山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (5): 7-13.doi: 10.6040/j.issn.1673-3770.1.2020.078

• 临床研究 • 上一篇    下一篇

年龄因素对直流电刺激诱发的前庭诱发肌源性电位的影响

张青1,2,陈耔辰1,2,赵欢娣1,魏馨雨1,张玉忠1,2,胡娟1,李岑菲1,刘英3,许信达4,杨军2   

  1. 张青1, 2, 陈耔辰1, 2, 赵欢娣1, 魏馨雨1, 张玉忠1, 2, 胡娟1, 李岑菲1, 刘英3, 许信达4, 杨军21. 西安交通大学第二附属医院 耳鼻咽喉头颈外科, 陕西 西安 710004;
    2. 上海交通大学医学院附属新华医院 耳鼻咽喉头颈外科 /上海交通大学医学院 耳科学研究所/上海市耳鼻疾病转化医学重点实验室, 上海 200092;
    3. 西安交通大学第二附属医院 麻醉科, 陕西 西安 710004;
    4. 复旦大学附属眼耳鼻喉科医院 耳鼻喉科, 上海 200031
  • 收稿日期:2020-08-06 出版日期:2020-09-20 发布日期:2020-11-17
  • 基金资助:
    国家自然科学基金(81670945,81600809,81700915);陕西省国际科技合作重点项目(2020KWZ-019);陕西省重点研发项目(2018SF-189)

Effects of aging on galvanic vestibular stimulation elicited vestibular evoked myogenic potential

To observe the effect of age on cervical vestibular-evoked myogenic potential(cVEMP)and ocular vestibular-evoked myogenic potential(oVEMP)elicited by galvanic vestibular stimulation(GVS)in healthy subjects. MethodsSixty-one healthy volunteers(122 ears)aged 22-81 years(45.0±13.8 years)were recruited as study subjects and divided into three groups according to age: 20-40(26 patients, 52 ears), 41-60(24 patients, 48 ears), and >60(11 patients, 22 ears)years. Each subject underwent both GVS-cVEMP and GVS-oVEMP. The elicit rate, threshold, p1 latency, n1 latency, amplitude, and interaural amplitude asymmetry ratio of both VEMPs were calculated and compared among the age groups. SPSS 18.0 software was used for statistical analyses. ResultsThe elicit rates of GVS-cVEMP were 96.15%, 89.58%, and 95.45% in age groups of 20-40, 41-60, and >60 years, respectively, without any statistically significant difference among groups(P>0.05). However, the elicit rates of GVS-oVEMP were 98.07%, 91.67%, and 72.13% in age groups of 20-40, 41-60, and >60 years, respectively, showing a decreased tendency with growing age(P<0.05). In the parametric analysis, the elicit rate, threshold, p1 latency, n1 latency, amplitude, no amplitude asymmetry ratio of cVEMP were not statistically correlated with age(P>0.05). However, growing age showed decreased elicit rate, increased threshold, and decreased amplitude of oVEMP(P<0.05)but no difference in the n1 latency, p1 latency, or amplitude asymmetry ratio. ConclusionWith growing age, the function of peripheral vestibular system decreased, which might affect GVS-cVEMP and GVS-oVEMP.   

  1. Key words: Vestibular evoked myogenic potential;
    Cervical vestibular evoked myogenic potential;
    Ocular vestibular evoked myogenic potential;
    Galvanic vestibular stimulation;
    Age
  • Received:2020-08-06 Online:2020-09-20 Published:2020-11-17

摘要: 目的 评估年龄因素对直流电刺激(GVS)诱发的颈肌前庭诱发肌源性电位(cVEMP)和眼肌前庭诱发肌源性电位(oVEMP)的影响。 方法 选择健康志愿者61名(122耳)作为研究对象,22~81岁,平均(45.0±13.8)岁。按年龄分为20~40岁组(26例,52耳)、41~60岁组(24例,48耳)以及>60岁组(11例,22耳),分别记录GVS-cVEMP和GVS-oVEMP。计算GVS-c/oVEMP在不同年龄段的引出率、阈值、潜伏期、振幅、振幅不对称比(interaural amplitude asymmetryratio,IAR),采用SPSS18.0软件进行统计学分析。 结果 GVS-cVEMP在20~40岁、41~60岁、>60岁年龄段的引出率分别为96.15%、89.58%和95.45%,组间比较差异无统计学意义(P>0.05)。GVS-oVEMP在20~40岁、41~60岁、>60岁年龄段的引出率分别为98.07%、91.67%和72.13%,随着年龄增长逐渐降低(P<0.05)。从参数分析来看,cVEMP的引出率、阈值、p1潜伏期、n1潜伏期、振幅和振幅不对称比在不同年龄组间差异无统计学意义(P>0.05);随着年龄增大,oVEMP的引出率下降、阈值增高、振幅减小(P<0.05),其他参数年龄组间差异无统计学意义(P>0.05)。 结论 随着年龄的增长,周围前庭系统的功能降低,有可能会对直流电刺激诱发的VEMP产生影响。

