Vestibular function

前庭功能
  • 文章类型: Journal Article
    感觉神经性听力损失(SNHL)儿童由于前庭功能受损和平衡能力降低而生活困难和活动受限。
    本研究评估了拉丁舞训练对SNHL儿童前庭功能和平衡的影响。
    将30名前庭功能和平衡能力无差异的SNHL儿童随机分为两组,拉丁舞训练组(LTG,n=15)和对照组(CONG,n=15)。前庭功能,在干预前后测量定时闭眼静态(ECS)和功能达到测试(FRT),并进行了双向重复测量方差分析。
    训练后,LTG的前庭功能表现高于CONG(CONG:16.425±3.616vs.LTG:12.241±2.610,p=0.0411,ES=1.3914),LTG的左足ECS性能高于CONG(CONG:2.765±0.872vs.LTG:4.688±1.113,p=0.0026,ES=1.9857),LTG的右脚ECS性能高于CONG(CONG:3.113±0.639。LTG:4.797±1.071,p=0.0137,ES=2.01),LTG的FRT性能高于CONG(CONG:32.009±6.134vs.LTG:43.797±6.616,p=0.0021,ES=1.9135)。
    拉丁舞训练结束后,SNHL患儿改善前庭功能和平衡。左脚的静态平衡能力比右脚有了明显的提高。
    UNASSIGNED: Sensorineural hearing loss (SNHL) children have difficulty living and limited movement due to impaired vestibular function and reduced balance ability.
    UNASSIGNED: The present study evaluated the effects of Latin dance training on the vestibular function and balance of SNHL children.
    UNASSIGNED: Thirty SNHL children with no difference in vestibular function and balance ability were randomly divided into two groups, the Latin dance training group (LTG, n = 15) and the control group (CONG, n = 15). Vestibular function, timed eyes-closed static (ECS) and functional reach test (FRT) were measured before and after the intervention, and a two-way repeated-measures analysis of variance was performed.
    UNASSIGNED: After training, the vestibular function performance of LTG was higher than that of CONG (CONG: 16.425 ± 3.616 vs. LTG: 12.241 ± 2.610, p = 0.0411, ES = 1.3914), the left foot ECS performance of LTG was higher than that of CONG (CONG: 2.765 ± 0.872 vs. LTG: 4.688 ± 1.113, p = 0.0026, ES = 1.9857), the right foot ECS performance of LTG was higher than that of CONG (CONG: 3.113 ± 0.639 vs. LTG: 4.797 ± 1.071, p = 0.0137, ES = 2.01), the FRT performance of LTG was higher than that of CONG (CONG: 32.009 ± 6.134 vs. LTG: 43.797 ± 6.616, p = 0.0021, ES = 1.9135).
    UNASSIGNED: After Latin dance training, SNHL children improved vestibular function and balance. The static balance ability of the left foot has been improved significantly than right foot.
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  • 文章类型: Journal Article
    Sleep disorders have a high comorbidity rate with vestibular diseases. The results of some small sample clinical studies have confirmed the effect of sleep deprivation on vestibular function. However, the mechanism of the effect of sleep disorder on vestibular system is still unclear. This article analyzes the possible mechanism of the effect of sleep disorders on vestibular function from the aspects of neuroanatomy and neurotransmitters, and summarizes the relationship between sleep disorder and benign paroxysmal positional vertigo, Meniere\'s disease, vestibular migraine and other diseases.
    摘要:睡眠障碍与前庭疾病有着较高的共患率。部分小样本的临床研究的结果证实了睡眠剥夺对前庭功能的影响。然而,睡眠障碍对前庭系统的影响机制尚不清楚,本文从神经解剖及神经递质方面分析睡眠障碍对前庭功能影响的可能机制,并对睡眠障碍与良性阵发性位置性眩晕、梅尼埃病、前庭性偏头痛等疾病的关系进行综述。.
