nystagmus

眼球震颤
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  • 文章类型: Journal Article
    微跳是基本的动眼现象和复杂的认知功能过程之间的接口,对于微妙的实验和充分的统计分析,它们也是一个挑战。在特殊主题问题的第二部分(第一部分见4),作者提出了一系列文章,这些文章表明,微跳仍然是科学研究的一个有趣和有益的领域,在许多领域的感官研究的前沿,感性的,和认知过程。.在他们的文章“复杂决策过程中对认知努力和情绪唤醒的瞳孔和微跳反应”中,44%urawska,Duchowski,&Wichary(1)研究了情感启动下多属性决策过程中瞳孔和微跳对信息处理的反应。参与者被随机分配到三个情感启动条件(中性,令人厌恶的,和色情),并指示做出歧视性决定。正如作者所假设的那样,结果表明,微小扫视速率抑制和瞳孔扩张,取决于决策前的认知努力,并通过情感启动来调节。逆向启动增加了瞳孔和微跳对信息处理工作的反应。结果表明,瞳孔反应受情感启动的影响比微扫视率更大。根据瞳孔和微视行为的神经心理学机制讨论了结果。在文章“在单眼和双眼刺激条件下的微跳速率特征相关”中,Leube,Rifai,&Wahl(2020)研究了微跳在单眼和双眼条件下的定向分布和速率。在两种刺激条件下,参与者都固定了一个Gabor贴片,该贴片在很宽的空间频率范围内以45°或135°的方向随机呈现。微扫视大多是水平取向的,而与光栅的空间频率无关。该结果在两种刺激条件之间是一致的。这项研究发现,微跳跳速率特征曲线在两种刺激条件之间相关,因此,将微跳的使用扩展到临床应用,由于参数为对比敏感度,在临床研究中经常进行单眼测量。马丁的这项研究“高速连续视觉搜索过程中的微跳”,戴维斯,Riesenhuber,&Thorpe(3)提供了对视觉搜索过程中发生的微跳的分析,针对小脸粘贴到杂乱的背景照片或简单的灰色背景。指示参与者在变化的场景中瞄准奇异的3度直立或倒置的面孔。一旦参与者的目光到达目标面部,在不同的随机位置显示了一张新的面孔。无论实验背景如何(例如背景场景,没有背景场景),或目标偏心(从4到20度的视角),作者发现,微视速率在12毫秒内降至接近零的水平。在刺激发作后和第一次扫视之前,几乎没有任何微跳。在大约20%的试验中,有一个单一的微扫视,几乎立即发生在前一个扫视的偏移。作者认为,需要通过处理刺激的视觉层次结构进行一次前馈才能实现长时间的连续视觉搜索,并提供证据证明微扫视可以发挥感知功能,例如在连续视觉搜索过程中纠正扫视或实现面向任务的目标。虽然许多研究已经描述了视觉注视过程中的眼球运动,包括微跳,在大多数情况下,只有水平和垂直分量被记录和分析。关于微跳的扭转成分知之甚少。在这项研究中,“在固定和视动刺激期间快速阶段的微跳的扭转成分”Sadeghpour&Otero-Millan(5)记录了在固定和扭转视动刺激期间围绕三个旋转轴的眼球运动。作者发现,固定过程中微扫视的扭转分量的平均幅度为0.34±0.07度,速度遵循主序列,其斜率与水平和垂直分量相当。微扫视过程中扭转位移的大小与水平分量相关,而与垂直分量无关。与固定刺激固定过程中产生的微跳相比,在存在视动刺激的情况下,诱导眼球震颤产生更频繁和更大的扭转快速阶段。快速相的扭转分量和垂直聚散分量随速度的增加而增加。在以前的研究中,微跳被解释为任务负荷的心理生理指标。到目前为止,不同类型的任务需求如何影响微扫视率仍在争论中。Schneider等人在他们的文章“任务难度与微视速率之间的相互作用:视觉负荷的关键作用的证据”中。(6)检查了视觉负荷之间的关系,心理负荷和微视速率。参与者执行了一个连续的绩效任务(n-back),其中视觉任务负载(字母与抽象数字)和心理任务负荷(1-back到4-back)作为受试者内部变量进行操纵。眼动追踪数据,记录了绩效数据和主观工作量。数据分析显示,对于高视觉需求的刺激(即抽象数字),微扫视速率增加,而精神需求(n-back-level)并不调节微视速率。作者得出结论,微小扫视率反映了任务的视觉负荷,而不是其心理负荷。这一结论符合克鲁格等人的命题。(2)“微跳区分看和看”,将感官与认知现象联系起来。当前的特殊主题为围绕微跳的研究景观增加了几个新的有趣方面。它们仍然是跨学科研究和跨学科应用的有吸引力的焦点。因此,正如在本期特别专题的第一部分中已经指出的那样,对微跳的研究不仅会持续下去,但随着知识库的扩展而不断发展。
    Microsaccades are at the interface between basic oculomotor phenomena and complex processes of cognitive functioning, and they also have been a challenge for subtle experimentation and adequate statistical analysis. In the second part of the special thematic issue (for the first part see  4) the authors present a series of articles which demonstrate that microsaccades are still an interesting and rewarding area of scientific research the forefront of research in many areas of sensory, perceptual, and cognitive processes.. In their article \"Pupillary and microsaccadic responses to cognitive effort and emotional arousal during complex decision making\" Krejtz, Żurawska, Duchowski, & Wichary (1) investigate pupillary and microsaccadic responses to information processing during multi-attribute decision making under affective priming. The participants were randomly assigned into three affective priming conditions (neutral, aversive, and erotic) and instructed to make discriminative decisions. As hypothesized by the authors, the results showed microsaccadic rate inhibition and pupillary dilation, depending on cognitive effort prior to decision and moderated by affective priming. Aversive priming increased pupillary and microsaccadic responses to information processing effort. The results indicate that pupillary response is more influenced by affective priming than microsaccadic rate. The results are discussed in the light of neuropsychological mechanisms of pupillary and microsaccadic behavior. In the article \"Microsaccadic rate signatures correlate under monocular and binocular stimulation conditions\" Essig, Leube, Rifai, & Wahl (2020) investigate microsaccades with respect to their directional distribution and rate under monocular and binocular conditions. In both stimulation conditions participants fixated a Gabor patch presented randomly in orientation of 45° or 135° over a wide range of spatial frequencies. Microsaccades were mostly horizontally oriented regardless of the spatial frequency of the grating. This outcome was consistent between both stimulation conditions. This study found that the microsaccadic rate signature curve correlates between both stimulation conditions, therefore extending the use of microsaccades to clinical applications, since parameters as contrast sensitivity, have frequently been measured monocularly in the clinical studies. The study \"Microsaccades during high speed continuous visual search\" by Martin, Davis, Riesenhuber, & Thorpe (3) provides an analysis of the microsaccades occurring during visual search, targeting to small faces pasted either into cluttered background photos or into a simple gray background.  