关键词: 前庭诱发肌源性电位, 颈肌前庭诱发肌源性电位, 眼肌前庭诱发肌源性电位, 直流电刺激, 年龄

Abstract: Objective To observe the effect of age on cervical vestibular-evoked myogenic potential(cVEMP)and ocular vestibular-evoked myogenic potential(oVEMP)elicited by galvanic vestibular stimulation(GVS)in healthy subjects. Methods Sixty-one healthy volunteers(122 ears)aged 22-81 years(45.0±13.8 years)were recruited as study subjects and divided into three groups according to age: 20-40(26 patients, 52 ears), 41-60(24 patients, 48 ears), and >60(11 patients, 22 ears)years. Each subject underwent both GVS-cVEMP and GVS-oVEMP. The elicit rate, threshold, p1 latency, n1 latency, amplitude, and interaural amplitude asymmetry ratio of both VEMPs were calculated and compared among the age groups. SPSS 18.0 software was used for statistical analyses. Results The elicit rates of GVS-cVEMP were 96.15%, 89.58%, and 95.45% in age groups of 20-40, 41-60, and >60 years, respectively, without any statistically significant difference among groups(P>0.05). However, the elicit rates of GVS-oVEMP were 98.07%, 91.67%, and 72.13% in age groups of 20-40, 41-60, and >60 years, respectively, showing a decreased tendency with growing age(P<0.05). In the parametric analysis, the elicit rate, threshold, p1 latency, n1 latency, amplitude, no amplitude asymmetry ratio of cVEMP were not statistically correlated with age(P>0.05). However, growing age showed decreased elicit rate, increased threshold, and decreased amplitude of oVEMP(P<0.05)but no difference in the n1 latency, p1 latency, or amplitude asymmetry ratio. Conclusion With growing age, the function of peripheral vestibular system decreased, which might affect GVS-cVEMP and GVS-oVEMP.

Key words: Vestibular evoked myogenic potential, Cervical vestibular evoked myogenic potential, Ocular vestibular evoked myogenic potential, Galvanic vestibular stimulation, Age

中图分类号: 

