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Sample records for acute unilateral vestibular

  1. Acute unilateral loss of vestibular function.

    PubMed

    Fetter, M

    2016-01-01

    Sudden unilateral loss of vestibular function is the most severe condition that can occur in the vestibular system. The clinical syndrome is caused by the physiologic properties of the vestibulo-ocular reflex (VOR) arc. In the normal situation, the two peripheral vestibular end organs are connected to a functional unit in coplanar pairs of semicircular canals working in a push-pull mode. "Push-pull" mode means that, when one side is excited, the other side is inhibited, and vice versa due to two mechanisms. First, first-order vestibular afferents are bipolar cells. They have a tonic firing rate that is modulated up or down depending on the direction of rotation. Second, via inhibitory neural connections of second-order vestibular neurons between the vestibular nuclei (vestibular commissural system), the excited side inhibits further the contralateral side. The neural signals are encoded as the difference of the change in firing rate of the vestibular neurons modulating the tonic firing rate on both sides in opposite directions (one side up, the contralateral side down). When the head is not moving, the two peripheral vestibular end organs generate a resting firing rate, which is exactly equal on both sides. When the head is rotated, for example, to the right, the right-sided first-order vestibular afferents increase their discharge rate and the left-sided ones decrease their firing rate. This leads to increase in firing rate of also the type I second-order vestibular neurons in the vestibular nuclei, which synapse with inhibitory type II neurons on the contralateral side, further decreasing the firing rate in the second-order vestibular neurons in the contralateral vestibular nucleus. When the direction of head rotation is reversed, the behavior of the type I neurons on the two sides of the head is reversed. The same relation exists between the coplanar vertical canal afferents on the two sides of the head. When there is unilateral damage to the end organ or the

  2. Vestibular perceptual thresholds to angular rotation in acute unilateral vestibular paresis and with galvanic stimulation.

    PubMed

    Cutfield, Nicholas J; Cousins, Sian; Seemungal, Barry M; Gresty, Michael A; Bronstein, Adolfo M

    2011-09-01

    Studies of compensation of injury to the human vestibular system have, in the main, focused on the vestibular-ocular reflex. Probing vestibular perception allows more of the sensory pathway to be assessed. We present a novel paradigm for simultaneously testing vestibular perceptual and nystagmic thresholds to angular acceleration around an earth vertical axis. The perceptual thresholds can be modulated asymmetrically in normal subjects by DC galvanic stimulation with the head flexed in the roll plane, as expected from the main torsional plane of action of the galvanic stimulus. The perceptual and nystagmic thresholds were bilaterally elevated in acute vestibular neuritis, a unilateral condition, possibly due to central suppression of vestibular input. The degree of asymmetry in thresholds was small in comparison with the large caloric asymmetry present in the patients, indicating a relatively preserved capacity for near-threshold performance of the non-damaged labyrinth both in the "on" and "off" directions.

  3. Chronic unilateral vestibular loss.

    PubMed

    Kerber, K A

    2016-01-01

    Chronic unilateral vestibular loss is a condition defined by the presence of reduced function of the peripheral vestibular system on one side, which has generally persisted for 3 or more months. The deficit is demonstrated by a reduction of the vestibular-ocular reflex either at the bedside or on laboratory testing. Though some patients with chronic vestibular loss have disabling symptoms, others are asymptomatic. Causes include a viral/postviral disorder, Menière's disease, structural lesions, ischemia, and trauma. Any other systemic or genetic disorder would be expected to involve both sides at some point. PMID:27638074

  4. Improvement of vestibular compensation by Levo-sulpiride in acute unilateral labyrinthine dysfunction.

    PubMed

    Zanetti, D; Civiero, N; Balzanelli, C; Tonini, M; Antonelli, A R

    2004-04-01

    L-sulpiride is the levorotatory enantiomer of sulpiride, a neuroleptic of the family of benzamide derivatives; it has a characteristic antagonist effect on central DA2 dopaminergic receptors and dopamine DA1 "autoreceptors". Its efficacy in the symptomatic control of acute vertigo spells has been recognized, apart from its well-known antiemetic, antidyspeptic and anti-depressant properties, at high dosages. To establish objective parameters of the results of its clinical application, a randomized prospective study was started comparing the effects of the drug in a group of 87 patients with vertigo of peripheral origin, with those in a control group treated with other vestibular suppressants. The drug was administered via the intravenous route, 25 mg t.i.d., for the first 3 days, then by oral administration, with the same schedule and dosage, for a further 7 days. After clinical evaluation of vestibular signs and symptoms, electronystagmographic recordings of rotatory tests were obtained, at admission and were then controlled after 6 months. A subjective Visual Analogue Scale was also delivered daily to the patients in order to monitor symptomatic improvements. When compared to conventional treatments, L-sulpiride appeared to induce a statistically significant faster recovery in unilateral vestibular lesions. An unexpected favourable outcome of treatment was the facilitation of spontaneous vestibular compensation, in terms of lesser residual labyrinthine dysfunction and reduction of recurrent vertigo attacks during the 6 months follow-up. The mechanisms of action of the drug and its interaction with the vestibular system are discussed.

  5. Postural responses without versus with acute external cervical spine fixation: a comparative study in healthy subjects and patients with acute unilateral vestibular loss.

    PubMed

    Bohne, Silvia; Heine, Sabrina; Volk, G Fabian; Stadler, Joachim; Guntinas-Lichius, Orlando

    2013-01-01

    Using a diagnostic prospective cohort single center study design, the influence of a cervical collar on standing balance during dynamic postural perturbations in healthy adults and patients with acute unilateral vestibular dysfunction was measured in 31 healthy subjects and 27 patients with acute unilateral vestibular loss. The main outcome measures were completed standard protocols on the Sensory Organization Test (SOT) and Motor Control Test (MCT) of the NeuroCom Equitest(®) computerized posturography platform measured without and with acute cervical fixation, respectively. Paired t test showed no significant difference during the six conditions of neither the SOT scores nor analyzing the SOT strategies or during the MCT between the non-fixed and fixed neck in healthy subjects and in the patients (all p > 0.05). Older healthy subjects showed decreased SOT scores but equal MCT results. The age effect was more dominant in the patients when wearing the collar. Gender had no influence whether in healthy individuals nor in patients. In almost all conditions of the SOT but only in some MCT subtests patients had significantly lower scores than healthy subjects without collar and with collar (all p < 0.05). In conclusion, the SOT but only some subtest of the MCT could clearly distinguish between healthy adults and patient with acute unilateral vestibular loss. Equilibrium scores did not change significantly when the cervical spine was fixed with a collar. Acute fixation of the neck with a collar seems not to affect standing balance, even not when vestibular, visual and/or somatosensory input are also reduced. PMID:22237759

  6. Unilateral vestibular loss impairs external space representation.

    PubMed

    Borel, Liliane; Redon-Zouiteni, Christine; Cauvin, Pierre; Dumitrescu, Michel; Devèze, Arnaud; Magnan, Jacques; Péruch, Patrick

    2014-01-01

    The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal) and far (extrapersonal) spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation), and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss.

  7. Unilateral Vestibular Loss Impairs External Space Representation

    PubMed Central

    Borel, Liliane; Redon-Zouiteni, Christine; Cauvin, Pierre; Dumitrescu, Michel; Devèze, Arnaud; Magnan, Jacques; Péruch, Patrick

    2014-01-01

    The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal) and far (extrapersonal) spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation), and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss. PMID:24523916

  8. Torsional optokinetic nystagmus after unilateral vestibular loss: asymmetry and compensation.

    PubMed

    Lopez, Christophe; Borel, Liliane; Magnan, Jacques; Lacour, Michel

    2005-07-01

    The aim of this study was to analyse torsional optokinetic nystagmus (tOKN) in 17 patients with Menière's disease before and after (1 week, 1 month and 3 months) a curative unilateral vestibular neurotomy (UVN). The tOKN was investigated during optokinetic stimulations around the line of sight directed towards either the lesioned or the healthy side, at various constant angular velocities. Dynamic properties of tOKN and static ocular cyclotorsion were analysed using videonystagmography. Patients' performances were compared with those of 10 healthy subjects. The results indicate that, in the acute stage after UVN, patients exhibited drastic impairment of tOKN velocity that depended on the direction of stimulation: tOKN velocity increased for ipsilesional stimulations and decreased for contralesional stimulations. These changes were responsible for a dramatic tOKN asymmetry, with ipsilesional directional preponderance of torsional slow-phase eye velocity. The changes were associated with static ocular cyclotorsion towards the operated side. Despite progressive compensation of tOKN deficits over time, tOKN velocity still differed from that recorded preoperatively, and tOKN asymmetry remained uncompensated 3 months after UVN. A static ocular cyclotorsion remained up to 3 months after lesion. These results are the first description of tOKN deficits and recovery after unilateral vestibular loss. They show that vestibular cues contribute to gaze stabilization during optokinetic stimulation around the line of sight. They also strongly suggest that tOKN impairment could be part of the long-term asymmetrical functions reported after unilateral loss of vestibular functions. PMID:15917290

  9. Compensation of Vestibular Function and Plasticity of Vestibular Nucleus after Unilateral Cochleostomy

    PubMed Central

    Suh, Myung-Whan; Hyun, Jaihwan; Lyu, Ah-Ra; Kim, Dong Woon; Park, Sung Jae; Choi, Jin Woong; Hur, Gang Min

    2016-01-01

    Dizziness and vertigo frequently occur after cochlear implantation (CI) surgery, particularly during the early stages. It could recover over time but some of the patients suffered from delayed or sustained vestibular symptoms after CI. This study used rat animal models to investigate the effect of unilateral cochleostomy on the vestibular organs over time. Twenty-seven Sprague Dawley rats underwent cochleostomy to evaluate the postoperative changes in hearing threshold, gain and symmetry of the vestibular ocular response, overall balance function, number of hair cells in the crista, and the c-Fos activity in the brainstem vestibular nucleus. Loss of vestibular function was observed during the early stages, but function recovered partially over time. Histopathological findings demonstrated a mild decrease in vestibular hair cells numbers. Increased c-Fos immunoreactivity in the vestibular nucleus, observed in the early stages after cochleostomy, decreased over time. Cochleostomy is a risk factor for peripheral vestibular organ damage that can cause functional impairment in the peripheral vestibular organs. Altered vestibular nucleus activity may be associated with vestibular compensation and plasticity after unilateral cochleostomy. PMID:26881130

  10. Changes of visual vertical perception: a long-term sign of unilateral and bilateral vestibular loss.

    PubMed

    Lopez, Christophe; Lacour, Michel; Ahmadi, Abdessadek El; Magnan, Jacques; Borel, Liliane

    2007-05-15

    This study investigates how unilateral and bilateral vestibular deafferentation modifies visual vertical perception in the presence of dynamic and static visual cues. We tested 40 Menière's patients before and after (from 1 week to 1 year) a curative unilateral vestibular neurotomy (UVN), and 4 patients with bilateral vestibular loss. Patients' performances were compared with those of 24 healthy subjects. The perception of the dynamic visual vertical (DVV) was investigated during optokinetic stimulations around the line of sight at various angular velocities. The static visual vertical (SVV) was recorded with a stationary visual pattern. In the acute stage after UVN, Menière's patients exhibited drastic impairment of DVV, which was tilted towards the lesioned side, whatever the direction of the optokinetic stimulation. In addition, the SVV was systematically tilted towards the lesioned side. The optokinetic-induced tilt of the vertical was asymmetrically organized around the new SVV with a significant decrease for contralesional stimulations and no change for ipsilesional stimulations, whatever the postoperative time. The SVV regained normal values 1 year postoperatively. For the patients with bilateral vestibular loss, the optokinetic-induced tilt of the visual vertical was drastically increased and symmetrically organized around an unmodified SVV aligned with the gravitational vertical. This study constitutes the first description of the recovery time-course of DVV perception after unilateral vestibular loss. Data reveal a long-term impairment of the DVV perception after unilateral vestibular loss, suggesting an asymmetrical processing of visual information and a permanent increased weight of dynamic visual cues after bilateral vestibular loss. PMID:17382977

  11. Cold shivering activity after unilateral destruction of the vestibular apparatus

    NASA Technical Reports Server (NTRS)

    Kuzmina, G. I.

    1980-01-01

    The bioelectric activity of muscles (flexors and extensors of the forelimbs and hindlimbs) during cold shivering after unilateral destruction of the vestibular apparatus. It was found, that unilateral delabyrinthing produces bilateral facilitation of cold shivering in the flexor extremities more pronounced on the ipsilateral side. In the extensor muscles there was an absence of bioelectric activity both before and after delabyrinthing. Enhancement of cold shivering in the flexor extremities following intervention was evidently conditioned by removal of the inhibiting effect of the vestibulary apparatus on the function of special centers.

  12. Magnetic Vestibular Stimulation in Subjects with Unilateral Labyrinthine Disorders

    PubMed Central

    Ward, Bryan K.; Roberts, Dale C.; Della Santina, Charles C.; Carey, John P.; Zee, David S.

    2014-01-01

    We recently discovered that static magnetic fields from high-strength MRI machines induce nystagmus in all normal humans, and that a magneto-hydrodynamic Lorentz force, derived from ionic currents in the endolymph and pushing on the cupula, best explains this effect. Individuals with no labyrinthine function have no nystagmus. The influence of magnetic vestibular stimulation (MVS) in individuals with unilateral deficits in labyrinthine function is unknown and may provide insight into the mechanism of MVS. These individuals should experience MVS, but with a different pattern of nystagmus consistent with their unilateral deficit in labyrinthine function. We recorded eye movements in the static magnetic field of a 7 T MRI machine in nine individuals with unilateral labyrinthine hypofunction, as determined by head impulse testing and vestibular-evoked myogenic potentials (VEMP). Eye movements were recorded using infrared video-oculography. Static head positions were varied in pitch with the body supine, and slow-phase eye velocity (SPV) was assessed. All subjects exhibited predominantly horizontal nystagmus after entering the magnet head-first, lying supine. The SPV direction reversed when entering feet-first. Pitching chin-to-chest caused subjects to reach a null point for horizontal SPV. Right unilateral vestibular hypofunction (UVH) subjects developed slow-phase-up nystagmus and left UVH subjects, slow-phase-down nystagmus. Vertical and torsional components were consistent with superior semicircular canal excitation or inhibition, respectively, of the intact ear. These findings provide compelling support for the hypothesis that MVS is a result of a Lorentz force and suggest that the function of individual structures within the labyrinth can be assessed with MVS. As a novel method of comfortable and sustained labyrinthine stimulation, MVS can provide new insights into vestibular physiology and pathophysiology. PMID:24659983

  13. Gray-matter atrophy after chronic complete unilateral vestibular deafferentation.

    PubMed

    Hüfner, Katharina; Stephan, Thomas; Hamilton, Derek A; Kalla, Roger; Glasauer, Stefan; Strupp, Michael; Brandt, Thomas

    2009-05-01

    It has been shown in blind patients that the abolition of sensory input can lead to changes in white- and cortical gray-matter volumes. Here the white- and gray-matter changes found with whole brain voxel-based morphometry in 16 patients with complete chronic unilateral vestibular deafferentation (UVD) due to vestibular schwannoma removal several years prior are reported on. Subtle deficits in spatial memory and navigation were previously shown in patients with right UVD. Images of the brains of right-UVD patients were flipped, standard preprocessing steps were performed, and the data were modulated. Patients showed a gray-matter volume reduction in the cerebellum due to schwannoma removal, in the supramarginal gyrus ipsilateral to the lesion, as well as in the postcentral and superior temporal gyrus, areas involved in the vestibular cortical network, and in the motion-sensitive area MT/V5. There was no correlation with behavioral navigational abilities. No gray-matter atrophy was found in the insular cortical vestibular region or the hippocampus, both of which receive bilateral vestibular projections. The thalamus and tegmentum of the mesencephalon showed gray-matter reduction on the opposite side; this was possibly due to reduced auditory input, which is known to cross at this level. In comparison to healthy controls, no regional increases in gray-matter volume were seen. No white-matter changes were detected at the selected threshold.

  14. Multiple Unilateral Vestibular Schwannomas: Segmental NF2 or Sporadic Occurrence?

    PubMed Central

    Carlson, Matthew L.; Gompel, Jamie J. Van

    2016-01-01

    Objective To report a case of a patient presenting with two separate unilateral vestibular schwannomas (VSs) without other stigmata of neurofibromatosis type 2 (NF2). Study Design This article discusses a case report and review of the literature. Setting Tertiary academic referral center. Participants A 41-year-old female was referred for evaluation of a left-sided 1.8-cm cerebellopontine angle tumor centered on the porus acusticus and a separate ipsilateral 3-mm intracanalicular tumor appearing to arise from the superior vestibular nerve. The patient denied a family history of NF2. Neurotologic examination was unremarkable and close review of magnetic resonance imaging did not find any other stigmata of NF2. Results The patient underwent left-sided retrosigmoid craniotomy with gross total resection of both tumors. Final pathology confirmed benign schwannoma. The INI1/SMARCB1 staining pattern did not suggest NF2 or schwannomatosis. Conclusions This is only the third report of a case with multiple unilateral VSs occurring in a patient without other features of NF2. Herein, the authors review the two other reports and discuss potential mechanisms for this rare phenomenon. PMID:27354931

  15. Kinematic analysis of locomotion in unilateral vestibular neurectomized cats.

    PubMed

    Lacour, M; Sun, J; Harlay, F

    1997-01-01

    The vestibular syndrome following unilateral lesion of the vestibular system and the subsequent behavioral compensation over time have been well documented in many species. However, the locomotor pattern changes and the behavioral strategies used to preserve balance have still not been described. This study was aimed at quantitatively describing posturolocomotor behavior in cats tested before and after unilateral vestibular neurectomy (UVN) by the rotating beam test, which provides locomotor tasks of various difficulty. The position of head, neck, and trunk and the trajectory of the forelimbs and hindlimbs were recorded in 5 cats by 3D motion analysis. Step length and frequency walking velocity, and body height were computed. Results showed that normal cats adapted their locomotor patterns to the speed of beam rotation by increasing step length and/or frequency, that is, by increasing walking velocity, but without drastically changing their body posture. By contrast, UVN cats typically lowered their body centers of gravity and modified their locomotor patterns according to the locomotor task. Mean walking velocity was decreased in the low range of beam rotation as a result of smaller step length and lower frequency, and it was increased in the high range by opposite effects on these step cycle parameters. Modifications of the locomotor parameters were a function of the direction of beam rotation, showing significant reduction of step length, frequency, and velocity in the low range of counterclockwise compared to clockwise beam rotation, that is, during rotations toward the lesioned side. Phase plane plots of foot linear velocity with respect to foot linear displacement along the horizontal longitudinal axis displayed two different limit cycles, adapted to easy (low range of beam rotation) and more difficult (high range of rotation) walking conditions, in the normal cat. These dynamic profiles of the trajectories of the limbs during the step cycle were not greatly

  16. Unilateral peripheral vestibular disorders in the emergency room of the ENT Department of Cluj-Napoca, Romania

    PubMed Central

    PETRI, MARIA; CHIRILA, MAGDALENA; BOLBOACA, SORANA; COSGAREA, MARCEL

    2015-01-01

    Objective To asses the management of unilateral peripheral vestibular disorders in the emergency room of the ENT Department of Cluj-Napoca, Romania. Material and method The study was prospective, non-randomized, and included the patients presented for dizziness or balance disorders at the emergency room of the ENT Department between March 2012 and March 2013. Demographic characteristics, specific clinical history, the onset of peripheral vestibular disorders, and co-morbidities were recorded. The patients charts included the type of onset and the treatment (medical, surgical, and rehabilitation) performed in the emergency room or, in case of hospital admission, the relieving measures for the vestibular symptoms with or without hearing recovery. Results One hundred and fifty-two subjects were included in our study, 97 with pure peripheral vestibular dysfunction (VD), 34 with cochlear-vestibular dysfunction (CVD), and 21 with Ménière’s disease (MD). No significant differences were identified when the proportion of patients with a certain onset (acute, subacute or chronic) were compared. Hypertension was the most frequent co-morbidity in all investigated groups. No significant difference was observed when the relief of vertigo or hearing recovery were compared between all groups. Conclusion This first Romanian report on the management of unilateral peripheral vestibular disorders showed that early corticosteroids treatment associated with electrolytes, antiemetic, and vasodilation drugs led to the recovery of the vestibular function without any differences between the types of peripheral vestibular dysfunction. In addition, we obtained the complete recovery of the vestibular and acoustic dysfunction in the cases treated with metylprednisolone intratympanic injection. PMID:26528069

  17. Vestibular Compensation in Unilateral Patients Often Causes Both Gain and Time Constant Asymmetries in the VOR

    PubMed Central

    Ranjbaran, Mina; Katsarkas, Athanasios; Galiana, Henrietta L.

    2016-01-01

    The vestibulo-ocular reflex (VOR) is essential in our daily life to stabilize retinal images during head movements. Balanced vestibular functionality secures optimal reflex performance which otherwise can be distorted by peripheral vestibular lesions. Luckily, vestibular compensation in different neuronal sites restores VOR function to some extent over time. Studying vestibular compensation gives insight into the possible mechanisms for plasticity in the brain. In this work, novel experimental analysis tools are employed to reevaluate the VOR characteristics following unilateral vestibular lesions and compensation. Our results suggest that following vestibular lesions, asymmetric performance of the VOR is not only limited to its gain. Vestibular compensation also causes asymmetric dynamics, i.e., different time constants for the VOR during leftward or rightward passive head rotation. Potential mechanisms for these experimental observations are provided using simulation studies. PMID:27065839

  18. Vestibular Compensation in Unilateral Patients Often Causes Both Gain and Time Constant Asymmetries in the VOR.

    PubMed

    Ranjbaran, Mina; Katsarkas, Athanasios; Galiana, Henrietta L

    2016-01-01

    The vestibulo-ocular reflex (VOR) is essential in our daily life to stabilize retinal images during head movements. Balanced vestibular functionality secures optimal reflex performance which otherwise can be distorted by peripheral vestibular lesions. Luckily, vestibular compensation in different neuronal sites restores VOR function to some extent over time. Studying vestibular compensation gives insight into the possible mechanisms for plasticity in the brain. In this work, novel experimental analysis tools are employed to reevaluate the VOR characteristics following unilateral vestibular lesions and compensation. Our results suggest that following vestibular lesions, asymmetric performance of the VOR is not only limited to its gain. Vestibular compensation also causes asymmetric dynamics, i.e., different time constants for the VOR during leftward or rightward passive head rotation. Potential mechanisms for these experimental observations are provided using simulation studies. PMID:27065839

  19. Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy.

    PubMed

    Batuecas-Caletrío, Angel; Yañez-Gonzalez, Raquel; Sanchez-Blanco, Carmen; Pérez, Pedro Blanco; González-Sanchez, Enrique; Sanchez, Luis Alberto Guardado; Kaski, Diego

    2015-11-01

    Acute unilateral vestibulopathy (AUV) is characterized by acute vertigo, nausea, and imbalance without neurological deficits or auditory symptomatology. Here, we explore the effect of glucocorticoid treatment on the degree of canal paresis in patients with AUV, and critically, establish its relationship with dizziness symptom recovery. We recruited consecutive patients who were retrospectively assigned to one of the two groups according to whether they received glucocorticoid treatment (n = 32) or not (n = 44). All patients underwent pure-tone audiometry, bithermal caloric testing, MRI brain imaging, and were asked to complete a dizziness handicap inventory on admission to hospital and just prior to hospital discharge. In the treatment group, the canal paresis at discharge was significantly lower than in the control group (mean ± SD % 38.04 ± 21.57 versus 82.79 ± 21.51, p < 0.001). We also observed a significant reduction in the intensity of nystagmus in patients receiving glucocorticoid treatment compared to the non-treatment group (p = 0.03). DHI test score was significantly lower at discharge in the treatment group (mean ± SD % 23.15 ± 12.40 versus 64.07 ± 12.87, p < 0.001), as was the length of hospital stay (2.18 ± 1.5 days versus 3.6 ± 1.7 days, p = 0.002). Glucocorticoid treatment leads to acute symptomatic improvement, with a reduced hospital stay and reduction in the intensity of acute nystagmus. Our findings suggest that glucocorticoids may accelerate vestibular compensation via a restoration of peripheral vestibular function, and therefore has important clinical implications for the treatment of AUV. PMID:26459091

  20. The differential effects of acute right- vs. left-sided vestibular failure on brain metabolism.

    PubMed

    Becker-Bense, Sandra; Dieterich, Marianne; Buchholz, Hans-Georg; Bartenstein, Peter; Schreckenberger, Mathias; Brandt, Thomas

    2014-07-01

    The human vestibular system is represented in the brain bilaterally, but it has functional asymmetries, i.e., a dominance of ipsilateral pathways and of the right hemisphere in right-handers. To determine if acute right- or left-sided unilateral vestibular neuritis (VN) is associated with differential patterns of brain metabolism in areas representing the vestibular network and the visual-vestibular interaction, patients with acute VN (right n = 9; left n = 13) underwent resting state (18)F-FDG PET once in the acute phase and once 3 months later after central vestibular compensation. The contrast acute vs. chronic phase showed signal differences in contralateral vestibular areas and the inverse contrast in visual cortex areas, both more pronounced in VN right. In VN left additional regions were found in the cerebellar hemispheres and vermis bilaterally, accentuated in severe cases. In general, signal changes appeared more pronounced in patients with more severe vestibular deficits. Acute phase PET data of patients compared to that of age-matched healthy controls disclosed similarities to these patterns, thus permitting the interpretation that the signal changes in vestibular temporo-parietal areas reflect signal increases, and in visual areas, signal decreases. These data imply that brain activity in the acute phase of right- and left-sided VN exhibits different compensatory patterns, i.e., the dominant ascending input is shifted from the ipsilateral to the contralateral pathways, presumably due to the missing ipsilateral vestibular input. The visual-vestibular interaction patterns were preserved, but were of different prominence in each hemisphere and more pronounced in patients with right-sided failure and more severe vestibular deficits.

  1. Hyperventilation-induced nystagmus in vestibular schwannoma and unilateral sensorineural hearing loss.

    PubMed

    Mandalà, Marco; Giannuzzi, Annalisa; Astore, Serena; Trabalzini, Franco; Nuti, Daniele

    2013-07-01

    We evaluated the incidence and characteristics of hyperventilation-induced nystagmus (HVN) in 49 patients with gadolinium-enhanced magnetic resonance imaging evidence of vestibular schwannoma and 53 patients with idiopathic unilateral sensorineural hearing loss and normal radiological findings. The sensitivity and specificity of the hyperventilation test were compared with other audio-vestibular diagnostic tests (bedside examination of eye movements, caloric test, auditory brainstem responses) in the two groups of patients. The hyperventilation test scored the highest diagnostic efficiency (sensitivity 65.3 %; specificity 98.1 %) of the four tests in the differential diagnosis of vestibular schwannoma and idiopathic unilateral sensorineural hearing loss. Small tumors with a normal caloric response or caloric paresis were associated with ipsilateral HVN and larger tumors and severe caloric deficits with contralateral HVN. These results confirm that the hyperventilation test is a useful diagnostic test for predicting vestibular schwannoma in patients with unilateral sensorineural hearing loss.

  2. Acute unilateral facial nerve palsy.

    PubMed

    Yeong, Siew Swan; Tassone, Peter

    2011-05-01

    Mrs PS, 78 years of age, presented with acute left-sided otalgia, ear swelling and subsequent unilateral facial paralysis (Figure 1). She denied any otorrhoea or hearing loss. Past medical history relevant to the presenting complaint included: * Bell palsy diagnosed 20 years ago with no residual effect * biopsy confirmed benign parotid lump (diagnosed 3 years previously). Histopathology revealed a pleomorphic adenoma. Mrs PS declined surgical intervention at the time * chicken pox as a child * normal fasting blood glucose 1 month previously and no known immune compromise. Examination revealed yellow crusts and small vesicles on the external acoustic meatus (Figure 2). A 10 mm well defined firm and nontender nodule was palpable at the ramus of the mandible.

  3. Normal Caloric Responses during Acute Phase of Vestibular Neuritis

    PubMed Central

    Lee, Sun-Uk; Park, Seong-Ho; Kim, Hyo-Jung; Koo, Ja-Won

    2016-01-01

    Background and Purpose We report a novel finding of caloric conversion from normal responses into unilateral paresis during the acute phase of vestibular neuritis (VN). Methods We recruited 893 patients with a diagnosis of VN at Dizziness Clinic of Seoul National University Bundang Hospital from 2003 to 2014 after excluding 28 patients with isolated inferior divisional VN (n=14) and those without follow-up tests despite normal caloric responses initially (n=14). We retrospectively analyzed the neurotological findings in four (0.5%) of the patients who showed a conversion from initially normal caloric responses into unilateral paresis during the acute phase. Results In those four patients, the initial caloric tests were performed within 2 days of symptom onset, and conversion into unilateral caloric paresis was documented 1–4 days later. The clinical and laboratory findings during the initial evaluation were consistent with VN in all four patients except for normal findings in bedside head impulse tests in one of them. Conclusions Normal findings in caloric tests should be interpreted with caution during the acute phase of suspected VN. Follow-up evaluation should be considered when the findings of the initial caloric test are normal, but VN remains the most plausible diagnosis. PMID:26932259

  4. Earth horizontal axis rotational responses in patients with unilateral peripheral vestibular deficits

    NASA Technical Reports Server (NTRS)

    Furman, Joseph M. R.; Kamerer, Donald B.; Wall, Conrad, III

    1989-01-01

    The vestibulo-ocular reflex (VOR) of five patients with surgically confirmed unilateral peripheral vestibular lesions is evaluated. Testing used both earth vertical axis (EVA) and earth horizontal axis (EHA) yaw rotation. Results indicated that the patients had short VOR time constants, asymmetric responses to both EVA and EHA rotation, and normal EHA modulation components. These findings suggest that unilateral peripheral vestibular loss causes a shortened VOR time constant even with the addition of dynamic otolithic stimulation and causes an asymmetry in semicircular canal-ocular reflexes and one aspect of otolith-ocular reflexes.

  5. Unilateral pulmonary edema following acute subglottic edema.

    PubMed

    Morisaki, H; Ochiai, R; Takeda, J; Nagano, M

    1990-01-01

    Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal of the endotracheal tube, he showed dyspnea and cyanosis and was later found to have acute subglottic edema. After reintubation of the trachea, frothy pink fluid was discharged from the tube, and chest roentgenogram showed a right-sided alveolar infiltrate. Many factors may cause unilateral pulmonary edema, but it is suggested that acute subglottic edema and unilateral bronchial fragility strongly affected this episode.

  6. Responses of central vestibular neurons to sinusoidal yaw rotation in compensated macaques after unilateral labyrinthectomy

    PubMed Central

    Wei, Min

    2013-01-01

    After vestibular labyrinth injury, behavioral measures of vestibular function partially recover through the process of vestibular compensation. The present study was performed to improve our understanding of the physiology of macaque vestibular nucleus neurons in the compensated state (>6 wk) after unilateral labyrinthectomy (UL). The responses of neurons to sinusoidal yaw rotation at a series of frequencies (0.1–2.0 Hz) and peak velocities (7.5–210°/s) were examined to determine how the behavior of these cells differed from those in animals with intact labyrinths. The sensitivity of neurons responding to ipsilateral rotation (type I) did not differ between the intact and injured sides after UL, although this sensitivity was lower bilaterally after lesion than before lesion. The sensitivity of neurons that increase firing with contralateral rotation (type II) was higher ipsilateral to the UL than before lesion or in the nucleus contralateral to the UL. UL did not increase asymmetry in the responses of individual type I or II neurons to ipsilateral vs. contralateral rotation, nor does it change the power law relationship between neuronal firing and level of stimulation. Increased sensitivities of contralesional type I neurons to the remaining vestibular nerve input and increased efficacy of inhibitory vestibular commissures projecting to the ipsilesional vestibular nucleus appear to be responsible for recovery of dynamic function of central vestibular neurons in compensated animals. The portion of type I neurons on the ipsilesional side is reduced in compensated animals, which likely accounts for the asymmetries in vestibular reflexes and perception that characterize vestibular function after UL. PMID:23864379

  7. Where is straight ahead to a patient with unilateral vestibular loss?

    PubMed

    Saj, Arnaud; Honoré, Jacques; Bernard-Demanze, Laurence; Devèze, Arnaud; Magnan, Jacques; Borel, Liliane

    2013-05-01

    The vestibular system is classically associated with postural control, oculomotor reflexes and self-motion perception. The patients with vestibular loss are primarily concerned with balance and gait problems including head and trunk tilt and walking trajectory deviation to the lesioned side. These long-lasting postural and locomotor biases are thought to originate from changes in spatial perception of self. Indeed, we show here that vestibular cues are necessary for an accurate representation of body orientation. Patients with right (RVN; n=11) or left vestibular neurotomy (LVN; 9) as a treatment for Menière's disease were compared with 10 healthy controls. The subjective straight ahead (SSA) was investigated using a method disentangling lateral shift and tilt components of error. In the horizontal plane, subjects were required to align a rod with their body midline. In the frontal plane, they were asked to align the rod with the midline of head or trunk. The analysis of SSA clearly showed distinct results according to the side of the lesion. The LVN patients had a contralesional lateral shift of SSA. In addition, they showed an ipsilesional tilt, more severe for the head than for the trunk. By contrast, in RVN patients, the representation of the body midline was fairly accurate in both the horizontal and frontal planes and did not differ from that of control subjects. The present study shows deviations in body orientation representation after unilateral vestibular loss. Deviations are observed in the horizontal as well as in the frontal planes. Interestingly, only patients with left vestibular loss were concerned with these changes in perception of self-orientation in space. These data support the hypothesis of an asymmetric vestibular function in healthy subjects and confirm the similarity of functional disorders in patients with vestibular deficits or spatial neglect. For the first time, this similarity is found at the level of body representation.

  8. Tonic eye movements induced by bilateral and unilateral galvanic vestibular stimulation (GVS) in guinea pigs.

    PubMed

    Kim, Juno

    2013-01-01

    Galvanic vestibular stimulation (GVS) stimulates primary vestibular afferents innervating the semicircular canals (SCCs) and otoliths found in the inner ear of humans and other mammals, including guinea pigs. To determine which pathways contribute to eye movements generated by this artificial vestibular stimulation in guinea pigs, low current intensities of GVS were passed either bilaterally between the tensor-tympani muscles of the two ears (up to 30 μA) or unilaterally between one tensor-tympani electrode and an indifferent on the back of the neck (up to 60 μA). Both forms of GVS were found to selectively generate tonic eye movements without nystagmus, characteristic of the otolith-ocular reflex; the axis of eye rotation did not align with any semicircular canal plane, but was oriented close to the expected axis of eye rotation that would occur in response to the net stimulation of otolith afferents. The induced eye rotation was predominantly vertical with a smaller horizontal deviation and very little torsion. Consistent with the results of previous human studies, the tonic eye movements were found to exhibit bilateral gain enhancement, whereby bilateral GVS generated twice the amplitude of eye rotation as unilateral anodal or cathodal stimulation alone. Eye movement responses to unilateral GVS were symmetrical in amplitude during equivalent intensities of anodal and cathodal stimulation, consistent with the known responses of more regularly and intermediately discharging primary vestibular afferents to GVS. These results together suggest that more regularly discharging otolith-ocular projections may mediate the tonic changes in eye position induced during maintained, low-intensity GVS in guinea pigs.

  9. Short-term galvanic vestibular stimulation promotes functional recovery and neurogenesis in unilaterally labyrinthectomized rats.

    PubMed

    Shaabani, Moslem; Lotfi, Yones; Karimian, Seyed Morteza; Rahgozar, Mehdi; Hooshmandi, Mehdi

    2016-10-01

    Current experimental research on the therapeutic effects of galvanic vestibular stimulation (GVS) has mainly focused on neurodegenerative disorders. However, it primarily stimulates the vestibular nuclei and could be potentially effective in modulating imbalance between them in the case of unilateral labyrinthectomy (UL). Fifty male Wistar rats (180-220g) were used in 5 groups of 10: intact, sham, right-UL (RUL; without intervention), and two other right-UL groups with GVS intervention [one group treated with low rate GVS (GVS.LF; 6-7Hz), and the other treated with high rate GVS (GVS.HF; 17-18Hz)]. The UL models were prepared by intratympanic injection of sodium arsanilate. GVS protocols were implemented 30min/day and continued for 14 days via ring-shaped copper electrodes inserted subcutaneously over each mastoid. Functional recovery was assessed by several postural tests including support surface area, landing and air-righting reflexes, and rotarod procedure. Immunohistochemical investigations were performed on ipsi- and contra-lesional medial vestibular nuclei (MVN) using bromodeoxyuridine (BrdU) and Ki67, as markers of cell proliferation. Behavioral evaluations showed significant functional recovery of GVS-treated groups compared to RUL group. The percent of marked cells with BrdU and Ki67 were significantly higher in the ipsilesional MVN of both GVS-treated groups compared with other groups. Our findings confirmed the effectiveness of GVS-intervention in accelerating static and dynamic vestibular compensation. This could be explained by the cell proliferation in ipsilesional MVN cells and rapid rebalancing of the VNs and the modulation of their motor outputs. Therefore, GVS could be promising for rehabilitating patients with unilateral vestibular weakness.

  10. Short-term galvanic vestibular stimulation promotes functional recovery and neurogenesis in unilaterally labyrinthectomized rats.

    PubMed

    Shaabani, Moslem; Lotfi, Yones; Karimian, Seyed Morteza; Rahgozar, Mehdi; Hooshmandi, Mehdi

    2016-10-01

    Current experimental research on the therapeutic effects of galvanic vestibular stimulation (GVS) has mainly focused on neurodegenerative disorders. However, it primarily stimulates the vestibular nuclei and could be potentially effective in modulating imbalance between them in the case of unilateral labyrinthectomy (UL). Fifty male Wistar rats (180-220g) were used in 5 groups of 10: intact, sham, right-UL (RUL; without intervention), and two other right-UL groups with GVS intervention [one group treated with low rate GVS (GVS.LF; 6-7Hz), and the other treated with high rate GVS (GVS.HF; 17-18Hz)]. The UL models were prepared by intratympanic injection of sodium arsanilate. GVS protocols were implemented 30min/day and continued for 14 days via ring-shaped copper electrodes inserted subcutaneously over each mastoid. Functional recovery was assessed by several postural tests including support surface area, landing and air-righting reflexes, and rotarod procedure. Immunohistochemical investigations were performed on ipsi- and contra-lesional medial vestibular nuclei (MVN) using bromodeoxyuridine (BrdU) and Ki67, as markers of cell proliferation. Behavioral evaluations showed significant functional recovery of GVS-treated groups compared to RUL group. The percent of marked cells with BrdU and Ki67 were significantly higher in the ipsilesional MVN of both GVS-treated groups compared with other groups. Our findings confirmed the effectiveness of GVS-intervention in accelerating static and dynamic vestibular compensation. This could be explained by the cell proliferation in ipsilesional MVN cells and rapid rebalancing of the VNs and the modulation of their motor outputs. Therefore, GVS could be promising for rehabilitating patients with unilateral vestibular weakness. PMID:27444558

  11. Effects of physiotherapy on balance and unilateral vestibular hypofunction in vertiginous elderly

    PubMed Central

    2014-01-01

    Background We aimed to analyze the effect of a physical therapy protocol on unilateral vestibular hypofunction and overall balance in elderly with vertigo. Methods The study included nine subjects, four male subjects (68.5 ± 11.09 years old) and five females (72.4 ± 7.09 years old). It was used the performance-oriented Mobility Assessment (POMA), to evaluate the balance and the Unterberger – Fukuda test for analysis of unilateral vestibular dysfunction through rotations and displacements of the body. We developed and applied a structured physical therapy protocol, consisting of group exercises. Results It was observed that after the protocol, all participants improved balance (33.9 ± 5.1 vs. 47.3 ± 7.6, p < 0.0001) and displacement (111.1 ± 38.0 vs. 53.3 ± 34.6, p = 0.0001). However, it was not found significant differences for rotation. Conclusion The proposed protocol has contributed to an improvement in balance and vestibular dysfunction of the aged. PMID:24576350

  12. [Changes and compensation in the locomotor pattern of unilateral vestibular neurectomized cats].