Participants were instructed to target singular 3-degree upright or inverted faces in changing scenes.  As soon as the participant\'s gaze reached the target face, a new face was displayed in a different random location.  Regardless of the experimental context (e.g. background scene, no background scene), or target eccentricity (from 4 to 20 degrees of visual angle), The authors found that the microsaccade rate dropped to near zero levels within 12 milliseconds.  There were almost never any microsaccades after stimulus onset and before the first saccade to the face. In about 20% of the trials, there was a single microsaccade that occurred almost immediately after the preceding saccade\'s offset.  The authors argue that a single feedforward pass through the visual hierarchy of processing a stimulus is needed to effectuate prolonged continuous visual search and provide evidence that microsaccades can serve perceptual functions like correcting saccades or effectuating task-oriented goals during continuous visual search. While many studies have characterized the eye movements during visual fixation, including microsaccades, in most cases only horizontal and vertical components have been recorded and analyzed. Little is known about the torsional component of microsaccades. In the study \"Torsional component of microsaccades during fixation and quick phases during optokinetic stimulation\" Sadeghpour & Otero-Millan (5) recorded eye movements around the three axes of rotation during fixation and torsional optokinetic stimulus. The authors found that the average amplitude of the torsional component of microsaccades during fixation was 0.34 ± 0.07 degrees with velocities following a main sequence with a slope comparable to the horizontal and vertical components. The size of the torsional displacement during microsaccades was correlated with the horizontal but not the vertical component. In the presence of an optokinetic stimulus a nystagmus was induced producing  more frequent and larger torsional quick phases compared to microsaccades produced during fixation of a stationary stimulus. The torsional component and the vertical vergence component of quick phases increased with higher velocities. In previous research, microsaccades have been interpreted as psychophysiological indicators of task load. So far, it is still under debate how different types of task demands are influencing microsaccade rate. In their article \"The interplay between task difficulty and microsaccade rate: Evidence for the critical role of visual load\" Schneider et al. (6) examined the relation between visual load, mental load and microsaccade rate. The participants carried out a continuous performance task (n-back) in which visual task load (letters vs. abstract figures) and mental task load (1-back to 4-back) were manipulated as within-subjects variables. Eye tracking data, performance data as well as subjective workload were recorded. Data analysis revealed an increased level of microsaccade rate for stimuli of high visual demand (i.e. abstract figures), while mental demand (n-back-level) did not modulate microsaccade rate. The authors concluded that microsaccade rate reflects visual load of a task rather than its mental load. This conclusion is in accordance with the proposition of Krueger et al. (2) \"Microsaccades distinguish looking from seeing\", linking sensory with cognitive phenomena. The present special thematic issue adds several new interesting facets to the research landscape around microsaccades. They still remain an attractive focus of interdisciplinary research and transdisciplinary applications. Thus, as already noted in the first part of this special thematic issue, research on microsaccades will not only endure, but keep evolving as the knowledge base expands.