  • R764.3
[1] 胡娟, 许珉, 张青. 眼肌前庭诱发肌源性电位的研究现状及展望[J]. 临床耳鼻咽喉头颈外科杂志, 2013,(7): 388-392. doi:10.13201/j.issn.1001-1781.2013.07.017. HU Juan, XU Min, ZHANG Qing. Present situation and development of ocular vestibular-evoked myogenic potential[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2013, 27(7): 388-392. doi:10.13201/j.issn.1001-1781.2013.07.017.
[2] Colebatch JG, Halmagyi GM. Vestibular evoked potentials in human neck muscles before and after unilateral vestibular deafferentation[J]. Neurology, 1992, 42(8): 1635-1636. doi:10.1212/wnl.42.8.1635.
[3] Kushiro K, Zakir M, Ogawa Y, et al. Saccular and utricular inputs to sternocleidomastoid motoneurons of decerebrate cats[J]. Exp Brain Res, 1999, 126(3): 410-416. doi:10.1007/s002210050747.
[4] Rosengren SM, Welgampola MS, Colebatch JG. Vestibular evoked myogenic potentials: past, present and future[J]. Clin Neurophysiol, 2010, 121(5): 636-651. doi:10.1016/j.clinph.2009.10.016.
[5] Uchino Y, Sato H, Suwa H. Excitatory and Inhibitory Inputs From Saccular Afferents to Single Vestibular Neurons in the Cat. J Neurophysiol, 1997, 78(4): 2186-2192. doi:10.1152/jn.1997.78.4.2186.
[6] Wu CH, Young YH, Murofushi T. Tone burst-evoked myogenic potentials in human neck flexor and extensor[J]. Acta Otolaryngol, 1999, 119(7): 741-744. doi:10.1080/00016489950180351.
[7] Kantner C, Gürkov R. The effects of commonly used upward gaze angles on ocular vestibular evoked myogenic potentials[J]. Otol Neurotol, 2014, 35(2): 289-293. doi:10.1097/MAO.0b013e318299a812.
[8] Rosengren SM, Colebatch JG, Straumann D, et al. Why do oVEMPs become larger when you look up? Explaining the effect of gaze elevation on the ocular vestibular evoked myogenic potential[J]. Clin Neurophysiol, 2013, 124(4): 785-791. doi:10.1016/j.clinph.2012.10.012.
[9] 吴子明, 张素珍. 前庭诱发肌源电位应用在中国15年[J]. 中华耳科学杂志, 2016, 14(4): 442-445. doi:10.3969/j.issn.1672-2922.2016.04.001. WU Ziming, ZHANG Suzhen. The application of vestibular evoked myogenic potential(VEMP)in the past 15 years in China[J]. Chinese Journal of Otology, 2016, 14(4): 442-445. doi:10.3969/j.issn.1672-2922.2016.04.001.
[10] Watson SR, Colebatch JG. EMG responses in the soleus muscles evoked by unipolar galvanic vestibular stimulation[J]. Electroencephalography and Clinical Neurophysiology, 1997, 105(6): 476-483. doi:10.1016/s0924-980x(97)00044-1.
[11] Cheng PW, Lue JH, Lin CT, et al. Assessment of gentamicin-induced vestibulotoxicity by click and galvanic vestibular-evoked myogenic potentials: a guinea pig investigation[J]. Neurotoxicology, 2010, 31(1): 121-125. doi:10.1016/j.neuro.2009.10.009.
[12] Viciana D, Lopez-Escamez JA. Short tone bursts are better than clicks for cervical vestibular-evoked myogenic potentials in clinical practice[J]. Eur Arch Otorhinolaryngol, 2012, 269(7): 1857-1863. doi:10.1007/s00405-011-1912-4.
[13] Janky KL, Shepard N. Vestibular evoked myogenic potential(VEMP)testing: normative threshold response curves and effects of age[J]. J Am Acad Audiol, 2009, 20(8): 514-522. doi:10.3766/jaaa.20.8.6.
[14] 张青, 宋辉, 胡娟, 等. 气导短纯音诱发的眼肌前庭诱发肌源性电位在健康青年人群中的波形特征[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47(1): 15-18. doi:10.3760/cma.j.issn.1673-0860.2012.01.005. ZHANG Qing, SONG Hui, HU Juan, et al. Characteristics of the air-conducted ocular evoked myogenic potential in the young normal Chinese subjects[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2012, 47(1): 15-18. doi:10.3760/cma.j.issn.1673-0860.2012.01.005.
[15] Isaacson B, Murphy E, Cohen H. Does the method of sternocleidomastoid muscle activation affect the vestibular evoked myogenic potential response?[J]. J Vestib Res, 2006, 16(4-5): 187-191.
[16] Tseng CL, Chou CH, Young YH. Aging effect on the ocular vestibular-evoked myogenic potentials[J]. Otol Neurotol, 2010, 31(6): 959-963. doi:10.1097/MAO.0b013e3181e8fb1a.
[17] Murofushi T, Halmagyi GM, Yavor RA, et al. Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis. An indicator of inferior vestibular nerve involvement?[J]. Arch Otolaryngol Head Neck Surg, 1996, 122(8): 845-848. doi:10.1001/archotol.1996.01890200035008.
[18] Murofushi T, Matsuzaki M, Mizuno M. Vestibular evoked myogenic potentials in patients with acoustic neuromas[J]. Arch Otolaryngol Head Neck Surg, 1998, 124(5): 509-512. doi:10.1001/archotol.124.5.509.