    PubMed

    Sun, J R

    1997-02-01

    In the present study the locomotor activity of unilateral vestibular neurectomized cats while crossing over a rotating beam along its longitudinal axis at different speeds was investigated. The kinematics of the body movement was recorded by means of a motion analysis system, with an optical automatic TV-image processor (E. L. I. T. E system) allowing a computer reconstruction of the 3 dimensional motion. Analysis was focused on the locomotion pattern as defined by several parameters including step length, step frequency and velocity, and an estimate of the height of the body gravity center. The results obtained with non-rotating beam showed that unilateral vestibular neurectomy induced significant changes in locomotor activity of the lesioned cats. Animals crossed over the beam with very slow locomotion speed and they typically exhibited a strong reduction in step length associated with a decrease in frequency. In addition, the gravity center of the walking cats was lower than the normal. The analysis performed with the rotating beam revealed different strategies of compensation, with cats moving either faster or slower as compared to their preoperative performance. Such strategies in locomotion speed regulation avoided falling from the rotating beam. Recovery to a nearly normal locomotor pattern was observed thereafter with a time delay comparable to that found in other behavioral studies dealing with the vestibular compensation process in the cat. PMID:9812828

  13. Effects of practicing tandem gait with and without vibrotactile biofeedback in subjects with unilateral vestibular loss

    PubMed Central

    Dozza, Marco; Wall, Conrad; Peterka, Robert J.; Chiari, Lorenzo; Horak, Fay B.

    2008-01-01

    Subjects with unilateral vestibular loss exhibit motor control impairments as shown by body and limb deviation during gait. Biofeedback devices have been shown to improve stance postural control, especially when sensory information is limited by environmental conditions or pathologies such as unilateral vestibular loss. However, the extent to which biofeedback could improve motor performance or learning while practicing a dynamic task such as narrow gait is still unknown. In this cross-over design study, 9 unilateral vestibular loss subjects practiced narrow gait with and without wearing a trunk-tilt, biofeedback device in 2 practice sessions. The biofeedback device informed the subjects of their medial-lateral angular tilt and tilt velocity during gait via vibration of the trunk. From motion analysis and tilt data, the performance of the subjects practicing tandem gait were compared over time with and without biofeedback. By practicing tandem gait, subjects reduced their trunk-tilt, center of mass displacement, medial-lateral feet distance, and frequency of stepping error. In both groups, use of tactile biofeedback consistently increased postural stability during tandem gait, beyond the effects of practice alone. However, one single session of practice with biofeedback did not result in conclusive short-term after-effects consistent with short-term retention of motor performance without this additional biofeedback. Results from this study support the hypothesis that tactile biofeedback acts similar to natural sensory feedback to improve dynamic motor performance but does not facilitate a recalibration of motor performance to improve function after short-term use. PMID:18525145

  14. Changes of some amino acid concentrations in the medial vestibular nucleus of conscious rats following acute hypotension.

    PubMed

    Li, Xiang-Lan; An, Ying; Jin, Qing-Hua; Kim, Min Sun; Park, Byung Rim; Jin, Yuan-Zhe

    2010-06-14

    Microdialysis and high performance liquid chromatography (HPLC) were used to measure the changes of certain amino acids in the medial vestibular nucleus (MVN) of conscious rats in order to understand whether those amino acids are involved in the regulation of blood pressure. Acute hypotension was induced by infusing sodium nitroprusside (SNP) into the femoral vein. In the control group, glutamate (Glu) release increased, though gamma-aminobutyric acid (GABA) and taurine (Tau) release decreased in the MVN following acute hypotension. In the unilateral labyrinthectomy group, the levels of Glu, GABA, and Tau were unchanged in the ipsilateral MVN to the lesion following acute hypotension. Furthermore, in the contralateral MVN to the lesion, Glu release increased, and GABA and Tau release decreased following acute hypotension. These results suggest that SNP-induced acute hypotension can influence the activity of neurons in the MVN through afferent signals from peripheral vestibular receptors, and that certain amino acid transmitters in the MVN are involved in this process.

  15. Expression of glycine receptors and gephyrin in rat medial vestibular nuclei and flocculi following unilateral labyrinthectomy

    PubMed Central

    Zhou, Wen; Zhou, Liu-Qing; Shi, Hong; Leng, Yang-Ming; Liu, Bo; Zhang, Su-Lin; Kong, Wei-Jia

    2016-01-01

    The medial vestibular nucleus (MVN) and the cerebellar flocculus have been known to be the key areas involved in vestibular compensation (VC) following unilateral labyrinthectomy (UL). In this study, we examined the role of gephyrin and glycine receptor (GlyR) in VC using Sprague-Dawley rats, in an aim to gain deeper insight into the mechanisms responsible for VC. The expression of the α1 and β subunits of GlyR and gephyrin was immunohistochemically localized in rat MVN and flocculi. The mRNA and protein expression of GlyR (α1 and β subunits) and gephyrin was quantitatively determined by RT-qPCR and western blot analysis at 8 h, and at 1, 3 and 7 days following UL. It was found that in the ipsilateral MVN, the mRNA and protein expression of the β subunit of GlyR was significantly increased in comparison to the sham-operated (P<0.01) rats, and in comparison to the contralateral side (P<0.01) at 8 h following UL. In the ipsilateral flocculi, GlyR β protein expression was significantly elevated (P<0.01 for all), as compared to the sham-operated rats at 8 h, and at 1 and 3 days and to the contralateral side 8 h, 1 and 3 days following UL. No significant differences were observed in the mRNA and protein expression of GlyR α1 and gephyrin in the MVN or flocculi between the two sides (ipsilateral and contralateral) in the UL group, and between the sham-operated group and the UL group at any time point. The findings of our study thus suggest that GlyR plays a major role in the recovery of the resting discharge of the deafferented MVN neurons in the central vestibular system.

  16. Compensatory saccade differences between outward versus inward head impulses in chronic unilateral vestibular hypofunction.

    PubMed

    Lee, Seung-Han; Newman-Toker, David E; Zee, David S; Schubert, Michael C

    2014-10-01

    The horizontal head impulse test (HIT) is a valuable clinical tool that can help identify peripheral vestibular hypofunction by the refixation (compensatory) saccade that returns the eyes to the target of interest after the head has stopped. We asked if there were differences in the compensatory saccade responses during the HIT when the head was rotated away or toward straight ahead (outward versus inward). We also investigated the influence of a fixation target. Using scleral search-coils, we tested five patients with chronic unilateral vestibular hypofunction (UVH) and three healthy control subjects. In UVH patients, the latencies of both overt and covert saccades were longer when the head was rotated inward from an initially eccentric position, regardless of a visual target. The proportion of HIT with covert saccades was independent of a visual target. In control subjects no compensatory saccades were observed and there were no differences in either angular vestibulo-ocular reflex gain or latency between inward and outward HIT. Our data suggest that inward applied HIT in chronic UVH is more likely to include an overt compensatory saccade based on its lengthened latency. Neither latency nor the occurrence of covert compensatory saccades during HIT depended on a visual target, suggesting they have become a learned behavior in response to chronic UVH.

  17. Hearing Outcomes After Stereotactic Radiosurgery for Unilateral Intracanalicular Vestibular Schwannomas: Implication of Transient Volume Expansion

    SciTech Connect

    Kim, Young-Hoon; Kim, Dong Gyu; Han, Jung Ho; Chung, Hyun-Tai; Kim, In Kyung; Song, Sang Woo; Park, Jeong-Hoon; Kim, Jin Wook; Kim, Yong Hwy; Park, Chul-Kee; Kim, Chae-Yong; Paek, Sun Ha; Jung, Hee-Won

    2013-01-01

    Purpose: We evaluated the prognostic factors for hearing outcomes after stereotactic radiosurgery (SRS) for unilateral sporadic intracanalicular vestibular schwannomas (IC-VSs) as a clinical homogeneous group of VSs. Methods and Materials: Sixty consecutive patients with unilateral sporadic IC-VSs, defined as tumors in the internal acoustic canal, and serviceable hearing (Gardner-Roberson grade 1 or 2) were treated with SRS as an initial treatment. The mean tumor volume was 0.34 {+-} 0.03 cm{sup 3} (range, 0.03-1.00 cm{sup 3}), and the mean marginal dose was 12.2 {+-} 0.1 Gy (range, 11.5-13.0 Gy). The median follow-up duration was 62 months (range, 36-141 months). Results: The actuarial rates of serviceable hearing preservation were 70%, 63%, and 55% at 1, 2, and 5 years after SRS, respectively. In multivariate analysis, transient volume expansion of {>=}20% from initial tumor size was a statistically significant risk factor for loss of serviceable hearing and hearing deterioration (increase of pure tone average {>=}20 dB) (odds ratio = 7.638; 95% confidence interval, 2.317-25.181; P=.001 and odds ratio = 3.507; 95% confidence interval, 1.228-10.018; P=.019, respectively). The cochlear radiation dose did not reach statistical significance. Conclusions: Transient volume expansion after SRS for VSs seems to be correlated with hearing deterioration when defined properly in a clinically homogeneous group of patients.

  18. Reliability, Validity, and Sensitivity to Change of Turkish Activities-Specific Balance Confidence Scale in Patients with Unilateral Peripheral Vestibular Disease

    ERIC Educational Resources Information Center

    Karapolat, Hale; Eyigor, Sibel; Kirazli, Yesim; Celebisoy, Nese; Bilgen, Cem; Kirazli, Tayfun

    2010-01-01

    The aim of this study is to evaluate the internal consistency, test-retest reliability, construct validity, and sensitivity to change of the Activities-specific Balance Confidence Scale (ABC) in people with peripheral vestibular disorder. Thirty-three patients with unilateral peripheral vestibular disease were included in the study. Patients were…

  19. Effect of unilateral labyrinthectomy on the molecular composition of perineuronal nets in the lateral vestibular nucleus of the rat.

    PubMed

    Deák, Ádám; Bácskai, Tímea; Gaál, Botond; Rácz, Éva; Matesz, Klara

    2012-03-28

    Disturbances in vestibular functions caused by unilateral labyrinthectomy (UL) are spontaneously restored during the process of vestibular compensation due to the plasticity of CNS. The underlying molecular background of vestibular compensation is not yet fully understood. Recent studies have shown that the extracellular matrix (ECM) molecules have either permissive or non-permissive effect on the neural plasticity. In our previous study we have demonstrated changes in the expression of hyaluronan (HA) in the vestibular nuclei (VN) of the frog following peripheral vestibular lesion. The present work was undertaken to examine the expression of the HA and chondroitin sulfate proteoglycans (CSPGs) in the lateral vestibular nucleus (LVN) of the rat following UL by using histochemical methods. On the first postoperative day, the condensation of the ECM around the neurons, the perineuronal net (PNN) was not distinguished from the surrounding neuropil on the side of UL indicating the desorganization of its molecular structure. At survival day 3, the PNN was recognizable with the HA probe, whereas its staining for the CSPGs was restored by the time of the seventh postoperative day. In the neuropil, the intensity of the HA increased on the operated side, while the CSPGs reaction almost completely disappeared. The present study have demonstrated for the first time that the UL is accompanied by the modification of the HA, and CSPG staining pattern in the PNN of the LVN in the rat. As the reorganization of the PNN corresponds to the restoration of spontaneous activity of vestibular neurons, our study implies the role of HA and CSPGs in the vestibular compensation.

  20. Changes in Histamine Receptors (H1, H2, and H3) Expression in Rat Medial Vestibular Nucleus and Flocculus after Unilateral Labyrinthectomy: Histamine Receptors in Vestibular Compensation

    PubMed Central

    Liu, Bo; Leng, Yangming; Zhou, Renhong; Kong, Weijia

    2013-01-01

    Vestibular compensation is the process of behavioral recovery following peripheral vestibular lesion. In clinics, the histaminergic medicine is the most widely prescribed for the treatment of vertigo and motion sickness, however, the molecular mechanisms by which histamine modulates vestibular function remain unclear. During recovery from the lesion, the modulation of histamine receptors in the medial vestibular nucleus (MVN) and the flocculus may play an important role. Here with the means of quantitative real-time PCR, western blotting and immunohistochemistry, we studied the expression of histamine receptors (H1, H2, and H3) in the bilateral MVN and the flocculus of rats on the 1st, 3rd, and 7th day following unilateral labyrinthectomy (UL). Our results have shown that on the ipsi-lesional flocculus the H1, H2 and H3 receptors mRNA and the protein increased significantly on the 1st and 3rd day, with compare of sham controls and as well the contralateral side of UL. However, on the 7th day after UL, this expression returned to basal levels. Furthermore, elevated mRNA and protein levels of H1, H2 and H3 receptors were observed in the ipsi-lesional MVN on the 1st day after UL compared with sham controls and as well the contralateral side of UL. However, this asymmetric expression was absent by the 3rd post-UL. Our findings suggest that the upregulation of histamine receptors in the MVN and the flocculus may contribute to rebalancing the spontaneous discharge in bilateral MVN neurons during vestibular compensation. PMID:23840519

  1. Modification of tenascin-R expression following unilateral labyrinthectomy in rats indicates its possible role in neural plasticity of the vestibular neural circuit.

    PubMed

    Gaal, Botond; Jóhannesson, Einar Örn; Dattani, Amit; Magyar, Agnes; Wéber, Ildikó; Matesz, Clara

    2015-09-01

    We have previously found that unilateral labyrinthectomy is accompanied by modification of hyaluronan and chondroitin sulfate proteoglycan staining in the lateral vestibular nucleus of rats and the time course of subsequent reorganization of extracellular matrix assembly correlates to the restoration of impaired vestibular function. The tenascin-R has repelling effect on pathfinding during axonal growth/regrowth, and thus inhibits neural circuit repair. By using immunohistochemical method, we studied the modification of tenascin-R expression in the superior, medial, lateral, and descending vestibular nuclei of the rat following unilateral labyrinthectomy. On postoperative day 1, tenascin-R reaction in the perineuronal nets disappeared on the side of labyrinthectomy in the superior, lateral, medial, and rostral part of the descending vestibular nuclei. On survival day 3, the staining intensity of tenascin-R reaction in perineuronal nets recovered on the operated side of the medial vestibular nucleus, whereas it was restored by the time of postoperative day 7 in the superior, lateral and rostral part of the descending vestibular nuclei. The staining intensity of tenascin-R reaction remained unchanged in the caudal part of the descending vestibular nucleus bilaterally. Regional differences in the modification of tenascin-R expression presented here may be associated with different roles of individual vestibular nuclei in the compensatory processes. The decreased expression of the tenascin-R may suggest the extracellular facilitation of plastic modifications in the vestibular neural circuit after lesion of the labyrinthine receptors.

  2. Modification of tenascin-R expression following unilateral labyrinthectomy in rats indicates its possible role in neural plasticity of the vestibular neural circuit

    PubMed Central

    Gaal, Botond; Jóhannesson, Einar Örn; Dattani, Amit; Magyar, Agnes; Wéber, Ildikó; Matesz, Clara

    2015-01-01

    We have previously found that unilateral labyrinthectomy is accompanied by modification of hyaluronan and chondroitin sulfate proteoglycan staining in the lateral vestibular nucleus of rats and the time course of subsequent reorganization of extracellular matrix assembly correlates to the restoration of impaired vestibular function. The tenascin-R has repelling effect on pathfinding during axonal growth/regrowth, and thus inhibits neural circuit repair. By using immunohistochemical method, we studied the modification of tenascin-R expression in the superior, medial, lateral, and descending vestibular nuclei of the rat following unilateral labyrinthectomy. On postoperative day 1, tenascin-R reaction in the perineuronal nets disappeared on the side of labyrinthectomy in the superior, lateral, medial, and rostral part of the descending vestibular nuclei. On survival day 3, the staining intensity of tenascin-R reaction in perineuronal nets recovered on the operated side of the medial vestibular nucleus, whereas it was restored by the time of postoperative day 7 in the superior, lateral and rostral part of the descending vestibular nuclei. The staining intensity of tenascin-R reaction remained unchanged in the caudal part of the descending vestibular nucleus bilaterally. Regional differences in the modification of tenascin-R expression presented here may be associated with different roles of individual vestibular nuclei in the compensatory processes. The decreased expression of the tenascin-R may suggest the extracellular facilitation of plastic modifications in the vestibular neural circuit after lesion of the labyrinthine receptors. PMID:26604908

  3. Effect of unilateral vestibular deafferentation on the initial human vestibulo-ocular reflex to surge translation

    PubMed Central

    Tian, Jun-Ru; Ishiyama, Akira; Demer, Joseph L.

    2007-01-01

    Transient whole-body surge (fore-aft) translation at 0.5 G peak acceleration was administered to six subjects with unilateral vestibular deafferentation (UVD), and eight age-matched controls. Subjects viewed eccentric targets to determine if linear vestibulo-ocular reflex (LVOR) asymmetry might lateralize otolith deficits. Eye rotation was measured using magnetic search coils. Immediately before surge, subjects viewed a luminous target 50 cm away, centered or displaced 10° horizontally or vertically. The target was extinguished during randomly directed surges. LVOR gain relative to ideal velocity in subjects with UVD for the contralesional horizontally eccentric target (0.59 ± 0.08, mean ± SEM) did not differ significantly from normal (0.50 ± 0.04), but gain for the ipsilesional eccentric target (0.35 ± 0.02) was significantly less than normal (0.48 ± 0.03, P < 0.05). Normal subjects had mean gain asymmetry for horizontally eccentric targets of 0.17 ± 0.03, but asymmetry in UVD was significantly increased to 0.35 ± 0.05 (P < 0.05). Four of six subjects with UVD had maximum gain asymmetry outside normal 95% confidence limits. Asymmetry did not correlate with UVD duration. Gain for 10° vertically eccentric targets averaged 0.38 ± 0.14 for subjects with UVD, insignificantly lower than the normal value of 0.75 ± 0.15 (P > 0.05). Surge LVOR latency was symmetrical in UVD, and did not differ significantly from normal. There was no significant difference in response between dark and visible target conditions until 200 ms after surge onset. Chronic human UVD, on average, significantly impairs the surge LVOR for horizontally eccentric targets placed ipsilesionally, but this asymmetry is small relative to interindividual variation. PMID:16900361

  4. Aspects of cerebral plasticity related to clinical features in acute vestibular neuritis: a "starting point" review from neuroimaging studies.

    PubMed

    Micarelli, A; Chiaravalloti, A; Schillaci, O; Ottaviani, F; Alessandrini, M

    2016-04-01

    Vestibular neuritis (VN) is one of the most common causes of vertigo and is characterised by a sudden unilateral vestibular failure (UVF). Many neuroimaging studies in the last 10 years have focused on brain changes related to sudden vestibular deafferentation as in VN. However, most of these studies, also due to different possibilities across diverse centres, were based on different times of first acquisition from the onset of VN symptoms, neuroimaging techniques, statistical analysis and correlation with otoneurological and psychological findings. In the present review, the authors aim to merge together the similarities and discrepancies across various investigations that have employed neuroimaging techniques and group analysis with the purpose of better understanding about how the brain changes and what characteristic clinical features may relate to each other in the acute phase of VN. Six studies that strictly met inclusion criteria were analysed to assess cortical-subcortical correlates of acute clinical features related to VN. The present review clearly reveals that sudden UVF may induce a wide variety of cortical and subcortical responses - with changes in different sensory modules - as a result of acute plasticity in the central nervous system. PMID:27196070

  5. Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial

    PubMed Central

    2012-01-01

    Background Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unkown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus® (NWFP) is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy. Methods/Design In a single (assessor) blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP) vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis). Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks) and at 6 months. Discussion Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated. Trial registration Clinical trials.gov identifier: NCT01442623 PMID:22449224

  6. Plasticity of the histamine H3 receptors after acute vestibular lesion in the adult cat

    PubMed Central

    Tighilet, Brahim; Mourre, Christiane; Lacour, Michel

    2014-01-01

    After unilateral vestibular neurectomy (UVN) many molecular and neurochemical mechanisms underlie the neurophysiological reorganizations occurring in the vestibular nuclei (VN) complex, as well as the behavioral recovery process. As a key regulator, the histaminergic system appears to be a likely candidate because drugs interfering with histamine (HA) neurotransmission facilitate behavioral recovery after vestibular lesion. This study aimed at analyzing the post-lesion changes of the histaminergic system by quantifying binding to histamine H3 receptors (H3R; mediating namely histamine autoinhibition) using a histamine H3 receptor agonist ([3H]N-α-methylhistamine). Experiments were done in brain sections of control cats (N = 6) and cats submitted to UVN and killed 1 (N = 6) or 3 (N = 6) weeks after the lesion. UVN induced a bilateral decrease in binding density of the agonist [3H]N-α-methylhistamine to H3R in the tuberomammillary nuclei (TMN) at 1 week post-lesion, with a predominant down-regulation in the ipsilateral TMN. The bilateral decrease remained at the 3 weeks survival time and became symmetric. Concerning brainstem structures, binding density in the VN, the prepositus hypoglossi, the subdivisions of the inferior olive decreased unilaterally on the ipsilateral side at 1 week and bilaterally 3 weeks after UVN. Similar changes were observed in the subdivisions of the solitary nucleus only 1 week after the lesion. These findings indicate vestibular lesion induces plasticity of the histamine H3R, which could contribute to vestibular function recovery. PMID:24427120

  7. Early Swept-Source Optical Coherence Tomography Angiography Findings in Unilateral Acute Idiopathic Maculopathy.

    PubMed

    Nicolo, Massimo; Rosa, Raffaella; Musetti, Donatella; Musolino, Maria; Traverso, Carlo Enrico

    2016-02-01

    Unilateral acute idiopathic maculopathy (UAIM) is a rare disorder presenting in young people with an acute onset of unilateral central visual loss often associated with a prodromal flu-like illness. The authors present the early anatomical findings of a 35-year-old man clinically diagnosed with UAIM using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography.

  8. The Risk Factors of Symptomatic Communicating Hydrocephalus After Stereotactic Radiosurgery for Unilateral Vestibular Schwannoma: The Implication of Brain Atrophy

    SciTech Connect

    Han, Jung Ho; Kim, Dong Gyu; Chung, Hyun-Tai; Paek, Sun Ha; Park, Chul-Kee; Kim, Chae-Yong; Hwang, Seung-Sik; Park, Jeong-Hoon; Kim, Young-Hoon; Kim, Jin Wook; Kim, Yong Hwy; Song, Sang Woo; Kim, In Kyung; Jung, Hee-Won

    2012-11-15

    Purpose: To identify the effect of brain atrophy on the development of symptomatic communicating hydrocephalus (SCHCP) after stereotactic radiosurgery (SRS) for sporadic unilateral vestibular schwannomas (VS). Methods and Materials: A total of 444 patients with VS were treated with SRS as a primary treatment. One hundred eighty-one patients (40.8%) were male, and the mean age of the patients was 53 {+-} 13 years (range, 11-81 years). The mean follow-up duration was 56.8 {+-} 35.8 months (range, 12-160 months). The mean tumor volume was 2.78 {+-} 3.33 cm{sup 3} (range, 0.03-23.30 cm{sup 3}). The cross-sectional area of the lateral ventricles (CALV), defined as the combined area of the lateral ventricles at the level of the mammillary body, was measured on coronal T1-weighted magnetic resonance images as an indicator of brain atrophy. Results: At distant follow-up, a total of 25 (5.6%) patients had SCHCP. The median time to symptom development was 7 months (range, 1-48 months). The mean CALV was 334.0 {+-} 194.0 mm{sup 2} (range, 44.70-1170 mm{sup 2}). The intraclass correlation coefficient was 0.988 (95% confidence interval [CI], 0.976-0.994; p < 0.001). In multivariate analysis, the CALV had a significant relationship with the development of SCHCP (p < 0.001; odds ration [OR] = 1.005; 95% CI, 1.002-1.007). Tumor volume and female sex also had a significant association (p < 0.001; OR = 1.246; 95% CI, 1.103-1.409; p < 0.009; OR = 7.256; 95% CI, 1.656-31.797, respectively). However, age failed to show any relationship with the development of SCHCP (p = 0.364). Conclusion: Brain atrophy may be related to de novo SCHCP after SRS, especially in female patients with a large VS. Follow-up surveillance should be individualized, considering the risk factors involved for each patient, for prompt diagnosis of SCHCP.

  9. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline

    PubMed Central

    Herdman, Susan J.; Whitney, Susan L.; Cass, Stephen P.; Clendaniel, Richard A.; Fife, Terry D.; Furman, Joseph M.; Getchius, Thomas S. D.; Goebel, Joel A.; Shepard, Neil T.; Woodhouse, Sheelah N.

    2016-01-01

    patient to understand the goals of the program and how to manage and progress themselves independently. As a general guide, persons without significant comorbidities that affect mobility and with acute or subacute unilateral vestibular hypofunction may need once a week supervised sessions for 2 to 3 weeks; persons with chronic unilateral vestibular hypofunction may need once a week sessions for 4 to 6 weeks; and persons with bilateral vestibular hypofunction may need once a week sessions for 8 to 12 weeks. In addition to supervised sessions, patients are provided a daily home exercise program. Disclaimer: These recommendations are intended as a guide for physical therapists and clinicians to optimize rehabilitation outcomes for persons with peripheral vestibular hypofunction undergoing vestibular rehabilitation. Video Abstract available for more insights from the author (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A124). PMID:26913496

  10. Early Diagnosis and Management of Acute Vertigo from Vestibular Migraine and Ménière's Disease.

    PubMed

    Seemungal, Barry; Kaski, Diego; Lopez-Escamez, Jose Antonio

    2015-08-01

    Vestibular migraine is the most common cause of acute episodic vestibular symptoms after benign paroxysmal positional vertigo. In contrast, Ménière's disease is an uncommon disorder. For both conditions, early and accurate diagnosis (or its exclusion) enables the correct management of patients with acute episodic vestibular symptoms. Long-term management of migraine requires changes in lifestyle to avoid triggers of migraine and/or prophylactic drugs if attacks become too frequent. The long-term management of Ménière's disease also involves lifestyle changes (low salt diet), medications (betahistine, steroids), and ablative therapy applied to the diseased ear (eg, intratympanic gentamicin).

  11. Vestibular compensation: the neuro-otologist's best friend.

    PubMed

    Lacour, Michel; Helmchen, Christoph; Vidal, Pierre-Paul

    2016-04-01

    Why vestibular compensation (VC) after an acute unilateral vestibular loss is the neuro-otologist's best friend is the question at the heart of this paper. The different plasticity mechanisms underlying VC are first reviewed, and the authors present thereafter the dual concept of vestibulo-centric versus distributed learning processes to explain the compensation of deficits resulting from the static versus dynamic vestibular imbalance. The main challenges for the plastic events occurring in the vestibular nuclei (VN) during a post-lesion critical period are neural protection, structural reorganization and rebalance of VN activity on both sides. Data from animal models show that modulation of the ipsilesional VN activity by the contralateral drive substitutes for the normal push-pull mechanism. On the other hand, sensory and behavioural substitutions are the main mechanisms implicated in the recovery of the dynamic functions. These newly elaborated sensorimotor reorganizations are vicarious idiosyncratic strategies implicating the VN and multisensory brain regions. Imaging studies in unilateral vestibular loss patients show the implication of a large neuronal network (VN, commissural pathways, vestibulo-cerebellum, thalamus, temporoparietal cortex, hippocampus, somatosensory and visual cortical areas). Changes in gray matter volume in these multisensory brain regions are structural changes supporting the sensory substitution mechanisms of VC. Finally, the authors summarize the two ways to improve VC in humans (neuropharmacology and vestibular rehabilitation therapy), and they conclude that VC would follow a "top-down" strategy in patients with acute vestibular lesions. Future challenges to understand VC are proposed. PMID:27083885

  12. Vestibular compensation: the neuro-otologist's best friend.

    PubMed

    Lacour, Michel; Helmchen, Christoph; Vidal, Pierre-Paul

    2016-04-01

    Why vestibular compensation (VC) after an acute unilateral vestibular loss is the neuro-otologist's best friend is the question at the heart of this paper. The different plasticity mechanisms underlying VC are first reviewed, and the authors present thereafter the dual concept of vestibulo-centric versus distributed learning processes to explain the compensation of deficits resulting from the static versus dynamic vestibular imbalance. The main challenges for the plastic events occurring in the vestibular nuclei (VN) during a post-lesion critical period are neural protection, structural reorganization and rebalance of VN activity on both sides. Data from animal models show that modulation of the ipsilesional VN activity by the contralateral drive substitutes for the normal push-pull mechanism. On the other hand, sensory and behavioural substitutions are the main mechanisms implicated in the recovery of the dynamic functions. These newly elaborated sensorimotor reorganizations are vicarious idiosyncratic strategies implicating the VN and multisensory brain regions. Imaging studies in unilateral vestibular loss patients show the implication of a large neuronal network (VN, commissural pathways, vestibulo-cerebellum, thalamus, temporoparietal cortex, hippocampus, somatosensory and visual cortical areas). Changes in gray matter volume in these multisensory brain regions are structural changes supporting the sensory substitution mechanisms of VC. Finally, the authors summarize the two ways to improve VC in humans (neuropharmacology and vestibular rehabilitation therapy), and they conclude that VC would follow a "top-down" strategy in patients with acute vestibular lesions. Future challenges to understand VC are proposed.

  13. Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Jang, Kyoung-Min; Kim, Young-Baeg; Park, Yong-Sook; Nam, Taek-Kyun; Lee, Young-Seok

    2015-01-01

    Objective Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed. PMID:26587189

  14. Clinical findings in unilateral acute idiopathic maculopathy: new findings in acute idiopathic maculopathy.

    PubMed

    Haruta, Hiroshi; Sawa, Miki; Saishin, Yoshitsugu; Ohguro, Nobuyuki; Tano, Yasuo

    2010-04-01

    We report a case of unilateral acute idiopathic maculopathy (UAIM) with new clinical findings. A 34-year-old Japanese man had a neurosensory retinal detachment (approximately 5 disk diameters) with yellowish-white exudates at the macula in the left eye (visual acuity (VA) 0.4). Fluorescein angiography (FA) showed early hypofluorescent spots and late pooling in the subretinal space. Three weeks after onset, indocyanine green angiography (IA) showed numerous hypofluorescent spots at the lesion. Optical coherence tomography (OCT) showed subretinal fluids and an elevated choroidal lesion with low reflectivity, suggesting choroidal edema. The VA and fundus appearance spontaneously resolved without treatment three months after onset. The VA was 1.0 six months after onset. Irregular pigmentation remained at the macular lesion. The main UAIM pathology may be outer retinal layer and retinal pigment epithelial inflammation. FA, IA, and OCT suggested that choroidal inflammation may be involved in the pathogenesis of UAIM.

  15. Electrical Vestibular Stimulation after Vestibular Deafferentation and in Vestibular Schwannoma

    PubMed Central

    Aw, Swee Tin; Todd, Michael John; Lehnen, Nadine; Aw, Grace Elizabeth; Weber, Konrad Peter; Eggert, Thomas; Halmagyi, Gabor Michael

    2013-01-01

    Background Vestibular reflexes, evoked by human electrical (galvanic) vestibular stimulation (EVS), are utilized to assess vestibular function and investigate its pathways. Our study aimed to investigate the electrically-evoked vestibulo-ocular reflex (eVOR) output after bilateral and unilateral vestibular deafferentations to determine the characteristics for interpreting unilateral lesions such as vestibular schwannomas. Methods EVOR was recorded with dual-search coils as binocular three-dimensional eye movements evoked by bipolar 100 ms-step at EVS intensities of [0.9, 2.5, 5.0, 7.5, 10.0]mA and unipolar 100 ms-step at 5 mA EVS intensity. Five bilateral vestibular deafferented (BVD), 12 unilateral vestibular deafferented (UVD), four unilateral vestibular schwannoma (UVS) patients and 17 healthy subjects were tested with bipolar EVS, and five UVDs with unipolar EVS. Results After BVD, bipolar EVS elicited no eVOR. After UVD, bipolar EVS of one functioning ear elicited bidirectional, excitatory eVOR to cathodal EVS with 9 ms latency and inhibitory eVOR to anodal EVS, opposite in direction, at half the amplitude with 12 ms latency, exhibiting an excitatory-inhibitory asymmetry. The eVOR patterns from UVS were consistent with responses from UVD confirming the vestibular loss on the lesion side. Unexpectedly, unipolar EVS of the UVD ear, instead of absent response, evoked one-third the bipolar eVOR while unipolar EVS of the functioning ear evoked half the bipolar response. Conclusions The bidirectional eVOR evoked by bipolar EVS from UVD with an excitatory-inhibitory asymmetry and the 3 ms latency difference between normal and lesion side may be useful for detecting vestibular lesions such as UVS. We suggest that current spread could account for the small eVOR to 5 mA unipolar EVS of the UVD ear. PMID:24349188

  16. The Changes in mGluR2 and mGluR7 Expression in Rat Medial Vestibular Nucleus and Flocculus Following Unilateral Labyrinthectomy

    PubMed Central

    Zhou, Wen; Zhou, Liu-Qing; Zhang, Su-Lin; Liu, Bo; Leng, Yang-Ming; Zhou, Ren-Hong; Kong, Wei-Jia

    2013-01-01

    It is known that the medial vestibular nucleus (MVN) and the cerebellar flocculus are the key areas, which contribute to the behavioral recovery (“vestibular compensation”) after unilateral labyrinthectomy (UL). In these areas, how the genetic activities of the metabotropic glutamate receptors mGluR2 and mGluR7 performance after UL is unknown. With the means of quantitative real-time PCR, Western blotting, and immunohistochemistry, we analyzed the expression of mGluR2 and mGluR7 in the bilateral MVN and the flocculus of rats in different stages after UL (the 1st, 3rd, and 7th day). Our results show that in the MVN, the mRNA, and protein expressions of mGluR7 were ipsilaterally decreased at the 1st day following UL. However, in the MVN, no change was observed in the mRNA and protein expressions of mGluR2. On the other hand, the mRNA and protein expression of mGluR2 were enhanced in the ipsilateral flocculus at the 1st day following UL, while in the flocculus no change was shown in mGluR7 mRNA and protein expressions. Our results suggest that mGluR2 and mGluR7 may contribute to the early rebalancing of spontaneous resting activity in the MVN. PMID:24264036

  17. [Acute unilateral deafness and contralateral hearing loss following inguinal hernia repair under controlled anesthesia].

    PubMed

    Constantinidis, J; Mertzlufft, F; Steinhart, H

    1999-10-01

    Acute hearing loss following non-otologic surgery and general anesthesia is a rare occurrence. Deafness following anesthesia has more commonly been associated with spinal anesthesia or cardiopulmonary bypass surgical procedures. We present a case with unilateral cochlear dysfunction and sensorineural hearing loss after inguinal hernia operation. The literature is reviewed and the mechanisms causing hearing loss during anesthesia are discussed.

  18. Melatonin protects kidney against apoptosis induced by acute unilateral ureteral obstruction in rats

    PubMed Central

    Badem, Hüseyin; Cakmak, Muzaffer; Yilmaz, Hakki; Kosem, Bahadir; Karatas, Omer Faruk; Bayrak, Reyhan; Cimentepe, Ersin

    2016-01-01

    Introduction To investigate whether there was a protective effect of melatonin on apoptotic mechanisms after an acute unilateral obstruction of the kidney. Material and methods A total of 25 rats consisting of five groups were used in the study, designated as follows: Group 1: control, Group 2: sham, Group 3: unilateral ureteral obstruction treated with only saline, Group 4: unilateral ureteral obstruction treated with melatonin immediately, and Group 5: unilateral obstruction treated with melatonin one day after obstruction. Melatonin was administered as a 10 mg/kg dose intraperitoneally. The kidneys were evaluated according to the apoptotic index and Ki-67 scores. Results Comparison of all obstruction groups (Group 3, 4, and 5), revealed that the apoptotic index was significantly higher in Groups 1 and 2. Despite melatonin reduced apoptotic mechanisms in Groups 4 and 5, there was no significant difference between Groups 4 and 5 in terms of the reduction of apoptosis. However, the reduction of apoptosis in the melatonin treated group did not decrease to the level of Groups 1 and 2. Conclusions Despite melatonin administration, which significantly reduces the apoptotic index occurring after acute unilateral ureteral obstruction, the present study did not observe a return to normal renal histology in the obstruction groups. PMID:27551563

  19. Vestibular migraine.

    PubMed

    von Brevern, M; Lempert, T

    2016-01-01

    During the last decades a new vestibular syndrome has emerged that is now termed vestibular migraine (VM). The main body of evidence for VM is provided by epidemiologic data demonstrating a strong association between migraine and vestibular symptoms. Today, VM is recognized as one of the most common causes of episodic vertigo. The clinical presentation of VM is heterogeneous in terms of vestibular symptoms, duration of episodes, and association with migrainous accompaniments. Similar to migraine, there is no clinical or laboratory confirmation for VM and the diagnosis relies on the history and the exclusion of other disorders. Recently, diagnostic criteria for VM have been elaborated jointly by the International Headache Society and the Bárány Society. Clinical examination of patients with acute VM has clarified that the vast majority of patients with VM suffer from central vestibular dysfunction. Findings in the interval may yield mild signs of damage to both the central vestibular and ocular motor system and to the inner ear. These interictal clinical signs are not specific to VM but can be also observed in migraineurs without a history of vestibular symptoms. How migraine affects the vestibular system is still a matter of speculation. In the absence of high-quality therapeutic trials, treatment is targeted at the underlying migraine. PMID:27638080

  20. The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome.

    PubMed

    Carmona, Sergio; Martínez, Carlos; Zalazar, Guillermo; Moro, Marcela; Batuecas-Caletrio, Angel; Luis, Leonel; Gordon, Carlos

    2016-01-01

    The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate.

  1. The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome

    PubMed Central

    Carmona, Sergio; Martínez, Carlos; Zalazar, Guillermo; Moro, Marcela; Batuecas-Caletrio, Angel; Luis, Leonel; Gordon, Carlos

    2016-01-01

    The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient’s age. Grade 2–3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2–3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate. PMID:27551274

  2. The Diagnostic Accuracy of Truncal Ataxia and HINTS as Cardinal Signs for Acute Vestibular Syndrome.

    PubMed

    Carmona, Sergio; Martínez, Carlos; Zalazar, Guillermo; Moro, Marcela; Batuecas-Caletrio, Angel; Luis, Leonel; Gordon, Carlos

    2016-01-01

    The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient's age. Grade 2-3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2-3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate. PMID:27551274

  3. Clinical interest of postural and vestibulo-ocular reflex changes induced by cervical muscles and skull vibration in compensated unilateral vestibular lesion patients.

    PubMed

    Dumas, Georges; Lion, Alexis; Gauchard, Gérome C; Herpin, Guillaume; Magnusson, Måns; Perrin, Philippe P

    2013-01-01

    Skull vibration induces nystagmus in unilateral vestibular lesion (UVL) patients. Vibration of skull, posterior cervical muscles or inferior limb muscles alters posture in recent UVL patients. This study aimed to investigate the postural effect of vibration in chronic compensated UVL patients. Vibration was applied successively to vertex, each mastoid, each side of posterior cervical muscles and of triceps surae in 12 UVL patients and 9 healthy subjects. Eye movements were recorded with videonystagmography. Postural control was evaluated in eyes open (EO) and eyes closed (EC) conditions. Sway area, sway path, anteroposterior and medio-lateral sways were recorded.A vibration induced nystagmus (VIN) beating toward the healthy side was obtained for each UVL patient during mastoid vibration. In EO, only sway path was higher in UVL group during vibration of mastoids and posterior cervical muscles.The EO postural impairments of UVL patients could be related to the eye movements or VIN, leading to visual perturbations, or to a proprioceptive error signal, providing an erroneous representation of head position. The vibration-induced sway was too small to be clinically useful. Vestibulo-ocular reflex observed with videonystagmography during mastoid vibration seems more relevant to reveal chronic UVL than vestibulo-spinal reflex observed with posturography.

  4. [CHARACTERIZATION OF VESTIBULAR DISORDERS IN THE INJURED PERSONS WITH THE BRAIN CONCUSSION IN ACUTE PERIOD].

    PubMed

    Skobska, O E; Kadzhaya, N V; Andreyev, O A; Potapov, E V

    2015-04-01

    There were examined 32 injured persons, ageing (34.1 ± 1.3) yrs at average, for the brain commotion (BC). The adopted protocol SCAT-3 (Standardized Concussion Assessment Tool, 3rd ed.), DHI (Dizziness Handicap Inventory questionnaire), computer stabilography (KS) were applied for the vestibular disorders diagnosis. There was established, that in acute period of BC a dyssociation between regression of objective neurological symptoms and permanence of the BC indices occurs, what confirms a latent disorder of the balance function. Changes of basic indices of statokinesiography, including increase of the vibration amplitude enhancement in general centre of pressure in a saggital square and the BC square (235.3 ± 13.7) mm2 in a modified functional test of Romberg with the closed eyes is possible to apply as objective criteria for the BC diagnosis.

