Differential effects of gender and age on dynamic subjective visual vertical.

Johannes Gerb, Lena Padovan, Nicole Lehrer, Thomas Brandt, Marianne Dieterich
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Abstract

In a retrospective study, the data of direction-dependent deviations in dynamic subjective visual vertical (SVV) testing were analysed in 1811 dizzy patients (174 benign paroxysmal positional vertigo, 99 unilateral vestibulopathy, 67 bilateral vestibulopathy, 151 Menière's disease, 375 vestibular migraine, 82 cerebellar disorder, 522 functional dizziness, 341 unclear diagnosis) and in 59 healthy controls. Major findings were (i) a significant gender difference with higher directional deviations in females over the entire range of age, (ii) a significant increase of directional deviations with increasing age for both genders and in all disease subgroups as well as in healthy controls, and (iii) a lack of significant difference of directional deviations between all tested diseases. Thus, the data allow no recommendation for performing additional angular deviation analysis in dynamic SVV testing as part of routine clinical management of dizzy patients. However, as shown in earlier longitudinal studies, it still appears reasonable that dynamic SVV in acute rather than chronic vestibular disorders may provide a useful instrument for the monitoring of acute unilateral vestibular tonus imbalances in the course of the disease.

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性别和年龄对动态主观视觉垂直的差异影响。
回顾性分析1811例眩晕患者(良性阵发性位置性眩晕174例、单侧前庭病变99例、双侧前庭病变67例、meni病151例、前庭偏头痛375例、小脑障碍82例、功能性头晕522例、诊断不清341例)和健康对照59例的动态主观视觉垂直(SVV)测试中方向依赖性偏差的数据。主要发现有:(1)在整个年龄范围内,女性的方向性偏差较大,存在显著的性别差异;(2)无论男女,在所有疾病亚组以及健康对照组中,方向性偏差都随着年龄的增长而显著增加;以及(3)所有测试疾病之间的方向性偏差没有显著差异。因此,这些数据不允许推荐在动态SVV测试中进行额外的角度偏差分析,作为眩晕患者常规临床管理的一部分。然而,正如早期的纵向研究所显示的那样,在急性而非慢性前庭疾病中动态SVV可能为疾病过程中监测急性单侧前庭张力失衡提供有用的工具,这似乎仍然是合理的。
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