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  • 文章类型: Journal Article
    OBJECTIVE: Acoustic neuroma (AN) is a benign tumor that usually affects a patient\'s hearing and balance function. For the screening and diagnosis of AN, the traditional approach mainly relies on audiological examination and magnetic resonance imaging (MRI), often ignoring the importance of vestibular function assessment in the affected area. As an emerging method of vestibular function detection, video head impulse test (vHIT) has been widely used in clinic, but research on its use in AN diagnosis is relatively limited. This study aims to explore the value of vHIT in the diagnosis of AN, vestibular dysfunction assessment, and postoperative compensation establishment in unilateral AN patients undergoing unilateral AN resection through labyrinthine approach.
    METHODS: This retrospective study was conducted on 27 AN patients who underwent unilateral AN resection via labyrinthine approach from October 2020 to March 2022 in the Department of Otolaryngology-Head and Neck Surgery, the Second Xiangya Hospital, Central South University. vHIT was performed 1 week before surgery to assess vestibular function, pure tone audiometry (PTA) was used to assess hearing level, and ear MRI was used to assess tumor size. Follow-up vHIT was conducted at 1 week, 1 month, 6 months, and 1 year post-surgery. The correlation of vHIT with hearing and tumor size was analyzed.
    RESULTS: Preoperative vHIT showed that the posterior semicircular canal on the affected side was the most common semicircular canal with reduced vestibulo-ocular reflex (VOR) gain. There was a correlation between the VOR gain of vHIT on the affected side and the hearing level (r=-0.47, P<0.05) or tumor size (r=-0.54, P<0.01). The results of vHIT on the affected side showed that the hearing level and mean VOR gain of the anterior semicircular canal increased slightly with time, and the amplitude and saccade percentage of the dominant saccades of the 3 semicircular canals increased, while the latency time decreased, with the most obvious changes occurring 1 week post-surgery.
    CONCLUSIONS: vHIT can effectively monitor the changes of vestibular function in AN patients before and after surgery and has application value in assisting the diagnosis of vestibular dysfunction in AN patients.
    目的: 听神经瘤(acoustic neuroma,AN)是一种良性肿瘤,通常会影响患者的听觉和前庭功能。对于AN的筛查和诊断,传统方法主要依赖于听力学检查和磁共振成像(magnetic resonance imaging,MRI),而忽略了对病变部位进行前庭功能评估的重要性。视频头脉冲试验(video head impulse test,vHIT)是一种新兴的前庭功能检测方法,已广泛应用于临床,但其应用于AN诊断的研究相对较少。本研究通过在术前及术后对经迷路入路AN切除术的单侧AN患者采用vHIT进行动态检测,以探究vHIT在AN诊断、前庭功能障碍评估、术后代偿建立中的价值。方法: 回顾性纳入2020年10月至2022年3月中南大学湘雅二医院耳鼻咽喉头颈外科的27例经迷路入路AN切除术单侧患者。术前1周进行vHIT以评估前庭功能,纯音测听(pure tone audiometry,PTA)评估听力水平,耳部MRI评估肿瘤大小;分别于术后1周、1个月、6个月、1年复查vHIT,并分析vHIT与听力、肿瘤大小之间的相关性。结果: 术前vHIT显示患侧后半规管是前庭眼反射(vestibulo-ocular reflex,VOR)增益降低最常见的半规管。术前患侧vHIT的VOR增益与听力水平(r=-0.47,P<0.05)或肿瘤大小(r=-0.54,P<0.01)存在显著相关性。术后患侧vHIT结果显示水平半规管和前半规管的平均VOR增益随时间略有上升;3个半规管显性扫视的振幅和扫视波百分比均增加,而潜伏期时间缩短,并且在术后1周变化最明显。结论: vHIT能有效监测AN患者手术前后的前庭功能变化,对辅助诊断和治疗AN患者前庭功能障碍具有临床应用价值。.
