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

摘要

目的 介绍直流电刺激诱发的前庭诱发肌源性电位(galvanic vestibular stimulation-vestibular evoked myogenic potentials,GVS-VEMP)的测试方法,观察我国健康青年人直流电刺激诱发的颈肌前庭诱发肌源性电位(cervical vestibular evoked myogenic potentials,cVEMP)和眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potentials,oVEMP)的引出情况并分析相关参数.方法 选择26名健康青年志愿者作为研究对象,其中女13名(26耳),男13名(26耳);年龄21～37岁,平均(25.8±3.7)岁.初始刺激使用3.0 mA/1 ms的直流电(阴极)刺激乳突,分别于胸锁乳突肌和眼下肌记录直流电刺激诱发的颈肌前庭诱发肌源性电位(GVS-cVEMP)和直流电刺激诱发的眼肌前庭诱发肌源性电位(GVS-oVEMP).刺激强度逐次递减直至不能诱发出稳定的波形,计算GVS-VEMP反应的阈值、潜伏期、波间期、振幅和振幅不对称比.采用SPSS 18.0软件进行统计学分析.结果 26名(52耳)健康青年志愿者在3.0 mA/1 ms的直流电刺激下,均可引出GVS-cVEMP和GVS-oVEMP,引出率为100％.随着刺激强度的减弱,二者的引出率均下降.GVS-cVEMP的阈值为(1.18±0.47)mA,p1潜伏期为(10.43±1.54)ms,n1潜伏期为(17.91±1.20)ms,振幅为(102.47±56.77)uV,振幅不对称比0.26±0.20;GVS-oVEMP的阈值为(1.12±0.50)mA,n1潜伏期为(8.46±1.05)ms,p1潜伏期为(11.83±1.27)ms,振幅(9.12±6.82)uV,振幅不对称比0.25±0.20.GVS-oVEMP振幅男性高于女性,差异有统计学意义(P<0.05);GVS-cVEMP和GVS-oVEMP其他参数在性别和侧别比较上,差异均无统计学意义(P值均>0.05).结论 健康青年人可稳定诱发出GVS-cVEMP和GVS-oVEMP反应,其相应波形参数可为后续前庭功能评估提供参考.%Objective To introduce the method of galvanic vestibular stimulation-vestibular evoked myogenic potentials (GVS-VEMP) as well as to observe and analyze the parameters and elicited rate of GVS-cVEMP and GVS-oVEMP in healthy young people in China. Methods Twenty six normal young subjects were recruited for conventional examinations of GVS-VEMP. The subjects were 21-37 years old, average age was (25.8±3.7) years old, including 13 males and 13 females. The galvanic stimulation intensityof 3 mA/1 ms was used to evoke cVEMP and oVEMP on the sternocleidomastoid and inferior extraocular muscles respectively, and the intensity of stimulus was decreased until the response disappeared, the threshold, latency, amplitude, interval phase and interaural amplitude ratio(IAR) were calculated. SPSS18.0 software was used for statistical analysis. Results All subjects were elicited normal GVS-cVEMP and GVS-oVEMP under 3 mA/1 ms, the elicited rate was 100％. The threshold of GVS-cVEMP was (1.18 ± 0.47) mA, p1 latency was (10.43 ± 1.54) ms, n1 latency was (17.91 ± 1.20) ms, the amplitude was (102.47 ± 56.77) uV and IAR was (0.26 ± 0.20). The threshold of GVS-oVEMP was (1.12 ± 0.50) mA, n1 latency was (8.46 ± 1.05) ms, p1 latency was (11.83 ± 1.27) ms, the amplitude was (9.12 ± 6.82) uV and IAR was (0.25 ± 0.20). In terms of gender and lateral comparison, only the GVS-oVEMP amplitude was higher for male than for female, which had significant statistical difference (P<0.05), and there was no statistical difference in the other parameters between GVS-cVEMP and GVS-oVEMP. Conclusion GVS-cVEMP and GVS-oVEMP could be elicited in healthy youth population, and the parameters could provide reference for subsequent vestibular function evaluation.