  5. Ocular lateropulsion as a central oculomotor sign in acute vestibular syndrome is not posturally dependent.

    PubMed

    Kattah, Jorge C; Pula, John; Newman-Toker, David E

    2011-09-01

    Horizontal conjugate gaze deviation (h-CGD) in acute vestibular syndrome (AVS) may be detected clinically or radiographically. While upright clinical ocular lateropulsion (OL) predicts central lesions, supine radiographic h-CGD does not. We sought to investigate the cause for this discordance by comparing upright to supine OL in AVS. We prospectively recorded clinical and radiographic h-CGD in 17 AVS patients. Horizontal eye position after brief eyelid closure was tested clinically following postural shifts. Radiographic h-CGD was assessed on axial magnetic resonance imaging (MRI) or computerized tomography (CT) images. All maintained central fixation with eyes open in light. OL was present in 8 (7 strokes, one central demyelination) and radiographic h-CGD in 14 (including all 6 with peripheral lesions). OL was unchanged after static postural testing. OL predicts central pathology and does not vary with postural shifts, regardless of lesion location. Radiographic h-CGD does not help localize, and this is not a positional effect.

  6. A Puzzle of Vestibular Physiology in a Meniere's Disease Acute Attack

    PubMed Central

    Martinez-Lopez, Marta; Manrique-Huarte, Raquel; Perez-Fernandez, Nicolas

    2015-01-01

    The aim of this paper is to present for the first time the functional evaluation of each of the vestibular receptors in the six semicircular canals in a patient diagnosed with Meniere's disease during an acute attack. A 54-year-old lady was diagnosed with left Meniere's disease who during her regular clinic review suffers an acute attack of vertigo, with fullness and an increase of tinnitus in her left ear. Spontaneous nystagmus and the results in the video head-impulse test (vHIT) are shown before, during, and after the attack. Nystagmus was initially left beating and a few minutes later an upbeat component was added. No skew deviation was observed. A decrease in the gain of the vestibuloocular reflex (VOR) and the presence of overt saccades were observed when the stimuli were in the plane of the left superior semicircular canal. At the end of the crisis nystagmus decreased and vestibuloocular reflex returned to almost normal. A review of the different possibilities to explain these findings points to a hypothetical utricular damage. PMID:26167320

  7. MRI assessment of paraspinal muscles in patients with acute and chronic unilateral low back pain

    PubMed Central

    Wan, Q; Lin, C; Li, X; Zeng, W

    2015-01-01

    Objective: To investigate the changes in paraspinal muscle cross-sectional area (CSA) and composition, using the digital data from lumbar spine MRIs of patients with acute and chronic low back pain (LBP). Methods: In total, 178 patients with unilateral LBP who had lumbar MRI examination were recruited. The data were obtained by a retrospective documentation audit. The CSAs and mean signal intensities of the bilateral paraspinal muscles [psoas major (PM), quadratus lumborum, multifidus (MF) and erector spinae (ES)] were measured, and the percentage of fat infiltration was calculated. The data between the painful side and non-painful side were compared, and between-group comparisons were tested. 42 patients with chronic unilateral LBP could indicate the problem level, and the CSA and mean signal intensity of the MF muscle were analysed at the problem level, and one vertebral above and one vertebral level below the problem level. Results: The CSAs of the PM and ES muscles were significantly decreased in the acute LBP group, while in the chronic LBP group, significant reduction in CSA was found in the MF and ES muscles on the painful side compared with the non-painful side. The mean signal intensity and fat content of the ES muscle on the painful side in the chronic LBP group was significantly higher than that on the painful side in the acute LBP group. The significant decrease of CSA in the MF muscle was found at multiple levels on the painful side. Conclusion: The present findings show that there is selective ipsilateral atrophy of paraspinal muscles, specific to the symptomatic side, in patients with acute and chronic LBP. The reduction of the muscle CSA and increased fatty infiltration occurred synchronously, and the extent of change is significantly greater in chronic LBP in the ES muscle. Atrophy of the MF muscle appears to be at multiple levels but side specific in relation to symptoms in patients with chronic LBP, and the decreased muscle CSA may occur prior to

  8. Characterization of pulse amplitude and pulse rate modulation for a human vestibular implant during acute electrical stimulation

    NASA Astrophysics Data System (ADS)

    Nguyen, T. A. K.; DiGiovanna, J.; Cavuscens, S.; Ranieri, M.; Guinand, N.; van de Berg, R.; Carpaneto, J.; Kingma, H.; Guyot, J.-P.; Micera, S.; Perez Fornos, A.

    2016-08-01

    Objective. The vestibular system provides essential information about balance and spatial orientation via the brain to other sensory and motor systems. Bilateral vestibular loss significantly reduces quality of life, but vestibular implants (VIs) have demonstrated potential to restore lost function. However, optimal electrical stimulation strategies have not yet been identified in patients. In this study, we compared the two most common strategies, pulse amplitude modulation (PAM) and pulse rate modulation (PRM), in patients. Approach. Four subjects with a modified cochlear implant including electrodes targeting the peripheral vestibular nerve branches were tested. Charge-equivalent PAM and PRM were applied after adaptation to baseline stimulation. Vestibulo-ocular reflex eye movement responses were recorded to evaluate stimulation efficacy during acute clinical testing sessions. Main results. PAM evoked larger amplitude eye movement responses than PRM. Eye movement response axes for lateral canal stimulation were marginally better aligned with PRM than with PAM. A neural network model was developed for the tested stimulation strategies to provide insights on possible neural mechanisms. This model suggested that PAM would consistently cause a larger ensemble firing rate of neurons and thus larger responses than PRM. Significance. Due to the larger magnitude of eye movement responses, our findings strongly suggest PAM as the preferred strategy for initial VI modulation.

  9. Acute Response to Unilateral Unipolar Electrical Carotid Sinus Stimulation in Patients With Resistant Arterial Hypertension.

    PubMed

    Heusser, Karsten; Tank, Jens; Brinkmann, Julia; Menne, Jan; Kaufeld, Jessica; Linnenweber-Held, Silvia; Beige, Joachim; Wilhelmi, Mathias; Diedrich, André; Haller, Hermann; Jordan, Jens

    2016-03-01

    Bilateral bipolar electric carotid sinus stimulation acutely reduced muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in patients with resistant arterial hypertension but is no longer available. The second-generation device uses a smaller unilateral unipolar disk electrode to reduce invasiveness while saving battery life. We hypothesized that the second-generation device acutely lowers BP and MSNA in treatment-resistant hypertensive patients. Eighteen treatment-resistant hypertensive patients (9 women/9 men; 53±11 years; 33±5 kg/m(2)) on stable medications have been included in the study. We monitored finger and brachial BP, heart rate, and MSNA. Without stimulation, BP was 165±31/91±18 mm Hg, heart rate was 75±17 bpm, and MSNA was 48±14 bursts per minute. Acute stimulation with intensities producing side effects that were tolerable in the short term elicited interindividually variable changes in systolic BP (-16.9±15.0 mm Hg; range, 0.0 to -40.8 mm Hg; P=0.002), heart rate (-3.6±3.6 bpm; P=0.004), and MSNA (-2.0±5.8 bursts per minute; P=0.375). Stimulation intensities had to be lowered in 12 patients to avoid side effects at the expense of efficacy (systolic BP, -6.3±7.0 mm Hg; range, 2.8 to -14.5 mm Hg; P=0.028 and heart rate, -1.5±2.3 bpm; P=0.078; comparison against responses with side effects). Reductions in diastolic BP and MSNA (total activity) were correlated (r(2)=0.329; P=0.025). In our patient cohort, unilateral unipolar electric baroreflex stimulation acutely lowered BP. However, side effects may limit efficacy. The approach should be tested in a controlled comparative study.

  10. Acute Response to Unilateral Unipolar Electrical Carotid Sinus Stimulation in Patients With Resistant Arterial Hypertension.

    PubMed

    Heusser, Karsten; Tank, Jens; Brinkmann, Julia; Menne, Jan; Kaufeld, Jessica; Linnenweber-Held, Silvia; Beige, Joachim; Wilhelmi, Mathias; Diedrich, André; Haller, Hermann; Jordan, Jens

    2016-03-01

    Bilateral bipolar electric carotid sinus stimulation acutely reduced muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in patients with resistant arterial hypertension but is no longer available. The second-generation device uses a smaller unilateral unipolar disk electrode to reduce invasiveness while saving battery life. We hypothesized that the second-generation device acutely lowers BP and MSNA in treatment-resistant hypertensive patients. Eighteen treatment-resistant hypertensive patients (9 women/9 men; 53±11 years; 33±5 kg/m(2)) on stable medications have been included in the study. We monitored finger and brachial BP, heart rate, and MSNA. Without stimulation, BP was 165±31/91±18 mm Hg, heart rate was 75±17 bpm, and MSNA was 48±14 bursts per minute. Acute stimulation with intensities producing side effects that were tolerable in the short term elicited interindividually variable changes in systolic BP (-16.9±15.0 mm Hg; range, 0.0 to -40.8 mm Hg; P=0.002), heart rate (-3.6±3.6 bpm; P=0.004), and MSNA (-2.0±5.8 bursts per minute; P=0.375). Stimulation intensities had to be lowered in 12 patients to avoid side effects at the expense of efficacy (systolic BP, -6.3±7.0 mm Hg; range, 2.8 to -14.5 mm Hg; P=0.028 and heart rate, -1.5±2.3 bpm; P=0.078; comparison against responses with side effects). Reductions in diastolic BP and MSNA (total activity) were correlated (r(2)=0.329; P=0.025). In our patient cohort, unilateral unipolar electric baroreflex stimulation acutely lowered BP. However, side effects may limit efficacy. The approach should be tested in a controlled comparative study. PMID:26831195

  11. Unilateral Renal Ischemia as a Model of Acute Kidney Injury and Renal Fibrosis in Cats.

    PubMed

    Schmiedt, C W; Brainard, B M; Hinson, W; Brown, S A; Brown, C A

    2016-01-01

    The objectives of this study were to define the acute and chronic effects of 1-hour unilateral in vivo renal ischemia on renal function and histology in cats. Twenty-one adult purpose-bred research cats were anesthetized, and 1 kidney underwent renal artery and vein occlusion for 1 hour. Serum creatinine and urea concentrations, urine protein:creatinine ratio, urine-specific gravity, glomerular filtration rate, hematocrit, platelet concentration and function, and white blood cell count were measured at baseline and variable time points after ischemia. Renal histopathology was evaluated on days 3, 6, 12, 21, 42, and 70 postischemia; changes in smooth muscle actin and interstitial collagen were examined. Following ischemia, whole animal glomerular filtration rate was significantly reduced (57% of baseline on day 6; P < .05). At the early time points, the ischemic kidneys exhibited severe acute epithelial necrosis accompanied by evidence of regeneration of tubules predominantly within the corticomedullary junction. At later periods, postischemic kidneys had evidence of tubular atrophy and interstitial inflammation with significantly more smooth muscle actin and interstitial collagen staining and interstitial fibrosis when compared with the contralateral control kidneys. This study characterizes the course of ischemic acute kidney injury in cats and demonstrates that ischemic acute kidney injury triggers chronic fibrosis, interstitial inflammation, and tubular atrophy in feline kidneys. These late changes are typical of those observed in cats with naturally occurring chronic kidney disease. PMID:26319781

  12. Out-of-Body Experiences and Other Complex Dissociation Experiences in a Patient with Unilateral Peripheral Vestibular Damage and Deficient Multisensory Integration.

    PubMed

    Kaliuzhna, Mariia; Vibert, Dominique; Grivaz, Petr; Blanke, Olaf

    2015-01-01

    Out-of-body experiences (OBEs) are illusory perceptions of one's body from an elevated disembodied perspective. Recent theories postulate a double disintegration process in the personal (visual, proprioceptive and tactile disintegration) and extrapersonal (visual and vestibular disintegration) space as the basis of OBEs. Here we describe a case which corroborates and extends this hypothesis. The patient suffered from peripheral vestibular damage and presented with OBEs and lucid dreams. Analysis of the patient's behaviour revealed a failure of visuo-vestibular integration and abnormal sensitivity to visuo-tactile conflicts that have previously been shown to experimentally induce out-of-body illusions (in healthy subjects). In light of these experimental findings and the patient's symptomatology we extend an earlier model of the role of vestibular signals in OBEs. Our results advocate the involvement of subcortical bodily mechanisms in the occurrence of OBEs. PMID:26595959

  13. Out-of-Body Experiences and Other Complex Dissociation Experiences in a Patient with Unilateral Peripheral Vestibular Damage and Deficient Multisensory Integration.

    PubMed

    Kaliuzhna, Mariia; Vibert, Dominique; Grivaz, Petr; Blanke, Olaf

    2015-01-01

    Out-of-body experiences (OBEs) are illusory perceptions of one's body from an elevated disembodied perspective. Recent theories postulate a double disintegration process in the personal (visual, proprioceptive and tactile disintegration) and extrapersonal (visual and vestibular disintegration) space as the basis of OBEs. Here we describe a case which corroborates and extends this hypothesis. The patient suffered from peripheral vestibular damage and presented with OBEs and lucid dreams. Analysis of the patient's behaviour revealed a failure of visuo-vestibular integration and abnormal sensitivity to visuo-tactile conflicts that have previously been shown to experimentally induce out-of-body illusions (in healthy subjects). In light of these experimental findings and the patient's symptomatology we extend an earlier model of the role of vestibular signals in OBEs. Our results advocate the involvement of subcortical bodily mechanisms in the occurrence of OBEs.

  14. A case of acute reversible Charles Bonnet syndrome following postsurgical unilateral eye patch placement.

    PubMed

    Khadavi, Nicole Miriam; Lew, Helen; Goldberg, Robert Alan; Mancini, Ronald

    2010-01-01

    A fully alert 70-year-old male with no significant medical or psychiatric history presented for surgical follow-up after uncomplicated right lower eyelid cicatricial ectropion surgery with postoperative unilateral, eye patch placement complaining of visual hallucinations. Preoperative unaided visual acuity was 20/20 in each eye. The patient described simple, nonformed and complex, formed images that were both static and animated. The images included crystal-like formations that appeared to bubble, green leaves against a vivid magenta backdrop, and an isolated hallucination of a lifelike plant with trembling leaves. These hallucinations began 2 days postoperatively and persisted 2 days following eye patch removal. The patient perceived the hallucinations multiple times a day over the 7-day period, without a stereotyped pattern. The images occurred when the eyes were open and ceased when they were closed. They were prompted by looking at a blank wall or white surface. The patient consistently recognized these images as unreal. They typically persisted for 1 to 2 minutes and could be extinguished by looking away. There were no associated auditory hallucinations, psychosis, or delirium and no history of visual, cognitive, or neurological deficit. The patient denied the use of hallucinogenic medications, including analgesics, or the initiation of any new medications. To the authors' knowledge, this is the first reported case of acute reversible CBS following unilateral eye patch placement. CBS may be a frightening postsurgical consequence of eye patch placement. It is important that the ophthalmic surgeon be aware of the potential for development of CBS and offer appropriate referral and reassurance should it occur. PMID:20551853

  15. Early and Phasic Cortical Metabolic Changes in Vestibular Neuritis Onset

    PubMed Central

    Alessandrini, Marco; Pagani, Marco; Napolitano, Bianca; Micarelli, Alessandro; Candidi, Matteo; Bruno, Ernesto; Chiaravalloti, Agostino; Di Pietro, Barbara; Schillaci, Orazio

    2013-01-01

    Functional brain activation studies described the presence of separate cortical areas responsible for central processing of peripheral vestibular information and reported their activation and interactions with other sensory modalities and the changes of this network associated to strategic peripheral or central vestibular lesions. It is already known that cortical changes induced by acute unilateral vestibular failure (UVF) are various and undergo variations over time, revealing different cortical involved areas at the onset and recovery from symptoms. The present study aimed at reporting the earliest change in cortical metabolic activity during a paradigmatic form of UVF such as vestibular neuritis (VN), that is, a purely peripheral lesion of the vestibular system, that offers the opportunity to study the cortical response to altered vestibular processing. This research reports [18F]fluorodeoxyglucose positron emission tomography brain scan data concerning the early cortical metabolic activity associated to symptoms onset in a group of eight patients suffering from VN. VN patients’ cortical metabolic activity during the first two days from symptoms onset was compared to that recorded one month later and to a control healthy group. Beside the known cortical response in the sensorimotor network associated to vestibular deafferentation, we show for the first time the involvement of Entorhinal (BAs 28, 34) and Temporal (BA 38) cortices in early phases of symptomatology onset. We interpret these findings as the cortical counterparts of the attempt to reorient oneself in space counteracting the vertigo symptom (Bas 28, 34) and of the emotional response to the new pathologic condition (BA 38) respectively. These interpretations were further supported by changes in patients’ subjective ratings in balance, anxiety, and depersonalization/derealization scores when tested at illness onset and one month later. The present findings contribute in expanding knowledge about

  16. Neurotransmitters in the vestibular system.

    PubMed

    Balaban, C D

    2016-01-01

    Neuronal networks that are linked to the peripheral vestibular system contribute to gravitoinertial sensation, balance control, eye movement control, and autonomic function. Ascending connections to the limbic system and cerebral cortex are also important for motion perception and threat recognition, and play a role in comorbid balance and anxiety disorders. The vestibular system also shows remarkable plasticity, termed vestibular compensation. Activity in these networks is regulated by an interaction between: (1) intrinsic neurotransmitters of the inner ear, vestibular nerve, and vestibular nuclei; (2) neurotransmitters associated with thalamocortical and limbic pathways that receive projections originating in the vestibular nuclei; and (3) locus coeruleus and raphe (serotonergic and nonserotonergic) projections that influence the latter components. Because the ascending vestibular interoceptive and thalamocortical pathways include networks that influence a broad range of stress responses (endocrine and autonomic), memory consolidation, and cognitive functions, common transmitter substrates provide a basis for understanding features of acute and chronic vestibular disorders. PMID:27638061

  17. Vertical eye movements during horizontal head impulse test: a new clinical sign of superior vestibular neuritis.

    PubMed

    D'Onofrio, F

    2013-12-01

    In some patients suffering from acute unilateral peripheral vestibular deficit, the head impulse test performed towards the affected side reveals the typical catch-up saccade in the horizontal plane, and an oblique, mostly vertical, upward catch-up saccade after the rotation of the head towards the healthy side. Three cases are reported herein, which have been studied using slow motion video analysis of the eye movements captured by a high-speed webcam (90 fps). The clinical evidence is discussed and a pathophysiological explanation is proposed, consisting in a selective hypofunction of the superior semicircular canal during superior vestibular neuritis. PMID:24376299

  18. Vestibular Neuronitis

    MedlinePlus

    ... Prevent Painful Swimmer's Ear Additional Content Medical News Vestibular Neuronitis By Lawrence R. Lustig, MD NOTE: This ... Drugs Herpes Zoster Oticus Meniere Disease Purulent Labyrinthitis Vestibular Neuronitis Vestibular neuronitis is a disorder characterized by ...

  19. Vestibular compensation in the cat: the role of the histaminergic system.

    PubMed

    Lacour, M; Tighilet, B

    2000-01-01

    Histamine is thought to be involved in the recovery of vestibular function as histaminergic medications are effective in vestibular-related syndromes. We conducted studies in the cat to assess the effects of betahistine (a histamine-like substance) on the behavioural recovery process after unilateral vestibular neurectomy (UVN). We also investigated histamine immunoreactivity changes in the vestibular and tuberomammillary nuclei of betahistine-treated lesioned cats compared with untreated and unlesioned cats. Betahistine strongly accelerated the behavioural recovery process after UVN, with a time benefit of approximately 2 weeks for both static posture (support surface) and dynamic equilibrium function (locomotor balance) compared with untreated animals. A bilateral decrease in histamine immunoreactivity was seen in both acute and compensated UVN cats; this effect was strongly accentuated with betahistine treatment. In conclusion, the results indicate that vestibular lesion reduces histamine staining due to an increase in histamine release in the vestibular and tuberomammillary nuclei that promote vestibular recovery. Betahistine dihydrochloride should contribute to this process by acting on both the presynaptic histamine H3 and postsynaptic histamine H1 receptors.

  20. Acute effects of unilateral whole body vibration training on single leg vertical jump height and symmetry in healthy men.

    PubMed

    Shin, Seungho; Lee, Kyeongjin; Song, Changho

    2015-12-01

    [Purpose] The aim of the present study was to investigate the acute effects of unilateral whole body vibration training on height and symmetry of the single leg vertical jump in healthy men. [Subjects] Thirty males with no history of lower limb dysfunction participated in this study. [Methods] The participants were randomly allocated to one of three groups: the unilateral vibratory stimulation group (n=10), bilateral vibratory stimulation group (n=10), and, no vibratory stimulation group (n=10). The subjects in the unilateral and bilateral stimulation groups participated in one session of whole body vibration training at 26 Hz for 3 min. The no vibratory stimulation group subjects underwent the same training for 3 min without whole body vibration. All participants performed the single leg vertical jump for each lower limb, to account for the strong and weak sides. The single leg vertical jump height and symmetry were measured before and after the intervention. [Results] The single leg vertical jump height of the weak lower limb significantly improved in the unilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump height of the strong lower limb significantly improved in the bilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump symmetry significantly improved in the unilateral vibratory stimulation group, but not in the other groups. [Conclusion] Therefore, the present study found that the effects of whole body vibration training were different depending on the type of application. To improve the single leg vertical jump height in the weak lower limbs as well as limb symmetry, unilateral vibratory stimulation might be more desirable.

  1. Acute effects of unilateral whole body vibration training on single leg vertical jump height and symmetry in healthy men

    PubMed Central

    Shin, Seungho; Lee, Kyeongjin; Song, Changho

    2015-01-01

    [Purpose] The aim of the present study was to investigate the acute effects of unilateral whole body vibration training on height and symmetry of the single leg vertical jump in healthy men. [Subjects] Thirty males with no history of lower limb dysfunction participated in this study. [Methods] The participants were randomly allocated to one of three groups: the unilateral vibratory stimulation group (n=10), bilateral vibratory stimulation group (n=10), and, no vibratory stimulation group (n=10). The subjects in the unilateral and bilateral stimulation groups participated in one session of whole body vibration training at 26 Hz for 3 min. The no vibratory stimulation group subjects underwent the same training for 3 min without whole body vibration. All participants performed the single leg vertical jump for each lower limb, to account for the strong and weak sides. The single leg vertical jump height and symmetry were measured before and after the intervention. [Results] The single leg vertical jump height of the weak lower limb significantly improved in the unilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump height of the strong lower limb significantly improved in the bilateral vibratory stimulation group, but not in the other groups. The single leg vertical jump symmetry significantly improved in the unilateral vibratory stimulation group, but not in the other groups. [Conclusion] Therefore, the present study found that the effects of whole body vibration training were different depending on the type of application. To improve the single leg vertical jump height in the weak lower limbs as well as limb symmetry, unilateral vibratory stimulation might be more desirable. PMID:26834381

  2. Vestibular recruitment

    NASA Technical Reports Server (NTRS)

    Tsemakhov, S. G.

    1980-01-01

    Vestibular recruitment is defined through the analysis of several references. It is concluded that vestibular recruitment is an objective phenomenon which manifests itself during the affection of the vestibular receptor and thus serves as a diagnostic tool during affection of the vestibular system.

  3. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    PubMed Central

    Greco, A.; Macri, G. F.; Gallo, A.; Fusconi, M.; De Virgilio, A.; Pagliuca, G.; Marinelli, C.; de Vincentiis, M.

    2014-01-01

    Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes. PMID:24741601

  4. Changes in diaphragm muscle collagen gene expression after acute unilateral denervation

    NASA Technical Reports Server (NTRS)

    Gosselin, L. E.; Sieck, G. C.; Aleff, R. A.; Martinez, D. A.; Vailas, A. C.

    1995-01-01

    The purpose of the present study was to examine the effects of acute (3 days) unilateral diaphragm denervation (DNV) on 1) levels of alpha 1(I) and alpha 1(III) procollagen mRNA; 2) collagen concentration [hydroxyproline (HYP)]; 3) amount of the nonreducible collagen cross-link hydroxylysylpyridinoline (HP); and 4) the passive force-length relationship of the muscle. The levels of alpha 1(I) and alpha 1(III) procollagen mRNA, HYP concentration, and amount of HP were measured in muscle segments from the midcostal region of DNV and intact (INT) hemidiaphragms of adult male Fischer 344 rats (250-300 g). The in vitro passive force-length relationship of DNV and INT hemidiaphragm was determined by lengthening and shortening the diaphragm muscle segments from 85 to 115% of optimal length at a constant velocity (0.6 optimal length/s). Three days after DNV, the level of alpha 1(I) procollagen mRNA was increased over 15-fold in the DNV hemidiaphragm compared with INT (P < 0.05), whereas the level of alpha 1(III) procollagen mRNA was increased by approximately sixfold in the DNV hemidiaphragm compared with INT (P < 0.05). Collagen (HYP) concentration did not differ between groups, averaging 8.7 and 8.9 micrograms/mg dry wt for the DNV and INT hemidiaphragms, respectively. In addition, there was no difference in the amount of the mature nonreducible collagen cross-link HP between the DNV and INT hemidiaphragms (0.66 vs. 0.76 mole HP/mole collagen, respectively). The amount of passive force developed during lengthening did not differ between DNV and INT hemidiaphragms. These data indicate that acute DNV of the hemidiaphragm is associated with an increase in the mRNA level of the two principal fibrillar collagen phenotypes in skeletal muscle. However, despite extensive muscle remodeling, the passive force-length relationship of the DNV hemidiaphragm is unaffected compared with the INT muscle.

  5. Studies on the Mechanism of Oliguria in a Model of Unilateral Acute Renal Failure

    PubMed Central

    Cox, John W.; Baehler, Richard W.; Sharma, Hari; O'Dorisio, Thomas; Osgood, Richard W.; Stein, Jay H.; Ferris, Thomas F.

    1974-01-01

    To further evaluate the mechanism of the oliguria of acute renal failure, a model was utilized in which intense and prolonged vasoconstriction produced the unilateral cessation of urine flow. The radioactive microsphere method was used to measure total and regional blood flow before and after the intrarenal infusion of norepinephrine, 0.75 μg/kg/min, for 2 h in the dog. In the control kidney, renal blood flow increased 32% 48 h after norepinephrine in association with a fall in the fractional distribution of flow to the outer cortex. In the experimental kidney, total renal blood flow fell from 190 ml/min before norepinephrine to 116 ml/min at 48 h (P < 0.025) with a uniform reduction in cortical blood flow. After the administration of 10% body wt Ringer's solution, there was a marked redistribution of flow to inner cortical nephrons in both the control and experimental kidney. In addition, there was a marked increase in total blood flow in both kidneys. On the experimental side, flow rose to 235 ml/min, a value greater than in either the control period (P < 0.05) or at 48 h after norepinephrine (P < 0.001). However, in spite of this marked increase in blood flow, there was essentially no urine flow from the experimental kidney. In separate studies, the animals were prepared for micropuncture. In all studies, the surface tubules were collapsed, and there was no evidence of tubular obstruction or leakage of filtrate. Over 99% of the 15-μM spheres were extracted in one pass through the experimental kidney. An analysis of the forces affecting filtration suggested that an alteration in the ultrafiltration coefficient may be responsible, at least in part, for the anuria in this model. In this regard, transmission and scanning electron microscopy revealed a marked abnormality in the epithelial structure of the glomerulus. It is suggested that a decrease in glomerular capillary permeability may be present in this model of acute renal failure. Images PMID:4830221

  6. Vestibular-related neuroscience and manned space flight

    NASA Technical Reports Server (NTRS)

    Igarashi, Makoto

    1988-01-01

    The effects of weightlessness on the human vestibular system are examined, reviewing the results of recent investigations. The functional, neurophysiological, and neurochemical changes which occur during adaptation to weightlessness are discussed; theoretical models proposed to explain the underlying mechanism are outlined; and particular attention is given to the author's experiments on squirrel monkeys. There, good correlations were found between (1) the recovery of locomotor balance function in the acute compensation phase after unilateral labyrinthectomy and (2) the bilateral imbalance in the optical density of GABA-like immunoreactivity.

  7. Compensatory saccades benefit from prediction during head impulse testing in early recovery from vestibular deafferentation.

    PubMed

    Mantokoudis, Georgios; Agrawal, Yuri; Newman-Toker, David E; Xie, Li; Saber Tehrani, Ali S; Wong, Aaron; Schubert, Michael C

    2016-06-01

    The head impulse test (HIT) can identify a deficient vestibulo-ocular reflex (VOR) by the compensatory saccade (CS) generated once the head stops moving. The inward HIT is considered safer than the outward HIT, yet might have an oculomotor advantage given that the subject would presumably know the direction of head rotation. Here, we compare CS latencies following inward (presumed predictable) and outward (more unpredictable) HITs after acute unilateral vestibular nerve deafferentation. Seven patients received inward and outward HITs delivered at six consecutive postoperative days (POD) and again at POD 30. All head impulses were recorded by portable video-oculography. CS included those occurring during (covert) or after (overt) head rotation. Inward HITs included mean CS latencies (183.48 ms ± 4.47 SE) that were consistently shorter than those generated during outward HITs in the first 6 POD (p = 0.0033). Inward HITs induced more covert saccades compared to outward HITs, acutely. However, by POD 30 there were no longer any differences in latencies or proportions of CS and direction of head rotation. Patients with acute unilateral vestibular loss likely use predictive cues of head direction to elicit early CS to keep the image centered on the fovea. In acute vestibular hypofunction, inwardly applied HITs may risk a preponderance of covert saccades, yet this difference largely disappears within 30 days. Advantages of inwardly applied HITs are discussed and must be balanced against the risk of a false-negative HIT interpretation.

  8. BDNF signaling in the rat cerebello-vestibular pathway during vestibular compensation: BDNF signaling in vestibular compensation.

    PubMed

    Zhou, Liuqing; Zhou, Wen; Zhang, Sulin; Liu, Bo; Liang, Pei; Zhou, Yan; Zhou, Tao; Zhang, Kun; Leng, Yangming; Kong, Weijia

    2015-09-01

    Vestibular compensation, which is the behavioral recovery from lesions to the peripheral vestibular system, is attributed to plasticity of the central vestibular system. It has been reported that brain-derived neurotrophic factor (BDNF) is expressed and released in an activity-dependent manner. Upon binding to the tyrosine receptor kinase B (TrkB), BDNF can acutely modulate synaptic transmission and plasticity in the central nervous system. To assess the possible contribution of BDNF to this recovery process, we studied the expression of BDNF, TrkB.FL, TrkB.T1 and KCC2 (K(+) -Cl(-) cotransporter isoform 2) in the bilateral medial vestibular nucleus (MVN) and the flocculus of rats at 4 h, 8 h, 1, 3 and 7 days following unilateral labyrinthectomy (UL) using immunohistochemistry, quantitative real-time PCR and western blotting. Our results have shown that, compared with the sham controls and the contra-lesional side, (a) the expression of BDNF and TrkB.FL increased at 4 h in the ipsi-lesional flocculus after UL; (b) the expression of TrkB.T1 decreased at 4 h and KCC2 decreased at 8 h and 1 day in the ipsi-lesional flocculus after UL; and (c) BDNF and TrkB.FL expression was enhanced and KCC2 expression was reduced in the ipsi-lesional MVN at 8 h after UL. Our data supported the hypothesis that BDNF upregulation may reduce the inhibitory effects of the flocculus and commissural inhibition system by regulating inhibitory GABAergic synaptic transmission in floccular Purkinje cells and Purkinje cell terminals in the MVN. Additionally, KCC2 may be a switch in this process. PMID:26111610

  9. Vestibular Hyperacusis

    MedlinePlus

    ... is a Top Rated Nonprofit! Volunteer. Donate. Review. Vestibular Hyperacusis Are you sensitive to certain sounds? Hyperacusis ... parade to a person with hyperacusis. Cochlear vs. vestibular hyperacusis With cochlear hyperacusis, subjects feel ear pain, ...

  10. Altered regional homogeneity in patients with unilateral acute open-globe injury: a resting-state functional MRI study

    PubMed Central

    Huang, Xin; Li, Hai-Jun; Ye, Lei; Zhang, Ying; Wei, Rong; Zhong, Yu-Lin; Peng, De-Chang; Shao, Yi

    2016-01-01

    Objective To investigate the underlying regional homogeneity (ReHo) brain activity changes in patients with unilateral acute open-globe injury (OGI) and their relationship with their clinical features. Patients and methods In total, 18 patients with acute OGI (16 males and two females) and 18 healthy controls (HCs; 16 males and two females) closely matched in age, sex, and education status participated in the study. Each subject underwent a resting-state functional magnetic resonance imaging scan. The ReHo method was used to assess local features of spontaneous brain activity. Receiver–operating characteristic curve was used to distinguish OGIs from HCs. The nonparametric statistical analysis was used to explore the relationship between the observed mean ReHo values of the different brain areas and the behavioral performance. Results Compared with HCs, acute OGI patients had significantly increased ReHo values in the right cerebellum posterior lobe/lingual gyrus, left superior temporal gyrus/inferior frontal gyrus, left inferior frontal gyrus, left posterior cingulate cortex/precuneus, and left precentral operculum. However, there was no relationship between the observed mean ReHo values of the different brain areas and the behavioral performance. Conclusion Acute OGI may cause dysfunction in many brain regions, which may reflect the underlying pathologic mechanisms of acute vision loss in OGI patients. PMID:27536111

  11. The asymmetric protein expression hypothesis - Explaining the unilaterality of HLA-B27-positive acute anterior uveitides.

    PubMed

    Clarke, Margo S; Plouznikoff, Alexandre; Deschênes, Jean

    2016-03-01

    For reasons still unclear, most HLA-B27-positive acute anterior uveitides occur unilaterally. Building upon the growing literature showing that left-right asymmetry exist at the biomolecular and at the cellular levels, we propose a new hypothesis to explain why HLA-B27-positive acute anterior uveitides tend to affect one eye selectively. We postulate that left and right uveal tissue may present quantitatively and qualitatively different proteins to the immune system, capable to trigger an autoimmune response, and that other variables, including anatomical, cellular and molecular barriers, as well as our own eye-derived immunological tolerance and immune suppressive intraocular microenvironment may also be unequally distributed, and impact differently the immune privileges of the left and right eye. These same quantitative and qualitative differences might also explain why HLA-B27-positive acute anterior uveitides can flip-flop between the left and the right eye, after the first attack. By trying to figure out why one eye is targeted by an autoimmune reaction while the other is clinically unaffected, we might be able to better understand how and why an autoimmune reaction starts. Hopefully, this will help us devise better treatments for ocular autoimmune diseases, and contribute to the management of autoinflammatory conditions with a marked asymmetric clinical presentation in other fields. PMID:26880626

  12. Unilateral Renal Ischemia-Reperfusion as a Robust Model for Acute to Chronic Kidney Injury in Mice

    PubMed Central

    Le Clef, Nathalie; Verhulst, Anja; D’Haese, Patrick C.; Vervaet, Benjamin A.

    2016-01-01

    Acute kidney injury (AKI) is an underestimated, yet important risk factor for development of chronic kidney disease (CKD). Even after initial total recovery of renal function, some patients develop progressive and persistent deterioration of renal function and these patients are more likely to progress to end-stage renal disease (ESRD). Animal models are indispensable for unravelling the mechanisms underlying this progression towards CKD and ESRD and for the development of new therapeutic strategies in its prevention or treatment. Ischemia (i.e. hypoperfusion after surgery, bleeding, dehydration, shock, or sepsis) is a major aetiology in human AKI, yet unilateral ischemia-reperfusion is a rarely used animal model for research on CKD and fibrosis. Here, we demonstrate in C57Bl/6J mice, by both histology and gene expression, that unilateral ischemia-reperfusion without contralateral nephrectomy is a very robust model to study the progression from acute renal injury to long-term tubulo-interstitial fibrosis, i.e. the histopathological hallmark of CKD. Furthermore, we report that the extent of renal fibrosis, in terms of Col I, TGFβ, CCN2 and CCN3 expression and collagen I immunostaining, increases with increasing body temperature during ischemia and ischemia-time. Thus, varying these two main determinants of ischemic injury allows tuning the extent of the long-term fibrotic outcome in this model. Finally, in order to cover the whole practical finesse of ischemia-reperfusion and allow model and data transfer, we provide a referenced overview on crucial technical issues (incl. anaesthesia, analgesia, and pre- and post-operative care) with the specific aim of putting starters in the right direction of implementing ischemia in their research and stimulate them, as well as the community, to have a critical view on ischemic literature data. PMID:27007127

  13. Unilateral Renal Ischemia-Reperfusion as a Robust Model for Acute to Chronic Kidney Injury in Mice.

    PubMed

    Le Clef, Nathalie; Verhulst, Anja; D'Haese, Patrick C; Vervaet, Benjamin A

    2016-01-01

    Acute kidney injury (AKI) is an underestimated, yet important risk factor for development of chronic kidney disease (CKD). Even after initial total recovery of renal function, some patients develop progressive and persistent deterioration of renal function and these patients are more likely to progress to end-stage renal disease (ESRD). Animal models are indispensable for unravelling the mechanisms underlying this progression towards CKD and ESRD and for the development of new therapeutic strategies in its prevention or treatment. Ischemia (i.e. hypoperfusion after surgery, bleeding, dehydration, shock, or sepsis) is a major aetiology in human AKI, yet unilateral ischemia-reperfusion is a rarely used animal model for research on CKD and fibrosis. Here, we demonstrate in C57Bl/6J mice, by both histology and gene expression, that unilateral ischemia-reperfusion without contralateral nephrectomy is a very robust model to study the progression from acute renal injury to long-term tubulo-interstitial fibrosis, i.e. the histopathological hallmark of CKD. Furthermore, we report that the extent of renal fibrosis, in terms of Col I, TGFβ, CCN2 and CCN3 expression and collagen I immunostaining, increases with increasing body temperature during ischemia and ischemia-time. Thus, varying these two main determinants of ischemic injury allows tuning the extent of the long-term fibrotic outcome in this model. Finally, in order to cover the whole practical finesse of ischemia-reperfusion and allow model and data transfer, we provide a referenced overview on crucial technical issues (incl. anaesthesia, analgesia, and pre- and post-operative care) with the specific aim of putting starters in the right direction of implementing ischemia in their research and stimulate them, as well as the community, to have a critical view on ischemic literature data. PMID:27007127

  14. In vivo cerebral incorporation of radiolabeled fatty acids after acute unilateral orbital enucleation in adult hooded Long-Evans rats

    SciTech Connect

    Wakabayashi, S.; Freed, L.M.; Bell, J.M.; Rapoport, S.I.

    1994-03-01

    We examined effects of acute unilateral enucleation on incorporation from blood of intravenously injected unsaturated [1-{sup 14}C]arachidonic acid ([{sup 14}C]AA) and [1-{sup 14}C]docosahexaenoic acid ([{sup 14}C]DHA), and of saturated [9,10-{sup 3}H]palmitic acid ([{sup 3}H]PA), into visual and nonvisual brain areas of awake adult Long-Evans hooded rats. Regional cerebral metabolic rate for glucose (rCMR{sub glc}) values also were assessed with 2-deoxy-D-[1-{sup 14}C]glucose ([{sup 14}C]DG). One day after unilateral enucleation, an awake rat was placed in a brightly lit visual stimulation box with black and white striped walls, and a radiolabeled fatty acid was infused for 5 min or [{sup 14}C]DG was injected as a bolus. [{sup 14}C]DG also was injected in a group of rats kept in the dark for 4 h. Fifteen minutes after starting an infusion of a radiolabeled fatty acid, or 45 min after injecting [{sup 14}C]DG, the rat was killed and the brain was prepared for quantitative autoradiography. Incorporation coefficients k* of fatty acids, or rCMR{sub glc} values, were calculated in homologous brain regions contralateral and ipsilateral to enucleation. As compared with ipsilateral regions, rCMR{sub glc} was reduced significantly (by as much as -39%) in contralateral visual areas, including the superior colliculus, lateral geniculate body, and layers I, IV, and V of the primary (striate) and secondary (association, extrastriate) visual cortices. These results indicate that enucleation acutely reduces neuronal activity in contralateral visual areas of the awake rat and that the reductions are coupled to reduced incorporation of unsaturated fatty acids into sn-2 regions of phosphatidylcholine, phosphatidylinositol, and phosphatidylethanolamine. Reduced fatty acid incorporation likely reflects reduced activity of phospholipases A{sub 2} and/or phospholipase C. 65 refs., 5 figs., 5 tabs.