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  • 文章类型: Journal Article
    回顾性分析青少年梅尼埃病(MD)的临床特征。
    回顾性分析2014年5月至2023年3月在山东省耳鼻喉科医院就诊的青少年MD(11-17岁)的病历资料,包括临床特征,一系列的听觉和前庭功能测试,感官组织试验,和成像评估。儿童复发性眩晕(RVC)患者作为对照。
    与RVC相比,青少年MD表现出更高的纯音平均阈值(p<.001),较低的言语辨别得分(p=.014),和较低的耳声发射合格率(p=0.005)。患有MD的青少年表现出平衡得分显着降低(条件1、5和6;p1=.035;p5=.033;p6=.003),复合感官评分(p=.014),和前庭感觉评分(p=.029)。与单侧MD的青少年相比,双侧MD的青少年在平衡得分和策略得分方面表现较差。对于受影响的耳朵,钆增强磁共振成像检测到更严重的内淋巴积液,听觉脑干反应阈值越高(r=.850,p=.007),耳声发射合格率越低(r=-.976,p<.001)。
    青少年MD的前庭信息输入与RVC相似,但是在患有MD的青少年中,神经中枢使用这些线索来保持平衡的能力较差。青少年单侧和双侧MD的前庭重量存在潜在差异,对视觉和本体感觉也有潜在影响。
    4级。
    UNASSIGNED: To retrospectively analyze clinical features in adolescent Menière\'s disease (MD).
    UNASSIGNED: The medical records of adolescents with MD (11-17 years old) from May 2014 to March 2023 in Shandong Provincial ENT Hospital were retrospectively analyzed, including clinical features, a battery of auditory and vestibular function tests, sensory organization test, and imaging assessments. Patients with recurrent vertigo of childhood (RVC) were as controls.
    UNASSIGNED: Compared with RVC, adolescent MD showed higher pure tone average threshold (p < .001), lower speech discrimination score (p = .014), and lower otoacoustic emission pass rates (p = .005). Adolescents with MD exhibited significant reduction in equilibrium score (Conditions 1, 5, and 6; p1 = .035; p5 = .033; p6 = .003), composite sensory score (p = .014), and vestibular sensory score (p = .029). Adolescents with bilateral MD exhibited worse performance in equilibrium score and strategy score compared to adolescents with unilateral MD. For the affected ear, the more severe endolymphatic hydrops detected by gadolinium-enhanced magnetic resonance imaging, the higher the auditory brainstem response threshold (r = .850, p = .007), and the lower the otoacoustic emission pass rate (r = -.976, p < .001).
    UNASSIGNED: Adolescent MD has similar vestibular information inputs with that of RVC, but the ability for the nerve center to use these clues to maintain balance is worse in adolescents with MD. There were potential differences in vestibular weights in adolescents with unilateral and bilateral MD, also potential effects on vision and proprioception.
    UNASSIGNED: Level 4.
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  • 文章类型: Journal Article
    渗出性中耳炎(OME)是耳鼻咽喉科诊所的常见表现。除了听力障碍,最近的证据表明,这些儿童中约有30%有一定程度的前庭和平衡障碍。评估OME儿童前庭功能障碍的存在。4至17岁的儿童,有或没有OME,使用视频头部脉冲测试(VHIT)进行前庭评估,主观视觉主观(SVV),和单腿抬高试验(SLS)。记录并分析数据。24名OME儿童以男性为主。VOR增益之间无统计学意义(p>0.05),SVV(p=0.056)和SLS(p=0.06)。简单线性回归分析表明,年龄和性别是VOR增加的潜在因素。我们的研究发现OME患儿前庭功能正常。
    Otitis media with effusion (OME) is a common presentation to the Otorhinolaryngology clinic. Besides hearing impairment, recent evidence shows that approximately 30% of these children have some degree of vestibular and balance impairment. To assess the presence of vestibular dysfunction among children with OME. Children between 4 and 17, with and without OME, underwent vestibular assessment using video head impulse test (VHIT), subjective visual subjective (SVV), and single leg raising test (SLS). Data were recorded and analysed. 24 OME children were included with male predominance. No statistical significance was found between the VOR gain (p > 0.05), SVV (p = 0.056) and SLS (p = 0.06). Simple linear regression analysis showed that age and gender are potential factors for VOR gain. Our study found that children with OME have normal vestibular function.