[19] 陈耔辰, 魏馨雨, 张玉忠, 等. 直流电刺激诱发健康青年人前庭诱发肌源性电位的初步观察[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(6): 432-438. doi:10.3760/cma.j.issn.1673-0860.2019.06.007. CHEN Zichen, WEI Xinyu, ZHANG Yuzhong, et al. Preliminary observation of galvanic vestibular stimulation-vestibular evoked myogenic potentials in healthy young people[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2019, 54(6): 432-438. doi:10.3760/cma.j.issn.1673-0860.2019.06.007.
[20] Watson SR, Colebatch JG. Vestibulocollic reflexes evoked by short-duration galvanic stimulation in man[J]. J Physiol, 1998, 513( Pt 2): 587-597. doi:10.1111/j.1469-7793.1998.587bb.x.
[21] Cheng PW, Chen CC, Wang SJ, et al. Acoustic, mechanical and galvanic stimulation modes elicit ocular vestibular-evoked myogenic potentials[J]. Clin Neurophysiol, 2009, 120(10): 1841-1844. doi:10.1016/j.clinph.2009.08.002.
[22] Murofushi T, Takegoshi H, Ohki M, et al. Galvanic-evoked myogenic responses in patients with an absence of click-evoked vestibulo-collic reflexes[J]. Clinical Neurophysiology, 2002, 113(2): 305-309. doi:10.1016/s1388-2457(01)00738-6.
[23] Colebatch JG, Halmagyi GM, Skuse NF. Myogenic potentials generated by a click-evoked vestibulocollic reflex[J]. J Neurol Neurosurg Psychiatry, 1994, 57(2): 190-197. doi:10.1136/jnnp.57.2.190.
[24] Murofushi T, Curthoys IS, Gilchrist DP. Response of guinea pig vestibular nucleus neurons to clicks[J]. Exp Brain Res, 1996, 111(1): 149-152. doi:10.1007/BF00229565.
[25] Watson SR, Fagan P, Colebatch JG. Galvanic stimulation evokes short-latency EMG responses in sternocleidomastoid which are abolished by selective vestibular nerve section[J]. Electroencephalogr Clin Neurophysiol, 1998, 109(6): 471-474. doi: 10.1016/S0924-980X(98)00033-2.
[26] 张青, 许信达, 牛晓蓉, 等. 年龄因素对气导声刺激诱发的眼肌和颈肌前庭诱发肌源性电位的影响[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(11): 897-901. doi:10.3760/cma.j.issn.1673-0860.2014.11.005. ZHANG Qing, XU Xinda, NIU Xiaorong, et al. Effects of aging on air-conducted sound elicited ocular vestibular-evoked myogenic potential and cervical vestibular-evoked myogenic potential[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2014, 49(11): 897-901. doi:10.3760/cma.j.issn.1673-0860.2014.11.005.
[27] Piker EG, Baloh RW, Witsell DL, et al. Assessment of the Clinical Utility of Cervical and Ocular Vestibular Evoked Myogenic Potential Testing in Elderly Patients[J]. Otol Neurotol, 2015, 36(7): 1238-1244. doi:10.1097/mao.0000000000000793.
[28] 李斐, 庄建华, 陈瑛, 等. 年龄因素对前庭诱发肌源性电位的影响[J]. 临床耳鼻咽喉头颈外科杂志, 2015,(22): 1992-1994. doi:10.13201/j.issn.1001-1781.2015.22.015. LI Fei, ZHUANG Jianhua, CHEN Ying, et al. Effects of aging on vestibular evoked myogenic potential[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2015, 29(22): 1992-1994. doi:10.13201/j.issn.1001-1781.2015.22.015.
[29] Iwasaki S, Smulders YE, Burgess AM, et al. Ocular vestibular evoked myogenic potentials to bone conducted vibration of the midline forehead at Fz in healthy subjects[J]. Clin Neurophysiol, 2008, 119(9): 2135-2147. doi:10.1016/j.clinph.2008.05.028.
[30] Rosenhall U. Degenerative patterns in the aging human vestibular neuro-epithelia[J]. Acta Otolaryngol, 1973, 76(2): 208-220. doi:10.3109/00016487309121501.
[31] Wang SJ, Yeh TH, Chang CH, et al. Consistent latencies of vestibular evoked myogenic potentials[J]. Ear Hear, 2008, 29(6): 923-929. doi:10.1097/AUD.0b013e3181853019.
[32] Engstrom H, Bergstrom B, Rosenhall U. Vestibular sensory epithelia[J]. Arch Otolaryngol, 1974, 100(6): 411-418. doi:10.1001/archotol.1974.00780040425002.
[33] Rauch SD, Velazquez-Villaseñor L, Dimitri PS, et al. Decreasing hair cell counts in aging humans[J]. Ann N Y Acad Sci, 2001, 942: 220-227. doi:10.1111/j.1749-6632.2001.tb03748.x.
[34] Johnsson LG, Hawkins JE, Jr. Sensory and neural degeneration with aging, as seen in microdissections of the human inner ear[J]. Ann Otol Rhinol Laryngol, 1972, 81(2): 179-193. doi:10.1177/000348947208100203.
[35] Richter E. Quantitative study of human Scarpas ganglion and vestibular sensory epithelia[J]. Acta Otolaryngol, 1980, 90(3-4): 199-208. doi:10.3109/00016488009131716.
[36] Lopez I, Honrubia V, Baloh RW. Aging and the human vestibular nucleus[J]. J Vestib Res, 1997, 7(1): 77-85.
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[7] 刘阳云,张彩霞,江文,陈琼,常恩格,赵花香,杨会. 突发性聋患者血脂分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 1 -4 .
[8] 席玲,袁满红,过朵芳,杨华丽. LASIK患者眼压测量的多因素分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 99 -103 .
[9] 程雷,钱俊俊,田慧琴. 变应性鼻炎研究的若干进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 1 -3 .
[10] 沙骥超,张策,朱冬冬. 变应性鼻炎鼻黏膜上皮细胞免疫活性研究进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 55 -59 .