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  • 文章类型: Journal Article
    含酰基-CoA结合域5(ACBD5)缺乏症是一种新定义的先天性过氧化物酶体疾病,迄今为止仅报告了7例患者。在这里,我们报告了1例ACBD5缺乏症患者,经过复杂的诊断过程后确诊.
    一名6岁男性患者因神经运动退化和视觉障碍而入院。他患有痉挛性轻瘫,以轴向低张姿势和水平眼震为主。他的超长链脂肪酸水平在正常范围内,C26:0/C22:0比例略有升高。脑磁共振成像显示脑白质受累。临床外显子组测序显示ACBD5(NM_145698.5)基因中的新的纯合内含子剪接位点变体(c.936+2T>G)。
    有了这份报告,描述了ACBD5缺乏症的一种新变体。在ACBD5缺乏症的文献中,首次通过光学相干断层扫描成像证明了黄斑营养不良。为了有助于了解临床,生物化学,和ACBD5缺乏症的遗传谱,需要定义新患者。
    UNASSIGNED: Acyl-CoA binding domain containing 5 (ACBD5) deficiency is a newly defined inborn peroxisomal disorder with only 7 patients reported to date. Herein, we report a patient with ACBD5 deficiency who was diagnosed after a complicated diagnostic process.
    UNASSIGNED: A 6-year-old male patient was admitted with complaints of neuromotor regression and visual disturbances. He had spastic paraparesis dominated with axial hypotonic posturing and horizontal nystagmus. His very-long-chain fatty acid levels were within normal ranges with a slightly elevated C26:0/C22:0 ratio. Brain magnetic resonance imaging revealed white matter involvement. Clinical exome sequencing displayed a novel homozygous intronic splice site variant (c.936 + 2T>G) in the ACBD5 (NM_145698.5) gene.
    UNASSIGNED: With this report, a novel variant in ACBD5 deficiency was described. Macular dystrophy was demonstrated with optical coherence tomography imaging for the first time in the literature in ACBD5 deficiency. In order to contribute to the knowledge about the clinical, biochemical, and genetic spectrum of ACBD5 deficiency, new patients need to be defined.
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  • 文章类型: Journal Article
    当躺在MRI扫描仪中甚至没有任何运动时,MRI扫描仪的静态磁场诱导受试者前庭器官(MVS)的磁流体动力学刺激。因此,MVS不仅会引起水平前庭眼球震颤,还会引起空间注意力的水平偏向。在这项研究中,我们旨在确定3TMRI扫描仪中MVS引起的VOR和空间注意力偏差的时程,以及参与者离开扫描仪后各自的副作用.以前在健康志愿者中评估了视觉搜索任务中的眼球运动和明显的空间注意力,during,经过一小时的MVS。所有参与者都在扫描仪内展示了VOR,随着时间的推移而下降,但从未完全消失。重要的是,在空间关注和探索中也存在MVS引起的水平偏差,它在扫描仪中持续了整整一个小时。退出扫描仪后,我们观察到在VOR和空间注意力中表现出的相反方向的后效应,7分钟后统计学上不再检测到。MVS对空间注意力的持续影响对于fMRI研究的设计和解释以及消除空间忽视的治疗干预措施的发展具有重要意义。
    When lying inside a MRI scanner and even in the absence of any motion, the static magnetic field of MRI scanners induces a magneto-hydrodynamic stimulation of subjects\' vestibular organ (MVS). MVS thereby not only causes a horizontal vestibular nystagmus but also induces a horizontal bias in spatial attention. In this study, we aimed to determine the time course of MVS-induced biases in both VOR and spatial attention inside a 3 T MRI-scanner as well as their respective aftereffects after participants left the scanner. Eye movements and overt spatial attention in a visual search task were assessed in healthy volunteers before, during, and after a one-hour MVS period. All participants exhibited a VOR inside the scanner, which declined over time but never vanished completely. Importantly, there was also an MVS-induced horizontal bias in spatial attention and exploration, which persisted throughout the entire hour within the scanner. Upon exiting the scanner, we observed aftereffects in the opposite direction manifested in both the VOR and in spatial attention, which were statistically no longer detectable after 7 min. Sustained MVS effects on spatial attention have important implications for the design and interpretation of fMRI-studies and for the development of therapeutic interventions counteracting spatial neglect.
