前庭疾病与视空间认知功能受损的发病机制与评估

摘要/Abstract

摘要： 前庭障碍相关的视空间认知障碍在前庭医学临床实践中日益成为关键问题。当前研究尚缺乏对各类前庭疾病特异性视空间认知损伤表型的系统性整合。本研究围绕解剖基础、损伤机制、评估方法及疾病实证四条主线展开,明确六种常见的前庭疾病(双侧前庭病、单侧前庭病、梅尼埃病、良性阵发性位置性眩晕、前庭性偏头痛、持续性姿势-知觉性头晕)的差异化视空间认知损伤表型并列举现有研究中已报道能够检测相应下降的评估工具,建立了“疾病-认知损伤表型-评估工具”临床决策矩阵,旨在促进临床诊疗从普适性筛查向疾病特异性精准评估的转型。此外,通过对现有文献中导致研究结论互相矛盾的方法学混杂因素(如认知储备、听力损失及情绪共病等)进行批判性辨析,澄清了当前临床评估中的误区。本研究提出了“诊断导向的精准评估”理论模型,为前庭相关视空间认知障碍的早期识别、临床分层及标准化管理提供了坚实的理论框架。

关键词: 前庭疾病, 视空间认知功能, 多感觉整合, 视空间认知评估

Abstract: Visuospatial cognitive impairment associated with vestibular dysfunction has increasingly become a critical concern in clinical vestibular medicine. Current research lacks a systematic integration of the distinct cognitive impairment phenotypes across various vestibular disorders. This study is carried out along four main threads: anatomical foundations, injury mechanisms, assessment methods and disease evidence. We delineate the differential patterns of visuospatial cognitive impairment across six common vestibular disorders(bilateral vestibulopathy, unilateral vestibulopathy, Meniere's disease, benign paroxysmal positional vertigo, vestibular migraine, and persistent postural-perceptual dizziness)and identify assessment tools reported in existing studies that can detect the corresponding declines. By establishing a "Disease-Cognitive Impairment Phenotype-Assessment Tool" clinical decision matrix, this study promotes the paradigm shift from generic screening to disease-specific precision assessment. Furthermore, by critically dissecting methodological confounders(such as cognitive reserve, hearing loss, and emotional comorbidities)that contribute to conflicting findings in the literature, we clarify current diagnostic misconceptions. This study proposes a theoretical model of "diagnosis-guided precision assessment", providing a robust framework for the early identification, clinical stratification, and standardized management of vestibular-related visuospatial cognitive impairment.

Key words: Vestibular disorders, Visuospatial cognitive function, Multisensory integration, Visuospatial cognitive assessment

中图分类号:

R764

冯露露, 陈钢钢,李玉琳,吴佳鑫,杨捷,李莹,周丽媛,张海利. 前庭疾病与视空间认知功能受损的发病机制与评估[J]. 山东大学耳鼻喉眼学报, 2026, 40(6): 117-124.

FENG Lulu, CHEN Ganggang, LI Yulin, WU Jiaxin, YANG Jie, LI Ying, ZHOU Liyuan, ZHANG Haili. Pathogenesis and assessment in vestibular disorders with visuospatial cognitive impairment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(6): 117-124.

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