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  • 文章类型: Journal Article
    目的:这项研究的主要目的是通过对所有六个半规管(SCC)进行完整的vHIT测试来检查参与高风险头部创伤运动的运动员的前庭功能。次要目标是调查在某些高风险运动中,运动员的前庭功能是否显着降低。
    方法:对137名足球成年运动员进行前瞻性横断面研究,手球,拳击,骑马,和冰球,在过去五年内至少有一次报告与运动有关的头部受伤。所有受试者都接受了筛查,并对所有六个SCC进行了全面检查,并完成了头晕障碍清单(DHI)。
    结果:两名受试者(1.5%)符合病理性vHIT的标准。自上次头部受伤以来,将数据分为个人运动和时间时,可以看到前庭功能受到一定程度的损害。同样,通过DHI总分进行评价时,运动员组未发现主观头晕.当分为头部受伤次数或自上次头部受伤以来的时间时,该评分在组间没有显着差异。当分为运动类型时,总DHI评分在组间差异显著.这些总DHI分数确实如此,然而,都在“无头晕障碍”分类的范围内。
    结论:结果表明,在高风险头部创伤运动中,运动员的前庭功能不受高风险头部创伤运动的影响。因此,vHIT在评估运动员的运动相关脑震荡(SRC)时没有临床实用性,没有主观的头晕感觉。
    OBJECTIVE: The primary aim of this study was to examine the vestibular function of athletes involved in high-risk head trauma sports by means of complete vHIT testing of all six semicircular canals (SCCs). The secondary objective was to investigate whether the vestibular function is significantly reduced among athletes within certain high-risk sports.
    METHODS: A prospective cross-sectional study of 137 adult athletes in football, handball, boxing, horseback riding, and ice hockey with a minimum of one reported sports-related head injury within the past five years. All subjects underwent screening with a complete examination of all six SCCs with vHIT and fulfillment of the dizziness handicap inventory (DHI).
    RESULTS: Two subjects (1.5 %) fulfilled the criteria of having a pathological vHIT. Some degree of impairment of the vestibular function was seen when data was divided into individual sports and time since the last head injury. Likewise, no subjective dizziness was seen in the group of athletes when evaluated by total DHI scores. This score did not differ significantly between groups when subgrouped into number of head injuries or time since the last head injury. When divided into type of sport, total DHI scores differed significantly between groups. These total DHI-scores did, however, all fall within the range of the \"no dizziness handicap\" classification.
    CONCLUSIONS: The results suggest that the vestibular function of athletes in high-risk head trauma sports is unaffected by the practice of a high-risk head trauma sport. Therefore, vHIT has no clinical utility in the assessment of a sports-related concussion (SRC) in athletes with no subjective feeling of dizziness.
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  • 文章类型: Journal Article
    Large vestibular aqueduct syndrome(LVAS) is a common recessive hereditary hearing loss disease, and some patients may also experience vestibular dysfunction. With the wide application of cochlear implant(CI) and the development of vestibular medicine, the pathophysiological mechanism of LVAS and the influence mechanism of CI on vestibular function are gradually elucidated. Consequently, the evaluation and rehabilitation of vestibular dysfunction function have also become research hotspots. This article reviews studies on vestibular function and related rehabilitation in patients with large vestibular aqueduct syndrome.
    摘要: 大前庭水管综合征(large vestibular aqueduct syndrome,LVAS)是临床常见的常染色体隐性遗传性听力损失疾病,大部分患者可伴发前庭功能障碍。随着人工耳蜗植入(cochlear implant,CI)的广泛应用和前庭医学的发展,LVAS的病理、生理机制及CI对于前庭功能的影响得到了广泛关注,针对LVAS的前庭功能以及CI术后的前庭功能康复逐步成为研究热点,本文就LVAS患者的前庭功能及其相关康复研究做一综述。.
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  • 文章类型: Journal Article
    BACKGROUND: The cochlear implant (CI) is effective for rehabilitating patients with severe to profound sensorineural hearing loss. However, its placement and use have been associated with various complications, such as those affecting the vestibular system. The objective of this study was to compare vestibular function using the video head impulse test (vHIT) in pediatric patients before and after CI placement.
    METHODS: A descriptive and retrospective study was conducted. The outcomes of 11 pediatric patients of both sexes with a history of profound hearing loss were evaluated. The results of vestibular-ocular reflex (VOR) gain, saccades, asymmetry, Pérez Rey (PR) index, and VOR/saccade ratio for both ears obtained by the vHIT test before and after CI placement were compared.