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  • 文章类型: English Abstract
    Objective:To explore the clinical value of supine median³ nystagmus in the accurate diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo(HC-BPPV). Methods:A total of 187 patients with HC-BPPV admitted to the First Affiliated Hospital of Xi\'an Jiaotong University from June 2020 to March 2021 were selected. Among them 42 cases of Cupulolithiasis and 145 cases of Canalithiasis. The nystagmus parameters of patients left and right supine position and supine median³ position were recorded in detail by RART. According to the direction of supine median³ nystagmus, patients were divided into three groups: group A(nystagmus to weak side), group B(nystagmus to strong side), group C(negative nystagmus). The canalith repositioning manoeuvres(CRM) was carried out by utility of an automatic vestibular function diagnosis and therapy system(SRM-IV). The cure rate of CRM in three groups of HC-BPPV patients was compared, Multivariate logistic regression analysis was performed to analyze the influencing factors of CRM for HC-BPPV. Results:The cure rates of group A, group B and group C were 81.58%, 16.13% and 56.25%, respectively. The difference among the three groups was statistically significant. Then a pairwise comparison of group A, B and C, the difference was statistically significant(χ²A-B=40.294,P<0.001,χ²B-C=14.528, P<0.001,χ²A-C=11.606, P=0.001); the results of multivariate logistic regression analysis showed that the direction of supine median³ nystagmus and BMI were the influencing factors of CRM for HC-BPPV. Conclusion:The direction, intensity and duration of supine median³ nystagmus play an important role in determining the responsibility semicircular canal of HC-BPPV.
    目的:探讨仰卧正中位³眼震特征在水平半规管良性阵发性位置性眩晕(horizontal canal benign paroxysmal positional vertigo,HC-BPPV)责任半规管准确判定及疗效预估中的临床价值。 方法:选取2020年6月至2021年3月就诊于西安交通大学第一附属医院耳鼻咽喉头颈外科并确诊为HC-BPPV的患者187例,其中嵴顶结石症42例,管石症145例。采取快速轴位滚转试验(rapid axial roll test,RART)并详细记录患者在双耳下及仰卧正中位³引出的眼震参数,按照仰卧正中位³眼震方向分为3组:A组(眼震向弱侧)、B组(眼震向强侧)、C组(眼震阴性)。通过全自动前庭功能诊治系统(SRM-Ⅳ)进行复位治疗,比较3组HC-BPPV患者的复位治愈率,并进行多因素logistic回归分析HC-BPPV复位疗效的影响因素。 结果:A组治愈率81.58%(62/76),B组治愈率16.13%(5/31),C组治愈率56.25%(45/80),3组治愈率比较,差异有统计学意义(χ²=40.038,P<0.001),3组两两比较,患者治愈率差异均有统计学意义(χ²A-B=40.294,P<0.001,χ²B-C=14.528,P<0.001,χ²A-C=11.606,P=0.001)。多因素logistic回归分析结果显示:仰卧正中位³眼震方向及BMI是HC-BPPV复位疗效的影响因素。 结论:仰卧正中位³眼震的方向、强度及持续时间在判定HC-BPPV责任半规管中有重要意义。.
