原发性良性阵发性位置性眩晕的力学模型和发病机制研究及其应用

Primary Benign Paroxysmal Positional Vertigo （BPPV） is the most common vertigo in clinic, however, the pathogenesis is unclear and has been in debate still now so that it is very easily misdiagnosed. The former research discovered that the structural abnormality of the semicircular canals (otolith shedding) may lead to the uncommon mechanical response on the vestibular ampulla and then cause the abnormal nystagmus to induce BPPV. In this project, we build a biomechanical numerical model of primary BPPV to quantitatively analyze the abnormality of the mechanical response on the ridge crest of the ampulla with the change of the body position, temperature and other changes in environment. The proposed model is also be used to investigate the threshold of the abnormal mechanical response that may trigger the BPPV. The clinical diagnosis and treatment of BPPV is usually depended on the nystagmus due to the close relationship between the nystagmus and BPPV. Therefore, we employ the nystagmus in our research for modifying the proposed model and also for developing some novel applications in clinic. Furthermore, using the artificial neural network to describe the patients' individual relation between the nystagmus signal features and the mechanical response on the ridge crest of the ampulla can help us to build a platform for clinical diagnosis, treatment improvement and healing efficacy assessment. Therefore, in this project, jointing the informatics, mechanics and medicine, we build a biomechanical numerical model for primary BPPV based on the features of the nystagmus signal. By using this model, some innovative achievements are looking forward to in the fields of the new pathogenesis theory and new treatment method.

原发性良性阵发性位置性眩晕（BPPV）是临床最常见眩晕症，其发病机制至今仍存在较大争议，在医学临床被称为极易误诊的眩晕症。前期研究表明，半规管结构异常（耳石脱落），导致前庭壶腹肌力学响应感知异常是非正常眼震诱发眩晕的根本原因。本项目拟基于原发性BPPV生物数值模型的构建，对人体体位、温度等环境变化时，壶腹嵴顶感知的力学响应异常进行定量分析，且探讨可能发生BPPV的壶腹肌力学响应阈值。因BPPV与眼震之间存在着密切关系，临床诊断和治疗基本依赖眼震信号，因此将眼震信号引入，不仅可对模型进行修正并具临床应用价值。利用人工神经网络为每位患者建立眼震信号特征与壶腹嵴顶处力学响应之间个性化的联系，可为临床诊断，治疗方案改进，以及治疗后疗效评估提供平台。因此将信息学、力学和医学学科交叉，构造基于眼震信号特征的原发性BPPV生物力学数值模型，有望在发病机制新学说和综合治疗方案等方面取得创新性成果。

原发性良性阵发性位置性眩晕（BPPV）是临床最常见眩晕症，其发病机制至今仍存在较大争议，在医学临床被称为极易误诊的眩晕症。前期研究表明，半规管结构异常（耳石脱落），导致前庭壶腹肌力学响应感知异常是非正常眼震诱发眩晕的根本原因。本项目拟基于原发性BPPV生物数值模型的构建，对人体体位、温度等环境变化时，壶腹嵴顶感知的力学响应异常进行定量分析，且探讨可能发生BPPV的壶腹肌力学响应阈值。因BPPV与眼震之间存在着密切关系，临床诊断和治疗基本依赖眼震信号，因此将眼震信号引入，不仅可对模型进行修正并具临床应用价值。利用数据拟合为每位患者建立眼震信号特征与壶腹嵴顶处力学响应之间个性化的联系，可为临床诊断，治疗方案改进，以及治疗后疗效评估提供平台。因此将信息学、力学和医学学科交叉，构造基于眼震信号特征的原发性BPPV生物力学数值模型，有望在发病机制新学说和综合治疗方案等方面取得创新性成果。.在国家基金的资助下，共完成取得如下成果：.一、.建立眼震信号特征与壶腹嵴顶处力学响应之间的关系；.使用数据拟合的方法建立了慢相角速度与外部角加速度之间的函数关系；利用所提出的力学数值模型，计算出外部角加速度激励下半规管嵴顶的力学响应.二、原发性BPPV的发病机制研究：采集126例良性阵发性位置性眩晕冷热试验的眼震视图并进行分析；采集60例良性阵发性位置性眩晕患者的眼震视图与纯音测听特征并进行分析；对原发性BPPV生物力学数值模型研究，完成了嵴顶结石症数值模拟及管道耳石症数值模拟。.三、自主研发无线视频眼震电仪一套，解决已有视频眼震电仪造价昂贵，需要有线传输，不适于对运动状态下患者的检测等问题..四、自主研发运动病物理治疗仪一套，由治疗仪产生适当刺激，通过导气管导入外耳道。进而影响内耳前庭中力学感受器的材料属性，以达到抑制晕车的目的。