    RESULTS: Of the 11 patients evaluated, the VOR gain showed that 81.8% had normal function, 18.2% had hypofunction, and no patients had hyperfunction before implantation. No statistically significant differences were found when compared with post-implant off and post-implant on conditions (p > 0.05). The extracted variables, asymmetry, PR index, and the VOR/saccades ratio also showed no statistically significant differences between the pre- and post-implant conditions, whether off or on.
    CONCLUSIONS: The vestibular function of pediatric patients did not show significant changes before and after CI placement. The vHIT test is a valuable tool for assessing vestibular function and could be considered a criterion for surgical and rehabilitation decisions in patients undergoing CI placement.
    UNASSIGNED: El implante coclear es un dispositivo eficaz para la rehabilitación de pacientes con hipoacusia neurosensorial severa a profunda. Sin embargo, su colocación y uso se ha asociado a diversas complicaciones, entre ellas a nivel del sistema vestibular. El objetivo del presente estudio fue comparar la función vestibular mediante la prueba de videoimpulso cefálico (vHIT) de pacientes pediátricos antes y después de la colocación del implante coclear.
    UNASSIGNED: Se llevó a cabo un estudio descriptivo y retrospectivo. Se evaluaron los resultados de 11 pacientes pediátricos de ambos sexos con antecedente de hipoacusia profunda. Se compararon los resultados de ganancia del VOR, sacadas, asimetría, índice PR así como la relación VOR/sacadas para ambos oídos obtenidos mediante la prueba vHIT antes y después de la colocación del implante coclear.
    RESULTS: De los 11 pacientes evaluados, la ganancia del VOR mostró que el 81.8% tenía normofunción, 18.2% hipofunción y ningún paciente hiperfunción antes del implante. Al compararlo con la ganancia post implante apagado y post implante encendido no se encontraron diferencias estadísticamente significativas (p > 0.05). Las variables sacadas, asimetría, índice PR así como la relación VOR/sacadas tampoco mostraron diferencias estadísticamente significativas entre las condiciones pre y pos implante ya sea apagado o encendido.
    CONCLUSIONS: La función vestibular de pacientes pediátricos no mostró cambios significativos previo y posterior a la colocación del implante coclear. La prueba vHIT es una herramienta útil que permite evaluar la función vestibular y que podría considerarse como criterio para tomar decisiones quirúrgicas en pacientes que se encuentran en protocolo para implante coclear.
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  • 文章类型: Journal Article
    根据年龄调查持续性姿势知觉头晕(PPPD)患者的临床特征差异。
    我们回顾性分析了143例诊断为PPPD的患者。患者按年龄分为三组:年轻组(19至44岁,n=60),中年组(45至64岁,n=56),老年组(65至85岁,n=27)。人口统计数据,头晕障碍量表(DHI)的分数,新泻PPPD问卷(NPQ),医院焦虑和抑郁量表(HADS),沉淀条件,和前庭功能测试的结果,包括热量测试,视频头脉冲测试(vHIT),颈和眼前庭诱发肌源性电位(cVEMPs和OVEMPs),和姿势描记术,在三组之间进行比较。
    虽然DHI或NPQ的得分没有显着差异,青年组HADS总分和焦虑评分均显著高于老年组(P<0.05)。另一方面,对于沉淀条件,老年组(77.8%)的外周前庭疾病发生率明显高于年轻组(41.7%,p<0.01)。热量测试的结果没有显着差异,vHIT,cVEMPs,或三组中的OVEMPs。对于姿势描记术,与年轻组和中年组相比,老年组睁眼和闭眼时的压力中心速度明显更大(分别为p<0.005)。
    PPPD的临床特征因年龄而异。年轻患者的焦虑倾向于比老年患者更强,而与年轻患者相比,老年患者的外周前庭疾病比例更高。
    UNASSIGNED: To investigate differences in the clinical characteristics of patients with persistent postural-perceptual dizziness (PPPD) according to age.