  15. Bilateral acute pyogenic conjunctivitis with iritis induced by unilateral topical application of bacterial peptidoglycan muramyl dipeptide in adult rabbits.

    PubMed

    Langford, Marlyn P; Foreman, Bridgett D; Srur, Lana; Ganley, James P; Redens, Thomas B

    2013-11-01

    The factors responsible for the conjunctivitis and iritis associated with acute ocular infection and post enteric inflammatory disease are not fully known. The pro-inflammatory activity of unilateral topical application of muramyl dipeptide (MDP; the smallest bio-active Gram-positive and Gram-negative bacterial cell wall component) was investigated in adult rabbits. The resultant bilateral conjunctivitis/iritis and pyogenic responses were characterized. Bilateral symptoms were graded by slit lamp examinations; tear fluid, Schirmer tests (tear production), blood and aqueous humor (AH) samples were obtained from MDP-treated and untreated rabbits. MDP concentration, gamma-glutamyltranspeptidase activity (GGT; key enzyme in glutathione recapture, xenobiotic detoxification, eicosanoid synthesis and neutrophil function), protein concentration, and tear cell density, cytology, and immunofluorescent antibody reactivity to GGT and calreticulin (CRT; MDP-binding protein) were determined. MDP was cleared from ipsilateral tears and serum by 6 h, but was undetected in mock-treated contralateral tears. Bilateral signs of acute transient pyogenic conjunctivitis, characterized by tearing, lid edema, conjunctival hyperemia, chemosis and leukocytic infiltrate with iritis (erythema and aqueous flare) were detected. Milder symptoms occurred in the mock-treated contralateral eyes. Bilateral symptoms, tear production, tear protein, GGT activity, and mucopurulent discharge (containing up to 2.5-5.0 × 10(6) cells/mL) were elevated 4-8 h post MDP and resolved to near pre-treatment levels by 24 h. Tear GGT activity and protein levels were higher in MDP-treated and mock-treated contralateral eyes than in eyes of untreated adult rabbits (p's < 0.001). Elevated tear GGT activity was associated with histopathology and increased vascular and epithelial permeability to serum protein, GGT-positive epithelia cells, macrophages and heterophils. Repeat MDP applications induced recurrent

  16. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia.

    PubMed

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-07-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  17. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

    PubMed Central

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-01-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy. PMID:23162409

  18. Acute unilateral vision loss with optic disc oedema in retinitis pigmentosa.

    PubMed

    Patil-Chhablani, Preeti; Tyagi, Mudit; Kekunnaya, Ramesh; Narayanan, Raja

    2015-01-01

    A 36-year-old woman presented with acute vision loss and was found to have disc oedema and retinitis pigmentosa (RP). She presented with a history of acute, painless vision loss in her left eye over a period of 10 days. Her best-corrected visual acuity was 20/50, N6 in the right eye (OD) and 20/160, N6 in the left eye (OS). She was found to have a swollen optic disc and the examination of her fundus showed changes suggestive of RP. The diagnosis of RP was confirmed by electroretinogram, and after ruling out demyelinating changes in the central nervous system and other possible infectious causes of papillitis, she was treated with intravenous steroids followed by a course of oral steroid therapy. Following treatment, her visual acuity improved to 20/60. Acute vision loss may occur in patients with RP and prompt steroid therapy may result in partial visual recovery. PMID:26240107

  19. Acute unilateral vision loss with optic disc oedema in retinitis pigmentosa.

    PubMed

    Patil-Chhablani, Preeti; Tyagi, Mudit; Kekunnaya, Ramesh; Narayanan, Raja

    2015-01-01

    A 36-year-old woman presented with acute vision loss and was found to have disc oedema and retinitis pigmentosa (RP). She presented with a history of acute, painless vision loss in her left eye over a period of 10 days. Her best-corrected visual acuity was 20/50, N6 in the right eye (OD) and 20/160, N6 in the left eye (OS). She was found to have a swollen optic disc and the examination of her fundus showed changes suggestive of RP. The diagnosis of RP was confirmed by electroretinogram, and after ruling out demyelinating changes in the central nervous system and other possible infectious causes of papillitis, she was treated with intravenous steroids followed by a course of oral steroid therapy. Following treatment, her visual acuity improved to 20/60. Acute vision loss may occur in patients with RP and prompt steroid therapy may result in partial visual recovery.

  20. Acute effects of unilateral sectioning the superior ovarian nerve of rats with unilateral ovariectomy on ovarian hormones (progesterone, testosterone and estradiol) levels vary during the estrous cycle

    PubMed Central

    2011-01-01

    The present study analyzed the participation of the left and right superior ovarian nerves (SON) in regulating progesterone, testosterone, and estradiol serum levels in unilaterally ovariectomized rats on each day of the estrous cycle. For this purpose, ovarian hormone concentrations in serum were measured in animals with either sham-surgery, unilateral ovariectomy (ULO), unilateral sectioning of the SON, or sectioning of the SON innervation of the in situ ovary in rats with ULO. This investigation results show that the right and left ovaries have different capacities to maintain normal hormone levels, that such capacity varies during the estrous cycle, and that it depends on the integrity of the SON innervation. In rats with only one ovary, the effects of ovarian denervation on hormone levels varied according to which ovary remained in situ, the specific hormone, and the day of the estrous cycle when treatment was performed. Present results support the idea that the ovaries send and receive neural information that is processed in the central nervous system and we propose that this information participates in controlling the secretion of gonadotropins related to the regulation of ovarian functions. PMID:21414235

  1. Vestibular symptoms and history taking.

    PubMed

    Bisdorff, A

    2016-01-01

    History taking is an essential part in the diagnostic process of vestibular disorders. The approach to focus strongly on the quality of symptoms, like vertigo, dizziness, or unsteadiness, is not that useful as these symptoms often coexist and are all nonspecific, as each of them may arise from vestibular and nonvestibular diseases (like cardiovascular disease) and do not permit to distinguish potentially dangerous from benign causes. Instead, patients should be categorized if they have an acute, episodic, or chronic vestibular syndrome (AVS, EVS, or CVS) to narrow down the spectrum of differential diagnosis. Typical examples of disorders provoking an AVS would be vestibular neuritis or stroke of peripheral or central vestibular structures, of an EVS Menière's disease, benign paroxysmal positional vertigo, or vestibular migraine and of a CVS long-standing uni- or bilateral vestibular failure or cerebellar degeneration. The presence of triggers should be established with a main distinction between positional (change of head orientation with respect to gravity), head motion-induced (time-locked to head motion regardless of direction) and orthostatic position change as the underlying disorders are quite different. Accompanying symptoms also help to orient to the underlying cause, like aural or neurologic symptoms, but also chest pain or dyspnea. PMID:27638064

  2. Unilateral microinjection of acrolein into thoracic spinal cord produces acute and chronic injury and functional deficits.

    PubMed

    Gianaris, Alexander; Liu, Nai-Kui; Wang, Xiao-Fei; Oakes, Eddie; Brenia, John; Gianaris, Thomas; Ruan, Yiwen; Deng, Ling-Xiao; Goetz, Maria; Vega-Alvarez, Sasha; Lu, Qing-Bo; Shi, Riyi; Xu, Xiao-Ming

    2016-06-21

    Although lipid peroxidation has long been associated with spinal cord injury (SCI), the specific role of lipid peroxidation-derived byproducts such as acrolein in mediating damage remains to be fully understood. Acrolein, an α-β unsaturated aldehyde, is highly reactive with proteins, DNA, and phospholipids and is considered as a second toxic messenger that disseminates and augments initial free radical events. Previously, we showed that acrolein increased following traumatic SCI and injection of acrolein induced tissue damage. Here, we demonstrate that microinjection of acrolein into the thoracic spinal cord of adult rats resulted in dose-dependent tissue damage and functional deficits. At 24h (acute) after the microinjection, tissue damage, motoneuron loss, and spinal cord swelling were observed on sections stained with Cresyl Violet. Luxol fast blue staining further showed that acrolein injection resulted in dose-dependent demyelination. At 8weeks (chronic) after the microinjection, cord shrinkage, astrocyte activation, and macrophage infiltration were observed along with tissue damage, neuron loss, and demyelination. These pathological changes resulted in behavioral impairments as measured by both the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale and grid walking analysis. Electron microscopy further demonstrated that acrolein induced axonal degeneration, demyelination, and macrophage infiltration. These results, combined with our previous reports, strongly suggest that acrolein may play a critical causal role in the pathogenesis of SCI and that targeting acrolein could be an attractive strategy for repair after SCI. PMID:27058147

  3. Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis.

    PubMed

    Kim, Chang-Hee; Yang, Young Soo; Im, Donghyuk; Shin, Jung Eun

    2016-06-01

    Conclusion The patients with serous labyrinthitis caused by acute otitis media (AOM) exhibited various patterns of nystagmus in which direction-fixed irritative-type nystagmus was the most common pattern. Differential effects on inner ear function by toxic or inflammatory mediators may be responsible for the various manifestation of nystagmus. Objective This study aimed to investigate nystagmus patterns in patients with serous labyrinthitis, and discuss possible mechanisms. Methods From October 2011 to March 2014, 13 consecutive patients with serous labyrinthitis were included. Eye movements of the patients were serially examined using video-nystagmography, and patterns of nystagmus were investigated. Results The most commonly observed pattern was direction-fixed nystagmus (nine of 13 patients). Of these, eight showed irritative-type, and one showed paretic-type. Direction of nystagmus, although the intensity gradually decreased, was not changed during the course of treatment. One patient showed direction-changing spontaneous nystagmus, which changed into paretic-type direction-fixed nystagmus 1 day after myringotomy. Three patients exhibited persistent direction-changing positional nystagmus in a supine head-roll test. Of them, two showed apogeotropic and one showed geotropic type. In all 13 patients, vertigo and hearing loss were improved after the treatment.

  4. What is the minimal vestibular function required for compensation?

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Wade, S. W.; Nashner, L. M.

    1996-01-01

    Living with an uncompensated, abnormal vestibular system requires oppressive modification of life style and often prevents return to work and activities of daily living. Patients with vestibular abnormalities were studied to determine the minimal residual vestibular function required to achieve compensation. Three groups of patients with (a) complete unilateral loss of vestibular function with normal horizontal canal-vestibulo-ocular (HCVOR) function in the opposite ear, (b) complete unilateral loss with abnormal HCVOR function in the opposite ear, and (c) bilateral reduction of vestibular function from aminoglycoside toxicity underwent vestibuloocular (VOR), optokinetic (OKN), visual-VOR (VVOR), and computerized dynamic posturography (CDP) tests before and after therapeutic procedures. Results suggest that a minimal VOR response amplitude must be present for compensation of VVOR function to occur. The roles of VOR and OKN phase shifts in vestibular compensation are more complicated and require further study. Compensation of vestibulospinal function does not necessarily accompany VOR or VVOR compensation. Ascending and descending vestibular compensatory mechanisms may involve different spatial sensory inputs. Results of these studies have important implications for the diagnosis and treatment of patients with vestibular disorders, including selection and monitoring of patients for therapeutic regimens such as vestibular nerve section and streptomycin therapy.

  5. Balance (or Vestibular) Rehabilitation

    MedlinePlus

    ... for the Public / Hearing and Balance Balance (or Vestibular) Rehabilitation Audiologic (hearing), balance, and medical diagnostic tests help indicate whether you are a candidate for vestibular (balance) rehabilitation. Vestibular rehabilitation is an individualized balance ...

  6. Basic Concepts in Understanding Recovery of Function in Vestibular Reflex Networks during Vestibular Compensation

    PubMed Central

    Peusner, Kenna D.; Shao, Mei; Reddaway, Rebecca; Hirsch, June C.

    2012-01-01

    Unilateral peripheral vestibular lesions produce a syndrome of oculomotor and postural deficits with the symptoms at rest, the static symptoms, partially or completely normalizing shortly after the lesion due to a process known as vestibular compensation. The symptoms are thought to result from changes in the activity of vestibular sensorimotor reflexes. Since the vestibular nuclei must be intact for recovery to occur, many investigations have focused on studying these neurons after lesions. At present, the neuronal plasticity underlying early recovery from the static symptoms is not fully understood. Here we propose that knowledge of the reflex identity and input–output connections of the recorded neurons is essential to link the responses to animal behavior. We further propose that the cellular mechanisms underlying vestibular compensation can be sorted out by characterizing the synaptic responses and time course for change in morphologically defined subsets of vestibular reflex projection neurons. Accordingly, this review focuses on the perspective gained by performing electrophysiological and immunolabeling studies on a specific subset of morphologically defined, glutamatergic vestibular reflex projection neurons, the principal cells of the chick tangential nucleus. Reference is made to pertinent findings from other studies on vestibular nuclei neurons, but no comprehensive review of the literature is intended since broad reviews already exist. From recording excitatory and inhibitory spontaneous synaptic activity in principal cells, we find that the rebalancing of excitatory synaptic drive bilaterally is essential for vestibular compensation to proceed. This work is important for it defines for the first time the excitatory and inhibitory nature of the changing synaptic inputs and the time course for changes in a morphologically defined subset of vestibular reflex projection neurons during early stages of vestibular compensation. PMID:22363316

  7. Functional organization of primate translational vestibulo-ocular reflexes and effects of unilateral labyrinthectomy

    NASA Technical Reports Server (NTRS)

    Angelaki, D. E.; McHenry, M. Q.; Newlands, S. D.; Dickman, J. D.

    1999-01-01

    Translational vestibulo-ocular reflexes (trVORs) are characterized by distinct spatio-temporal properties and sensitivities that are proportional to the inverse of viewing distance. Anodal (inhibitory) labyrinthine stimulation (100 microA, < 2 s) during motion decreased the high-pass filtered dynamics, as well as horizontal trVOR sensitivity and its dependence on viewing distance. Cathodal (excitatory) currents had opposite effects. Translational VORs were also affected after unilateral labyrinthectomy. Animals lost their ability to modulate trVOR sensitivity as a function of viewing distance acutely after the lesion. These deficits partially recovered over time, albeit a significant reduction in trVOR sensitivity as a function of viewing distance remained in compensated animals. During fore-aft motion, the effects of unilateral labyrinthectomy were more dramatic. Both acute and compensated animals permanently lost their ability to modulate fore-aft trVOR responses as a function of target eccentricity. These results suggest that (1) the dynamics and viewing distance-dependent properties of the trVORs are very sensitive to changes in the resting firing rate of vestibular afferents and, consequently, vestibular nuclei neurons; (2) the most irregularly firing primary otolith afferents that are most sensitive to labyrinthine electrical stimulation might contribute to reflex dynamics and sensitivity; (3) inputs from both labyrinths are necessary for the generation of the translational VORs.

  8. Procedures for restoring vestibular disorders

    PubMed Central

    Walther, Leif Erik

    2005-01-01

    This paper will discuss therapeutic possibilities for disorders of the vestibular organs and the neurons involved, which confront ENT clinicians in everyday practice. Treatment of such disorders can be tackled either symptomatically or causally. The possible strategies for restoring the body's vestibular sense, visual function and co-ordination include medication, as well as physical and surgical procedures. Prophylactic or preventive measures are possible in some disorders which involve vertigo (bilateral vestibulopathy, kinetosis, height vertigo, vestibular disorders when diving (Tables 1 (Tab. 1) and 2 (Tab. 2)). Glucocorticoid and training therapy encourage the compensation of unilateral vestibular loss. In the case of a bilateral vestibular loss, it is important to treat the underlying disease (e.g. Cogan's disease). Although balance training does improve the patient's sense of balance, it will not restore it completely. In the case of Meniere's disease, there are a number of medications available to either treat bouts or to act as a prophylactic (e.g. dimenhydrinate or betahistine). In addition, there are non-ablative (sacculotomy) as well as ablative surgical procedures (e.g. labyrinthectomy, neurectomy of the vestibular nerve). In everyday practice, it has become common to proceed with low risk therapies initially. The physical treatment of mild postural vertigo can be carried out quickly and easily in outpatients (repositioning or liberatory maneuvers). In very rare cases it may be necessary to carry out a semicircular canal occlusion. Isolated disturbances of the otolith function or an involvement of the otolith can be found in roughly 50% of labyrinth disturbances. A specific surgical procedure to selectively block the otolith organs is currently being studied. When an external perilymph fistula involving loss of perilymph is suspected, an exploratory tympanotomy involving also the round and oval window niches must be carried out. A traumatic rupture of

  9. The vestibular system

    NASA Technical Reports Server (NTRS)

    Graybiel, A.

    1973-01-01

    The end organs, central nervous system connections, and static and dynamic characteristics of the vestibular system are presented. Vestibular servation in man and vestibular side effect prevention from space missions involving artificial gravity generation are also considered. Vestibular models and design criteria for rotating space vehicles are appended.

  10. [Vestibular migraine].

    PubMed

    Hansen, Lars Juul; Kirchmann, Malene; Friis, Morten

    2015-12-14

    Dizziness caused by migraine, vestibular migraine (VM), has been highly debated over the last three decades. The co-morbidity of migraine and dizziness is higher than a random concurrence. One third of the patients with migraine and dizziness have VM. Recently, The International Headache Society approved VM as a diagnostic entity and the diagnostic criteria for VM appear in the appendix for The International Classification of Headache Disorders. VM is common but often underdiagnosed. Treatment follows migraine management guidelines although evidence is sparse.

  11. Nystagmus in Enlarged Vestibular Aqueduct: A Case Series

    PubMed Central

    White, Judith; Krakovitz, Paul

    2015-01-01

    Enlarged vestibular aqueduct (EVA) is one of the commonly identified congenital temporal bone abnormalities associated with sensorineural hearing loss. Hearing loss may be unilateral or bilateral, and typically presents at birth or in early childhood. Vestibular symptoms have been reported in up to 50% of affected individuals, and may be delayed in onset until adulthood. The details of nystagmus in patients with EVA have not been previously reported. The objectives were to describe the clinical history, vestibular test findings and nystagmus seen in a case series of patients with enlarged vestibular aqueduct anomaly. Chart review, included computed tomography temporal bones, infrared nystagmography with positional and positioning testing, caloric testing, rotary chair and vibration testing. Clinical history and nystagmus varied among the five patients in this series. All patients were initially presumed to have benign paroxysmal positional vertigo, but repositioning treatments were not effective, prompting referral, further testing and evaluation. In three patients with longstanding vestibular complaints, positional nystagmus was consistently present. One patient had distinct recurrent severe episodes of positional nystagmus. Nystagmus was unidirectional and horizontal. In one case horizontal nystagmus was consistently reproducible with seated head turn to the affected side, and reached 48 d/s. Nystagmus associated with enlarged vestibular aqueduct is often positional, and can be confused with benign paroxysmal positional vertigo. Unexplained vestibular symptoms in patients with unilateral or bilateral sensorineural hearing loss should prompt diagnostic consideration of EVA. PMID:26557362

  12. Unilateral perseveration.

    PubMed

    Acosta, Lealani Mae Y; Goodman, Ira J; Heilman, Kenneth M

    2013-12-01

    The brain's action-intentional ("when") programming system helps to control when to and when not to initiate an action, when to persist at an action, and when to terminate an action. Motor perseveration is a failure to terminate an action. This disengagement disorder most often results from dysfunction of the executive frontal-subcortical networks that control the action-intentional programming system. Reports of unilateral perseveration are unusual. Here we describe a patient with a form of progressive supranuclear palsy (PSP) who exhibited continuous right-hand motor perseveration. This 68-year-old right-handed man had impaired walking and vertical gaze, consistent with PSP. He often repeated words, and on many motor tasks he showed continuous perseveration of his right but not his left hand. Unilateral motor perseveration may be a sign of PSP, the corticobasal syndrome, or a subtype of these disorders. Future studies of patients with both disorders should use tasks that assess for asymmetric hand perseveration. The mechanism of the unilateral perseveration must also be determined. Bilateral perseveration is found most often in patients with unilateral right frontal-subcortical (basal ganglia) or insula dysfunction. Because patients with PSP or corticobasal syndrome have callosal degeneration, their unilateral perseveration might result from a callosal disconnection of the right frontal lobe from the left hemisphere's premotor and motor as well as speech areas. PMID:24366105

  13. Primary unilateral cleft lip repair

    PubMed Central

    Adenwalla, H. S.; Narayanan, P. V.

    2009-01-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web. PMID:19884683

  14. Transneuronal down regulation of vestibulo-ocular neurons following vestibular ablation.

    PubMed

    Gacek, R R; Schoonmaker, J E

    1997-11-01

    Unilateral ablation of vestibular input causes lasting morphological changes bilaterally in superior vestibulo-ocular neurons (SVON). The present study was performed to see if these changes in SVON are more pronounced after bilateral vestibular neurectomy. Twenty-three SVON from both vestibular nuclei of 2 cats sacrificed 8 weeks after bilateral ablation were examined utilizing morphometric ultrastructural techniques. There was a significantly greater somal atrophy, loss of synaptic profiles, rough endoplasmic reticulum and polyribosomes compared to unilateral neurectomy. These changes indicate a down regulation that is proportional to the level of deafferentation and may account for functional deficits seen in the vestibulo-ocular reflex after peripheral ablation. PMID:9442818

  15. Altered spontaneous brain activity patterns in patients with unilateral acute open globe injury using amplitude of low-frequency fluctuation: a functional magnetic resonance imaging study

    PubMed Central

    Tan, Gang; Huang, Xin; Ye, Lei; Wu, An-Hua; He, Li-Xian; Zhong, Yu-Lin; Jiang, Nan; Zhou, Fu-Qing; Shao, Yi

    2016-01-01

    Objective The aim of this study was to evaluate altered spontaneous brain activities in patients with unilateral acute open globe injury (OGI) using amplitude of low-frequency fluctuation (ALFF) method and its relationship with their clinical manifestations. Patients and methods A total of 18 patients with acute OGI (16 males and two females) and 18 healthy controls (HCs, 16 males and two females) closely matched in age, sex, and education were recruited in this study. The ALFF method was used to evaluate the altered spontaneous brain activities. The relationships between the mean ALFF signal values of different brain regions and the clinical features were evaluated by correlation analysis. Acute OGI patients were distinguished from HCs by receiver operating characteristic curve. Results Compared with HCs, acute OGI patients had significantly higher ALFF values in the left cuneus, left middle cingulum cortex, and bilateral precuneus. Furthermore, the age of OGI patients showed a negative correlation with the ALFF signal value of the left middle cingulum cortex (r=−0.557, P=0.016) and a negative correlation with the mean ALFF signal value of the bilateral precuneus (r=−0.746, P<0.001). The ALFF signal value of the bilateral precuneus was negatively correlated with the duration of OGI (r=−0.493, P=0.038) and positively correlated with the vision acuity of the injured eye (r=0.583, P=0.011). Conclusion Acute OGI mainly induces dysfunction in the left cuneus, left middle cingulum cortex, and bilateral precuneus, which may reflect the underlying pathologic mechanisms of abnormal brain activities in OGI patients. PMID:27570455

  16. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery

    PubMed Central

    Lacour, Michel; Bernard-Demanze, Laurence

    2015-01-01

    This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalog of results but to provide clinicians with an understandable view on when and how to perform VR therapy, and why VR may benefit from basic knowledge and may influence the recovery process. With this perspective, 10 major recommendations are proposed as ways to identify an optimal functional recovery. Among them are the crucial role of active and early VR therapy, coincidental with a post-lesion sensitive period for neuronal network remodeling, the instructive role that VR therapy may play in this functional reorganization, the need for progression in the VR therapy protocol, which is based mainly on adaptation processes, the necessity to take into account the sensorimotor, cognitive, and emotional profile of the patient to propose individual or “à la carte” VR therapies, and the importance of motivational and ecologic contexts. More than 10 general principles are very likely, but these principles seem crucial for the fast recovery of vestibular loss patients to ensure good quality of life. PMID:25610424

  17. Complications of Microsurgery of Vestibular Schwannoma

    PubMed Central

    Zvěřina, Eduard; Balogová, Zuzana; Skřivan, Jiří; Kraus, Josef; Syka, Josef; Chovanec, Martin

    2014-01-01

    Background. The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery. PMID:24987677

  18. Clinical verification of a unilateral otolith test

    NASA Astrophysics Data System (ADS)

    Wetzig, J.; Hofstetter-Degen, K.; Maurer, J.; von Baumgarten, R. J.

    In a previous study 13 we reported promising results for a new test to differentiate in vivo unilateral otolith functions. That study pointed to a need for further validation on known pathological cases. In this presentation we will detail the results gathered on a group of clinically verified vestibular defectives (verum) and a normal (control) group. The subjects in the verum group were former patients of the ENT clinic of the university hospital. These subjects had usually suffered from neurinoma of the VIIth cranial nerve or inner ear infections. All had required surgical intervention including removal of the vestibular system. The patients were contacted usually two or more years postoperatively. A group of students from the pre- and clinical phase of medical training served as control. Both groups were subjected to standardized clinical tests. These tests served to reconfirm the intra- or postoperative diagnosis of unilateral vestibular loss in the verum group. In the control group they had to establish the normalcy of the responses of the vestibular system. Both groups then underwent testing on our exccentric rotary chair in the manner described before 13. Preliminary results of the trials indicate that this test may indeed for the first time offer a chance to look at isolated otolith apparati in vivo.

  19. Effects of acute unilateral ovariectomy to pre-pubertal rats on steroid hormones secretion and compensatory ovarian responses

    PubMed Central

    2011-01-01

    In the present study we analyzed the existence of asymmetry in the secretion of steroid hormones in pre-pubertal female rats treated with unilateral ovariectomy (ULO) or unilateral perforation of the abdominal wall (sham-surgery). Treated rats were sacrificed at different times after surgery. Since sham-surgery had an apparent effect on the age of first vaginal estrous (FVE) and serum levels hormone, the results of the sham surgery groups were used to assess the effects of their respective surgery treatment groups. On the day of FVE, compensatory ovulation (CO) and compensatory ovarian hypertrophy (COH) were similar in animals with ULO, regardless of the ovary remaining in situ. In ULO treated animals, progesterone (P4) levels were higher than in animals with sham-surgery one hour after treatment but lower in rats sacrificed at FEV. Left-ULO resulted in lower testosterone (T) concentration 48 and 72 hours after surgery. In rats with Right-ULO lower T concentrations were observed in rats sacrificed one or 72 hours after surgery, and at FVE. ULO (left or right) resulted in lower estradiol (E2) concentrations one or 72 hours after treatment. In rats with Left-ULO, E2 levels were higher 48 hours after surgery and at FVE. Left-ULO resulted in higher levels of follicle stimulating hormone (FSH) five hours after surgery and at FVE. FSH levels were higher in rats with Right-ULO sacrificed on FVE. The present results suggest that in the pre-pubertal rat both ovaries have similar capacities to secrete P4, and that the right ovary has a higher capacity to secrete E2. Taken together, the present results support the idea that the effects of ULO result from the decrease in glandular tissue and changes in the neural information arising from the ovary. PMID:21450102

  20. Aging and the human vestibular nuclei: morphometric analysis.

    PubMed

    Alvarez, J C; Díaz, C; Suárez, C; Fernández, J A; González del Rey, C; Navarro, A; Tolivia, J

    2000-04-14

    The data concerning the effects of age on the brainstem are scarce and few works are devoted to the human vestibular nuclear complex. The study of the effects of aging in the vestibular nuclei could have clinical interest due to the high prevalence of balance control and gait problems in the elderly. We have used in this work eight human brainstems of different ages sectioned and stained by the formaldehyde-thionin technique. The neuron's profiles were drawn with a camera lucida and Abercrombie's method was used to estimate the total number of neurons. The test of Kolmogorov-Smirnov with the correction of Lilliefors was used to evaluate the fit of our data to a normal distribution and a regression analysis was done to determine if the variation of our data with age was statistically significant. Aging does not affect the volume or length of the vestibular nuclear complex. Our results clearly show that neuronal loss occurs with aging in the descending (DVN), medial (MVN), and lateral (LVN) vestibular nuclei, but not in the superior (SVN). There are changes in the proportions of neurons of different sizes but they are not statistically significant. The neuronal loss could be related with the problems that elderly people have to compensate unilateral vestibular lesions and the alterations of the vestibulospinal reflexes. The preservation of SVN neurons can explain why vestibulo-ocular reflexes are compensated after unilateral vestibular injuries.

  1. The acute effects of unilateral ankle plantar flexors static- stretching on postural sway and gastrocnemius muscle activity during single-leg balance tasks.

    PubMed

    Lima, Bráulio N; Lucareli, Paulo R G; Gomes, Willy A; Silva, Josinaldo J; Bley, Andre S; Hartigan, Erin H; Marchetti, Paulo H

    2014-09-01

    The aim of this study was to investigate the acute effects of unilateral ankle plantar flexors static- stretching on surface electromyography (sEMG) and the center of pressure (COP) during a single-leg balance task in both lower limbs. Fourteen young healthy, non-athletic individuals performed unipodal quiet standing for 30s before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) a unilateral ankle plantar flexor static- stretching protocol [6 sets of 45s/15s, 70-90% point of discomfort (POD)]. Postural sway was described using the COP area, COP speed (antero-posterior and medio-lateral directions) and COP frequency (antero-posterior and medio-lateral directions). Surface EMG (EMG integral [IEMG] and Median frequency[FM]) was used to describe the muscular activity of gastrocnemius lateralis. Ankle dorsiflexion passive range of motion increased in the stretched limb before and after the static-stretching protocol (mean ± SD: 15.0° ± 6.0 and 21.5° ± 7.0 [p < 0.001]). COP area and IEMG increased in the stretch limb between pre-stretching and immediately post-stretching (p = 0.015 and p = 0.036, respectively). In conclusion, our static- stretching protocol effectively increased passive ankle ROM. The increased ROM appears to increase postural sway and muscle activity; however these finding were only a temporary or transient effect. Key PointsThe postural control can be affected by static- stretching protocol.The lateral gastrocnemius muscle action was increased after the static- stretching protocol.The static- stretching effects remain for less than 10 minutes.

  2. Surgical Procedures for Vestibular Dysfunction

    MedlinePlus

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  3. Review of book vestibular crises

    NASA Technical Reports Server (NTRS)

    Blagoveshchenskaya, N. S.

    1980-01-01

    The etiology, pathogenesis, clinical practice, treatment and rehabilitation of patients with vestibular crises is discussed. Classifications for vestibular disorders are given. Information on the frequency of vestibular crises is given.

  4. [Vestibular compensation studies]. [Vestibular Compensation and Morphological Studies

    NASA Technical Reports Server (NTRS)

    Perachio, Adrian A. (Principal Investigator)

    1996-01-01

    The following topics are reported: neurophysiological studies on MVN neurons during vestibular compensation; effects of spinal cord lesions on VNC neurons during compensation; a closed-loop vestibular compensation model for horizontally canal-related MVN neurons; spatiotemporal convergence in VNC neurons; contributions of irregularly firing vestibular afferents to linear and angular VOR's; application to flight studies; metabolic measures in vestibular neurons; immediate early gene expression following vestibular stimulation; morphological studies on primary afferents, central vestibular pathways, vestibular efferent projection to the vestibular end organs, and three-dimensional morphometry and imaging.

  5. Vestibular efferent neurons project to the flocculus

    NASA Technical Reports Server (NTRS)

    Shinder, M. E.; Purcell, I. M.; Kaufman, G. D.; Perachio, A. A.

    2001-01-01

    A bilateral projection from the vestibular efferent neurons, located dorsal to the genu of the facial nerve, to the cerebellar flocculus and ventral paraflocculus was demonstrated. Efferent neurons were double-labeled by the unilateral injections of separate retrograde tracers into the labyrinth and into the floccular and ventral parafloccular lobules. Efferent neurons were found with double retrograde tracer labeling both ipsilateral and contralateral to the sites of injection. No double labeling was found when using a fluorescent tracer with non-fluorescent tracers such as horseradish peroxidase (HRP) or biotinylated dextran amine (BDA), but large percentages of efferent neurons were found to be double labeled when using two fluorescent substances including: fluorogold, microruby dextran amine, or rhodamine labeled latex beads. These data suggest a potential role for vestibular efferent neurons in modulating the dynamics of the vestibulo-ocular reflex (VOR) during normal and adaptive conditions.

  6. Principles of vestibular pharmacotherapy.

    PubMed

    Chabbert, C

    2016-01-01

    Ideally, vestibular pharmacotherapy is intended, through specific and targeted molecular actions, to significantly alleviate vertigo symptoms, to protect or repair the vestibular sensory network under pathologic conditions, and to promote vestibular compensation, with the eventual aim of improving the patient's quality of life. In fact, in order to achieve this aim, considerable progress still needs to be made. The lack of information on the etiology of vestibular disorders and the pharmacologic targets to modulate, as well as the technical challenge of targeting a drug to its effective site are some of the main issues yet to be overcome. In this review, my intention is to provide an account of the therapeutic principles that have shaped current vestibular pharmacotherapy and to further explore crucial questions that must be taken into consideration in order to develop targeted and specific pharmacologic therapies for each type and stage of vestibular disorders. PMID:27638072

  7. Organization of projections from the raphe nuclei to the vestibular nuclei in rats

    NASA Technical Reports Server (NTRS)

    Halberstadt, A. L.; Balaban, C. D.

    2003-01-01

    Previous anatomic and electrophysiological evidence suggests that serotonin modulates processing in the vestibular nuclei. This study examined the organization of projections from serotonergic raphe nuclei to the vestibular nuclei in rats. The distribution of serotonergic axons in the vestibular nuclei was visualized immunohistochemically in rat brain slices using antisera directed against the serotonin transporter. The density of serotonin transporter-immunopositive fibers is greatest in the superior vestibular nucleus and the medial vestibular nucleus, especially along the border of the fourth ventricle; it declines in more lateral and caudal regions of the vestibular nuclear complex. After unilateral iontophoretic injections of Fluoro-Gold into the vestibular nuclei, retrogradely labeled neurons were found in the dorsal raphe nucleus (including the dorsomedial, ventromedial and lateral subdivisions) and nucleus raphe obscurus, and to a minor extent in nucleus raphe pallidus and nucleus raphe magnus. The combination of retrograde tracing with serotonin immunohistofluorescence in additional experiments revealed that the vestibular nuclei receive both serotonergic and non-serotonergic projections from raphe nuclei. Tracer injections in densely innervated regions (especially the medial and superior vestibular nuclei) were associated with the largest numbers of Fluoro-Gold-labeled cells. Differences were observed in the termination patterns of projections from the individual raphe nuclei. Thus, the dorsal raphe nucleus sends projections that terminate predominantly in the rostral and medial aspects of the vestibular nuclear complex, while nucleus raphe obscurus projects relatively uniformly throughout the vestibular nuclei. Based on the topographical organization of raphe input to the vestibular nuclei, it appears that dense projections from raphe nuclei are colocalized with terminal fields of flocculo-nodular lobe and uvula Purkinje cells. It is hypothesized that

  8. A case of isolated nodulus infarction presenting as a vestibular neuritis.

    PubMed

    Lee, Hyung; Cho, Yong-Won

    2004-06-15

    We reported a patient with cerebellar infarction who presented with purely isolated vertigo, ipsilesional spontaneous nystagmus, and contralesional axial lateropulsion without usual symptoms or signs of cerebellar dysfunction. An MRI of the brain showed a small left cerebellar infarct selectively involving the nodulus. A pure vestibular syndrome in our patient may be explained by ipsilateral involvement of nodulo-vestibular inhibitory projection to vestibular nucleus. Clinicians should be aware of the possibility of a nodulus infarction in patient with acute vestibular syndrome, even if the pattern of nystagmus and lateropulsion is typical of a vestibular neuritis.

  9. Neuronal loss in human medial vestibular nucleus.

    PubMed

    Alvarez, J C; Díaz, C; Suárez, C; Fernández, J A; González del Rey, C; Navarro, A; Tolivia, J

    1998-08-01

    The data concerning the effects of age on the brainstem are inconsistent, and few works are devoted to the human vestibular nuclear complex. The medial vestibular nucleus (MVN) is the largest nucleus of the vestibular nuclear complex, and it seems to be related mainly to vestibular compensation and vestibulo-ocular reflexes. Eight human brainstems have been used in this work. The specimens were embedded in paraffin, sectioned, and stained by the formaldehyde-thionin technique. Neuron profiles were drawn with a camera lucida at x330. Abercrombie's method was used to estimate the total number of neurons. We used the test of Kolmogorov-Smirnov with the correction of Lilliefors to evaluate the fit of our data to a normal distribution, and a regression analysis was performed to determine if the variation of our data with age was statistically significant. The present study clearly shows that neuronal loss occurs with aging. The total number of neurons decreases with age, from 122,241 +/- 651 cells in a 35-year-old individual to 75,915 +/- 453 cells in an 89-year-old individual. Neuron loss was significant in the caudal and intermediate thirds of the nucleus, whereas the changes in the rostral third were not significant. The nuclear diameter of surviving neurons decreased significantly with age. There is a neuron loss in the MVN that seems to be age-related. It could help explain why elderly people find it hard to compensate for unilateral vestibular deficits. The preservation of neurons in the rostral third could be related to the fact that this area primarily innervates the oculolmotor nuclei; these latter neurons do not decrease in number in other species studied.

  10. Otolith-Canal Convergence in Vestibular Nuclei Neurons

    NASA Technical Reports Server (NTRS)

    Dickman, J. David

    1996-01-01

    During manned spaceflight, acute vestibular disturbances often occur, leading to physical duress and a loss of performance. Vestibular adaptation to the weightless environment follows within two to three days yet the mechanisms responsible for the disturbance and subsequent adaptation are still unknown In order to understand vestibular system function in space and normal earth conditions the basic physiological mechanisms of vestibular information co coding must be determined. Information processing regarding head movement and head position with respect to gravity takes place in the vestibular nuclei neurons that receive signals From the semicircular canals and otolith organs in the vestibular labyrinth. These neurons must synthesize the information into a coded output signal that provides for the head and eye movement reflexes as well as the conscious perception of the body in three-dimensional space The current investigation will for the first time. determine how the vestibular nuclei neurons quantitatively synthesize afferent information from the different linear and angular acceleration receptors in the vestibular labyrinths into an integrated output signal. During the second year of funding, progress on the current project has been focused on the anatomical orientation of semicircular canals and the spatial orientation of the innervating afferent responses. This information is necessary in order to understand how vestibular nuclei neurons process the incoming afferent spatial signals particularly with the convergent otolith afferent signals that are also spatially distributed Since information from the vestibular nuclei is presented to different brain regions associated with differing reflexive and sensory functions it is important to understand the computational mechanisms used by vestibular neurons to produce the appropriate output signal.

  11. Unilateral asterixis associated with a mesencephalic syndrome.

    PubMed

    Tarsy, D; Lieberman, B; Chirico-Post, J; Benson, F

    1977-07-01

    Unilateral asterixis due to a focal brain lesion is a rare occurrence. Acute asterixis restricted to the left upper extremity appeared in a patient in association with signs of acute midbrain dysfunction, without changes in mental status or in the EEG, and in the absence of metabolic or toxic disturbance. Electromyography disclosed features typical of asterixis due to metabolic causes.

  12. An electronic prosthesis mimicking the dynamic vestibular function

    NASA Astrophysics Data System (ADS)

    Shkel, Andrei M.

    2006-03-01

    This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular motion is translated into voltage pulses. The voltage pulses are converted into current pulses and are delivered through specially designed electrodes, conditioned to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular neurons to those in animal models reported in the literature. The proposed design is scalable; the sensing unit, pulse generator, and the current source can be potentially implemented on a single chip using integrated MEMS technology.

