背景:单-或双侧前庭周围性损伤会导致客观的空间定向缺陷,可以使用笔和纸测试或感觉运动任务(导航或指向)进行测量。对于患者的主观定向能力,问卷是常用的(例如,圣巴巴拉方向感刻度[SBSODS])。然而,对空间技能的主观评估与客观前庭功能之间的关系几乎没有研究。
方法:共177例患者(平均年龄57.86±17.53岁,90名女性)在我们的眩晕和平衡障碍三级中心就诊,接受了神经耳科检查,包括双热水热量,视频头脉冲测试(vHIT),和主观视觉垂直(SVV)的测试,并填写了SBSODS(德语版)。对前庭检测结果与自评评分进行相关性分析和线性多元回归模型分析。此外,分组前庭功能低的患者,平均,并分析了较高的自我报告分数。
结果:42例患者符合双侧前庭病的诊断标准,93用于慢性单侧前庭病变(68例单侧热量功能减退和25例孤立的水平前庭眼反射缺陷),42例患者前庭检查结果正常。SBSODS评分显示出明显的性别差异,男性主观技能水平较高(平均得分为男性:4.94±0.99,女性4.40±0.94;学生t检验:t-3.78,p<.001***)。没有发现客观前庭功能与主观空间定向之间的稳定相关性。多元线性回归模型不能可靠地解释自我报告的方差。这三个患者组的低,平均,高的自我评估得分显示前庭功能没有显着差异。
结论:自我报告的空间方向评估与客观的外周前庭功能并不密切相关。因此,在现实世界和虚拟环境中测量空间技能的其他方法需要揭示由于前庭功能减退导致的方位缺陷。
BACKGROUND: Uni- or bilateral peripheralvestibular impairment causes objective spatial orientation deficits, which can be measured using pen-and-paper-tests or sensorimotor tasks (navigation or pointing). For patients\' subjective orientation abilities, questionnaires are commonly used (e.g., Santa Barbara sense of direction scale [SBSODS]). However, the relationship between subjective assessment of spatial skills and objective vestibular function has only been scarcely investigated.
METHODS: A total of 177 patients (mean age 57.86 ± 17.53 years, 90 females) who presented in our tertiary Center for Vertigo and Balance Disorders underwent neuro-otological examinations, including bithermal water calorics, video head impulse test (vHIT), and testing of the subjective visual vertical (SVV), and filled out the SBSODS (German version). Correlation analyses and linear multiple regression model analyses were performed between vestibular test results and self-assessment scores. Additionally, groupwise vestibular function for patients with low, average, and high self-report scores was analyzed.
RESULTS: Forty-two patients fulfilled the diagnostic criteria for bilateral vestibulopathy, 93 for chronic unilateral vestibulopathy (68 unilateral caloric hypofunction and 25 isolated horizontal vestibulo-ocular reflex deficits), and 42 patients had normal vestibular test results. SBSODS scores showed clear sex differences with higher subjective skill levels in males (mean score males: 4.94 ± 0.99, females 4.40 ± 0.94; Student\'s t-test: t-3.78, p < .001***). No stable correlation between objective vestibular function and subjective sense of spatial orientation was found. A multiple linear regression model could not reliably explain the self-reported variance. The three patient groups with low, average, and high self-assessment-scores showed no significant differences of vestibular function.
CONCLUSIONS: Self-reported assessment of spatial orientation does not robustly correlate with objective peripheral vestibular function. Therefore, other methods of measuring spatial skills in real-world and virtual environments are required to disclose orientation deficits due to vestibular hypofunction.