Characteristic manifestation of ocular and cervical vestibular evoked myogenic potentials findings in severe obstructive sleep apnea patients

Abstract

Background

Studies of saccular and utricular function in patients with obstructive sleep apnea (OSA) are rare. We noticed that some OSA patients also had positive results in vestibular function tests, and this inspired our interest in exploring the vestibular function patterns of OSA patients.

Objectives

To investigate otolithic organ function in severe OSA patients who lack vestibular symptoms and systemic disease.

Material and methods

32 patients (64 ears) with severe OSA and 22 healthy controls (44 ears) were enrolled. The ocular and cervical vestibular-evoked myogenic potentials (oVEMP and cVEMP) and the caloric test were recorded and analyzed.

Results

The response rates of oVEMP (73.4%) and cVEMP (82.8%) in patients with severe OSA were significantly lower than those in controls. In oVEMP, elevated thresholds (p = .002), decreased n1-p1 amplitudes (p < .001), prolonged n1 latencies (p < .001) were observed. In cVEMP, the elevation of thresholds (p < .001), decrease in p1-n1 amplitudes (p < .001), and n1-p2 amplitudes (p < .001), prolongation of p1 latencies (p = .003) were observed. No significant difference in the caloric test was found between the two groups.

Conclusions and significance

Disappearance or impairment of VEMPs could be observed in patients with severe OSA, and reflects different degrees of impairment in the utricle and saccule.

Chinese abstract

背景：阻塞性睡眠呼吸暂停 (OSA) 患者的球囊和椭圆囊功能研究很少见。我们注意到一些 OSA 患者在前庭功能测试中也有阳性结果, 这激起了我们探索 OSA 患者前庭功能模式的兴趣。

目的：调查无前庭症状和全身性疾病的重度 OSA 患者的耳石器官功能。

材料与方法：重度 OSA 患者 32 例（64 个耳）和健康对照者 22 例（44 个耳）注册。记录并分析了眼部和颈部前庭诱发的肌源性电位（oVEMP 和 cVEMP）和热量测试。

结果：重度OSA患者的oVEMP（73.4%）和cVEMP（82.8%）的缓解率明显低于对照组。在 oVEMP 中, 观察到阈值升高 (p = .002)、n1-p1振幅降低 (p < .001)、 n1 延迟的延长 (p < .001)。在 cVEMP 中, 观察到阈值升高（p < .001）、p1-n1 振幅（p< .001）和 n1-p2 振幅（p < .001）的降低、p1 延迟的延长（p = .003）。两组之间热量测试无显著差异。

结论和意义：在严重 OSA患者中, 可以观察到 VEMP 的消失或损坏, 反映了椭圆囊和球囊不同程度的损伤。

Keywords:

• Ocular vestibular-evoked myogenic potential (oVEMP)
• cervical vestibular-evoked myogenic potential (cVEMP)
• obstructive sleep apnea
• vestibular function
• utricle
• saccule

Disclosure statement

No potential conflict of interest was reported by the authors(s).

Additional information

Funding

Supported by National Natural Science Foundation of China (No. 81700915) to X. Xu; The Youth Foundation of Shanghai Municipal Health Commission (No. 20194Y0190) to H. Luo; Shanghai “Rising Stars of Medical Talent” Youth Development Program (Youth Medical Talents-Specialist Program) to X. Xu; Key Project of Chinese National Programs (2016YFC0905202); National Natural Science Foundation of China (Grant No. 81420108010) to F.C.; Innovation Project of Shanghai Municipal Science and Technology Commission (Grant No. 11411952300) to F.C.; Science and Technology Commission of Shanghai Municipality of China (Grant NO17411962000) to H. Wu; Health and Family Planning Commission of Shanghai Municipality of China (Grant NO 2019SY059) to H. Wu; National Natural Science Foundation of China (Grant No. 81200739) to J.W.; Project of Shanghai health and family planning commission (Grant No. 201740018) to J.W.; National Natural Science Foundation of China (No.81970891 to Q. Zhang).