  13. Management of growing vestibular schwannomas.

    PubMed

    Ferri, Gian Gaetano; Pirodda, Antonio; Ceroni, Alberto Rinaldi; Fioravanti, Antonio; Calbucci, Fabio; Modugno, Giovanni Carlo

    2013-07-01

    Conservative management of small vestibular schwannomas is frequently proposed as most tumours do not grow. Anyway, tumour growth is reported in 30-40 % of the cases, so that surgery is consequently generally proposed. We primarily observed 161 patients affected by unilateral vestibular schwannomas. All patients were examined by means of gadolinium-enhanced magnetic resonance imaging scans. Tumour growth was recorded in 58 cases (35.8 %) and these subjects set up the group of study. Twenty-two (37.9 %) patients were surgically treated; tumour was always completely removed, all patients had normal facial function after surgery and only one patient suffered from a major complication (cerebellar haematoma). Fourteen patients (24.1 %) were submitted to radiotherapy, while one patient was lost at follow-up and another one died because of other medical reasons. Finally, 20 (34.5 %) subjects continued to be observed for different reasons. The mean follow-up period after identification of growth was 6.1 years. Nine tumours continued to grow, nine tumours stopped growing, one tumour grew and then regressed in size and one tumour decreased. Sixty percent of patients with useful hearing at diagnosis preserved it during the entire observation period. In conclusion, most of VS do not grow; in case of tumour growth, a surgical procedure may be suggested and the outcomes are not negatively influenced by the delay of the procedure. But in some cases, patients can still follow the "wait and scan" policy. In fact, only less than half of the growing tumours continued to grow. Moreover, most of the patients continued to retain a useful hearing. PMID:23135237

  14. Polyamines in the lateral vestibular nuclei of the squirrel monkey and their potential role in vestibular compensation

    NASA Technical Reports Server (NTRS)

    Henley, C.; Igarashi, M.

    1993-01-01

    Polyamine synthesis increases in response to injurious stimuli including axotomy and denervation. Reduced eye nystagmus and head-deviation have been observed in unilateral labyrinthectomized (UL) guinea pigs treated with an inhibitor of polyamine synthesis, alpha-difluoromethylornithine (DFMO). We quantified polyamines in the lateral vestibular nuclei (LVN) of control and UL squirrel monkeys during the phase of vestibular compensation (VC) and performed an experiment to determine if DFMO reduces nystagmus previously observed in the guinea pig. Polyamines were detected in the LVN of control and UL squirrel monkeys. Putrescine and spermidine increased in the ipsilateral LVN 3 days after UL with no change in the contralateral LVN. No left-right differences were noted in the 5-day post-UL monkey. DFMO reduced nystagmus in a UL squirrel monkey. These findings suggest that polyamines are important in vestibular function and may contribute to nystagmus observed in VC.

  15. Static Balance in Patients with Vestibular Impairments: A Preliminary Study

    PubMed Central

    Talebi, Hossein; Abtahi, Seyed Hamid Reza; Fereshtenejad, Niloofar

    2016-01-01

    Aims. Vestibular system is indicated as one of the most important sensors responsible for static and dynamic postural control. In this study, we evaluated static balance in patients with unilateral vestibular impairments. Materials and Methods. We compared static balance control using Kistler force plate platform between 10 patients with unilateral vestibular impairments and 20 normal counterparts in the same sex ratio and age limits (50 ± 7). We evaluated excursion and velocity of center of pressure (COP) and path length in anteroposterior (AP) and mediolateral (ML) planes with eyes open and with eyes closed. Results. There was no significant difference between COP excursions in ML and AP planes between both groups with eyes open and eyes closed (p value > 0.05). In contrast, the difference between velocity and path length of COP in the mentioned planes was significant between both groups with eyes open and eyes closed (p value < 0.05). Conclusions. The present study showed the static instability and balance of patients with vestibular impairments indicated by the abnormal characteristics of body balance. PMID:27379198

  16. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis

    MedlinePlus

    ... Home » Health Info » Hearing, Ear Infections, and Deafness Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis On this page: ... more information about vestibular schwannomas? What is a vestibular schwannoma (acoustic neuroma)? Inner ear with vestibular schwannoma ( ...

  17. Data on galvanic-evoked head movements in healthy and unilaterally labyrinthectomized rats.

    PubMed

    Shaabani, Moslem; Lotfi, Yones; Karimian, Seyed Morteza; Rahgozar, Mehdi; Hooshmandi, Mehdi

    2016-12-01

    In this dataset, we analyzed galvanic-evoked head movements (GEHMs) in the spatial planes of yaw, and roll in normal and unilaterally labyrinthectomized (UL) Wistar rats. The rats were assigned in 4 groups of 10: control, sham, right-UL and left-UL. Bilateral galvanic vestibular stimulation (GVS) was presented by our "ring-shaped electrode" design (see "Short-term galvanic vestibular stimulation promotes functional recovery and neurogenesis in unilaterally labyrinthectomized rats" (M. Shaabani et al., 2016) [1]). Required data were collected through video recording of GEHMs followed by image processing and statistical analysis. PMID:27672673

  18. Plasticity of spontaneous excitatory and inhibitory synaptic activity in morphologically defined vestibular nuclei neurons during early vestibular compensation

    PubMed Central

    Shao, Mei; Hirsch, June C.

    2012-01-01

    After unilateral peripheral vestibular lesions, the brain plasticity underlying early recovery from the static symptoms is not fully understood. Principal cells of the chick tangential nucleus offer a subset of morphologically defined vestibular nuclei neurons to study functional changes after vestibular lesions. Chickens show posture and balance deficits immediately after unilateral vestibular ganglionectomy (UVG), but by 3 days most subjects begin to recover, although some remain uncompensated. With the use of whole cell voltage-clamp, spontaneous excitatory and inhibitory postsynaptic currents (sEPSCs and sIPSCs) and miniature excitatory and inhibitory postsynaptic currents (mEPSCs and mIPSCs) were recorded from principal cells in brain slices 1 and 3 days after UVG. One day after UVG, sEPSC frequency increased on the lesion side and remained elevated at 3 days in uncompensated chickens only. Also by 3 days, sIPSC frequency increased on the lesion side in all operated chickens due to major increases in GABAergic events. Significant change also occurred in decay time of the events. To determine whether fluctuations in frequency and kinetics influenced overall excitatory or inhibitory synaptic drive, synaptic charge transfer was calculated. Principal cells showed significant increase in excitatory synaptic charge transfer only on the lesion side of uncompensated chickens. Thus compensation continues when synaptic charge transfer is in balance bilaterally. Furthermore, excessive excitatory drive in principal cells on the lesion side may prevent vestibular compensation. Altogether, this work is important for it defines the time course and excitatory and inhibitory nature of changing spontaneous synaptic inputs to a morphologically defined subset of vestibular nuclei neurons during critical early stages of recovery after UVG. PMID:21957228

  19. Medication (for Vestibular Disorders)

    MedlinePlus

    ... and should be carried out in every patient. Eye movement evaluation is one of the major windows in this respect because particular eye movements are evoked by particular vestibular conditions. A precise ...

  20. Vestibular Disorders Association

    MedlinePlus

    ... your journey to diagnosis and recovery. VEDA Resource Library Visit VEDA's Resource Library to get more information about your vestibular disorder ... VEDA | ALL RIGHTS RESERVED | SITE MAINTAINED BY BROOKS DIGITAL Did this information help you? Become a member ...

  1. Correlation of Fos expression and circling asymmetry during gerbil vestibular compensation

    NASA Technical Reports Server (NTRS)

    Kaufman, G. D.; Shinder, M. E.; Perachio, A. A.

    1999-01-01

    Vestibular compensation is a central nervous system process resulting in recovery of functional movement and control following a unilateral vestibular lesion. Small pressure injections of phosphorothioate 20mer oligonucleotides were used to probe the role of the Fos transcription protein during vestibular compensation in the gerbil brainstem. During isoflurane gas anesthesia, antisense probes against the c-fos mRNA sequence were injected into the medial vestibular and prepositus nuclei unilaterally prior to a unilateral surgical labyrinthectomy. Anionic dyes, which did not interact with the oligonucleotides, were used to mark the injection site and help determine the extent of diffusion. The antiFos oligonucleotide injections reduced Fos expression at the injection site in neurons which normally express Fos after the lesion, and also affected circling behavior induced by hemilabyrinthectomy. With both ipsilateral and contralateral medial vestibular and prepositus nuclei injections, less ipsilateral and more contralateral circling was noted in animals injected with antiFos injections as compared to non-injected controls. The degree of change in these behaviors was dependent upon the side of the injection. Histologically, antiFos injections reduced the number of Fos immunolabeled neurons around the injection site, and increased Fos expression contralaterally. The correlation of the number of neurons with Fos expression to turning behavior was stronger for contralateral versus ipsilateral turns, and for neurons in the caudal and ipsilateral sub-regions of the medial vestibular and prepositus nuclei. The results are discussed in terms of neuronal firing activity versus translational activity based on the asymmetrical expression of the Fos inducible transcription factor in the medial vestibular and prepositus nuclei. Although ubiquitous in the brain, transcription factors like Fos can serve localized and specific roles in sensory-specific adaptive stimuli. Antisense

  2. GABAB RECEPTORS CONTRIBUTE TO THE RESTORATION OF BALANCE DURING VESTIBULAR COMPENSATION IN MICE

    PubMed Central

    Heskin-Sweezie, Raquel; Titley, Heather K.; Baizer, Joan S.; Broussard, Dianne M.

    2010-01-01

    Following unilateral vestibular damage (UVD), vestibular compensation restores both static and dynamic vestibular reflexes. The cerebellar cortex provides powerful GABAergic inhibitory input to the vestibular nuclei which is necessary for compensation. Metabotropic GABA type B (GABAB) receptors in the vestibular nuclei are thought to be involved. However, the contribution of GABAB receptors may differ between static and dynamic compensation. We tested static and dynamic postural reflexes and gait in young mice, while they compensated for unilateral vestibular damage (UVD) caused by injection of air into the vestibular labyrinth. The effects of an agonist (baclofen), an antagonist (CGP56433A) and a positive allosteric modulator (CGP7930) of the GABAB receptor were evaluated during compensation. Static postural reflexes recovered very rapidly in our model, and baclofen slightly accelerated recovery. However, CGP56433A significantly impaired static compensation. Dynamic reflexes were evaluated by balance-beam performance and by gait; both showed significant decrements following UVD and performance improved over the next 2 days. Both CGP56433A and baclofen temporarily impaired the ability to walk on a balance beam after UVD. Two days later, there were no longer any significant effects of drug treatments on balance-beam performance. Baclofen slightly accelerated the recovery of stride length on a flat surface, but CGP7930 worsened the gait impairment following UVD. Using immunohistochemistry, we confirmed that GABAB receptors are abundantly expressed on the vestibulospinal neurons of Deiters in mice. Our results suggest that GABAB receptors contribute to the compensation of static vestibular reflexes following unilateral peripheral damage. We also conclude that impairment of the first stage of compensation, static recovery, does not necessarily result in an impairment of dynamic recovery in the long term. PMID:20394801

  3. Unilateral adaptation of the human angular vestibulo-ocular reflex.

    PubMed

    Migliaccio, Americo A; Schubert, Michael C

    2013-02-01

    A recent study showed that the angular vestibulo-ocular reflex (VOR) can be better adaptively increased using an incremental retinal image velocity error signal compared with a conventional constant large velocity-gain demand (×2). This finding has important implications for vestibular rehabilitation that seeks to improve the VOR response after injury. However, a large portion of vestibular patients have unilateral vestibular hypofunction, and training that raises their VOR response during rotations to both the ipsilesional and contralesional side is not usually ideal. We sought to determine if the vestibular response to one side could selectively be increased without affecting the contralateral response. We tested nine subjects with normal vestibular function. Using the scleral search coil and head impulse techniques, we measured the active and passive VOR gain (eye velocity / head velocity) before and after unilateral incremental VOR adaptation training, consisting of self-generated (active) head impulses, which lasted ≈ 15 min. The head impulses consisted of rapid, horizontal head rotations with peak-amplitude 15°, peak-velocity 150°/s and peak-acceleration 3,000°/s(2). The VOR gain towards the adapting side increased after training from 0.92 ± 0.18 to 1.11 ± 0.22 (+22.7 ± 20.2 %) during active head impulses and from 0.91 ± 0.15 to 1.01 ± 0.17 (+11.3 ± 7.5 %) during passive head impulses. During active impulses, the VOR gain towards the non-adapting side also increased by ≈ 8 %, though this increase was ≈ 70 % less than to the adapting side. A similar increase did not occur during passive impulses. This study shows that unilateral vestibular adaptation is possible in humans with a normal VOR; unilateral incremental VOR adaptation may have a role in vestibular rehabilitation. The increase in passive VOR gain after active head impulse adaptation suggests that the training effect is robust.

  4. Assessing vestibular dysfunction. Exploring treatments of a complex condition.

    PubMed

    Childs, Lisa A

    2010-07-01

    In summary, patients with BPPV can be treated with the canalith repositioning maneuver. Patients with unilateral vestibular hypofunction can be treated using adaptation, substitution, and/or habituation exercises. Patients with motion sensitivity can demonstrate improved tolerance to motion after performing habituation exercises. Patients with bilateral vestibular loss will benefit from substitution and adaptation exercises. Each patient requires a treatment regime that is individualized and appropriate to address their impairments. Often the treatment is determined through the evaluation process. The task that causes the patient's complaints, whether it be dizziness, imbalance, and/or issues with eye-head coordination, often becomes the treatment of choice, gradually increasing difficulty as appropriate and safe. Patients with TBI who have concomitant vestibular dysfunction are a challenging population to treat. One has to be cognizant of cognitive deficits that may interfere with or prolong treatment as well as the many other neurological deficits that may be present because of the brain injury. For example, attempting to perform the canalith repositioning maneuver on a patient status post TBI when they are not able to comprehend the reasoning behind the treatment can lead to agitation or behavioral issues. Communication with the patient's primary doctor is a necessity so that the team is always on the same page about the approach to treatment. Vestibular evaluation and rehabilitation are a necessity for patients who have experienced a TBI. The sooner the problems are identified, the sooner treatment can be initiated with the goal of helping patients recover their maximal functional level of independence and safety. Also, treating patients with TBI and vestibular impairments can require increased treatment time in comparison to treatment of a patient with only vestibular dysfunction, so the sooner the treatment for vestibular dysfunction can be started, the

  5. Central vestibular disorders.

    PubMed

    Dieterich, Marianne

    2007-05-01

    Dizziness or vertigo is an erroneous perception of selfmotion or object-motion as well as an unpleasant distortion of static gravitational orientation. It is caused by a mismatch between the vestibular, visual, and somatosensory systems. Thanks to their functional overlap, the three systems are able to compensate, in part, for each other's deficiencies. Thus, vertigo is not a well-defined disease entity, but rather a multisensory syndrome that results when there is a pathological dysfunction of any of the stabilizing sensory systems (e.g., central vestibular disorders, peripheral vestibular diseases with asymmetric input into the vestibular nuclei). This article provides an overview of the most important and frequent forms of central vestibular vertigo syndromes, including basilar/vestibular migraine, which are characterized by ocular motor, postural, and perceptual signs. In a simple clinical classification they can be separated according to the three major planes of action of the vestibulo-ocular reflex: yaw, roll, and pitch. A tonic imbalance in yaw is characterized by horizontal nystagmus, lateropulsion of the eyes, past-pointing, rotational and lateral body falls, and lateral deviation of the perceived straight-ahead. A tonic imbalance in roll is defined by torsional nystagmus, skew deviation, ocular torsion, tilts of head, body, and the perceived vertical. Finally, a tonic imbalance in pitch can be characterized by some forms of upbeat or downbeat nystagmus, fore-aft tilts and falls, and vertical deviation of the perceived straight ahead. The thus defined syndromes allow for a precise topographic diagnosis as regards their level and side.

  6. Recovery from vestibular ototoxicity

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Gianna-Poulin, C.; Pesznecker, S. C.

    2001-01-01

    OBJECTIVE: Determine whether subjects with documented vestibular ototoxicity recover vestibular function and, if so, investigate the recovery dynamics. STUDY DESIGN: Prospective and retrospective reviews and repeated measures. SETTING: Clinical research and technology center. SUBJECTS: Twenty-eight subjects who received vestibulotoxic medications were followed for at least 12 months after initial treatment. CONTROLS: Our subject sample was compared with a published database of normal individuals. INTERVENTIONS: All 28 subjects received systemically administered medications known to be ototoxic. The subjects' treating physicians controlled medication, dosage, and administration schedules. MAIN OUTCOME MEASURES: Tests of horizontal canal vestibulo-ocular function were performed. Subjects' auditory and vestibular symptoms were recorded. RESULTS: Eleven subjects (39%) showed changes in horizontal canal vestibulo-ocular gain constant (GC) and/or time constant (TC) consistent with vestibular ototoxicity. When tested 1 year after ototoxic drug administration, eight of the nine subjects who experienced ototoxic decrease in GC showed a recovery of GC to normal limits. Only one of the eight subjects who experienced ototoxic decrease in TC showed recovery of TC to within normal limits. Ototoxicity onset and recovery were independent of baseline vestibular function, and ototoxicity onset did not correlate with cumulative dose of ototoxic medication. There was no relationship between subjective symptoms and ototoxicity onset. CONCLUSIONS: Recovery of GC after vestibular ototoxicity is more commonly observed than recovery of TC. Because ototoxic changes developed and continued in an unpredictable time and manner in relation to ototoxic drug administration, we propose that once ototoxic changes in vestibulo-ocular reflex are detected, ototoxic medications should be discontinued as soon as possible.

  7. Relationships among rat ultrasonic vocalizations, behavioral measures of striatal dopamine loss, and striatal tyrosine hydroxylase immunoreactivity at acute and chronic time points following unilateral 6-hydroxydopamine-induced dopamine depletion.

    PubMed

    Grant, Laura M; Barnett, David G; Doll, Emerald J; Leverson, Glen; Ciucci, Michelle

    2015-09-15

    Voice deficits in Parkinson disease (PD) emerge early in the disease process, but do not improve with standard treatments targeting dopamine. Experimental work in the rat shows that severe and chronic unilateral nigrostriatal dopamine depletion with 6-OHDA results in decreased intensity, bandwidth, and complexity of ultrasonic vocalizations. However, it is unclear if mild/acute dopamine depletion, paralleling earlier stages of PD, results in vocalization deficits, or to what degree vocalization parameters are correlated with other dopamine-dependent indicators of lesion severity or percent of tyrosine hydroxylase (%TH) loss. Here, we assayed ultrasonic vocalizations, forelimb asymmetry, and apomorphine rotations in rats with a range of unilateral dopamine loss resulting from 6-OHDA or vehicle control infusions to the medial forebrain bundle at acute (72 h) and chronic (4 weeks) time points post-infusion. The %TH loss was evaluated at 4 weeks. At 72 h, forelimb asymmetry and %TH loss were significantly correlated, while at 4 weeks, all measures of lesion severity were significantly correlated with each other. Call complexity was significantly correlated with all measures of lesion severity at 72 h but only with %TH loss at 4 weeks. Bandwidth was correlated with forelimb asymmetry at both time points. Duration was significantly correlated with all dopamine depletion measures at 4 weeks. Notably, not all parameters were affected universally or equally across time. These results suggest that vocalization deficits may be a sensitive index of acute and mild catecholamine loss and further underscores the need to characterize the neural mechanisms underlying vocal deficits in PD.

  8. Modern vestibular function testing.

    PubMed Central

    Baloh, R W; Furman, J M

    1989-01-01

    Current tests of vestibular function concentrate on the horizontal semicircular canal-ocular reflex because it is the easiest reflex to stimulate (calorically and rotationally) and record (using electro-oculography). Tests of the other vestibulo-ocular reflexes (vertical semicircular canal and otolith) and of the vestibulospinal reflexes have yet to be shown useful in the clinical setting. Digital video recording of eye movements and vestibular-evoked responses are promising new technologies that may affect clinical testing in the near future. PMID:2660408

  9. Modification of unilateral otolith responses following spaceflight.

    PubMed

    Clarke, Andrew H; Schönfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing.

  10. Modification of unilateral otolith responses following spaceflight.

    PubMed

    Clarke, Andrew H; Schönfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing. PMID:26358122

  11. Vestibular system paresis due to emergency endovascular catheterization

    PubMed Central

    Simoceli, Lucinda; Sguillar, Danilo Anunciatto; Santos, Henrique Mendes Paiva; Caputti, Camilla

    2012-01-01

    Summary Objective: The objective of this story of case is to describe an uncommon cause of associated peripheral Vestibulopathy to the unilateral auditory loss in aged patient after catheterization of urgency. Story of case: Patient of the masculine sort, 82 years, submitted to the correction of abdominal ragged aneurism of aorta, in the intra-operative suffered heart attack acute from the myocardium needing primary angioplasty. High after hospital it relates to complaint of accented hearing loss to the right and crippling vertigo, without focal neurological signals. To the otorhinolaryngological clinical examination it presented: Test of Weber lateralized for the left, spontaneous nystagmus for the left, marches rocking, has taken normal disbasia and ataxia, index-nose and diadochokinesia, Test of Romberg with oscillation without fall and Fukuda with lateral shunting line for the right. The audiometric examination evidenced deafness to the right and sensorineural loss to the left in sharps, areflexia initial to the right in caloric test e, the computerized tomography of the secular bones and brainstem, presence of metallic connecting rod crossing the right secular bone, from the vein internal jugular vein and bulb jugular vein, crossing the posterior, superior and vestibule semicircular canals, projecting itself in temporal lobe. The radiological diagnoses was traumatic injury for guide to endovascular metallic during catheterization of urgency and the behavior, considering that the patient had not compensated the balance, it was vestibular rehabilitation. Conclusion: Complaints of giddiness in the aged patient must be closely evaluated of its pathological clinical description because the antecedents of illnesses and previous treatments, in general, direct the diagnostic hypotheses however they can bring unexpected alterations. PMID:25991947

  12. Heritable unilateral clinical anophthalmia.

    PubMed

    Griepentrog, Gregory J; Lucarelli, Mark J

    2004-03-01

    We examined a newborn child with unilateral right-sided clinical anophthalmos born to a mother with unilateral left-sided anophthalmos. Although rare, isolated nonsyndromic heritable unilateral anophthalmia and microphthalmia have been reported in the literature. We briefly review the genetics of such anomalies and discuss the importance of a full clinical genetics evaluation. Treatment of this patient's anophthalmic socket consists of progressive conformer expansion to be followed by placement of a self-inflating polymer expander.

  13. Staging in giant vestibular schwannoma surgery: A two consecutive day technique for complete resection in basic neurosurgical setups

    PubMed Central

    Bandlish, Deepak; Biswas, Nilay; Deb, Sumit

    2014-01-01

    Introduction: Vestibular schwannomas constitute 8% of all intracranial tumors. A majority of vestibular schwannomas are sporadic and unilateral. Giant vestibular schwannomas are seen in our country due to the late diagnosis and long duration of symptoms before diagnosis. These giant schwannomas are challenging to manage as most of the patients are having brainstem compression. Materials and Methods: Twelve cases of a giant vestibular schwannoma were operated in our department between May 2011 and December 2012. Vestibular schwannomas with a maximal diameter of more than 4 cm were defined as a giant vestibular schwannoma. All the patients had a unilateral vestibular schwannoma. Performance status of all the patients were graded as per the Karnofsky performance score. Pre-operative assessment of 5th, 7th, 8th and lower cranial nerve status was done in all cases. Ventriculoperitoneal shunting was done pre-operatively in all cases. All patients were operated through retromastoid suboccipital craniectomy and retrosigmoid approach. These patients were operated in two stages in two consecutive days with overnight elective ventilation in ICU. Ultrasonic aspirator and nerve monitoring techniques were not used. Results: Giant acoustic schwannomas can be safely resected completely by a staged resection on two consecutive days without any increased morbidity or mortality. This technique may be employed to achieve complete resection of such lesions without deterioration of facial nerve function in institutions which do not have advanced facilities like nerve monitoring or ultrasonic aspirator. PMID:25002760

  14. Dizziness and Imbalance in the Elderly: Age-related Decline in the Vestibular System.

    PubMed

    Iwasaki, Shinichi; Yamasoba, Tatsuya

    2015-02-01

    Dizziness and imbalance are amongst the most common complaints in older people, and are a growing public health concern since they put older people at a significantly higher risk of falling. Although the causes of dizziness in older people are multifactorial, peripheral vestibular dysfunction is one of the most frequent causes. Benign paroxysmal positional vertigo is the most frequent form of vestibular dysfunction in the elderly, followed by Meniere's disease. Every factor associated with the maintenance of postural stability deteriorates during aging. Age-related deterioration of peripheral vestibular function has been demonstrated through quantitative measurements of the vestibulo-ocular reflex with rotational testing and of the vestibulo-collic reflex with testing of vestibular evoked myogenic potentials. Age-related decline of vestibular function has been shown to correlate with the age-related decrease in the number of vestibular hair cells and neurons. The mechanism of age-related cellular loss in the vestibular endorgan is unclear, but it is thought that genetic predisposition and cumulative effect of oxidative stress may both play an important role. Since the causes of dizziness in older people are multi-factorial, management of this disease should be customized according to the etiologies of each individual. Vestibular rehabilitation is found to be effective in treating both unilateral and bilateral vestibular dysfunction. Various prosthetic devices have also been developed to improve postural balance in older people. Although there have been no medical treatments improving age-related vestibular dysfunction, new medical treatments such as mitochondrial antioxidants or caloric restriction, which have been effective in preventing age-related hearing loss, should be ienvestigated in the future. PMID:25657851

  15. Dizziness and Imbalance in the Elderly: Age-related Decline in the Vestibular System

    PubMed Central

    Iwasaki, Shinichi; Yamasoba, Tatsuya

    2015-01-01

    Dizziness and imbalance are amongst the most common complaints in older people, and are a growing public health concern since they put older people at a significantly higher risk of falling. Although the causes of dizziness in older people are multifactorial, peripheral vestibular dysfunction is one of the most frequent causes. Benign paroxysmal positional vertigo is the most frequent form of vestibular dysfunction in the elderly, followed by Meniere’s disease. Every factor associated with the maintenance of postural stability deteriorates during aging. Age-related deterioration of peripheral vestibular function has been demonstrated through quantitative measurements of the vestibulo-ocular reflex with rotational testing and of the vestibulo-collic reflex with testing of vestibular evoked myogenic potentials. Age-related decline of vestibular function has been shown to correlate with the age-related decrease in the number of vestibular hair cells and neurons. The mechanism of age-related cellular loss in the vestibular endorgan is unclear, but it is thought that genetic predisposition and cumulative effect of oxidative stress may both play an important role. Since the causes of dizziness in older people are multi-factorial, management of this disease should be customized according to the etiologies of each individual. Vestibular rehabilitation is found to be effective in treating both unilateral and bilateral vestibular dysfunction. Various prosthetic devices have also been developed to improve postural balance in older people. Although there have been no medical treatments improving age-related vestibular dysfunction, new medical treatments such as mitochondrial antioxidants or caloric restriction, which have been effective in preventing age-related hearing loss, should be ienvestigated in the future. PMID:25657851

  16. Reconsidering the Role of Neuronal Intrinsic Properties and Neuromodulation in Vestibular Homeostasis

    PubMed Central

    Beraneck, Mathieu; Idoux, Erwin

    2011-01-01

    The sensorimotor transformations performed by central vestibular neurons constantly adapt as the animal faces conflicting sensory information or sustains injuries. To ensure the homeostasis of vestibular-related functions, neural changes could in part rely on the regulation of 2° VN intrinsic properties. Here we review evidence that demonstrates modulation and plasticity of central vestibular neurons’ intrinsic properties. We first present the partition of Rodents’ vestibular neurons into distinct subtypes, namely type A and type B. Then, we focus on the respective properties of each type, their putative roles in vestibular functions, fast control by neuromodulators and persistent modifications following a lesion. The intrinsic properties of central vestibular neurons can be swiftly modulated by a wealth of neuromodulators to adapt rapidly to temporary changes of ecophysiological surroundings. To illustrate how intrinsic excitability can be rapidly modified in physiological conditions and therefore be therapeutic targets, we present the modulation of vestibular reflexes in relation to the variations of the neuromodulatory inputs during the sleep/wake cycle. On the other hand, intrinsic properties can also be slowly, yet permanently, modified in response to major perturbations, e.g., after unilateral labyrinthectomy (UL). We revisit the experimental evidence, which demonstrates that drastic alterations of the central vestibular neurons’ intrinsic properties occur following UL, with a slow time course, more on par with the compensation of dynamic deficits than static ones. Data are interpreted in the framework of distributed processes that progress from global, large-scale coping mechanisms (e.g., changes in behavioral strategies) to local, small-scale ones (e.g., changes in intrinsic properties). Within this framework, the compensation of dynamic deficits improves over time as deeper modifications are engraved within the finer parts of the vestibular

  17. Neuronal detection thresholds during vestibular compensation: contributions of response variability and sensory substitution

    PubMed Central

    Jamali, Mohsen; Mitchell, Diana E; Dale, Alexis; Carriot, Jerome; Sadeghi, Soroush G; Cullen, Kathleen E

    2014-01-01

    The vestibular system is responsible for processing self-motion, allowing normal subjects to discriminate the direction of rotational movements as slow as 1–2 deg s−1. After unilateral vestibular injury patients’ direction–discrimination thresholds worsen to ∼20 deg s−1, and despite some improvement thresholds remain substantially elevated following compensation. To date, however, the underlying neural mechanisms of this recovery have not been addressed. Here, we recorded from first-order central neurons in the macaque monkey that provide vestibular information to higher brain areas for self-motion perception. Immediately following unilateral labyrinthectomy, neuronal detection thresholds increased by more than two-fold (from 14 to 30 deg s−1). While thresholds showed slight improvement by week 3 (25 deg s−1), they never recovered to control values – a trend mirroring the time course of perceptual thresholds in patients. We further discovered that changes in neuronal response variability paralleled changes in sensitivity for vestibular stimulation during compensation, thereby causing detection thresholds to remain elevated over time. However, we found that in a subset of neurons, the emergence of neck proprioceptive responses combined with residual vestibular modulation during head-on-body motion led to better neuronal detection thresholds. Taken together, our results emphasize that increases in response variability to vestibular inputs ultimately constrain neural thresholds and provide evidence that sensory substitution with extravestibular (i.e. proprioceptive) inputs at the first central stage of vestibular processing is a neural substrate for improvements in self-motion perception following vestibular loss. Thus, our results provide a neural correlate for the patient benefits provided by rehabilitative strategies that take advantage of the convergence of these multisensory cues. PMID:24366259

  18. Functional and psychiatric vestibular disorders.

    PubMed

    Staab, J P

    2016-01-01

    Behavioral factors have long been recognized as affecting spatial orientation and balance function. Neuroanatomic and neurophysiologic studies conducted worldwide over the last 30 years have substantially advanced our knowledge about the inherently strong connectivity among threat/anxiety, vestibular, visual, and somatosensory systems in the brain. Clinical investigations have shed greater light on the nature of functional and psychiatric disorders that manifest or magnify vestibular morbidity. Concepts of these syndromes have changed over 150 years. Even their nomenclature has had different meanings in different eras. This chapter will review functional and psychiatric vestibular disorders. Terminology will follow the International Classification of Diseases, 11th edition, beta draft and the International Classification of Vestibular Disorders. Anxiety plays a central role in behavioral vestibular morbidity. Anxiety, traumatic stress, obsessive, and depressive disorders may be primary causes of episodic and chronic vestibular symptoms or secondary complications of other vestibular disorders. These psychiatric illnesses affect 30-50% of patients who consult neurologists or otologists for vestibular symptoms. Coexisting psychiatric disorders adversely affect treatment for patients with structural vestibular diseases, especially when unrecognized. Persistent postural-perceptual dizziness is the leading cause of long-term vestibular disability. Fortunately, pharmacologic, psychotherapeutic, and rehabilitative treatments of these illnesses have improved in recent years. PMID:27638082

  19. Neural Network Model of Vestibular Nuclei Reaction to Onset of Vestibular Prosthetic Stimulation

    PubMed Central

    DiGiovanna, Jack; Nguyen, T. A. K.; Guinand, Nils; Pérez-Fornos, Angelica; Micera, Silvestro

    2016-01-01

    The vestibular system incorporates multiple sensory pathways to provide crucial information about head and body motion. Damage to the semicircular canals, the peripheral vestibular organs that sense rotational velocities of the head, can severely degrade the ability to perform activities of daily life. Vestibular prosthetics address this problem by using stimulating electrodes that can trigger primary vestibular afferents to modulate their firing rates, thus encoding head movement. These prostheses have been demonstrated chronically in multiple animal models and acutely tested in short-duration trials within the clinic in humans. However, mainly, due to limited opportunities to fully characterize stimulation parameters, there is a lack of understanding of “optimal” stimulation configurations for humans. Here, we model possible adaptive plasticity in the vestibular pathway. Specifically, this model highlights the influence of adaptation of synaptic strengths and offsets in the vestibular nuclei to compensate for the initial activation of the prosthetic. By changing the synaptic strengths, the model is able to replicate the clinical observation that erroneous eye movements are attenuated within 30 minutes without any change to the prosthetic stimulation rate. Although our model was only built to match this time point, we further examined how it affected subsequent pulse rate modulation (PRM) and pulse amplitude modulation (PAM). PAM was more effective than PRM for nearly all stimulation configurations during these acute tests. Two non-intuitive relationships highlighted by our model explain this performance discrepancy. Specifically, the attenuation of synaptic strengths for afferents stimulated during baseline adaptation and the discontinuity between baseline and residual firing rates both disproportionally boost PAM. Comodulation of pulse rate and amplitude has been experimentally shown to induce both excitatory and inhibitory eye movements even at high

  20. Neural Network Model of Vestibular Nuclei Reaction to Onset of Vestibular Prosthetic Stimulation.

    PubMed

    DiGiovanna, Jack; Nguyen, T A K; Guinand, Nils; Pérez-Fornos, Angelica; Micera, Silvestro

    2016-01-01

    The vestibular system incorporates multiple sensory pathways to provide crucial information about head and body motion. Damage to the semicircular canals, the peripheral vestibular organs that sense rotational velocities of the head, can severely degrade the ability to perform activities of daily life. Vestibular prosthetics address this problem by using stimulating electrodes that can trigger primary vestibular afferents to modulate their firing rates, thus encoding head movement. These prostheses have been demonstrated chronically in multiple animal models and acutely tested in short-duration trials within the clinic in humans. However, mainly, due to limited opportunities to fully characterize stimulation parameters, there is a lack of understanding of "optimal" stimulation configurations for humans. Here, we model possible adaptive plasticity in the vestibular pathway. Specifically, this model highlights the influence of adaptation of synaptic strengths and offsets in the vestibular nuclei to compensate for the initial activation of the prosthetic. By changing the synaptic strengths, the model is able to replicate the clinical observation that erroneous eye movements are attenuated within 30 minutes without any change to the prosthetic stimulation rate. Although our model was only built to match this time point, we further examined how it affected subsequent pulse rate modulation (PRM) and pulse amplitude modulation (PAM). PAM was more effective than PRM for nearly all stimulation configurations during these acute tests. Two non-intuitive relationships highlighted by our model explain this performance discrepancy. Specifically, the attenuation of synaptic strengths for afferents stimulated during baseline adaptation and the discontinuity between baseline and residual firing rates both disproportionally boost PAM. Comodulation of pulse rate and amplitude has been experimentally shown to induce both excitatory and inhibitory eye movements even at high baseline

  1. Neural Network Model of Vestibular Nuclei Reaction to Onset of Vestibular Prosthetic Stimulation.

    PubMed

    DiGiovanna, Jack; Nguyen, T A K; Guinand, Nils; Pérez-Fornos, Angelica; Micera, Silvestro

    2016-01-01

    The vestibular system incorporates multiple sensory pathways to provide crucial information about head and body motion. Damage to the semicircular canals, the peripheral vestibular organs that sense rotational velocities of the head, can severely degrade the ability to perform activities of daily life. Vestibular prosthetics address this problem by using stimulating electrodes that can trigger primary vestibular afferents to modulate their firing rates, thus encoding head movement. These prostheses have been demonstrated chronically in multiple animal models and acutely tested in short-duration trials within the clinic in humans. However, mainly, due to limited opportunities to fully characterize stimulation parameters, there is a lack of understanding of "optimal" stimulation configurations for humans. Here, we model possible adaptive plasticity in the vestibular pathway. Specifically, this model highlights the influence of adaptation of synaptic strengths and offsets in the vestibular nuclei to compensate for the initial activation of the prosthetic. By changing the synaptic strengths, the model is able to replicate the clinical observation that erroneous eye movements are attenuated within 30 minutes without any change to the prosthetic stimulation rate. Although our model was only built to match this time point, we further examined how it affected subsequent pulse rate modulation (PRM) and pulse amplitude modulation (PAM). PAM was more effective than PRM for nearly all stimulation configurations during these acute tests. Two non-intuitive relationships highlighted by our model explain this performance discrepancy. Specifically, the attenuation of synaptic strengths for afferents stimulated during baseline adaptation and the discontinuity between baseline and residual firing rates both disproportionally boost PAM. Comodulation of pulse rate and amplitude has been experimentally shown to induce both excitatory and inhibitory eye movements even at high baseline

  2. The vestibular body: Vestibular contributions to bodily representations.

    PubMed

    Ferrè, Elisa Raffaella; Haggard, Patrick

    2016-01-01

    Vestibular signals are integrated with signals from other sensory modalities. This convergence could reflect an important mechanism for maintaining the perception of the body. Here we review the current literature in order to develop a framework for understanding how the vestibular system contributes to body representation. According to recent models, we distinguish between three processes for body representation, and we look at whether vestibular signals might influence each process. These are (i) somatosensation, the primary sensory processing of somatic stimuli, (ii) somatoperception, the processes of constructing percepts and experiences of somatic objects and events and (iii) somatorepresentation, the knowledge about the body as a physical object in the world. Vestibular signals appear to contribute to all three levels in this model of body processing. Thus, the traditional view of the vestibular system as a low-level, dedicated orienting module tends to underestimate the pervasive role of vestibular input in bodily self-awareness. PMID:27389959

  3. Vestibular lesion-induced developmental plasticity in spinal locomotor networks during Xenopus laevis metamorphosis.

    PubMed

    Beyeler, Anna; Rao, Guillaume; Ladepeche, Laurent; Jacques, André; Simmers, John; Le Ray, Didier

    2013-01-01

    During frog metamorphosis, the vestibular sensory system remains unchanged, while spinal motor networks undergo a massive restructuring associated with the transition from the larval to adult biomechanical system. We investigated in Xenopus laevis the impact of a pre- (tadpole stage) or post-metamorphosis (juvenile stage) unilateral labyrinthectomy (UL) on young adult swimming performance and underlying spinal locomotor circuitry. The acute disruptive effects on locomotion were similar in both tadpoles and juvenile frogs. However, animals that had metamorphosed with a preceding UL expressed restored swimming behavior at the juvenile stage, whereas animals lesioned after metamorphosis never recovered. Whilst kinematic and electrophysiological analyses of the propulsive system showed no significant differences in either juvenile group, a 3D biomechanical simulation suggested that an asymmetry in the dynamic control of posture during swimming could account for the behavioral restoration observed in animals that had been labyrinthectomized before metamorphosis. This hypothesis was subsequently supported by in vivo electromyography during free swimming and in vitro recordings from isolated brainstem/spinal cord preparations. Specifically, animals lesioned prior to metamorphosis at the larval stage exhibited an asymmetrical propulsion/posture coupling as a post-metamorphic young adult. This developmental alteration was accompanied by an ipsilesional decrease in propriospinal coordination that is normally established in strict left-right symmetry during metamorphosis in order to synchronize dorsal trunk muscle contractions with bilateral hindlimb extensions in the swimming adult. Our data thus suggest that a disequilibrium in descending vestibulospinal information during Xenopus metamorphosis leads to an altered assembly of adult spinal locomotor circuitry. This in turn enables an adaptive compensation for the dynamic postural asymmetry induced by the vestibular imbalance

  4. Vestibular Lesion-Induced Developmental Plasticity in Spinal Locomotor Networks during Xenopus laevis Metamorphosis

    PubMed Central

    Beyeler, Anna; Rao, Guillaume; Ladepeche, Laurent; Jacques, André; Simmers, John; Le Ray, Didier

    2013-01-01

    During frog metamorphosis, the vestibular sensory system remains unchanged, while spinal motor networks undergo a massive restructuring associated with the transition from the larval to adult biomechanical system. We investigated in Xenopus laevis the impact of a pre- (tadpole stage) or post-metamorphosis (juvenile stage) unilateral labyrinthectomy (UL) on young adult swimming performance and underlying spinal locomotor circuitry. The acute disruptive effects on locomotion were similar in both tadpoles and juvenile frogs. However, animals that had metamorphosed with a preceding UL expressed restored swimming behavior at the juvenile stage, whereas animals lesioned after metamorphosis never recovered. Whilst kinematic and electrophysiological analyses of the propulsive system showed no significant differences in either juvenile group, a 3D biomechanical simulation suggested that an asymmetry in the dynamic control of posture during swimming could account for the behavioral restoration observed in animals that had been labyrinthectomized before metamorphosis. This hypothesis was subsequently supported by in vivo electromyography during free swimming and in vitro recordings from isolated brainstem/spinal cord preparations. Specifically, animals lesioned prior to metamorphosis at the larval stage exhibited an asymmetrical propulsion/posture coupling as a post-metamorphic young adult. This developmental alteration was accompanied by an ipsilesional decrease in propriospinal coordination that is normally established in strict left-right symmetry during metamorphosis in order to synchronize dorsal trunk muscle contractions with bilateral hindlimb extensions in the swimming adult. Our data thus suggest that a disequilibrium in descending vestibulospinal information during Xenopus metamorphosis leads to an altered assembly of adult spinal locomotor circuitry. This in turn enables an adaptive compensation for the dynamic postural asymmetry induced by the vestibular imbalance

  5. Linear Path Integration Deficits in Patients with Abnormal Vestibular Afference

    PubMed Central

    Arthur, Joeanna C.; Kortte, Kathleen B.; Shelhamer, Mark; Schubert, Michael C.