    UNASSIGNED: We retrospectively reviewed 143 patients diagnosed with PPPD. Patients were classified into three groups by age: young group (19 to 44 years, n = 60), middle-age group (45 to 64 years, n = 56), old group (65 to 85 years, n = 27). Demographic data, scores of the Dizziness Handicap Inventory (DHI), the Niigata PPPD Questionnaire (NPQ), the Hospital Anxiety and Depression Scale (HADS), precipitating conditions, and the results of vestibular function tests including caloric testing, video head impulse test (vHIT), cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs), and posturography, were compared among the three groups.
    UNASSIGNED: While there were no significant differences in the scores of the DHI or NPQ, the total score and anxiety score in HADS in the young group were significantly higher than in the old group (p < 0.05, each). On the other hand, for precipitating conditions, the rate of peripheral vestibular diseases was significantly greater in the old group (77.8%) compared to the young group (41.7%, p < 0.01). There was no significant difference in the results of caloric testing, vHIT, cVEMPs, or oVEMPs among the three groups. For posturography, the velocity of the center of pressure with eyes-open as well as with eyes-closed was significantly greater in the old group compared to the young group and the middle-age group (p < 0.005, respectively).
    UNASSIGNED: The clinical characteristics of PPPD were different according to age. Young patients tended to have stronger anxiety than old patients whereas the old patients had a higher proportion of peripheral vestibular diseases among the precipitating conditions compared to young patients.
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  • 文章类型: Journal Article
    背景:体位性低血压(OH)是多系统萎缩(MSA)患者最常见的症状之一。在体位挑战期间,前庭系统通过前庭交感神经反射在血压调节中起重要作用。本研究旨在探讨MSA患者前庭功能与OH的关系。
    方法:MSA参与者,包括20岁的OH(平均年龄,57.55±8.44岁;7名女性)和15名无OH(平均年龄,59.00±8.12岁;2名女性)和18名健康对照(平均年龄,59.03±6.44岁;8名女性)入选。进行颈部和眼部前庭诱发肌源性电位(cVEMPs和oVEMPs)测试以评估前庭功能。
    结果:MSA患者的cVEMPs缺失率明显更高(57.1%vs11.1%,p=0.001)和oVEMPs(25.7%vs0,p=0.021)比对照组。伴有OH的MSA患者表现出更多的cVEMPs缺失(75.0%vs11.1%,Bonferroni校正p<0.001)和oVEMPs(40.0%vs0,Bonferroni校正p=0.003)比对照组。与没有OH的患者相比,有OH的患者也显示出更高的cVEMPs缺失率(33.3%,Bonferroni校正p=0.014)。
    结论:我们的结果表明前庭功能受损与MSA有关,特别是那些与OH。缺乏VEMP可能是MSA严重程度的潜在标志物。我们的发现表明,前庭功能受损与OH的发育有关,并可能作为干预目标。
    BACKGROUND: Orthostatic hypotension (OH) is one of the most common symptoms in patients with multiple system atrophy (MSA). Vestibular system plays an important role in blood pressure regulation during orthostatic challenges through vestibular-sympathetic reflex. The current study aimed to investigate the relationship between vestibular function and OH in patients with MSA.
    METHODS: Participants with MSA, including 20 with OH (mean age, 57.55 ± 8.44 years; 7 females) and 15 without OH (mean age, 59.00 ± 8.12 years; 2 females) and 18 healthy controls (mean age, 59.03 ± 6.44 years; 8 females) were enrolled. Cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) tests were conducted to evaluate vestibular function.
    RESULTS: Patients with MSA presented with significantly higher rate of absent cVEMPs (57.1% vs 11.1%, p = 0.001) and oVEMPs (25.7% vs 0, p = 0.021) than controls. MSA patients with OH showed more absent cVEMPs (75.0% vs 11.1%, Bonferroni corrected p < 0.001) and oVEMPs (40.0% vs 0, Bonferroni corrected p = 0.003) than controls. Patients with OH also showed higher rate of absent cVEMPs than those without OH (33.3%, Bonferroni corrected p = 0.014).
    CONCLUSIONS: Our results demonstrated that impairment of vestibular function was associated with MSA, particularly in those with OH. Absent VEMPs may be a potential marker for MSA severity. Our findings suggest that impaired vestibular function is involved in OH development and may serve as an intervention target.
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