and days following the injury. Vestibular compensation is a neuroplastic process divided into a rapid, complete, static compensation and a longer-term, incomplete, dynamic compensation. Static compensation primarily occurs through electrophysiological rebalancing of the bilateral vestibular nuclei, whereas dynamic compensation involves three mechanisms: vestibular adaptation, substitution, and acculturation, all of which participate in the overall reorganization of systems throughout the brain. In recent decades, studies have investigated the mechanisms of neuroplasticity in vestibular compensation. Static compensation is attributed to a series of changes in the vestibular nuclei, including molecular alterations, cell proliferation and excitability, synaptic plasticity and transmission, and neural circuit projections. In contrast, dynamic compensation involves reorganization throughout the whole brain. In this paper, we briefly summarize the research progress into neuroplasticity mechanisms in vestibular compensation, providing a basis for improvement of treatment strategies in patients with vestibular disorders in China.

Key words: Vestibular diseases, Vestibular compensation, Dynamic symptoms, Static symptoms, Dynamic compensation, Static compensation

中图分类号:

R764

汪学志,杨令,黄颖茜,吕萍. 前庭代偿中神经系统可塑性机制的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 132-139.

WANG Xuezhi, YANG Ling, HUANG Yingxi, LYU Ping. Advances in the mechanisms of nervous system plasticity in vestibular compensation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 132-139.

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