    2014-01-01

    Effective navigation requires the ability to keep track of one’s location and maintain orientation during linear and angular displacements. Path integration is the process of updating the representation of body position by integrating internally-generated self-motion signals over time (e.g., walking in the dark). One major source of input to path integration is vestibular afference. We tested patients with reduced vestibular function (unilateral vestibular hypofunction, UVH), patients with aberrant vestibular function (benign paroxysmal positional vertigo, BPPV), and healthy participants (controls) on two linear path integration tasks: experimenter-guided walking and target-directed walking. The experimenter-guided walking task revealed a systematic underestimation of self-motion signals in UVH patients compared to the other groups. However, we did not find any difference in the distance walked between the UVH group and the control group for the target-directed walking task. Results from neuropsychological testing and clinical balance measures suggest that the errors in experimenter-guided walking were not attributable to cognitive and/or balance impairments. We conclude that impairment in linear path integration in UVH patients stem from deficits in self-motion perception. Importantly, our results also suggest that patients with a UVH deficit do not lose their ability to walk accurately without vision to a memorized target location. PMID:22726251

  6. Tests of walking balance for screening vestibular disorders

    PubMed Central

    Cohen, Helen S.; Mulavara, Ajitkumar P.; Peters, Brian T.; Sangi-Haghpeykar, Haleh; Bloomberg, Jacob J.

    2013-01-01

    Few reliable tests are available for screening people rapidly for vestibular disorders although such tests would be useful for a variety of testing situations. Balance testing is widely performed but of unknown value for screening. The goal of this study was to determine the value of tests of walking balance for screening people with vestibular impairments. We tested three groups of patients with known vestibular impairments: benign paroxysmal positional vertigo, unilateral vestibular weakness, and post-acoustic neuroma resection. We compared them to normal subjects. All subjects were independently ambulatory without gait aids. Subjects were tested on tandem walking (TW) with eyes open and eyes closed for 10 steps, walking with no additional head motions and with augmented head rotations in yaw for 7 m (WwHT), and an obstacle avoidance task, the Functional Mobility Test (FMT). Subjects wore a 3-D motion sensor centered at mid-torso to capture kinematic measures. Patients and normals differed significantly on some behavioral measures, such as the number of steps to perform TW, and on some but not all kinematic measures. ROC analyses, however, were at best only moderate, and failed to find strong differences and cut-points that would differentiate the groups. These findings suggest that although patients and normals differ in performance of these tests in some interesting ways the groups are not sufficiently different on these tests for easy use as screening tests to differentiate the populations. PMID:23000609

  7. Enlarged Vestibular Aqueducts and Childhood Hearing Loss

    MedlinePlus

    ... Health Info » Hearing, Ear Infections, and Deafness Enlarged Vestibular Aqueducts and Childhood Hearing Loss On this page: ... more information about enlarged vestibular aqueducts? What are vestibular aqueducts? The inner ear Credit: NIH Medical Arts ...

  8. Endolymphatic space size in patients with vestibular migraine and Ménière's disease.

    PubMed

    Nakada, Takafumi; Yoshida, Tadao; Suga, Kenji; Kato, Masahiro; Otake, Hironao; Kato, Ken; Teranishi, Masaaki; Sone, Michihiko; Sugiura, Saiko; Kuno, Kayao; Pyykkö, Ilmari; Naganawa, Shinji; Watanabe, Hirohisa; Sobue, Gen; Nakashima, Tsutomu

    2014-11-01

    Ménière's disease (MD) is characterized by episodic vertigo, fluctuating hearing loss and tinnitus. Vestibular migraine (VM) is a relatively new disorder that is characterized by episodic vertigo or dizziness, coexisting migraine and absence of hearing loss. It is occasionally difficult to distinguish between VM and vestibular MD with headache. Because endolymphatic hydrops (EH) is a characteristic sign of MD, we attempted to evaluate endolymphatic space size in both diseases. Endolymphatic space size in the vestibule and the cochlea was evaluated in seven patients with VM and in seven age- and sex-matched patients with vestibular MD. For visualization of the endolymphatic space, 3T magnetic resonance imaging was taken 4 h after intravenous injection of gadolinium contrast agents using three-dimensional fluid-attenuated inversion recovery and HYbriD of reversed image of positive endolymph signal and native image of positive perilymph signal techniques. In the vestibule of VM patients, EH was not observed, with the exception of two patients with unilateral or bilateral EH. In contrast, in the vestibule of patients with vestibular MD, all patients had significant EH, bilaterally or unilaterally. These results indicate that endolymphatic space size is significantly different between patients with VM and vestibular MD.

  9. Role of the commissural inhibitory system in vestibular compensation in the rat

    PubMed Central

    Bergquist, Filip; Ludwig, Mike; Dutia, Mayank B

    2008-01-01

    We investigated the role of the vestibular commissural inhibitory system in vestibular compensation (VC, the behavioural recovery that follows unilateral vestibular loss), using in vivo microdialysis to measure GABA levels in the bilateral medial vestibular nucleus (MVN) at various times after unilateral labyrinthectomy (UL). Immediately after UL, in close correlation with the appearance of the characteristic oculomotor and postural symptoms, there is a marked increase in GABA release in the ipsi-lesional MVN. This is not prevented by bilateral flocculectomy, indicating that it is due to hyperactivity of vestibular commissural inhibitory neurones. Over the following 96 h, as VC occurs and the behavioural symptoms ameliorate, the ipsi-lesional GABA levels return to near-normal. Contra-lesional GABA levels do not change significantly in the initial stages of VC, but decrease at late stages so that when static symptoms have abated there remains a significant difference between the MVNs of the two sides. We also investigated the role of the commissural inhibition in Bechterew's phenomenon, by reversibly inactivating the intact contra-lesional labyrinth in compensating animals through superfusion of local anaesthetic on the round window. Transient inactivation of the intact labyrinth elicited the lateralized behaviour described by Bechterew, but did not alter the GABA levels in either MVN, suggesting the involvement of distinct cellular mechanisms. These findings indicate that an imbalanced commissural inhibitory system is a root cause of the severe oculomotor and postural symptoms of unilateral vestibular loss, and that re-balancing of commissural inhibition occurs in parallel with the subsequent behavioural recovery during VC. PMID:18635647

  10. An overview of vestibular rehabilitation.

    PubMed

    Whitney, S L; Alghwiri, A A; Alghadir, A

    2016-01-01

    Data related to the efficacy of vestibular rehabilitation and its evolution as an intervention are provided. Concepts and various treatment strategies are described, with explanations of why people with uncompensated peripheral and central vestibular disorders might improve with rehabilitation. Various tests and measures are described that are commonly used to examine patients and determine their level of ability to participate in their environment. Factors that affect recovery, both positively and negatively, are described in order to better prognosticate recovery. A case utilizing many of the principles discussed is included to provide insight into how to utilize vestibular rehabilitation with a person with an uncompensated peripheral vestibular loss. PMID:27638071

  11. Vestibular-evoked myogenic potentials.

    PubMed

    Colebatch, J G; Rosengren, S M; Welgampola, M S

    2016-01-01

    The vestibular-evoked myogenic potential (VEMP) is a short-latency potential evoked through activation of vestibular receptors using sound or vibration. It is generated by modulated electromyographic signals either from the sternocleidomastoid muscle for the cervical VEMP (cVEMP) or the inferior oblique muscle for the ocular VEMP (oVEMP). These reflexes appear to originate from the otolith organs and thus complement existing methods of vestibular assessment, which are mainly based upon canal function. This review considers the basis, methodology, and current applications of the cVEMP and oVEMP in the assessment and diagnosis of vestibular disorders, both peripheral and central. PMID:27638068

  12. Vestibular Function Measurement Devices

    PubMed Central

    Miles, Richard D.; Zapala, David A.

    2015-01-01

    Vestibular function laboratories utilize a multitude of diagnostic instruments to evaluate a dizzy patient. Caloric irrigators, oculomotor stimuli, and rotational chairs produce a stimulus whose accuracy is required for the patient response to be accurate. Careful attention to everything from cleanliness of equipment to threshold adjustments determine on a daily basis if patient data are going to be correct and useful. Instrumentation specifications that change with time such as speed and temperature must periodically be checked using calibrated instruments. PMID:27516710

  13. [Objective evaluation of compensation of permanent loss of vestibular function].

    PubMed

    Kugler, R; Andrzejewski, K; Szecherew, G

    1980-01-01

    The method of quantitative assessment of the dynamics of compensation of peripheral equilibrium disturbances was applied in patients with sudden permanent unilateral loss of vestibular function of different aetiology. The course of compensation was assessed by means of the test of threshold excitability during rotation for establishing the threshold of practical compensation. It was found that the rate of the compensation process was influenced by: 1) greater adaptation of the central nervous system in young subjects, 2) earlier beginning of exercises. The clinical importance of early detection of the threshold of practical compensation and its significance for expert opinion are discussed.

  14. Electromyographic activity of sternocleidomastoid and masticatory muscles in patients with vestibular lesions.

    PubMed

    Tartaglia, Gianluca M; Barozzi, Stefania; Marin, Federico; Cesarani, Antonio; Ferrario, Virgilio F

    2008-01-01

    This study evaluated the electromyographic characteristics of masticatory and neck muscles in subjects with vestibular lesions. Surface electromyography of the masseter, temporalis and sternocleidomastoid muscles was performed in 19 patients with Ménière's disease, 12 patients with an acute peripheral vestibular lesion, and 19 control subjects matched for sex and age. During maximum voluntary clenching, patients with peripheral vestibular lesions had the highest co-contraction of the sternocleidomastoid muscle (analysis of covariance, p=0.02), the control subjects had the smallest values, and the patients with Ménière's disease had intermediate values. The control subjects had larger standardized muscle activities than the other patient groups (p=0.001). In conclusion, during maximum voluntary tooth clenching, patients with vestibular alterations have both more active neck muscles, and less active masticatory muscles than normal controls. Results underline the importance of a more inclusive craniocervical assessment of patients with vestibular lesions.

  15. ELECTROMYOGRAPHIC ACTIVITY OF STERNOCLEIDOMASTOID AND MASTICATORY MUSCLES IN PATIENTS WITH VESTIBULAR LESIONS

    PubMed Central

    Tartaglia, Gianluca M.; Barozzi, Stefania; Marin, Federico; Cesarani, Antonio; Ferrario, Virgilio F.

    2008-01-01

    This study evaluated the electromyographic characteristics of masticatory and neck muscles in subjects with vestibular lesions. Surface electromyography of the masseter, temporalis and sternocleidomastoid muscles was performed in 19 patients with Ménière's disease, 12 patients with an acute peripheral vestibular lesion, and 19 control subjects matched for sex and age. During maximum voluntary clenching, patients with peripheral vestibular lesions had the highest co-contraction of the sternocleidomastoid muscle (analysis of covariance, p=0.02), the control subjects had the smallest values, and the patients with Ménière's disease had intermediate values. The control subjects had larger standardized muscle activities than the other patient groups (p=0.001). In conclusion, during maximum voluntary tooth clenching, patients with vestibular alterations have both more active neck muscles, and less active masticatory muscles than normal controls. Results underline the importance of a more inclusive craniocervical assessment of patients with vestibular lesions. PMID:19082397

  16. Disrupted functional brain connectome in unilateral sudden sensorineural hearing loss.

    PubMed

    Xu, Haibo; Fan, Wenliang; Zhao, Xueyan; Li, Jing; Zhang, Wenjuan; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong

    2016-05-01

    Sudden sensorineural hearing loss (SSNHL) is generally defined as sensorineural hearing loss of 30 dB or greater over at least three contiguous audiometric frequencies and within a three-day period. This hearing loss is usually unilateral and can be associated with tinnitus and vertigo. The pathogenesis of unilateral sudden sensorineural hearing loss is still unknown, and the alterations in the functional connectivity are suspected to involve one possible pathogenesis. Despite scarce findings with respect to alterations in brain functional networks in unilateral sudden sensorineural hearing loss, the alterations of the whole brain functional connectome and whether these alterations were already in existence in the acute period remains unknown. The aim of this study was to investigate the alterations of brain functional connectome in two large samples of unilateral sudden sensorineural hearing loss patients and to investigate the correlation between unilateral sudden sensorineural hearing loss characteristics and changes in the functional network properties. Pure tone audiometry was performed to assess hearing ability. Abnormal changes in the peripheral auditory system were examined using conventional magnetic resonance imaging. The graph theoretical network analysis method was used to detect brain connectome alterations in unilateral sudden sensorineural hearing loss. Compared with the control groups, both groups of unilateral SSNHL patients exhibited a significantly increased clustering coefficient, global efficiency, and local efficiency but a significantly decreased characteristic path length. In addition, the primary increased nodal strength (e.g., nodal betweenness, hubs) was observed in several regions primarily, including the limbic and paralimbic systems, and in the auditory network brain areas. These findings suggest that the alteration of network organization already exists in unilateral sudden sensorineural hearing loss patients within the acute period

  17. Disrupted functional brain connectome in unilateral sudden sensorineural hearing loss.

    PubMed

    Xu, Haibo; Fan, Wenliang; Zhao, Xueyan; Li, Jing; Zhang, Wenjuan; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong

    2016-05-01

    Sudden sensorineural hearing loss (SSNHL) is generally defined as sensorineural hearing loss of 30 dB or greater over at least three contiguous audiometric frequencies and within a three-day period. This hearing loss is usually unilateral and can be associated with tinnitus and vertigo. The pathogenesis of unilateral sudden sensorineural hearing loss is still unknown, and the alterations in the functional connectivity are suspected to involve one possible pathogenesis. Despite scarce findings with respect to alterations in brain functional networks in unilateral sudden sensorineural hearing loss, the alterations of the whole brain functional connectome and whether these alterations were already in existence in the acute period remains unknown. The aim of this study was to investigate the alterations of brain functional connectome in two large samples of unilateral sudden sensorineural hearing loss patients and to investigate the correlation between unilateral sudden sensorineural hearing loss characteristics and changes in the functional network properties. Pure tone audiometry was performed to assess hearing ability. Abnormal changes in the peripheral auditory system were examined using conventional magnetic resonance imaging. The graph theoretical network analysis method was used to detect brain connectome alterations in unilateral sudden sensorineural hearing loss. Compared with the control groups, both groups of unilateral SSNHL patients exhibited a significantly increased clustering coefficient, global efficiency, and local efficiency but a significantly decreased characteristic path length. In addition, the primary increased nodal strength (e.g., nodal betweenness, hubs) was observed in several regions primarily, including the limbic and paralimbic systems, and in the auditory network brain areas. These findings suggest that the alteration of network organization already exists in unilateral sudden sensorineural hearing loss patients within the acute period

  18. Altered cupular mechanics: a cause of peripheral vestibular disorders?

    PubMed

    Helling, Kai; Watanabe, Nobuhiro; Jijiwa, Hiroyasu; Mizuno, Yoshio; Watanabe, Satoru; Scherer, Hans

    2002-06-01

    It has taken many decades to arrive at today's concept of cupula mechanics in the stimulation of endolymphatic flows on the hair cells in the ampullae of the semicircular canal. While Steinhausen assumed free swing-door movement of the cupula in the 1930s, Hillman was the first to demonstrate firm cupula attachment to the ampulla wall as a physiological necessity in the 1970s. In contrast to the present clinical concepts of acute peripheral vestibular functional disorders (circulatory disturbances, viral or bacterial infection, altered electrolytes in the endolymph), this study examines the extent to which an impaired attachment mechanism can trigger peripheral vestibular disorders. For this purpose, we used a pigeon model (n = 8), in which mechanical detachment of the cupula from the ampulla wall was achieved by means of a targeted pressure increase in the ampulla of the lateral semicircular canal. In two additional animals the labyrinth was completely destroyed on one side in order to directly compare partial and complete vestibular disorders. In this way partial damage to the lateral semicircular canal ampulla presents a clinical picture whose symptoms are very similar to those of an idiopathic vestibular disorder in humans. Their intensity and course of compensation differ markedly from the symptoms of complete vestibular destruction. Subsequent histological examination revealed that the hair cells remained intact during the experimental detachment of the cupula. Our results thus show that only altered cupula mechanics seem to trigger the clinical picture of a peripheral vestibular disorder. This may result in completely new approaches to differential diagnosis and the therapy of vestibular neuronitis.

  19. Acute vertigo due to hemispheric stroke: a case report and comprehensive review of the literature.

    PubMed

    von Brevern, Michael; Süßmilch, Sina; Zeise, Daniel

    2014-04-15

    Acute cortical lesions rarely cause vertigo. We report a 51-year-old patient presenting with an acute vestibular syndrome including spontaneous vertigo and nystagmus, lateropulsion and nausea due to middle cerebral artery infarction. The central origin of the acute vestibular syndrome was revealed by a normal head impulse test. A comprehensive literature review on patients with hemispheric stroke manifesting with acute vertigo is provided. Typically, patients with an acute vestibular syndrome due to cortical stroke have involvement of the temporoparietal junction.

  20. Role of the Insula and Vestibular System in Patients with Chronic Subjective Dizziness: An fMRI Study Using Sound-Evoked Vestibular Stimulation

    PubMed Central

    Indovina, Iole; Riccelli, Roberta; Chiarella, Giuseppe; Petrolo, Claudio; Augimeri, Antonio; Giofrè, Laura; Lacquaniti, Francesco; Staab, Jeffrey P.; Passamonti, Luca

    2015-01-01

    Chronic subjective dizziness (CSD) is a common vestibular disorder characterized by persistent non-vertiginous dizziness, unsteadiness, and heightened sensitivity to motion stimuli that may last for months to years after events that cause acute vestibular symptoms or disrupt balance. CSD is not associated with abnormalities of basic vestibular or oculomotor reflexes. Rather, it is thought to arise from persistent use of high-threat postural control strategies and greater reliance on visual cues for spatial orientation (i.e., visual dependence), long after triggering events resolve. Anxiety-related personality traits confer vulnerability to CSD. Anomalous interactions between the central vestibular system and neural structures related to anxiety may sustain it. Vestibular- and anxiety-related processes overlap in the brain, particularly in the insula and hippocampus. Alterations in activity and connectivity in these brain regions in response to vestibular stimuli may be the neural basis of CSD. We examined this hypothesis by comparing brain activity from 18 patients with CSD and 18 healthy controls measured by functional magnetic resonance imaging during loud short tone bursts, which are auditory stimuli that evoke robust vestibular responses. Relative to controls, patients with CSD showed reduced activations to sound-evoked vestibular stimulation in the parieto-insular vestibular cortex (PIVC) including the posterior insula, and in the anterior insula, inferior frontal gyrus, hippocampus, and anterior cingulate cortex. Patients with CSD also showed altered connectivity between the anterior insula and PIVC, anterior insula and middle occipital cortex, hippocampus and PIVC, and anterior cingulate cortex and PIVC. We conclude that reduced activation in PIVC, hippocampus, anterior insula, inferior frontal gyrus, and anterior cingulate cortex, as well as connectivity changes among these regions, may be linked to long-term vestibular symptoms in patients with CSD

  1. Vestibular pathways involved in cognition

    PubMed Central

    Hitier, Martin; Besnard, Stephane; Smith, Paul F.

    2014-01-01

    Recent discoveries have emphasized the role of the vestibular system in cognitive processes such as memory, spatial navigation and bodily self-consciousness. A precise understanding of the vestibular pathways involved is essential to understand the consequences of vestibular diseases for cognition, as well as develop therapeutic strategies to facilitate recovery. The knowledge of the “vestibular cortical projection areas”, defined as the cortical areas activated by vestibular stimulation, has dramatically increased over the last several years from both anatomical and functional points of view. Four major pathways have been hypothesized to transmit vestibular information to the vestibular cortex: (1) the vestibulo-thalamo-cortical pathway, which probably transmits spatial information about the environment via the parietal, entorhinal and perirhinal cortices to the hippocampus and is associated with spatial representation and self-versus object motion distinctions; (2) the pathway from the dorsal tegmental nucleus via the lateral mammillary nucleus, the anterodorsal nucleus of the thalamus to the entorhinal cortex, which transmits information for estimations of head direction; (3) the pathway via the nucleus reticularis pontis oralis, the supramammillary nucleus and the medial septum to the hippocampus, which transmits information supporting hippocampal theta rhythm and memory; and (4) a possible pathway via the cerebellum, and the ventral lateral nucleus of the thalamus (perhaps to the parietal cortex), which transmits information for spatial learning. Finally a new pathway is hypothesized via the basal ganglia, potentially involved in spatial learning and spatial memory. From these pathways, progressively emerges the anatomical network of vestibular cognition. PMID:25100954

  2. Childhood Vestibular Disorders: A Tutorial

    ERIC Educational Resources Information Center

    Mehta, Zarin; Stakiw, Daria B.

    2004-01-01

    There is a growing body of evidence that childhood disorders affecting the vestibular system, although rare, do exist. Describing symptoms associated with the vestibular mechanism for children may be difficult, resulting in misdiagnosing or under-diagnosing these conditions. The pathophysiology, symptoms, and management options of the more common…

  3. Vestibular pathways involved in cognition.

    PubMed

    Hitier, Martin; Besnard, Stephane; Smith, Paul F

    2014-01-01

    Recent discoveries have emphasized the role of the vestibular system in cognitive processes such as memory, spatial navigation and bodily self-consciousness. A precise understanding of the vestibular pathways involved is essential to understand the consequences of vestibular diseases for cognition, as well as develop therapeutic strategies to facilitate recovery. The knowledge of the "vestibular cortical projection areas", defined as the cortical areas activated by vestibular stimulation, has dramatically increased over the last several years from both anatomical and functional points of view. Four major pathways have been hypothesized to transmit vestibular information to the vestibular cortex: (1) the vestibulo-thalamo-cortical pathway, which probably transmits spatial information about the environment via the parietal, entorhinal and perirhinal cortices to the hippocampus and is associated with spatial representation and self-versus object motion distinctions; (2) the pathway from the dorsal tegmental nucleus via the lateral mammillary nucleus, the anterodorsal nucleus of the thalamus to the entorhinal cortex, which transmits information for estimations of head direction; (3) the pathway via the nucleus reticularis pontis oralis, the supramammillary nucleus and the medial septum to the hippocampus, which transmits information supporting hippocampal theta rhythm and memory; and (4) a possible pathway via the cerebellum, and the ventral lateral nucleus of the thalamus (perhaps to the parietal cortex), which transmits information for spatial learning. Finally a new pathway is hypothesized via the basal ganglia, potentially involved in spatial learning and spatial memory. From these pathways, progressively emerges the anatomical network of vestibular cognition.

  4. Vestibular disease in dogs and cats.

    PubMed

    Rossmeisl, John H

    2010-01-01

    The vestibular system is the major sensory (special proprioceptive) system that, along with the general proprioceptive and visual systems, maintains balance. Clinical signs of vestibular disease include asymmetric ataxia, head tilt, and pathologic nystagmus. Neuroanatomic localization of observed vestibular signs to either the peripheral or central components of the vestibular system is paramount to the management of the patient with vestibular dysfunction, as the etiology, diagnostic approaches, and prognoses are dependent on the neuroanatomic diagnosis. This article reviews functional vestibular neuroanatomy as well as the diagnosis and treatment of common causes of small animal vestibular disease. PMID:19942058

  5. Visuo-Vestibular Interactions

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Session TA3 includes short reports covering: (1) Vestibulo-Oculomotor Interaction in Long-Term Microgravity; (2) Effects of Weightlessness on the Spatial Orientation of Visually Induced Eye Movements; (3) Adaptive Modification of the Three-Dimensional Vestibulo-Ocular Reflex during Prolonged Microgravity; (4) The Dynamic Change of Brain Potential Related to Selective Attention to Visual Signals from Left and Right Visual Fields; (5) Locomotor Errors Caused by Vestibular Suppression; and (6) A Novel, Image-Based Technique for Three-Dimensional Eye Measurement.

  6. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review

    PubMed Central

    2011-01-01

    Background Manual therapy is an intervention commonly advocated in the management of dizziness of a suspected cervical origin. Vestibular rehabilitation exercises have been shown to be effective in the treatment of unilateral peripheral vestibular disorders, and have also been suggested in the literature as an adjunct in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness. Methods A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria. Results A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity. Discussion Although it has been argued that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness, there are currently no observational and experimental studies demonstrating such effects. A rationale for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is presented. Conclusion There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy

  7. Effects of Vestibular Prosthesis Electrode Implantation and Stimulation on Hearing in Rhesus Monkeys

    PubMed Central

    Dai, Chenkai; Fridman, Gene Y.; Della Santina, Charles C.

    2011-01-01

    To investigate the effects of vestibular prosthesis electrode implantation and activation on hearing in rhesus monkeys, we measured auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DPOAE) in four rhesus monkeys before and after unilateral implantation of vestibular prosthesis electrodes in each of 3 left semicircular canals (SCC). Each of the 3 left SCCs were implanted with electrodes via a transmastoid approach. Right ears, which served as controls, were not surgically manipulated. Hearing tests were conducted before implantation (BI) and then 4 weeks post implantation both without electrical stimulation (NS) and with electrical stimulation (S). During the latter condition, prosthetic electrical stimuli encoding 3 dimensions of head angular velocity were delivered to the 3 ampullary branches of the left vestibular nerve via each of 3 electrode pairs of a multichannel vestibular prosthesis. Electrical stimuli comprised charge-balanced biphasic pulses at a baseline rate of 94 pulses/sec, with pulse frequency modulated from 48–222 pulses/s by head angular velocity. ABR hearing thresholds to clicks and tone pips at 1, 2, and 4 kHz increased by 5–10 dB from BI to NS and increased another ~5 dB from NS to S in implanted ears. No significant change was seen in right ears. DPOAE amplitudes decreased by 2–14 dB from BI to NS in implanted ears. There was a slight but insignificant decrease of DPOAE amplitude and a corresponding increase of DPOAE/Noise floor ratio between NS and S in implanted ears. Vestibular prosthesis electrode implantation and activation have small but measurable effects on hearing in rhesus monkeys. Coupled with the clinical observation that patients with cochlear implants only rarely exhibit signs of vestibular injury or spurious vestibular nerve stimulation, these results suggest that although implantation and activation of multichannel vestibular prosthesis electrodes in human will carry a risk of hearing loss

  8. Unilateral phrenic nerve lesion in Lyme neuroborreliosis

    PubMed Central

    2013-01-01

    Background Among a variety of more common differential diagnoses, the aetiology of acute respiratory failure includes Lyme neuroborreliosis. Case presentation We report an 87-years old huntsman with unilateral phrenic nerve palsy as a consequence of Lyme neuroborreliosis. Conclusion Although Lyme neuroborreliosis is a rare cause of diaphragmatic weakness, it should be considered in the differential workup because of its potentially treatable nature. PMID:23327473

  9. Unilateral sensorineural hearing loss: analysis of 200 consecutive cases.

    PubMed

    Kumar, A; Maudelonde, C; Mafee, M

    1986-01-01

    The spectrum of diseases diagnosed and the protocol used in the investigation of 200 consecutive patients with unilateral sensorineural hearing loss (SNHL) is presented. The diagnostic tests found most useful in defining the site of the lesion were a combination of a well-masked pure tone audiogram, speech discrimination score (SDS), acoustic reflex test (ART), and a vestibular evaluation using photoelectric nystagmography (PENG) and the Torok Monothermal Differential Caloric Test. With this protocol, the site of the lesion was correctly defined in 94% of patients with unilateral progressive SNHL. Laboratory and radiological studies confirmed a variety of lesions other than acoustic tumors. It is, therefore, felt that the primary objective of investigations should be to define the site of the lesion rather than aim to diagnose a specific disease entity.

  10. Vestibular results after intratympanic gentamicin therapy in disabling Menière's disease.

    PubMed

    Junet, Philippe; Karkas, Alexandre; Dumas, Georges; Quesada, Jean Louis; Schmerber, Sébastien

    2016-10-01

    Intratympanic injection of gentamicin is increasingly used in the treatment of unilateral disabling Menière's disease (MD). Several objective functional and subjective tests have been developed to assess the control of vertigo after gentamicin treatment. The aim of this study was to show that subjective results require a vestibular deafferentation as profound as possible, evidenced with multifrequency vestibular assessment. Sixty four patients with intractable MD in situation of medical treatment failure longer than 6 months were included between 1998 and 2013 in this case control study. A 2-year follow-up was performed after the last intratympanic gentamicin performed with the titration technique. A vestibular assessment was applied before and after 2 years of treatment with a functional level score using the AAOHNS vertigo scale and multifrequency vestibular assessment: skull vibration-induced nystagmus test (SVINT), head-shaking test (HST) and caloric test (CaTe). The correlation between the results of the questionnaire and the level of the deafferentation as evaluated by the tests was analyzed with the Spearman test. Among the 64 included patients, 56 (87.5 %) described vertigo control. There was a correlation (=-0.33 [-0.53; -0.09], p = 0.008) between subjective improvement (AAO -HNS 1 or 2) and the degree of vestibular deafferentation as evidenced by a destructive nystagmus (beating toward the safe side) with the HST and the SVINT, as well as a caloric hypofunction >90 % with the CaTe. The present study demonstrates that a profound vestibular deafferentation confirmed with multifrequency test evaluation is needed to have a subjective improvement in the treatment of unilateral disabling MD with intratympanic gentamicin. PMID:26780342

  11. Vestibular reflexes of otolith origin

    NASA Technical Reports Server (NTRS)

    Wilson, Victor J.

    1988-01-01

    The vestibular system and its role in the maintenance of posture and in motion sickness is investigated using cats as experimental subjects. The assumption is that better understanding of the physiology of vestibular pathways is not only of intrinsic value, but will help to explain and eventually alleviate the disturbances caused by vestibular malfunction, or by exposure to an unusual environment such as space. The first project deals with the influence on the spinal cord of stimulation of the vestibular labyrinth, particularly the otoliths. A second was concerned with the properties and neural basis of the tonic neck reflex. These two projects are related, because vestibulospinal and tonic neck reflexes interact in the maintenance of normal posture. The third project began with an interest in mechanisms of motion sickness, and eventually shifted to a study of central control of respiratory muscles involved in vomiting.

  12. Neuropharmacology of Vestibular System Disorders

    PubMed Central

    Soto, Enrique; Vega, Rosario

    2010-01-01

    This work reviews the neuropharmacology of the vestibular system, with an emphasis on the mechanism of action of drugs used in the treatment of vestibular disorders. Otolaryngologists are confronted with a rapidly changing field in which advances in the knowledge of ionic channel function and synaptic transmission mechanisms have led to the development of new scientific models for the understanding of vestibular dysfunction and its management. In particular, there have been recent advances in our knowledge of the fundamental mechanisms of vestibular system function and drug mechanisms of action. In this work, drugs acting on vestibular system have been grouped into two main categories according to their primary mechanisms of action: those with effects on neurotransmitters and neuromodulator receptors and those that act on voltage-gated ion channels. Particular attention is given in this review to drugs that may provide additional insight into the pathophysiology of vestibular diseases. A critical review of the pharmacology and highlights of the major advances are discussed in each case. PMID:20808544

  13. Eye movements in vestibular disorders.

    PubMed

    Kheradmand, A; Colpak, A I; Zee, D S

    2016-01-01

    The differential diagnosis of patients with vestibular symptoms usually begins with the question: is the lesion central or is it peripheral? The answer commonly emerges from a careful examination of eye movements, especially when the lesion is located in otherwise clinically silent areas of the brain such as the vestibular portions of the cerebellum (flocculus, paraflocculus which is called the tonsils in humans, nodulus, and uvula) and the vestibular nuclei as well as immediately adjacent areas (the perihypoglossal nuclei and the paramedian nuclei and tracts). The neural circuitry that controls vestibular eye movements is intertwined with a larger network within the brainstem and cerebellum that also controls other types of conjugate eye movements. These include saccades and pursuit as well as the mechanisms that enable steady fixation, both straight ahead and in eccentric gaze positions. Navigating through this complex network requires a thorough knowledge about all classes of eye movements to help localize lesions causing a vestibular disorder. Here we review the different classes of eye movements and how to examine them, and then describe common ocular motor findings associated with central vestibular lesions from both a topographic and functional perspective. PMID:27638066

  14. Perspectives on Aging Vestibular Function.

    PubMed

    Anson, Eric; Jeka, John

    2015-01-01

    Much is known about age-related anatomical changes in the vestibular system. Knowledge regarding how vestibular anatomical changes impact behavior for older adults continues to grow, in line with advancements in diagnostic testing. However, despite advancements in clinical diagnostics, much remains unknown about the functional impact that an aging vestibular system has on daily life activities such as standing and walking. Modern diagnostic tests are very good at characterizing neural activity of the isolated vestibular system, but the tests themselves are artificial and do not reflect the multisensory aspects of natural human behavior. Also, the majority of clinical diagnostic tests are passively applied because active behavior can enhance performance. In this perspective paper, we review anatomical and behavioral changes associated with an aging vestibular system and highlight several areas where a more functionally relevant perspective can be taken. For postural control, a multisensory perturbation approach could be used to bring balance rehabilitation into the arena of precision medicine. For walking and complex gaze stability, this may result in less physiologically specific impairments, but the trade-off would be a greater understanding of how the aging vestibular system truly impacts the daily life of older adults. PMID:26779116

  15. Vestibular Deficits Following Youth Concussion

    PubMed Central

    Corwin, Daniel J.; Wiebe, Douglas J.; Zonfrillo, Mark R.; Grady, Matthew F.; Robinson, Roni L.; Goodman, Arlene M.; Master, Christina L.

    2015-01-01

    Objective To characterize the prevalence and recovery of pediatric patients with concussion who manifest clinical vestibular deficits, and to describe the correlation of these deficits with neurocognitive function, based on computerized neurocognitive testing, in a sample of pediatric patients with concussion. Methods This was a retrospective cohort study of patients age 5–18 years old with concussion referred to a tertiary pediatric hospital-affiliated sports medicine clinic from 7/1/2010–12/31/2011. A random sample of all eligible patient visits was obtained, and all related visits for those patients were reviewed. Results 247 patients were chosen from 3740 eligible visits for detailed review and abstraction. 81% showed a vestibular abnormality on initial clinical exam. Those patients with vestibular signs on initial exam took a significantly longer time to return to school (median 59 days vs. 6 days, p=0.001) or to be fully cleared (median 106 days vs. 29 days, p=0.001). They additionally scored more poorly on initial computerized neurocognitive testing, and took longer for neurocognitive deficits to recover. Those patients with three or more prior concussions had a higher prevalence of vestibular deficits and took longer for those deficits to resolve. Conclusion Vestibular deficits in children and adolescents with a history of concussion are highly prevalent. These deficits appear to be associated with extended recovery times and poorer performance on neurocognitive testing. Further studies evaluating the effectiveness of vestibular therapy on improving such deficits are warranted. PMID:25748568

  16. Vestibular hearing and speech processing.

    PubMed

    Emami, Seyede Faranak; Pourbakht, Akram; Sheykholeslami, Kianoush; Kamali, Mohammad; Behnoud, Fatholah; Daneshi, Ahmad

    2012-01-01

    Vestibular hearing in human is evoked as a result of the auditory sensitivity of the saccule to low-frequency high-intensity tone. The objective was to investigate the relationship between vestibular hearing using cervical vestibular-evoked myogenic potentials (cVEMPs) and speech processing via word recognition scores in white noise (WRSs in wn). Intervention comprised of audiologic examinations, cVEMPs, and WRS in wn. All healthy subjects had detectable cVEMPs (safe vestibular hearing). WRSs in wn were obtained for them (66.9 ± 9.3% in the right ears and 67.5 ± 11.8% in the left ears). Dizzy patients in the affected ears, had the cVEMPs abnormalities (insecure vestibular hearing) and decreased the WRS in wn (51.4 ± 3.8% in the right ears and 52.2 ± 3.5% in the left ears). The comparison of the cVEMPs between the subjects revealed significant differences (P < 0.05). Therefore, the vestibular hearing can improve the speech processing in the competing noisy conditions. PMID:23724272

  17. Morphological studies of the vestibular nerve

    NASA Technical Reports Server (NTRS)

    Bergstroem, B.

    1973-01-01

    The anatomy of the intratemporal part of the vestibular nerve in man, and the possible age related degenerative changes in the nerve were studied. The form and structure of the vestibular ganglion was studied with the light microscope. A numerical analysis of the vestibular nerve, and caliber spectra of the myelinated fibers in the vestibular nerve branches were studied in individuals of varying ages. It was found that the peripheral endings of the vestibular nerve form a complicated pattern inside the vestibular sensory epithelia. A detailed description of the sensory cells and their surface organelles is included.

  18. Effects of vestibular training on motion sickness, nystagmus, and subjective vertical.

    PubMed

    Clément, Gilles; Deguine, Olivier; Bourg, Mathieu; Pavy-LeTraon, Anne

    2007-01-01

    Pitch head-and-trunk movements during constant velocity rotation are a provocative vestibular stimulus that produces vertigo and nausea. When exposed to this stimulus repeatedly, motion sickness symptoms diminish as the subjects habituate. Acetylleucine is a drug that is used to treat acute vestibular vertigo. In this study, we wanted to ascertain whether this drug (a) lessened motion sickness or delayed habituation; (b) accelerated the recovery following habituation; and (c) whether changes in the subjective vertical accompanied habituation. Twenty subjects were administered acetylleucine or placebo in a double-blind study during a five-day vestibular training. Horizontal vestibulo-ocular reflex, optokinetic nystagmus, smooth pursuit, and subjective visual vertical were evaluated before, during, and up to two months after the vestibular training. Based on Graybiel's diagnostic criteria, motion sickness decreased steadily in each vestibular training session, and there was no difference between the scores in the acetylleucine and placebo groups. Post-rotatory nystagmus peak velocity and time constant also declined in both groups at the same rate. Thus, acetylleucine neither reduced the nausea associated with this provocative stimulus, nor hastened the acquisition or retention of vestibular habituation of motion sickness and nystagmus. There was no difference in optokinetic nystagmus and smooth pursuit between the acetylleucine and placebo groups. However, subjects showed larger error in the subjective visual vertical after habituation, which indicates that spatial orientation is also affected by vestibular training.