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  • 文章类型: Case Reports
    眼球震颤是众所周知的抗癫痫药物(ASM)的副作用,但它往往被低估和忽视。这里,我们描述了使用常规脑电图(EEG)早期发现闭眼期间的眼球震颤的情况。一名34岁的男子在25岁的头部外伤后患上了局灶性癫痫。患者接受卡马西平治疗,但观察到肝功能障碍;因此,尝试使用拉科沙胺(LCM)和拉莫三嗪进行治疗.随着LCM剂量的增加,在眼电图中观察到提示水平眼球震颤的陡峭电位变化,脑电图上的F7和F8,患者抱怨闭眼时眼睛颤抖。这些症状和脑电图发现随着LCM剂量的减少而改善。如果同时在脑电图上发现了眼球震颤的存在,并且确认了患者的ASM主观症状,建议逐渐减少和/或停止病原体。
    Nystagmus is a well-known side effect of antiseizure medicines (ASMs), but it is often underestimated and overlooked. Here, we describe a case in which nystagmus during eye closure was identified early using routine electroencephalography (EEG). A 34-year-old man developed focal epilepsy after head trauma at the age of 25 years. The patient was treated with carbamazepine but liver dysfunction was observed; therefore, treatment was attempted with lacosamide (LCM) and lamotrigine. With an increase in the LCM dose, steep potential changes suggestive of horizontal nystagmus were observed in the electrooculogram, F7, and F8 on EEG, and the patient complained of eye shaking during eye closure. These symptoms and EEG findings improved with LCM dose reduction. If the presence of nystagmus is identified on EEG coincidentally and a patient\'s subjective symptoms with ASM are confirmed, it is advisable to taper and/or discontinue the causative agent.
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  • 文章类型: Case Reports
    核间眼肌麻痹(INO)可能在经皮冠状动脉介入治疗和血管造影后发生。然而,目前尚无桡动脉血管成形术期间INO的报告.我们报告了一例罕见的病例,其中一名47岁的男子在桡动脉血管成形术后出现复视。虽然症状在60天后消失,诊断这种障碍是必要的,以减少病人和医生的焦虑。
    Internuclear ophthalmoplegia (INO) may happen following percutaneous coronary intervention and angiography. However, no reports of INO during radial artery angioplasty were reported yet. We report a rare case in a 47-year-old man presenting with diplopia after radial artery angioplasty. Although the symptoms were resolved after 60 days, diagnosing this obstacle is necessary to reduce the patient and physician\'s anxiety.
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  • 文章类型: Case Reports
    该病例报告了一名20岁的女性患者,该患者于2020年1月31日宣布紧急状态时在意大利北部,在返回西班牙15天后出现发热的上呼吸道症状。头痛和嗅觉缺失被视为鼻窦炎。三周后出现头晕和间歇性水平眼球震颤,伴有旋转成分。耳鼻咽喉科和包括MRI在内的神经系统检查均正常。COVID-19IgG抗体阳性。在当前大流行的背景下,并将症状与阳性IgG抗体联系起来,我们可以认为SARS-CoV-2的感染是获得性眼球震颤的可能原因。
    This case reports a 20-year-old female patient who was in northern Italy when the state of emergency was declared on the 31st of January 2020, developing 15 days after return to Spain upper respiratory symptoms characterized by fever, headache and anosmia that was treated as sinusitis. Three weeks later presented with dizziness and an intermittent horizontal nystagmus with rotatory component. Otorhinolaryngology and neurological examination including MRI were normal. COVID-19 IgG antibodies where positive. In the context of the ongoing pandemic, and associating the symptoms with positive IgG antibodies, we can consider the infection of SARS-CoV-2 as a probable cause of the acquired nystagmus.
