上海交通大学学报（医学版）

上海交通大学学报（医学版）

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前庭代偿机制研究新进展及其临床意义

时海波   

  1. 上海交通大学附属第六人民医院耳鼻咽喉头颈外科， 上海 200233
  • 出版日期:2016-09-28 发布日期:2016-10-31
  • 作者简介:时海波（1971—），男，主任医师，博士；电子信箱：haibo99@hotmail.com。
  • 基金资助:

    国家自然科学基金项目（81570909）；上海市教育委员会高峰高原学科建设计划(20152233) ；上海市卫生和计划生育委员会“新百人计划”（XBR2013085）

Research progresses of vestibular compensation mechanism and its clinical significance

SHI Hai-bo   

  1. Department of Otorhinolaryngology Head & Neck Surgery, Shanghai Sixth Peoples Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2016-09-28 Published:2016-10-31
  • Supported by:

    National Natural Science Foundation of China, 81570909； Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support，20152233； Excellent Academic Leader Training Program of Shanghai Municipal Health System，XBR2013085

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摘要：

前庭系统是一套感知及控制平衡的精密操作系统，司职运动感知、凝视、肢体平衡等功能，并参与情感、记忆等认知功能。前庭功能障碍患者表现为失平衡、视物模糊、眩晕等，并由此导致严重的社会行为障碍。在前庭功能障碍早期，前庭中枢结构具有自发的、功能强大的再平衡功能，亦即前庭代偿。前庭康复是一种外源性干预策略，已经明确在单侧前庭损害中具有积极的促代偿效果。该文阐述了前庭代偿机制的研究新进展，以及基于此的前庭康复理念，亦即最佳前庭代偿效果并非依赖于最佳康复技术，而是有赖于把握神经网络发生内在可塑性改变的时间窗。

关键词: 平衡, 前庭功能障碍, 前庭代偿, 中枢可塑性, 前庭康复

Abstract:

The vestibular system is a complicated operating system contributing to monitor and control balance and has functions such as motion perception, gaze, and truck stability. More recently, the vestibular system has been recognized for its contribution to emotion, memory and social cognition. Patients with vestibular dysfunction present with loss of balance, blurred vision, vertigo and so on, resulting in serious social-behavioral impairments. At the early stage of vestibular dysfunction, the vestibular system often experiences a spontaneous recovery from the static and dynamic deficit, i.e. vestibular compensation. As an extrinsic intervention, vestibular rehabilitation can actively promote the compensation in unilateral vestibular impairment. This article reviews the latest research progresses of vestibular compensation mechanism and vestibular rehabilitation ideas, i.e. the best vestibular compensation relies on cross-talk windows between retraining processes and post-lesion brain-plasticity mechanisms, rather than rehabilitation techniques.

Key words: balance, vestibular dysfunction, vestibular compensation, centric plasticity, vestibular rehabilitation