  19. Clinical and Radiographic Factors Predicting Hearing Preservation Rates in Large Vestibular Schwannomas.

    PubMed

    Mendelsohn, Daniel; Westerberg, Brian D; Dong, Charles; Akagami, Ryojo

    2016-06-01

    Objectives Postoperative hearing preservation rates for patients with large vestibular schwannomas range from 0 to 43%. The clinical and radiographic factors predicting hearing preservation in smaller vestibular schwannomas are well described; however, their importance in larger tumors is unclear. We investigated factors predicting hearing preservation in large vestibular schwannomas. Design Retrospective review. Setting Quaternary care academic center. Participants A total of 85 patients with unilateral vestibular schwannomas > 3 cm underwent retrosigmoid resections. Main Outcomes Measures Preoperative and postoperative serviceable hearing rates. Methods Clinical and radiographic data including preoperative and postoperative audiograms, preoperative symptoms, magnetic resonance imaging features, and postoperative facial weakness were analyzed. Results Hearing was preserved in 41% of patients (17 of 42) with preoperative serviceable hearing. Hypertension and diabetes increased the likelihood of preoperative hearing loss. Preoperative tinnitus predicted a lower likelihood of hearing preservation. No radiographic factors predicted hearing preservation; however, larger tumor size, smaller fourth ventricular width, and the presence of a cerebrospinal fluid cleft surrounding the tumor predicted postoperative facial weakness. Conclusion Systemic comorbidities may influence hearing loss preoperatively in patients with large vestibular schwannomas. The absence of tinnitus may reflect hearing reserve and propensity for hearing preservation. Preoperative radiographic features did not predict hearing preservation despite some associations with postoperative facial weakness. PMID:27175312

  20. Vestibular disorders and dual task performance: Impairment when walking a straight path

    PubMed Central

    Roberts, Jess C.; Cohen, Helen S.; Sangi-Haghpeykar, Haleh

    2013-01-01

    Locomotion is impaired in some people with vestibular disorders. Performance on cognitive tasks is also impaired in many people with vestibular disorders. The goal of this study was to determine if patients with vestibular disorders have decreased ability to complete a dual task performance involving a cognitive task, an additional motor task or both tasks, combined along a linear path. Subjects were normal, had benign paroxysmal positional vertigo, or had various vestibular disorders that caused unilateral weakness. They were asked to walk 7.62 m in a straight line with eyes open or closed, without extra tasks, and while nodding the head, naming things, and both nodding and naming. The patients walked significantly slower than controls, especially when performing the cognitive task. Patients had greater ataxia and began veering sooner than normals. The subjects’ veering increased significantly with the addition of cognitive tasks. The patient groups did not differ significantly from each other. The changes in velocity did not affect the veering. These data suggest that patients with vestibular disorders are impaired in their ability to complete a linear path when cognitive tasks are added. PMID:21558642

  1. Unilateral Acute Closed-Angle Glaucoma After Elective Lumbar Surgery Reveals Multiple Intracranial Aneurysms. A Case Report and Discussion on Workup of Differential Diagnoses.

    PubMed

    Storey, Christopher; Menger, Richard; Hefner, Matthew; Keating, Patrick; Ahmed, Osama; Guthikonda, Bharat

    2015-11-01

    The purpose of our paper is to present a case of a rare complication of posterior lumbar surgery. Our patient presented for elective lumbar decompression, which was complicated by durotomy. She then developed sudden headache and right eye pain once upright on postoperative day 2. Then on postoperative day 3, she developed a dilated nonreactive pupil with extraocular movements intact. A computed tomography scan of the head was negative for subarachnoid hemorrhage. Magnetic resonance angiography showed a possible right posterior communicating artery aneurysm. She was transferred to a tertiary center with a severe headache and a nonreactive pupil, raising concern for evolving third nerve palsy due to aneurysm. A cerebral angiogram was performed and showed multiple aneurysms. Aneurysm location did not explain the patient's symptoms, and ophthalmology was consulted. Elevated intraocular pressure was noted, and the patient was diagnosed with acute angle-closure glaucoma (AACG). Our patient was medically treated and subsequently underwent laser peripheral iridotomy. She has had improved vision and pupillary function at 1 month follow-up. The diagnosis is complicated by a durotomy, which led to cascade in the differential diagnosis to rule out intracranial pathology. Her age and home medications, which had sympathomimetic effects, placed her at increased risk, but lying prone in the dark under the drapes was likely the lead causative factor. In conclusion, a postoperative posterior spine patient with eye pain and changes in vision and pupils should be evaluated with AACG in mind due to the devastating consequences if left untreated or treatment is delayed.

  2. Unilateral Partial Nephrectomy with Warm Ischemia Results in Acute Hypoxia Inducible Factor 1-Alpha (HIF-1α) and Toll-Like Receptor 4 (TLR4) Overexpression in a Porcine Model

    PubMed Central

    Zhang, Zhiyong; Haimovich, Beatrice; Kwon, Young Suk; Lu, Tyler; Fyfe-Kirschner, Billie; Olweny, Ephrem Odoy

    2016-01-01

    Purpose Ischemia/reperfusion (I/R) during partial nephrectomy (PN) contributes to acute kidney injury (AKI), which is inaccurately assessed using existent clinical markers of renal function. We evaluated I/R-related changes in expression in hypoxia inducible factor 1α (HIF-1α) and toll-like receptor 4 (TLR4), within kidney tissue and peripheral blood leukocytes (PBL) in a porcine model of PN. Materials and Methods Three adult pigs each underwent unilateral renal hilar cross clamping for 180 min followed by a 15 min reperfusion. The contralateral kidney served as control. Biopsies of clamped kidneys were obtained at baseline (time 0), every 60 min during the hypoxic phase, and post-reperfusion. Control kidneys were biopsied once at 180 min. Peripheral blood was sampled at time 0, every 30 min during the hypoxic phase, and post-reperfusion. HIF-1α and TLR4 expression in kidney tissue and PBL were analyzed by Western blotting. I/R-related histological changes were assessed. Results Expression of HIF-1α in clamped kidneys and PBL was below detection level at baseline, rising to detectable levels after 60 min of hypoxia, and continuing to rise throughout the hypoxic and reperfusion phases. Expression of TLR-4 in clamped kidneys followed a similar trend with initial detection after 30–60 min of hypoxia. Control kidneys exhibited no change in HIF-1α or TLR-4 expression. I/R-related histologic changes were minimal, primarily mild tubular dilatation. Conclusions In a porcine model of PN, HIF-1α and TLR4 exhibited robust, I/R-related increases in expression in kidney tissue and PBL. Further studies investigating these molecules as potential markers of AKI are warranted. PMID:27149666

  3. Climbing fibers mediate vestibular modulation of both "complex" and "simple spikes" in Purkinje cells.

    PubMed

    Barmack, N H; Yakhnitsa, V

    2015-10-01

    Climbing and mossy fibers comprise two distinct afferent paths to the cerebellum. Climbing fibers directly evoke a large multispiked action potential in Purkinje cells termed a "complex spike" (CS). By logical exclusion, the other class of Purkinje cell action potential, termed "simple spike" (SS), has often been attributed to activity conveyed by mossy fibers and relayed to Purkinje cells through granule cells. Here, we investigate the relative importance of climbing and mossy fiber pathways in modulating neuronal activity by recording extracellularly from Purkinje cells, as well as from mossy fiber terminals and interneurons in folia 8-10. Sinusoidal roll-tilt vestibular stimulation vigorously modulates the discharge of climbing and mossy fiber afferents, Purkinje cells, and interneurons in folia 9-10 in anesthetized mice. Roll-tilt onto the side ipsilateral to the recording site increases the discharge of both climbing fibers (CSs) and mossy fibers. However, the discharges of SSs decrease during ipsilateral roll-tilt. Unilateral microlesions of the beta nucleus (β-nucleus) of the inferior olive blocks vestibular modulation of both CSs and SSs in contralateral Purkinje cells. The blockage of SSs occurs even though primary and secondary vestibular mossy fibers remain intact. When mossy fiber afferents are damaged by a unilateral labyrinthectomy (UL), vestibular modulation of SSs in Purkinje cells ipsilateral to the UL remains intact. Two inhibitory interneurons, Golgi and stellate cells, could potentially contribute to climbing fiber-induced modulation of SSs. However, during sinusoidal roll-tilt, only stellate cells discharge appropriately out of phase with the discharge of SSs. Golgi cells discharge in phase with SSs. When the vestibularly modulated discharge is blocked by a microlesion of the inferior olive, the modulated discharge of CSs and SSs is also blocked. When the vestibular mossy fiber pathway is destroyed, vestibular modulation of ipsilateral CSs and

  4. [Vestibular evoked potentials in people].

    PubMed

    Fraczkowski, K; Pośpiech, L; Orendorz-Fraczkowska, K

    1997-01-01

    In the article had been presented the structure and functioning of a prototype system for stimulation and registration vestibular evoked potentials, and the first recording of evoked vestibular potentials (VsEPs) in human beings. This system consist of a original stimulator accelerated for the stimulation of vestibular organ, modul registratory VsEPs as well as string elements and synchronizing stimulation with recording. IMB PC 486 is quickly process of investigation with help of standard interface and a original computer programme. Vestibular organ had been evoked by 200 to 500 cyclicly repealed angular decelerations of 4000 degrees/s2. During investigation white noise was used for masking to avoid the evoking of auditory potentials. Seven of the examined healthy persons (including one deaf person whose vestibular organ was not damaged) had registered a response consisting of several waves with vertex positive peaks. The first two waves P1 and P2 with the mean value 2.02 ms and 5.6 ms are most often during in the 10 ms. The registered deaf persons response does not differ from the record of healthy persons. PMID:9518319

  5. Active unilateral condylar hyperplasia.

    PubMed

    Luz, J G; de Rezende, J R; de Araújo, V C; Chilvarquer, I

    1994-01-01

    Two cases of active unilateral condylar hyperplasia which were treated with condylectomy alone are presented. The first case was an adult form and the other a juvenile form. Both were classified as active by using 99Tc bone scintigraphy. Clinical and radiographic features of both cases conformed to the hemimandibular hypertrophy type. Satisfactory facial symmetry and dental occlusion were achieved. Histopathological data confirmed the activity of the articular cartilage layers. PMID:8181091

  6. Evidence for a Role of Orexin/Hypocretin System in Vestibular Lesion-Induced Locomotor Abnormalities in Rats.

    PubMed

    Pan, Leilei; Qi, Ruirui; Wang, Junqin; Zhou, Wei; Liu, Jiluo; Cai, Yiling

    2016-01-01

    Vestibular damage can induce locomotor abnormalities in both animals and humans. Rodents with bilateral vestibular loss showed vestibular deficits syndrome such as circling, opisthotonus as well as locomotor and exploratory hyperactivity. Previous studies have investigated the changes in the dopamine system after vestibular loss, but the results are inconsistent and inconclusive. Numerous evidences indicate that the orexin system is implicated in central motor control. We hypothesized that orexin may be potentially involved in vestibular loss-induced motor disorders. In this study, we examined the effects of arsanilate- or 3,3'-iminodipropionitrile (IDPN)-induced vestibular lesion (AVL or IVL) on the orexin-A (OXA) labeling in rat hypothalamus using immunohistochemistry. The vestibular lesion-induced locomotor abnormalities were recorded and verified using a histamine H4 receptor antagonist JNJ7777120 (20 mg/kg, i.p.). The effects of the orexin receptor type 1 antagonist SB334867 (16 μg, i.c.v.) on these behavior responses were also investigated. At 72 h post-AVL and IVL, animals exhibited vestibular deficit syndrome and locomotor hyperactivity in the home cages. These responses were significantly alleviated by JNJ7777120 which also eliminated AVL-induced increases in exploratory behavior in an open field. The numbers of OXA-labeled neurons in the hypothalamus were significantly increased in the AVL animals at 72 h post-AVL and in the IVL animals at 24, 48, and 72 h post-IVL. SB334867 significantly attenuated the vestibular deficit syndrome and locomotor hyperactivity at 72 h post-AVL and IVL. It also decreased exploratory behavior in the AVL animals. These results suggested that the alteration of OXA expression might contribute to locomotor abnormalities after acute vestibular lesion. The orexin receptors might be the potential therapeutic targets for vestibular disorders. PMID:27507932

  7. Evidence for a Role of Orexin/Hypocretin System in Vestibular Lesion-Induced Locomotor Abnormalities in Rats

    PubMed Central

    Pan, Leilei; Qi, Ruirui; Wang, Junqin; Zhou, Wei; Liu, Jiluo; Cai, Yiling

    2016-01-01

    Vestibular damage can induce locomotor abnormalities in both animals and humans. Rodents with bilateral vestibular loss showed vestibular deficits syndrome such as circling, opisthotonus as well as locomotor and exploratory hyperactivity. Previous studies have investigated the changes in the dopamine system after vestibular loss, but the results are inconsistent and inconclusive. Numerous evidences indicate that the orexin system is implicated in central motor control. We hypothesized that orexin may be potentially involved in vestibular loss-induced motor disorders. In this study, we examined the effects of arsanilate- or 3,3′-iminodipropionitrile (IDPN)-induced vestibular lesion (AVL or IVL) on the orexin-A (OXA) labeling in rat hypothalamus using immunohistochemistry. The vestibular lesion-induced locomotor abnormalities were recorded and verified using a histamine H4 receptor antagonist JNJ7777120 (20 mg/kg, i.p.). The effects of the orexin receptor type 1 antagonist SB334867 (16 μg, i.c.v.) on these behavior responses were also investigated. At 72 h post-AVL and IVL, animals exhibited vestibular deficit syndrome and locomotor hyperactivity in the home cages. These responses were significantly alleviated by JNJ7777120 which also eliminated AVL-induced increases in exploratory behavior in an open field. The numbers of OXA-labeled neurons in the hypothalamus were significantly increased in the AVL animals at 72 h post-AVL and in the IVL animals at 24, 48, and 72 h post-IVL. SB334867 significantly attenuated the vestibular deficit syndrome and locomotor hyperactivity at 72 h post-AVL and IVL. It also decreased exploratory behavior in the AVL animals. These results suggested that the alteration of OXA expression might contribute to locomotor abnormalities after acute vestibular lesion. The orexin receptors might be the potential therapeutic targets for vestibular disorders. PMID:27507932

  8. Vestibular stimulation by magnetic fields

    PubMed Central

    Ward, Bryan K.; Roberts, Dale C.; Della Santina, Charles C.; Carey, John P.; Zee, David S.

    2015-01-01

    Individuals working next to strong static magnetic fields occasionally report disorientation and vertigo. With the increasing strength of magnetic fields used for magnetic resonance imaging (MRI) studies, these reports have become more common. It was recently learned that humans, mice and zebrafish all demonstrate behaviors consistent with constant peripheral vestibular stimulation while inside a strong, static magnetic field. The proposed mechanism for this effect involves a Lorentz force resulting from the interaction of a strong static magnetic field with naturally occurring ionic currents flowing through the inner ear endolymph into vestibular hair cells. The resulting force within the endolymph is strong enough to displace the lateral semicircular canal cupula, inducing vertigo and the horizontal nystagmus seen in normal mice and in humans. This review explores the evidence for interactions of magnetic fields with the vestibular system. PMID:25735662

  9. Negative emotional stimuli enhance vestibular processing.

    PubMed

    Preuss, Nora; Ellis, Andrew W; Mast, Fred W

    2015-08-01

    Recent studies have shown that vestibular stimulation can influence affective processes. In the present study, we examined whether emotional information can also modulate vestibular perception. Participants performed a vestibular discrimination task on a motion platform while viewing emotional pictures. Six different picture categories were taken from the International Affective Picture System: mutilation, threat, snakes, neutral objects, sports, and erotic pictures. Using a Bayesian hierarchical approach, we were able to show that vestibular discrimination improved when participants viewed emotionally negative pictures (mutilation, threat, snake) when compared to neutral/positive objects. We conclude that some of the mechanisms involved in the processing of vestibular information are also sensitive to emotional content. Emotional information signals importance and mobilizes the body for action. In case of danger, a successful motor response requires precise vestibular processing. Therefore, negative emotional information improves processing of vestibular information. PMID:26098730

  10. Negative emotional stimuli enhance vestibular processing.

    PubMed

    Preuss, Nora; Ellis, Andrew W; Mast, Fred W

    2015-08-01

    Recent studies have shown that vestibular stimulation can influence affective processes. In the present study, we examined whether emotional information can also modulate vestibular perception. Participants performed a vestibular discrimination task on a motion platform while viewing emotional pictures. Six different picture categories were taken from the International Affective Picture System: mutilation, threat, snakes, neutral objects, sports, and erotic pictures. Using a Bayesian hierarchical approach, we were able to show that vestibular discrimination improved when participants viewed emotionally negative pictures (mutilation, threat, snake) when compared to neutral/positive objects. We conclude that some of the mechanisms involved in the processing of vestibular information are also sensitive to emotional content. Emotional information signals importance and mobilizes the body for action. In case of danger, a successful motor response requires precise vestibular processing. Therefore, negative emotional information improves processing of vestibular information.

  11. Vestibular Schwannoma Presenting as Oral Dysgeusia: An Easily Missed Diagnosis.

    PubMed

    Brown, Emma; Staines, Konrad

    2016-01-01

    We present a case of a fifty-year-old male patient who was referred to the Oral Medicine Department with a complaint of a salty taste. History taking subsequently revealed that the patient was also experiencing intermittent numbness of his left lower lip, tinnitus, and a feeling of fullness in the left ear. Magnetic resonance imaging was performed which revealed a large vestibular schwannoma affecting the left vestibulocochlear nerve, which was treated surgically. This case shows the importance of taking a detailed history in a patient presenting with an initial complaint of oral dysgeusia. It also highlights the possibility of significant underlying pathology, presenting with initial low level, nonspecific complaints such as an altered taste, and the rationale for imaging patients who report unilateral facial hypoesthesia. PMID:27022490

  12. Vestibular Schwannoma Presenting as Oral Dysgeusia: An Easily Missed Diagnosis

    PubMed Central

    Staines, Konrad

    2016-01-01

    We present a case of a fifty-year-old male patient who was referred to the Oral Medicine Department with a complaint of a salty taste. History taking subsequently revealed that the patient was also experiencing intermittent numbness of his left lower lip, tinnitus, and a feeling of fullness in the left ear. Magnetic resonance imaging was performed which revealed a large vestibular schwannoma affecting the left vestibulocochlear nerve, which was treated surgically. This case shows the importance of taking a detailed history in a patient presenting with an initial complaint of oral dysgeusia. It also highlights the possibility of significant underlying pathology, presenting with initial low level, nonspecific complaints such as an altered taste, and the rationale for imaging patients who report unilateral facial hypoesthesia. PMID:27022490

  13. Perception of tilt and ocular torsion of vestibular patients during eccentric rotation.

    PubMed

    Clément, Gilles; Deguine, Olivier

    2010-01-01

    Four patients following unilateral vestibular loss and four patients complaining of otolith-dependent vertigo were tested during eccentric yaw rotation generating 1 x g centripetal acceleration directed along the interaural axis. Perception of body tilt in roll and in pitch was recorded in darkness using a somatosensory plate that the subjects maintained parallel to the perceived horizon. Ocular torsion was recorded by a video camera. Unilateral vestibular-defective patients underestimated the magnitude of the roll tilt and had a smaller torsion when the centrifugal force was towards the operated ear compared to the intact ear and healthy subjects. Patients with otolithic-dependent vertigo overestimated the magnitude of roll tilt in both directions of eccentric rotation relative to healthy subjects, and their ocular torsion was smaller than in healthy subjects. Eccentric rotation is a promising tool for the evaluation of vestibular dysfunction in patients. Eye torsion and perception of tilt during this stimulation are objective and subjective measurements, which could be used to determine alterations in spatial processing in the CNS. PMID:19887100

  14. The Vestibular Implant: Quo Vadis?

    PubMed Central

    van de Berg, Raymond; Guinand, Nils; Stokroos, Robert J.; Guyot, Jean-Philippe; Kingma, Herman

    2011-01-01

    Objective: To assess the progress of the development of the vestibular implant (VI) and its feasibility short-term. Data sources: A search was performed in Pubmed, Medline, and Embase. Key words used were “vestibular prosth*” and “VI.” The only search limit was language: English or Dutch. Additional sources were medical books, conference lectures and our personal experience with per-operative vestibular stimulation in patients selected for cochlear implantation. Study selection: All studies about the VI and related topics were included and evaluated by two reviewers. No study was excluded since every study investigated different aspects of the VI. Data extraction and synthesis: Data was extracted by the first author from selected reports, supplemented by additional information, medical books conference lectures. Since each study had its own point of interest with its own outcomes, it was not possible to compare data of different studies. Conclusion: To use a basic VI in humans seems feasible in the very near future. Investigations show that electric stimulation of the canal nerves induces a nystagmus which corresponds to the plane of the canal which is innervated by the stimulated nerve branch. The brain is able to adapt to a higher baseline stimulation, while still reacting on a dynamic component. The best response will be achieved by a combination of the optimal stimulus (stimulus profile, stimulus location, precompensation), complemented by central vestibular adaptation. The degree of response will probably vary between individuals, depending on pathology and their ability to adapt. PMID:21991260

  15. Dynamic visual acuity testing for screening patients with vestibular impairments.

    PubMed

    Peters, Brian T; Mulavara, Ajitkumar P; Cohen, Helen S; Sangi-Haghpeykar, Haleh; Bloomberg, Jacob J

    2012-01-01

    Dynamic visual acuity (DVA) may be a useful indicator of the function of the vestibulo-ocular reflex (VOR) but most DVA tests involve active head motion in the yaw plane. During gait the passive, vertical VOR may be more relevant and passive testing would be less likely to elicit compensatory strategies. The goal of this study was to determine if testing dynamic visual acuity during passive vertical motion of the subject would differentiate normal subjects from patients with known vestibular disorders. Subjects, normals and patients who had been diagnosed with either unilateral vestibular weaknesses or were post-acoustic neuroma resections, sat in a chair that could oscillate vertically with the head either free or constrained with a cervical orthosis. They viewed a computer screen 2 m away that showed Landholt C optotypes in one of 8 spatial configurations and which ranged in size from 0.4 to 1.0 logMAR. They were tested while the chair was stationary and while it was moving. Scores were worse for both groups during the dynamic condition compared to the static condition. In the dynamic condition patients' scores were significantly worse than normals' scores. Younger and older age groups differed slightly but significantly; the sample size was too small to examine age differences by decade. The data suggest that many well-compensated patients have dynamic visual acuity that is as good as age-matched normals. Results of ROC analyses were only moderate, indicating that the differences between patients and normals were not strong enough, under the conditions tested, for this test to be useful for screening people to determine if they have vestibular disorders. Modifications of the test paradigm may make it more useful for screening potential patients.

  16. Dynamic visual acuity testing for screening patients with vestibular impairments.

    PubMed

    Peters, Brian T; Mulavara, Ajitkumar P; Cohen, Helen S; Sangi-Haghpeykar, Haleh; Bloomberg, Jacob J

    2012-01-01

    Dynamic visual acuity (DVA) may be a useful indicator of the function of the vestibulo-ocular reflex (VOR) but most DVA tests involve active head motion in the yaw plane. During gait the passive, vertical VOR may be more relevant and passive testing would be less likely to elicit compensatory strategies. The goal of this study was to determine if testing dynamic visual acuity during passive vertical motion of the subject would differentiate normal subjects from patients with known vestibular disorders. Subjects, normals and patients who had been diagnosed with either unilateral vestibular weaknesses or were post-acoustic neuroma resections, sat in a chair that could oscillate vertically with the head either free or constrained with a cervical orthosis. They viewed a computer screen 2 m away that showed Landholt C optotypes in one of 8 spatial configurations and which ranged in size from 0.4 to 1.0 logMAR. They were tested while the chair was stationary and while it was moving. Scores were worse for both groups during the dynamic condition compared to the static condition. In the dynamic condition patients' scores were significantly worse than normals' scores. Younger and older age groups differed slightly but significantly; the sample size was too small to examine age differences by decade. The data suggest that many well-compensated patients have dynamic visual acuity that is as good as age-matched normals. Results of ROC analyses were only moderate, indicating that the differences between patients and normals were not strong enough, under the conditions tested, for this test to be useful for screening people to determine if they have vestibular disorders. Modifications of the test paradigm may make it more useful for screening potential patients. PMID:23000614

  17. Effect of vestibular rehabilitation on passive dynamic visual acuity.

    PubMed

    Scherer, Matthew; Migliaccio, Americo A; Schubert, Michael C

    2008-01-01

    While active dynamic visual acuity (DVA) has been shown to improve with gaze stabilization exercises, we sought to determine whether DVA during passive head impulses (pDVA) would also improve following a rehabilitation course of vestibular physical therapy (VPT) in patients with unilateral and bilateral vestibular hypofunction. VPT consisted of gaze and gait stabilization exercises done as a home exercise program. Scleral search coil was used to characterize the angular vestibulo-ocular reflex (aVOR) during pDVA before and after VPT. Mean duration of VPT was 66 +/- 24 days, over a total of 5 +/- 1.4 outpatient visits. Two of three subjects showed improvements in pDVA with a mean reduction of 43% (LogMAR 0.58 to 0.398 and 0.92 to 0.40). Our data suggest improvements in pDVA may be due in part to improvements in aVOR velocity and acceleration gains or reduced latency of the aVOR. Each subject demonstrated a reduction in the ratio of compensatory saccades to head impulses after VPT. Preliminary data suggest that active gaze stability exercises may contribute to improvements in pDVA in some individuals.

  18. Effect of vestibular rehabilitation on passive dynamic visual acuity

    PubMed Central

    Scherer, Matthew; Migliaccio, Americo A.; Schubert, Michael C.

    2010-01-01

    While active dynamic visual acuity (DVA) has been shown to improve with gaze stabilization exercises, we sought to determine whether DVA during passive head impulses (pDVA) would also improve following a rehabilitation course of vestibular physical therapy (VPT) in patients with unilateral and bilateral vestibular hypofunction. VPT consisted of gaze and gait stabilization exercises done as a home exercise program. Scleral search coil was used to characterize the angular vestibulo-ocular reflex (aVOR) during pDVA before and after VPT. Mean duration of VPT was 66 ± 24 days, over a total of 5 ± 1.4 outpatient visits. Two of three subjects showed improvements in pDVA with a mean reduction of 43% (LogMAR 0.58 to 0.398 and 0.92 to 0.40). Our data suggest improvements in pDVA may be due in part to improvements in aVOR velocity and acceleration gains or reduced latency of the aVOR. Each subject demonstrated a reduction in the ratio of compensatory saccades to head impulses after VPT. Preliminary data suggest that active gaze stability exercises may contribute to improvements in pDVA in some individuals. PMID:19126985

  19. Vestibular findings in military band musicians.

    PubMed

    Zeigelboim, Bianca Simone; Gueber, Crislaine; Silva, Thanara Pruner da; Liberalesso, Paulo Breno Noronha; Gonçalves, Claudia Giglio de Oliveira; Faryniuk, João Henrique; Marques, Jair Mendes; Jurkiewicz, Ari Leon

    2014-04-01

    Introduction Exposure to music is the subject of many studies because it is related to an individual's professional and social activities. Objectives Evaluate the vestibular behavior in military band musicians. Methods A retrospective cross-sectional study was performed. Nineteen musicians with ages ranging from 21 to 46 years were evaluated (average = 33.7 years and standard deviation = 7.2 years). They underwent anamnesis and vestibular and otolaryngologic evaluation through vectoelectronystagmography. Results The most evident otoneurologic symptoms in the anamnesis were tinnitus (84.2%), hearing difficulties (47.3%), dizziness (36.8%), headache (26.3%), intolerance to intense sounds (21.0%), and earache (15.7%). Seven musicians (37.0%) showed vestibular abnormality, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system, and there was a predominance of irritative peripheral vestibular disorders. Conclusion The alteration in vestibular exam occurred in the caloric test (37.0%). There were changes in the prevalence of peripheral vestibular system with a predominance of irritative vestibular dysfunction. Dizziness was the most significant symptom for the vestibular test in correlation with neurotologic symptoms. The present study made it possible to verify the importance of the labyrinthine test, which demonstrates that this population should be better studied because the systematic exposure to high sound pressure levels may cause major vestibular alterations.

  20. Vestibular Findings in Military Band Musicians

    PubMed Central

    Zeigelboim, Bianca Simone; Gueber, Crislaine; Silva, Thanara Pruner da; Liberalesso, Paulo Breno Noronha; Gonçalves, Claudia Giglio de Oliveira; Faryniuk, João Henrique; Marques, Jair Mendes; Jurkiewicz, Ari Leon

    2014-01-01

    Introduction Exposure to music is the subject of many studies because it is related to an individual's professional and social activities. Objectives Evaluate the vestibular behavior in military band musicians. Methods A retrospective cross-sectional study was performed. Nineteen musicians with ages ranging from 21 to 46 years were evaluated (average = 33.7 years and standard deviation = 7.2 years). They underwent anamnesis and vestibular and otolaryngologic evaluation through vectoelectronystagmography. Results The most evident otoneurologic symptoms in the anamnesis were tinnitus (84.2%), hearing difficulties (47.3%), dizziness (36.8%), headache (26.3%), intolerance to intense sounds (21.0%), and earache (15.7%). Seven musicians (37.0%) showed vestibular abnormality, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system, and there was a predominance of irritative peripheral vestibular disorders. Conclusion The alteration in vestibular exam occurred in the caloric test (37.0%). There were changes in the prevalence of peripheral vestibular system with a predominance of irritative vestibular dysfunction. Dizziness was the most significant symptom for the vestibular test in correlation with neurotologic symptoms. The present study made it possible to verify the importance of the labyrinthine test, which demonstrates that this population should be better studied because the systematic exposure to high sound pressure levels may cause major vestibular alterations. PMID:25992076

  1. Improvement of a face perception deficit via subsensory galvanic vestibular stimulation.

    PubMed

    Wilkinson, David; Ko, Philip; Kilduff, Patrick; McGlinchey, Regina; Milberg, William

    2005-11-01

    The remediative effect of galvanic vestibular stimulation (GVS) was investigated in a patient who, following right hemisphere damage, is profoundly unable to recognize faces. We administered a two-alternative forced choice match-to-sample task in which the patient had to choose which of two faces matched a sample face presented directly above, while bipolar, transcutaneous current was applied to the left and right vestibular nerves at a level below the patient's sensory threshold. Performance improved beyond the chance-level observed prestimulation, and relied on reversing the electrode polarity across two separate blocks of trials, such that each mastoid received positive current for one block and then negative charge for the next. Although our study involved only a single case, the data provide preliminary evidence that a deficit in perceptual face matching can be reduced by GVS. This raises the intriguing possibility that other unilateral visual disorders may also respond in such a manner. PMID:16519272

  2. Neural substrates underlying vestibular compensation: contribution of peripheral versus central processing.

    PubMed

    Cullen, Kathleen E; Minor, Lloyd B; Beraneck, Mathieu; Sadeghi, Soroush G

    2009-01-01

    The vestibulo-ocular reflex (VOR), which functions to stabilize gaze and ensure clear vision during everyday activities, shows impressive adaptation in response to environmental requirements. In particular, the VOR exhibits remarkable recovery following the loss of unilateral labyrinthine input as a result of injury or disease. The relative simplicity of the pathways that mediate the VOR, make it an excellent model system for understanding the changes (learning) that occur in the brain following peripheral vestibular loss to yield adaptive changes. This mini review considers the findings of behavioral, single unit recording and lesion studies of VOR compensation. Recent experiments have provided evidence that the brain makes use of multiple plasticity mechanisms (i.e., changes in peripheral as well as central processing) during the course of vestibular compensation to accomplish the sensory-motor transformations required to accurately guide behavior.

  3. Unilateral cerebellar aplasia.

    PubMed

    Boltshauser, E; Steinlin, M; Martin, E; Deonna, T

    1996-02-01

    We describe three children with unilateral cerebellar aplasia (UCA). Deliveries at term and neonatal periods were uneventful. Pregnancy was normal in one and complicated by mild bleeding (in second and fourth month respectively) in two instances. Presenting signs were delayed motor development with marked contralateral torticollis (n = 1), hemiplegia (n = 1) and unusual head nodding (n = 1). Neuroradiological investigations revealed complete aplasia (n = 1) and subtotal aplasia (n = 2) of one cerebellar hemisphere with only a residual wing-like structure below the tentorium. There was contralateral underdevelopment of the brainstem. The infant with hemiplegic cerebral palsy had an additional supratentorial periventricular parenchymal defect, contralateral to the cerebellar hypoplasia. In view of literature reports, describing similar neuroradiological or neuropathological findings in asymptomatic individuals, it is doubtful whether UCA is responsible for our patient's problems. In our cases UCA has presumably resulted from a prenatal destructive lesion, possibly an infarct, but the timing and exact nature are unknown. PMID:8677027

  4. DARA vestibular equipment onboard MIR.

    PubMed

    Hofmann, P; Kellig, A; Hoffmann, H U; Ruyters, G

    1998-01-01

    In space, the weightless environment provides a different stimulus to the otolith organs of the vestibular system, and the resulting signals no longer correspond with the visual and other sensory signals sent to the brain. This signal conflict causes disorientation. To study this and also to understand the vestibular adaptation to weightlessness, DARA has developed scientific equipment for vestibular and visuo-oculomotoric investigations. Especially, two video-oculography systems (monocular--VOG--and binocular--BIVOG, respectively) as well as stimuli such as an optokinetic stimulation device have successfully been employed onboard MIR in the frame of national and European missions since 1992. The monocular VOG was used by Klaus Flade during the MIR '92 mission, by Victor Polyakov during his record 15 months stay onboard MIR in 1993/94 as well as by Ulf Merbold during EUROMIR '94. The binocular version was used by Thomas Reiter and Sergej Avdeyev during the 6 months EUROMIR '95 mission. PIs of the various experiments include H. Scherer and A. Clarke (FU Berlin), M. Dieterichs and S. Krafczyk (LMU Munchen) from Germany as well as C.H. Markham and S.G. Diamond from the United States. Video-Oculography (VOG) is a technique for examining the function of the human balance system located in the inner ear (vestibular system) and the visio-oculomotor interactions of the vestibular organ. The human eye movements are measured, recorded and evaluated by state-of-the-art video techniques. The method was first conceived and designed at the Vestibular Research Laboratory of the ENT Clinic in Steglitz, FU Berlin (A. Clarke, H. Scherer). Kayser-Threde developed, manufactured and tested the facilities for space application under contract to DARA. Evaluation software was first provided by the ENT Clinic, Berlin, later by our subcontractor Sensomotoric Instruments (SMI), Teltow. Optokinetic hardware to support visuo-oculomotoric investigations, has been shipped to MIR for EUROMIR '95

  5. Effects of Unilateral Cochlear Implantation on Balance Control and Sensory Organization in Adult Patients with Profound Hearing Loss

    PubMed Central

    Parietti-Winkler, Cécile; Lion, Alexis; Montaut-Verient, Bettina; Grosjean, Rémy; Gauchard, Gérome C.

    2015-01-01

    Many studies were interested in the consequence of vestibular dysfunction related to cochlear implantation on balance control. This pilot study aimed to assess the effects of unilateral cochlear implantation on the modalities of balance control and sensorimotor strategies. Posturographic and vestibular evaluations were performed in 10 patients (55 ± 20 years) with profound hearing loss who were candidates to undergo unilateral multichannel cochlear implantation. The evaluation was carried out shortly before and one year after surgery. Posturographic tests were also performed in 10 age-matched healthy participants (63 ± 16 years). Vestibular compensation was observed within one year. In addition, postural performances of the patients increased within one year after cochlear implantation, especially in the more complex situations, in which sensory information is either unavailable or conflicting. Before surgery, postural performances were higher in the control group compared to the patients' group. One year after cochlear implantation, postural control was close to normalize. The improvement of postural performance could be explained by a mechanism of vestibular compensation. In addition, the recovery of auditory information which is the consequence of cochlear implantation could lead to an extended exploration of the environment possibly favoring the development of new balance strategies. PMID:26583121

  6. Molecular aging of the mammalian vestibular system.

    PubMed

    Brosel, Sonja; Laub, Christoph; Averdam, Anne; Bender, Andreas; Elstner, Matthias

    2016-03-01

    Dizziness and imbalance frequently affect the elderly and contribute to falls and frailty. In many geriatric patients, clinical testing uncovers a dysfunction of the vestibular system, but no specific etiology can be identified. Neuropathological studies have demonstrated age-related degeneration of peripheral and central vestibular neurons, but the molecular mechanisms are poorly understood. In contrast, recent studies into age-related hearing loss strongly implicate mitochondrial dysfunction, oxidative stress and apoptotic cell death of cochlear hair cells. While some data suggest that analogous biological pathomechanisms may underlie vestibular dysfunction, actual proof is missing. In this review, we summarize the available data on the molecular causes of vestibular dysfunction. PMID:26739358

  7. A vestibular phenotype for Waardenburg syndrome?

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Pesznecker, S. C.; Allen, K.; Gianna, C.

    2001-01-01

    OBJECTIVE: To investigate vestibular abnormalities in subjects with Waardenburg syndrome. STUDY DESIGN: Retrospective record review. SETTING: Tertiary referral neurotology clinic. SUBJECTS: Twenty-two adult white subjects with clinical diagnosis of Waardenburg syndrome (10 type I and 12 type II). INTERVENTIONS: Evaluation for Waardenburg phenotype, history of vestibular and auditory symptoms, tests of vestibular and auditory function. MAIN OUTCOME MEASURES: Results of phenotyping, results of vestibular and auditory symptom review (history), results of vestibular and auditory function testing. RESULTS: Seventeen subjects were women, and 5 were men. Their ages ranged from 21 to 58 years (mean, 38 years). Sixteen of the 22 subjects sought treatment for vertigo, dizziness, or imbalance. For subjects with vestibular symptoms, the results of vestibuloocular tests (calorics, vestibular autorotation, and/or pseudorandom rotation) were abnormal in 77%, and the results of vestibulospinal function tests (computerized dynamic posturography, EquiTest) were abnormal in 57%, but there were no specific patterns of abnormality. Six had objective sensorineural hearing loss. Thirteen had an elevated summating/action potential (>0.40) on electrocochleography. All subjects except those with severe hearing loss (n = 3) had normal auditory brainstem response results. CONCLUSION: Patients with Waardenburg syndrome may experience primarily vestibular symptoms without hearing loss. Electrocochleography and vestibular function tests appear to be the most sensitive measures of otologic abnormalities in such patients.

  8. Vestibular dysfunction in occupational chronic solvent intoxication.

    PubMed

    Arlien-Søborg, P; Zilstorff, K; Grandjean, B; Milling Pedersen, L

    1981-08-01

    Neurotoxic volatile organic solvents used by house and car painters may lead to professional toxic encephalopathy after several years of exposure. The symptoms are memory impairment, fatigue, personality changes, headache and dizziness. Vestibular dysfunction was found in 55% of 113 painters examined, mainly in the form of reduced caloric vestibular reactions. No correlation between vestibular dysfunction and the duration of exposure, cerebral atrophy or intellectual impairment could be demonstrated. Vestibular examination may be helpful in detecting early changes in exposed persons and in determining more accurate safety limits for harmful chemicals.

  9. Vestibular Function Research aboard Spacelab

    NASA Technical Reports Server (NTRS)

    Mah, R. W.; Daunton, N. G.

    1978-01-01

    NASA is planning to perform a series of Vestibular Function Research (VFR) investigations on the early STS missions to investigate those neurosensory and related physiological processes believed to be associated with the space flight nausea syndrome. The first flight is scheduled for the 1981 Spacelab III Mission in which four frog specimens, mounted on a frog tilting/centrifuge device, will be subjected to periodic acceleration stimuli and periods of artificial gravity. The vestibular nerve firing responses of each frog specimen will be monitored through implanted neutral bouyancy microelectrodes and transmitted to the ground for quick analysis during the flight. The experimentation will be directed at investigating: (1) adaptation to weightlessness; (2) response to acceleration stimuli; (3) response to artificial gravity (in a weightlessness environment) and (4) readaptation to earth's gravity upon return.