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  • 文章类型: Journal Article
    背景:良性阵发性位置性眩晕(BPPV)的特点是短暂的,由头部位置的突然变化引发的眩晕的剧烈发作。它通常被认为是在成年人中最常见的,虽然它在儿童中被认为是罕见的。为了更好地了解疾病的特征及其自然史,有必要在儿童和成人患者之间进行比较。本研究旨在确定儿童BPPV的临床特征,并将其与成人BPPV患者进行比较。方法:检索我院电子数据库,选择所有诊断为BPPV的≤18岁儿童。通过病历审查确定临床特征。对于成年患者,我们收集了年龄>19岁患者的数据.结果:共纳入30例儿科患者(13.65±4.15岁)和264例成人患者(60.86±13.74岁)。在儿科患者中,侧管占80%,后管占16.67%。在成年患者中,侧管和后管受累相似(p=0.007)。儿科患者的眼震程度为6.82±12.09,而成年人为15.58±20.90(p<0.001)。小儿组并发头晕障碍较高,成年组复发率较高。在回归分析中,发现成年患者的眼球震颤更强,值为6.206deg/sec,小儿组并发头晕障碍的风险高5.413倍(p<0.05)。结论:BPPV发生在患病率较低的儿科患者中,但不容忽视。在儿科组,相对较高比例的患者表现出侧管受累,较弱的眼球震颤,和额外的头晕障碍。
    Background: Benign paroxysmal positional vertigo (BPPV) is characterized by brief, intense episodes of vertigo triggered by abrupt changes in head position. It is generally accepted as being most common in adults, while it is regarded as rare in children. It is necessary to compare the disease between pediatric and adult patients for a better understanding of the disease\'s characteristics and its natural history. This study aimed to identify the clinical characteristics of BPPV in children and compare them with those of adult BPPV patients. Methods: All children ≤ 18 years old who were diagnosed with BPPV were selected by searching the electronic database of our hospital. Clinical features were identified by medical record review. For adult patients, we collected data from patients > 19 years of age. Results: A total of 30 pediatric (13.65 ± 4.15 years old) and 264 adult patients (60.86 ± 13.74 years old) were included in the study. Among pediatric patients, the lateral canals were involved in 80% and the posterior canals in 16.67%. In adult patients, the lateral and posterior canals were involved similarly (p = 0.007). The degree of nystagmus in pediatric patients was 6.82 ± 12.09, while in adults it was 15.58 ± 20.90 (p < 0.001). The concurrent dizziness disorder was higher in the pediatric group and recurrence was higher in the adult group. In the regression analysis, it was found that adult patients had a stronger nystagmus with a value of 6.206 deg/sec, and the risk of concurrent dizziness disorder was found to be 5.413 times higher in the pediatric group (p < 0.05). Conclusions: BPPV occurs in pediatric patients with lower prevalence, but it cannot be overlooked. In the pediatric group, a relatively high proportion of patients demonstrated lateral canal involvement, weaker nystagmus, and additional dizziness disorder.
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  • 文章类型: Journal Article
    急性前庭综合征(AVS)的特征是突然的眩晕,步态不稳定,恶心和眼球震颤.对AVS患者进行准确和快速的分诊,以区分中枢(潜在的险恶)和外周(通常是良性的)根本原因是急诊医学设置面临的挑战。虽然有床边检查可以可靠地区分严重病例,由于临床医生普遍不熟悉和低置信度的解释结果,它们未得到充分利用。眼球震颤是AVS的基本组成部分,可以促进分类,但是识别相关特征需要专业知识。这项工作提出了两种来自眼球震颤分析的定量数字生物标志物,捕获诊断相关信息。方向性生物标志物评估方向的变化,以区分自发和凝视诱发(方向改变)的眼球震颤,而强度差异生物标志物描述了偏心凝视测试中强度的变化。为了评估生物标志物,24组三个凝视测试(左,对,和主要)进行了分析。两种新的生物标志物都表现良好,特别是方向性,这是一个完美的分类器。一般来说,这些生物标志物与文献中发现的定量眼震特征的表现相匹配或黯然失色.他们还超越了在同一数据集上训练的支持向量机分类器的性能,达到了75%的准确率。总之,这些生物标志物简化了非专业临床医生的诊断过程,弥合急诊护理和专家评估之间的差距,最终使AVS患者受益。
    Acute vestibular syndrome (AVS) is characterised by a sudden vertigo, gait instability, nausea and nystagmus. Accurate and rapid triage of patients with AVS to differentiate central (potentially sinister) from peripheral (usually benign) root causes is a challenge faced across emergency medicine settings. While there exist bedside exams which can reliably differentiate serious cases, they are underused due to clinicians\' general unfamiliarity and low confidence interpreting results. Nystagmus is a fundamental part of AVS and can facilitate triaging, but identification of relevant characteristics requires expertise. This work presents two quantitative digital biomarkers from nystagmus analysis, which capture diagnostically-relevant information. The directionality biomarker evaluates changes in direction to differentiate spontaneous and gaze-evoked (direction-changing) nystagmus, while the intensity differential biomarker describes changes in intensity across eccentric gaze tests. In order to evaluate biomarkers, 24 sets of three gaze tests (left, right, and primary) are analysed. Both novel biomarkers were found to perform well, particularly directionality which was a perfect classifier. Generally, the biomarkers matched or eclipsed the performance of quantitative nystagmus features found in the literature. They also surpassed the performance of a support vector machine classifier trained on the same dataset, which achieved an accuracy of 75%. In conclusion, these biomarkers simplify the diagnostic process for non-specialist clinicians, bridging the gap between emergency care and specialist evaluation, ultimately benefiting patients with AVS.
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