OBJECTIVE: The aim of this study was to assess the vestibulo-spinal reflex (VSR) and vestibulo-ocular reflex (VOR) in FMS using the cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) tests, respectively, and to evaluate their relation to disease severity.
METHODS: This study included 30 female FMS patients and 30 well-matched healthy controls. They underwent full history taking and assessment of the severity of dizziness/vertigo using the Dizziness Handicap Inventory; assessment of the severity of FMS symptoms using the Revised Fibromyalgia Impact Questionnaire; bedside examination of the dizzy patient; videonystagmography, cVEMP, and oVEMP tests; basic audiologic evaluation; and uncomfortable loudness level (UCL) testing.
RESULTS: Dizziness was reported in 46.6% and vertigo in 11.1% of patients. Abnormalities in cVEMP (50%) and oVEMP (63.3%) were mostly unilateral, irrespective of FMS severity. Disease duration affected only the oVEMP amplitude. Fibromyalgia syndrome patients had a statistically significant lower UCL and narrower dynamic range compared to controls.
CONCLUSIONS: The VSR and VOR are commonly affected in FMS patients, and findings suggest central sensitization involving the brain stem. We recommend routine cVEMP and oVEMP testing to assess brainstem function in FMS patients.
目的:本研究的目的是使用颈前庭诱发肌源性电位(cVEMP)和眼前庭诱发肌源性电位(oVEMP)测试来评估FMS中的前庭脊髓反射(VSR)和前庭眼反射(VOR)。分别,并评估它们与疾病严重程度的关系。
方法:本研究包括30名女性FMS患者和30名匹配良好的健康对照。他们接受了完整的病史记录,并使用头晕障碍量表评估头晕/眩晕的严重程度;使用修订的纤维肌痛影响问卷评估FMS症状的严重程度;头晕患者的床边检查;视频眼震描记术,cVEMP,和oVEMP测试;基本听力学评估;和不舒服响度水平(UCL)测试。
结果:据报道,46.6%的患者出现头晕,11.1%的患者出现眩晕。cVEMP(50%)和oVEMP(63.3%)的异常大多是单方面的,无论FMS严重程度如何。疾病持续时间仅影响oVEMP振幅。与对照相比,纤维肌痛综合征患者具有统计学上显著较低的UCL和较窄的动态范围。
结论:在FMS患者中,VSR和VOR通常受到影响,研究结果表明涉及脑干的中枢致敏。我们建议常规cVEMP和oVEMP测试来评估FMS患者的脑干功能。