  10. Changes in the histaminergic system during vestibular compensation in the cat.

    PubMed

    Tighilet, Brahim; Trottier, Suzanne; Mourre, Christiane; Lacour, Michel

    2006-06-15

    To determine how the histaminergic system is implicated in vestibular compensation, we studied the changes in histidine decarboxylase (HDC; the enzyme synthesizing histamine) mRNA regulation in the tuberomammillary (TM) nuclei of cats killed 1 week, 3 weeks and 3 months after unilateral vestibular neurectomy (UVN). We also used one- and two-step bilateral vestibular neurectomized (BVN) cats to determine whether HDC mRNA regulation depended on the asymmetrical vestibular input received by the TM nuclei neurons. In addition, we analysed the HDC mRNA changes in the TM nuclei and the recovery of behavioural functions in UVN cats treated with thioperamide, a pure histaminergic drug. Finally, we quantified binding to histamine H3 receptors (H3Rs) in the medial vestibular nucleus (VN) by means of a histamine H3R agonist ([3H]N-alpha-methylhistamine) in order to further investigate the sites and mechanisms of action of histamine in this structure. This study shows that UVN increases HDC mRNA expression in the ipsilateral TM nucleus at 1 week. This increased expression persisted 3 weeks after UVN, and regained control values at 3 months. HDC mRNA expression was unchanged in the one-step BVN cats but showed mirror asymmetrical increases in the two-step BVN compared to the 1 week UVN cats. Three weeks' thioperamide treatment induced a bilateral HDC mRNA up-regulation in the UVN cats, which was higher than in the untreated UVN group. Binding to histamine H3Rs in the MVN showed a strong bilateral decrease after thioperamide treatment, while it was reduced ipsilaterally in the UVN cats. That such changes of the histaminergic system induced by vestibular lesion and treatment may play a functional role in vestibular compensation is strongly supported by the behavioural data. Indeed, spontaneous nystagmus, posture and locomotor balance were rapidly recovered in the UVN cats treated with thioperamide. These results demonstrate that changes in histamine levels are related to

  11. Effects of vestibular prosthesis electrode implantation and stimulation on hearing in rhesus monkeys.

    PubMed

    Dai, Chenkai; Fridman, Gene Y; Della Santina, Charles C

    2011-07-01

    To investigate the effects of vestibular prosthesis electrode implantation and activation on hearing in rhesus monkeys, we measured auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DPOAE) in four rhesus monkeys before and after unilateral implantation of vestibular prosthesis electrodes in each of 3 left semicircular canals (SCC). Each of the 3 left SCCs were implanted with electrodes via a transmastoid approach. Right ears, which served as controls, were not surgically manipulated. Hearing tests were conducted before implantation (BI) and then 4 weeks post-implantation both without electrical stimulation (NS) and with electrical stimulation (S). During the latter condition, prosthetic electrical stimuli encoding 3 dimensions of head angular velocity were delivered to the 3 ampullary branches of the left vestibular nerve via each of 3 electrode pairs of a multichannel vestibular prosthesis. Electrical stimuli comprised charge-balanced biphasic pulses at a baseline rate of 94 pulses/s, with pulse frequency modulated from 48 to 222 pulses/s by head angular velocity. ABR hearing thresholds to clicks and tone pips at 1, 2, and 4 kHz increased by 5-10 dB from BI to NS and increased another ∼5 dB from NS to S in implanted ears. No significant change was seen in right ears. DPOAE amplitudes decreased by 2-14 dB from BI to NS in implanted ears. There was a slight but insignificant decrease of DPOAE amplitude and a corresponding increase of DPOAE/Noise floor ratio between NS and S in implanted ears. Vestibular prosthesis electrode implantation and activation have small but measurable effects on hearing in rhesus monkeys. Coupled with the clinical observation that patients with cochlear implants only rarely exhibit signs of vestibular injury or spurious vestibular nerve stimulation, these results suggest that although implantation and activation of multichannel vestibular prosthesis electrodes in human will carry a risk of hearing loss

  12. Occupational noise induced vestibular malfunction?

    PubMed Central

    Hinchcliffe, R; Coles, R R; King, P F

    1992-01-01

    This paper comprises a review of the evidence for the possibility that exposure to noise may damage the vestibular receptors in the internal ear as well as those in the cochlea. The review covers lay and medical publications, observations on patients, experimental studies, and compensation claims. It concludes that the verdict must be "not proven"--that is, although such damage is possible, the evidence is not strong enough to regard it as probable. PMID:1733458

  13. Endoscopic Resection of Vestibular Schwannomas

    PubMed Central

    Setty, Pradeep; D'Andrea, Kenneth P.; Stucken, Emily Z.; Babu, Seilesh; LaRouere, Michael J.; Pieper, Daniel R.

    2015-01-01

    Objective To report our results and the technical details of fully endoscopic resection of vestibular schwannomas. Design Prospective observational study. Setting A single academic institution involving neurosurgery and neurotology. Participants Twelve consecutive patients who underwent fully endoscopic resection of a vestibular schwannoma. Main Outcome Measures Hearing preservation, based on the American Association of Otolaryngology-Head and Neck Surgeons (AAO-HNS) score as well as the Gardener and Robertson Modified Hearing Classification (GR). Facial nerve preservation based on the House-Brackmann (HB) score. Results All patients successfully underwent gross total resection. Facial nerve preservation rate was 92% with 11 of 12 patients retaining an HB score of 1/6 postoperatively. Hearing preservation rate was 67% with 8 of 12 patients maintaining a stable AAO-HNS grade and GR score at follow-up. Mean tumor size was 1.5 cm (range: 1–2 cm). No patients experienced postoperative cerebrospinal fluid leak, infection, or cranial nerve palsy for a complication rate of 0%. Mean operative time was 261.6 minutes with an estimated blood loss of 56.3 mL and average length of hospital stay of 3.6 days. Conclusion A purely endoscopic approach is a safe and effective option for hearing preservation surgery for vestibular schwannomas in appropriately selected patients. PMID:26225307

  14. Lateropulsion and upbeat nystagmus are manifestations of central vestibular dysfunction.

    PubMed

    Benjamin, E E; Zimmerman, C F; Troost, B T

    1986-09-01

    An elderly man presented with acute onset of gait instability, characterized by leaning to the left while walking, vertigo, diplopia, and transient facial numbness. The examination was remarkable for ocular lateropulsion and primary position upbeat nystagmus. Computed tomography of the brain revealed a right-hemispheric cerebellar infarction. This report illustrates that lateropulsion can occur in cerebellar lesions, but that it may be contralateral to the cerebellar hemisphere involved. Primary position upbeat nystagmus and lateropulsion may represent forms of central vestibular dysfunction due to interruption of vestibulo-ocular pathways.

  15. Altered Contralateral Auditory Cortical Morphology in Unilateral Sudden Sensorineural Hearing Loss

    PubMed Central

    Fan, Wenliang; Zhang, Wenjuan; Li, Jing; Zhao, Xueyan; Mella, Grace; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong; Xu, Haibo

    2015-01-01

    Objective: To investigate the cerebral gray matter volume alterations in unilateral sudden sensorineural hearing loss patients within the acute period by the voxel-based morphometry method, and to determine if hearing impairment is associated with regional gray matter alterations in unilateral sudden sensorineural hearing loss patients. Study Design: Prospective case study. Setting: Tertiary class A teaching hospital. Patients: Thirty-nine patients with left-side unilateral sudden sensorineural hearing loss and 47 patients with right-side unilateral sudden sensorineural hearing loss. Intervention: Diagnostic. Main Outcome Measure: To compare the regional gray matter of unilateral sudden sensorineural hearing loss patients and healthy control participants. Results: Compared with control groups, patients with left side unilateral sudden sensorineural hearing loss had significant gray matter reductions in the right middle temporal gyrus and right superior temporal gyrus, whereas patients with right side unilateral sudden sensorineural hearing loss showed gray matter decreases in the left superior temporal gyrus and left middle temporal gyrus. A significant negative correlation with the duration of the sudden sensorineural hearing loss (R = −0.427, p = 0.012 for left-side unilateral SSNHL and R = −0.412, p = 0.013 for right-side unilateral SSNHL) was also found in these brain areas. There was no region with increased gray matter found in both groups of unilateral sudden sensorineural hearing loss patients. Conclusions: This study confirms that detectable decreased contralateral auditory cortical morphological changes have occurred in unilateral SSNHL patients within the acute period by voxel-based morphometry methods. The gray matter volumes of these brain areas also perform a negative correlation with the duration of the disease, which suggests a gradual brain structural impairment after the progression of the disease. PMID:26595717

  16. Electrical Stimulation to Restore Vestibular Function – Development of a 3-D Vestibular Prosthesis

    PubMed Central

    Della Santina, Charles C.; Migliaccio, Americo A.; Patel, Amit H.

    2009-01-01

    Patients who fail to compensate for bilateral loss of vestibular sensory function are disabled by disequilibrium and illusory movement of the visual field during head movement. An implantable prosthesis that restores vestibular sensation could significantly improve quality of life for these patients. To be effective, such a device should encode head rotation in all 3 dimensions. We describe the 3-dimensional angular vestibulo-ocular reflex of normal chinchillas and vestibular-deficient chinchillas undergoing functional electrical stimulation of the vestibular nerve. We also describe the design and fabrication of a head-mounted, 8 electrode vestibular prosthesis that encodes head movement in 3 dimensions. PMID:17281986

  17. Temporoparietal encoding of space and time during vestibular-guided orientation.

    PubMed

    Kaski, Diego; Quadir, Shamim; Nigmatullina, Yuliya; Malhotra, Paresh A; Bronstein, Adolfo M; Seemungal, Barry M

    2016-02-01

    When we walk in our environment, we readily determine our travelled distance and location using visual cues. In the dark, estimating travelled distance uses a combination of somatosensory and vestibular (i.e., inertial) cues. The observed inability of patients with complete peripheral vestibular failure to update their angular travelled distance during active or passive turns in the dark implies a privileged role for vestibular cues during human angular orientation. As vestibular signals only provide inertial cues of self-motion (e.g., velocity, °/s), the brain must convert motion information to distance information (a process called 'path integration') to maintain our spatial orientation during self-motion in the dark. It is unknown, however, what brain areas are involved in converting vestibular-motion signals to those that enable such vestibular-spatial orientation. Hence, using voxel-based lesion-symptom mapping techniques, we explored the effect of acute right hemisphere lesions in 18 patients on perceived angular position, velocity and motion duration during whole-body angular rotations in the dark. First, compared to healthy controls' spatial orientation performance, we found that of the 18 acute stroke patients tested, only the four patients with damage to the temporoparietal junction showed impaired spatial orientation performance for leftward (contralesional) compared to rightward (ipsilesional) rotations. Second, only patients with temporoparietal junction damage showed a congruent underestimation in both their travelled distance (perceived as shorter) and motion duration (perceived as briefer) for leftward compared to rightward rotations. All 18 lesion patients tested showed normal self-motion perception. These data suggest that the cerebral cortical regions mediating vestibular-motion ('am I moving?') and vestibular-spatial perception ('where am I?') are distinct. Furthermore, the congruent contralesional deficit in time (motion duration) and position

  18. Temporoparietal encoding of space and time during vestibular-guided orientation.

    PubMed

    Kaski, Diego; Quadir, Shamim; Nigmatullina, Yuliya; Malhotra, Paresh A; Bronstein, Adolfo M; Seemungal, Barry M

    2016-02-01

    When we walk in our environment, we readily determine our travelled distance and location using visual cues. In the dark, estimating travelled distance uses a combination of somatosensory and vestibular (i.e., inertial) cues. The observed inability of patients with complete peripheral vestibular failure to update their angular travelled distance during active or passive turns in the dark implies a privileged role for vestibular cues during human angular orientation. As vestibular signals only provide inertial cues of self-motion (e.g., velocity, °/s), the brain must convert motion information to distance information (a process called 'path integration') to maintain our spatial orientation during self-motion in the dark. It is unknown, however, what brain areas are involved in converting vestibular-motion signals to those that enable such vestibular-spatial orientation. Hence, using voxel-based lesion-symptom mapping techniques, we explored the effect of acute right hemisphere lesions in 18 patients on perceived angular position, velocity and motion duration during whole-body angular rotations in the dark. First, compared to healthy controls' spatial orientation performance, we found that of the 18 acute stroke patients tested, only the four patients with damage to the temporoparietal junction showed impaired spatial orientation performance for leftward (contralesional) compared to rightward (ipsilesional) rotations. Second, only patients with temporoparietal junction damage showed a congruent underestimation in both their travelled distance (perceived as shorter) and motion duration (perceived as briefer) for leftward compared to rightward rotations. All 18 lesion patients tested showed normal self-motion perception. These data suggest that the cerebral cortical regions mediating vestibular-motion ('am I moving?') and vestibular-spatial perception ('where am I?') are distinct. Furthermore, the congruent contralesional deficit in time (motion duration) and position

  19. Temporoparietal encoding of space and time during vestibular-guided orientation

    PubMed Central

    Kaski, Diego; Quadir, Shamim; Nigmatullina, Yuliya; Malhotra, Paresh A.; Bronstein, Adolfo M.

    2016-01-01

    When we walk in our environment, we readily determine our travelled distance and location using visual cues. In the dark, estimating travelled distance uses a combination of somatosensory and vestibular (i.e. inertial) cues. The observed inability of patients with complete peripheral vestibular failure to update their angular travelled distance during active or passive turns in the dark implies a privileged role for vestibular cues during human angular orientation. As vestibular signals only provide inertial cues of self-motion (e.g. velocity, °/s), the brain must convert motion information to distance information (a process called ‘path integration’) to maintain our spatial orientation during self-motion in the dark. It is unknown, however, what brain areas are involved in converting vestibular-motion signals to those that enable such vestibular-spatial orientation. Hence, using voxel-based lesion–symptom mapping techniques, we explored the effect of acute right hemisphere lesions in 18 patients on perceived angular position, velocity and motion duration during whole-body angular rotations in the dark. First, compared to healthy controls’ spatial orientation performance, we found that of the 18 acute stroke patients tested, only the four patients with damage to the temporoparietal junction showed impaired spatial orientation performance for leftward (contralesional) compared to rightward (ipsilesional) rotations. Second, only patients with temporoparietal junction damage showed a congruent underestimation in both their travelled distance (perceived as shorter) and motion duration (perceived as briefer) for leftward compared to rightward rotations. All 18 lesion patients tested showed normal self-motion perception. These data suggest that the cerebral cortical regions mediating vestibular-motion (‘am I moving?’) and vestibular-spatial perception (‘where am I?’) are distinct. Furthermore, the congruent contralesional deficit in time (motion duration

  20. Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction

    PubMed Central

    2012-01-01

    Background Peripheral vestibular hypofunction is a major cause of dizziness. When complicated with postural imbalance, this condition can lead to an increased incidence of falls. In traditional clinical practice, gaze stabilization exercise is commonly used to rehabilitate patients. In this study, we established a computer-aided vestibular rehabilitation system by coupling infrared LEDs to an infrared receiver. This system enabled the subjects’ head-turning actions to be quantified, and the training was performed using vestibular exercise combined with computer games and interactive video games that simulate daily life activities. Methods Three unilateral and one bilateral vestibular hypofunction patients volunteered to participate in this study. The participants received 30 minutes of computer-aided vestibular rehabilitation training 2 days per week for 6 weeks. Pre-training and post-training assessments were completed, and a follow-up assessment was completed 1 month after the end of the training period. Results After 6 weeks of training, significant improvements in balance and dynamic visual acuity (DVA) were observed in the four participants. Self-reports of dizziness, anxiety and depressed mood all decreased significantly. Significant improvements in self-confidence and physical performance were also observed. The effectiveness of this training was maintained for at least 1 month after the end of the training period. Conclusion Real-time monitoring of training performance can be achieved using this rehabilitation platform. Patients demonstrated a reduction in dizziness symptoms after 6 weeks of training with this short-term interactive game approach. This treatment paradigm also improved the patients’ balance function. This system could provide a convenient, safe and affordable treatment option for clinical practitioners. PMID:23043886

  1. A novel treatment for vestibular disorder with FGLM-NH2 plus SSSR.

    PubMed

    Toyota, Hideki; Shimogori, Hiroaki; Sugahara, Kazuma; Yamashita, Hiroshi

    2012-09-27

    Topical FGLM-NH(2) (Phenylalanine-Glycine-Leucine-Methionine-Amide) plus SSSR (Serine-Serine-Serine-Arginine) facilitates recovery from vestibular disorders induced by (±)-α-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid (AMPA) in guinea pigs and might offer a treatment strategy for patients with peripheral vestibular disorders. The tetrapeptide FGLM-NH(2) derived from substance P (SP) can be used to treat corneal disorders when combined with SSSR, which is a tetrapeptide derived from insulin-like growth factor-1 (IGF-1). We examined the influence of FGLM-NH(2) plus SSSR when locally applied to the unilateral inner ear of guinea pigs with vestibular disorder induced by AMPA. A total of 18 Hartley white guinea pigs were assigned to groups receiving either FGLM-NH(2) plus SSSR, artificial perilymph, or no treatment at all. A hole was drilled adjacent to the round window, with AMPA then infused into the hole in order to induce the vestibular disorder. Thereafter, FGLM-NH(2) plus SSSR or artificial perilymph was delivered via an osmotic pump that was inserted into the hole. Sinusoidal rotation tests were used for observing spontaneous nystagmus and for measurements of the vestibulo-ocular reflexes (VOR). Two animals from each group were immunohistochemically examined at 24h after the treatment. Spontaneous nystagmus decreased immediately after FGLM-NH(2) plus SSSR infusion. The recovery of the VOR gains was statistically faster than that seen in the control group at 3 and 7 days after treatment. Immunohistochemical examination revealed that many synaptic ribbons, which are markers of the synapse, were stained in the FGLM-NH(2) plus SSSR group compared with the untreated group. Topical application of FGLM-NH(2) plus SSSR accelerates functional recovery from AMPA-induced vestibular disorders by facilitating synaptic regeneration in guinea pigs.

  2. Advances in Auditory and Vestibular Medicine

    PubMed Central

    Trune, Dennis R.; Dutia, Mayank B.

    2010-01-01

    Auditory and Vestibular medicine is becoming more accepted as a specialty of its own, Medical NeurOtology. Recent advances in the field have been instrumental in the understanding of the scientific foundations, pathophysiology, clinical approach and management of patients with hearing and vestibular disorders. This paper will review these advances. PMID:20711412

  3. Vestibular-visual interactions in flight simulators

    NASA Technical Reports Server (NTRS)

    Clark, B.

    1977-01-01

    The following research work is reported: (1) vestibular-visual interactions; (2) flight management and crew system interactions; (3) peripheral cue utilization in simulation technology; (4) control of signs and symptoms of motion sickness; (5) auditory cue utilization in flight simulators, and (6) vestibular function: Animal experiments.

  4. Galvanic vestibular stimulation improves the results of vestibular rehabilitation.

    PubMed

    Carmona, Sergio; Ferrero, Antonela; Pianetti, Guillermina; Escolá, Natalia; Arteaga, María Victoria; Frankel, Lilian

    2011-09-01

    Here, we present findings from a three-step investigation of the effect of galvanic vestibular stimulation (GVS) in normal subjects and in subjects undergoing vestibular rehabilitation (VR). In an initial study, we examined the body sway of 10 normal subjects after one minute of 2 mA GVS. The effect of the stimulation lasted for at least 20 minutes in all subjects and up to two hours in 70% of the subjects. We then compared a group of patients who received conventional VR (40 patients) with a group that received a combination of VR and GVS. Results suggest a significant improvement in the second group. Finally, we attempted to establish the optimal number of GVS sessions and to rule out a placebo effect. Fifteen patients received "systematic" GVS: five sessions, once a week. Five patients received "nonsystematic" galvanic stimulation in a sham protocol, which included two stimulations of the clavicle. These data were analyzed with Fisher's exact test and indicated that the best results were obtained after three sessions of GVS and no placebo effect was observed. PMID:22360772

  5. Aging of the Human Vestibular System.

    PubMed

    Zalewski, Christopher K

    2015-08-01

    Aging affects every sensory system in the body, including the vestibular system. Although its impact is often difficult to quantify, the deleterious impact of aging on the vestibular system is serious both medically and economically. The deterioration of the vestibular sensory end organs has been known since the 1970s; however, the measurable impact from these anatomical changes remains elusive. Tests of vestibular function either fall short in their ability to quantify such anatomical deterioration, or they are insensitive to the associated physiologic decline and/or central compensatory mechanisms that accompany the vestibular aging process. When compared with healthy younger individuals, a paucity of subtle differences in test results has been reported in the healthy older population, and those differences are often observed only in response to nontraditional and/or more robust stimuli. In addition, the reported differences are often clinically insignificant insomuch that the recorded physiologic responses from the elderly often fall within the wide normative response ranges identified for normal healthy adults. The damaging economic impact of such vestibular sensory decline manifests itself in an exponential increase in geriatric dizziness and a subsequent higher prevalence of injurious falls. An estimated $10 to $20 billion dollar annual cost has been reported to be associated with falls-related injuries and is the sixth leading cause of death in the elderly population, with a 20% mortality rate. With an estimated 115% increase in the geriatric population over 65 years of age by the year 2050, the number of balanced-disordered patients with a declining vestibular system is certain to reach near epidemic proportions. An understanding of the effects of age on the vestibular system is imperative if clinicians are to better manage elderly patients with balance disorders, dizziness, and vestibular disease. PMID:27516717

  6. Aging of the Human Vestibular System

    PubMed Central

    Zalewski, Christopher K.

    2015-01-01

    Aging affects every sensory system in the body, including the vestibular system. Although its impact is often difficult to quantify, the deleterious impact of aging on the vestibular system is serious both medically and economically. The deterioration of the vestibular sensory end organs has been known since the 1970s; however, the measurable impact from these anatomical changes remains elusive. Tests of vestibular function either fall short in their ability to quantify such anatomical deterioration, or they are insensitive to the associated physiologic decline and/or central compensatory mechanisms that accompany the vestibular aging process. When compared with healthy younger individuals, a paucity of subtle differences in test results has been reported in the healthy older population, and those differences are often observed only in response to nontraditional and/or more robust stimuli. In addition, the reported differences are often clinically insignificant insomuch that the recorded physiologic responses from the elderly often fall within the wide normative response ranges identified for normal healthy adults. The damaging economic impact of such vestibular sensory decline manifests itself in an exponential increase in geriatric dizziness and a subsequent higher prevalence of injurious falls. An estimated $10 to $20 billion dollar annual cost has been reported to be associated with falls-related injuries and is the sixth leading cause of death in the elderly population, with a 20% mortality rate. With an estimated 115% increase in the geriatric population over 65 years of age by the year 2050, the number of balanced-disordered patients with a declining vestibular system is certain to reach near epidemic proportions. An understanding of the effects of age on the vestibular system is imperative if clinicians are to better manage elderly patients with balance disorders, dizziness, and vestibular disease. PMID:27516717

  7. Progress Toward Development of a Multichannel Vestibular Prosthesis for Treatment of Bilateral Vestibular Deficiency

    PubMed Central

    FRIDMAN, GENE Y.; DELLA SANTINA, CHARLES C.

    2014-01-01

    This article reviews vestibular pathology and the requirements and progress made in the design and construction of a vestibular prosthesis. Bilateral loss of vestibular sensation is disabling. When vestibular hair cells are injured by ototoxic medications or other insults to the labyrinth, the resulting loss of sensory input disrupts vestibulo-ocular reflexes (VORs) and vestibulo-spinal reflexes that normally stabilize the eyes and body. Affected individuals suffer poor vision during head movement, postural instability, chronic disequilibrium, and cognitive distraction. Although most individuals with residual sensation compensate for their loss over time, others fail to do so and have no adequate treatment options. A vestibular prosthesis analogous to cochlear implants but designed to modulate vestibular nerve activity during head movement should improve quality of life for these chronically dizzy individuals. We describe the impact of bilateral loss of vestibular sensation, animal studies supporting feasibility of prosthetic vestibular stimulation, the current status of multichannel vestibular sensory replacement prosthesis development, and challenges to successfully realizing this approach in clinical practice. In bilaterally vestibular-deficient rodents and rhesus monkeys, the Johns Hopkins multichannel vestibular prosthesis (MVP) partially restores the three-dimensional (3D) VOR for head rotations about any axis. Attempts at prosthetic vestibular stimulation of humans have not yet included the 3D eye movement assays necessary to accurately evaluate VOR alignment, but these initial forays have revealed responses that are otherwise comparable to observations in animals. Current efforts now focus on refining electrode design and surgical technique to enhance stimulus selectivity and preserve cochlear function, optimizing stimulus protocols to improve dynamic range and reduce excitation–inhibition asymmetry, and adapting laboratory MVP prototypes into devices

  8. Vestibular implants: Hope for improving the quality of life of patients with bilateral vestibular loss.

    PubMed

    Guinand, N; van de Berg, R; Ranieri, M; Cavuscens, S; DiGiovanna, J; Nguyen, T A K; Micera, S; Stokroos, R; Kingma, H; Guyot, J P; Perez Fornos, A

    2015-01-01

    The vestibular system plays an essential role in crucial tasks such as postural control, gaze stabilization, and spatial orientation. Currently, there is no effective treatment for a bilateral loss of the vestibular function (BVL). The quality of life of affected patients is significantly impaired. During the last decade, our group has explored the potential of using electrical stimulation to artificially restore the vestibular function. Our vestibular implant prototype consists of a custom modified cochlear implant featuring one to three vestibular electrodes implanted in the proximity of the ampullary branches of the vestibular nerve; in addition to the main cochlear array. Special surgical techniques for safe implantation of these devices have been developed. In addition, we have developed stimulation strategies to generate bidirectional eye movements as well as the necessary interfaces to capture the signal from a motion sensor (e.g., gyroscope) and use it to modulate the stimulation signals delivered to the vestibular nerves. To date, 24 vestibular electrodes have been implanted in 11 BVL patients. Using a virtual motion profile to modulate the "baseline" electrical stimulation, vestibular responses could be evoked with 21 electrodes. Eye movements with mean peak eye velocities of 32°/s and predominantly in the plane of the stimulated canal were successfully generated. These are within the range of normal compensatory eye movements during walking and were large enough to have a significant effect on the patients' visual acuity. These results indicate that electrical stimulation of the vestibular nerve has a significant functional impact; eye movements generated this way could be sufficient to restore gaze stabilization during essential everyday tasks such as walking. The innovative concept of the vestibular implant has the potential to restore the vestibular function and have a central role in improving the quality of life of BVL patients in the near future

  9. Vestibular-induced vomiting after vestibulocerebellar lesions

    NASA Technical Reports Server (NTRS)

    Miller, A. D.; Wilson, V. J.

    1982-01-01

    Vestibular stimulation, by sinusoidal electrical polarization of the labyrinths of decerebrate cats which can produce vomiting and related activity which resembles motion sickness was examined. The symptoms include panting, salivation, swallowing, and retching as well as vomiting. These symptoms can be produced in cats with lesions of the posterior cerebellar vermis. It is suggested that a transcerebellar pathway from the vestibular apparatus through the nodulus and uvula to the vomiting center is not essential for vestibular induced vomiting and the occurrence of many symptoms of motion.

  10. Vestibular-induced vomiting after vestibulocerebellar lesions

    NASA Technical Reports Server (NTRS)

    Miller, A. D.; Wilson, V. J.

    1983-01-01

    Vestibular stimulation, by sinusoidal electrical polarization of the labyrinths of decerebrate cats which can produce vomiting and related activity which resembles motion sickness was examined. The symptoms include panting, salivation, swallowing, and retching as well as vomiting. These symptoms can be produced in cats with lesions of the posterior cerebellar vermis. It is suggested that a transcerebellar pathway from the vestibular apparatus through the nodulus and uvula to the vomiting center is not essential for vestibular induced vomiting and the occurrence of many symptoms of motion.

  11. Vestibular reactions to spaceflight: human factors issues.

    PubMed

    Young, L R

    2000-09-01

    Vestibular function, along with other sensory systems influencing spatial orientation, can have a profound influence on the ability of astronauts to function effectively. Beyond the well-known problems of space motion sickness, vestibular effects can influence astronaut well-being and performance during all phases of a space mission. This paper discusses some of the major vestibular reactions affecting human factors encountered in all space missions, and covers them chronologically in the following sequence: launch, early on-orbit, late on-orbit, EVA, artificial gravity, re-entry, and post-landing.

  12. Normal and abnormal human vestibular ocular function

    NASA Technical Reports Server (NTRS)

    Peterka, R. J.; Black, F. O.

    1986-01-01

    The major motivation of this research is to understand the role the vestibular system plays in sensorimotor interactions which result in spatial disorientation and motion sickness. A second goal was to explore the range of abnormality as it is reflected in quantitative measures of vestibular reflex responses. The results of a study of vestibular reflex measurements in normal subjects and preliminary results in abnormal subjects are presented in this report. Statistical methods were used to define the range of normal responses, and determine age related changes in function.

  13. One-shot, low-dosage intratympanic gentamicin for Ménière's disease: Clinical, posturographic and vestibular test findings

    PubMed Central

    Daneshi, Ahmad; Pousti, Seyed Behzad; Mohammadi, Shabahang

    2014-01-01

    Background Ménière's disease has been remained as a difficult therapeutic challenge. The present study aimed to determine the effects of one-shot low-dosage intratympanic gentamicin on vertigo control, auditory outcomes and findings of computerized dynamic posturography and vestibular evoked myogenic potentials in patients with unilateral Ménière's disease. Methods In a prospective clinical study, 30 patients with unilateral Ménière's disease were treated with one-shot intratympanic injection of 20 milligrams gentamicin. Main outcome measures included clinical, audiometric, postural and vestibular outcomes evaluated 1 and 9 months after the treatment. Results Mean vertigo attacks frequency, pure tone average threshold and functional level scale significantly decreased after the treatment (P < 0.05). Effective vertigo control (class A and B) obtained in 95.8% of the patients. In total, 75% of patients reported decrease in both aural fullness and tinnitus. Vestibular evoked myogenic potentials became absent in all the patients but four of them. Posturographic scores were improved after the treatment. Conclusion One-shot low-dosage gentamicin was effective in controlling vertigo attacks in Ménière's disease and has useful effects on aural fullness and tinnitus of patients as well. Postural and vestibular tests only have adjunctive role for monitoring therapeutic responses in intratympanic gentamicin-therapy. PMID:24800045

  14. Primal Terror: A Perspective of Vestibular Dysfunction.

    ERIC Educational Resources Information Center

    Shaffer, Martin

    1979-01-01

    The effects of "primal terror", the emotional experience of one's inability to naturally maintain balance in opposition to gravity and to integrate vestibular input, are discussed for children with learning and perceptual problems. (CL)

  15. The three faces of vestibular ganglionitis.

    PubMed

    Gacek, Richard R; Gacek, Mark R

    2002-02-01

    We present temporal bone and clinical evidence that common syndromes of recurrent vertigo are caused by a viral infection of the vestibular ganglion. In the present series, histopathologic and radiologic changes in the vestibular ganglion and meatal ganglion were consistent with a viral inflammation of ganglion cells in cases of Meniere's disease, benign paroxysmal positional vertigo, and vestibular neuronitis. Clinical observations of multiple neuropathies involving cranial nerves V, VII, and VIII on the same side in patients with recurrent vertigo are best explained by a cranial polyganglionitis caused by a neurotrophic virus, which is reactivated by a stressful event later in life. The reactivation of the latent virus may manifest as one of the above vertigo syndromes, depending on the part of the vestibular ganglion that is inflamed, the type and strain of the virus, and host resistance.

  16. Axial length in unilateral idiopathic central serous chorioretinopathy

    PubMed Central

    Moon, Hoseok; Lee, Dae Yeong; Nam, Dong Heun

    2016-01-01

    AIM To evaluate the axial length (AXL) in unilateral idiopathic central serous chorioretinopathy (CSC). METHODS This retrospective case-control study was comprised of a consecutive case series of 35 patients with acute unilateral idiopathic CSC, and age- and sex-matched 50 control eyes. AXL of both eyes of unilateral CSC patients and the control eyes were investigated. AXL was measured by ultrasonic biometry, and the adjusted AXL was calculated for CSC eyes as measured AXL plus differences of foveal thickness between CSC and normal fellow eyes in millimeters. The main outcome measures were comparison of AXL between CSC, fellow and control eyes. RESULTS The mean age of 35 CSC patients was 45.5y, and 31 males were included. The adjusted AXL of CSC eyes was 23.52 mm, and the AXL of fellow eyes was 23.46 mm, and of control eyes 23.94 mm. The AXL of both CSC and fellow eyes were significantly shorter than control eyes (CSC vs control, P=0.044; fellow vs control, P=0.026). There was no statistically significant difference in AXL between CSC and fellow eyes. CONCLUSION In unilateral idiopathic CSC, the AXL of CSC and fellow eyes are shorter than that of control eyes. Short AXL may be related with choroidal circulation abnormality in CSC. PMID:27275428

  17. Outcome analysis of individualized vestibular rehabilitation protocols

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Angel, C. R.; Pesznecker, S. C.; Gianna, C.

    2000-01-01

    OBJECTIVE: To determine the outcome of vestibular rehabilitation protocols in subjects with peripheral vestibular disorders compared with normal and abnormal control subjects. STUDY DESIGN: Prospective study using repeated measure, matched control design. Subjects were solicited consecutively according to these criteria: vestibular disorder subjects who had abnormal results of computerized dynamic posturography (CDP) sensory organization tests (SOTs) 5 and 6 and underwent rehabilitation; vestibular disorder subjects who had abnormal results of SOTs 5 and 6 and did not undergo rehabilitation; and normal subjects (normal SOTs). SETTING: Tertiary neurotology clinic. SUBJECTS: Men and women over age 18 with chronic vestibular disorders and chief complaints of unsteadiness, imbalance, and/or motion intolerance, and normal subjects. INTERVENTIONS: Pre- and post-rehabilitation assessment included CDP, vestibular disability, and activities of daily living questionnaires. Individualized rehabilitation plans were designed and implemented to address the subject's specific complaints and functional deficits. Supervised sessions were held at weekly intervals, and self-administered programs were devised for daily home use. MAIN OUTCOME MEASURES: CDP composite and SOT scores, number of falls on CDP, and self-assessment questionnaire results. RESULTS: Subjects who underwent rehabilitation (Group A) showed statistically significant improvements in SOTs, overall composite score, and reduction in falls compared with abnormal (Group B) control groups. Group A's performances after rehabilitation were not significantly different from those of normal subjects (Group C) in SOTs 3 through 6, and close to normal on SOTs 1 and 2. Subjects in Group A also reported statistically significant symptomatic improvement. CONCLUSIONS: Outcome measures of vestibular protocol physical therapy confirmed objective and subjective improvement in subjects with chronic peripheral vestibular disorders. These

  18. Vestibular development in marsupials and monotremes.

    PubMed

    Ashwell, Ken W S; Shulruf, Boaz

    2014-04-01

    The young of marsupials and monotremes are all born in an immature state, followed by prolonged nurturing by maternal lactation in either a pouch or nest. Nevertheless, the level of locomotor ability required for newborn marsupials and monotremes to reach the safety of the pouch or nest varies considerably: some are transferred to the pouch or nest in an egg (monotremes); others are transferred passively by gravity (e.g. dasyurid marsupials); some have only a horizontal wriggle to make (e.g. peramelid and didelphid marsupials); and others must climb vertically for a long distance to reach the maternal pouch (e.g. diprotodontid marsupials). In the present study, archived sections of the inner ear and hindbrain held in the Bolk, Hill and Hubrecht collections at the Museum für Naturkunde, Berlin, were used to test the relationship between structural maturity of the vestibular apparatus and the locomotor challenges that face the young of these different mammalian groups. A system for staging different levels of structural maturity of the vestibular apparatus was applied to the embryos, pouch young and hatchlings, and correlated with somatic size as indicated by greatest body length. Dasyurids are born at the most immature state, with the vestibular apparatus at little more than the otocyst stage. Peramelids are born with the vestibular apparatus at a more mature state (fully developed semicircular ducts and a ductus reuniens forming between the cochlear duct and saccule, but no semicircular canals). Diprotodontids and monotremes are born with the vestibular apparatus at the most mature state for the non-eutherians (semicircular canals formed, maculae present, but vestibular nuclei in the brainstem not yet differentiated). Monotremes and marsupials reach the later stages of vestibular apparatus development at mean body lengths that lie within the range of those found for laboratory rodents (mouse and rat) reaching the same vestibular stage.

  19. Vestibular-visual interactions in flight simulators

    NASA Technical Reports Server (NTRS)

    Clark, B.

    1977-01-01

    All 139 research papers published under this ten-year program are listed. Experimental work was carried out at the Ames Research Center involving man's sensitivity to rotational acceleration, and psychophysical functioning of the semicircular canals; vestibular-visual interactions and effects of other sensory systems were studied in flight simulator environments. Experiments also dealt with the neurophysiological vestibular functions of animals, and flight management investigations of man-vehicle interactions.

  20. Vestibular development in marsupials and monotremes

    PubMed Central

    Ashwell, Ken W S; Shulruf, Boaz

    2014-01-01

    The young of marsupials and monotremes are all born in an immature state, followed by prolonged nurturing by maternal lactation in either a pouch or nest. Nevertheless, the level of locomotor ability required for newborn marsupials and monotremes to reach the safety of the pouch or nest varies considerably: some are transferred to the pouch or nest in an egg (monotremes); others are transferred passively by gravity (e.g. dasyurid marsupials); some have only a horizontal wriggle to make (e.g. peramelid and didelphid marsupials); and others must climb vertically for a long distance to reach the maternal pouch (e.g. diprotodontid marsupials). In the present study, archived sections of the inner ear and hindbrain held in the Bolk, Hill and Hubrecht collections at the Museum für Naturkunde, Berlin, were used to test the relationship between structural maturity of the vestibular apparatus and the locomotor challenges that face the young of these different mammalian groups. A system for staging different levels of structural maturity of the vestibular apparatus was applied to the embryos, pouch young and hatchlings, and correlated with somatic size as indicated by greatest body length. Dasyurids are born at the most immature state, with the vestibular apparatus at little more than the otocyst stage. Peramelids are born with the vestibular apparatus at a more mature state (fully developed semicircular ducts and a ductus reuniens forming between the cochlear duct and saccule, but no semicircular canals). Diprotodontids and monotremes are born with the vestibular apparatus at the most mature state for the non-eutherians (semicircular canals formed, maculae present, but vestibular nuclei in the brainstem not yet differentiated). Monotremes and marsupials reach the later stages of vestibular apparatus development at mean body lengths that lie within the range of those found for laboratory rodents (mouse and rat) reaching the same vestibular stage. PMID:24298911

  1. Vestibular development in marsupials and monotremes.

    PubMed

    Ashwell, Ken W S; Shulruf, Boaz

    2014-04-01

    The young of marsupials and monotremes are all born in an immature state, followed by prolonged nurturing by maternal lactation in either a pouch or nest. Nevertheless, the level of locomotor ability required for newborn marsupials and monotremes to reach the safety of the pouch or nest varies considerably: some are transferred to the pouch or nest in an egg (monotremes); others are transferred passively by gravity (e.g. dasyurid marsupials); some have only a horizontal wriggle to make (e.g. peramelid and didelphid marsupials); and others must climb vertically for a long distance to reach the maternal pouch (e.g. diprotodontid marsupials). In the present study, archived sections of the inner ear and hindbrain held in the Bolk, Hill and Hubrecht collections at the Museum für Naturkunde, Berlin, were used to test the relationship between structural maturity of the vestibular apparatus and the locomotor challenges that face the young of these different mammalian groups. A system for staging different levels of structural maturity of the vestibular apparatus was applied to the embryos, pouch young and hatchlings, and correlated with somatic size as indicated by greatest body length. Dasyurids are born at the most immature state, with the vestibular apparatus at little more than the otocyst stage. Peramelids are born with the vestibular apparatus at a more mature state (fully developed semicircular ducts and a ductus reuniens forming between the cochlear duct and saccule, but no semicircular canals). Diprotodontids and monotremes are born with the vestibular apparatus at the most mature state for the non-eutherians (semicircular canals formed, maculae present, but vestibular nuclei in the brainstem not yet differentiated). Monotremes and marsupials reach the later stages of vestibular apparatus development at mean body lengths that lie within the range of those found for laboratory rodents (mouse and rat) reaching the same vestibular stage. PMID:24298911

  2. Vestibular Impairment in Frontotemporal Dementia Syndrome

    PubMed Central

    Nakamagoe, Kiyotaka; Kadono, Kotarou; Koganezawa, Tadachika; Takiguchi, Mao; Terada, Makoto; Yamamoto, Fumiko; Moriyama, Tetsuya; Yanagiha, Kumi; Nohara, Seitaro; Tozaka, Naoki; Miyake, Zenshi; Aizawa, Satoshi; Furusho, Kentaro; Tamaoka, Akira

    2016-01-01

    Background No studies to date have attempted to evaluate frontotemporal lobar degeneration from the perspective of the vestibular system. Objective The present study examined vestibular function in patients with frontotemporal dementia (FTD) clinical syndrome and evaluated whether vestibular disorders are involved in the clinical symptoms due to FTD. Methods Fourteen patients with FTD syndrome, as well as healthy elderly controls without dementia, were included in the present study. All subjects underwent vestibular function tests using electronystagmography, such as caloric tests and visual suppression (VS) tests, in which the induced caloric nystagmus was suppressed by visual stimuli. The association between clinical symptoms and vestibular function in the FTD syndrome group was further examined. Results In the FTD syndrome group, caloric nystagmus was not necessarily suppressed during VS tests. Furthermore, VS was observed to be significantly impaired in FTD syndrome patients with gait disturbance as compared to those without such disturbance. Conclusion The present study revealed that impairment of VS in patients with FTD results in an inability to regulate vestibular function by means of visual perception, regardless of multiple presumed neuropathological backgrounds. This could also be associated with gait disturbance in patients with FTD syndrome. PMID:27350780

  3. Vestibular function assessment using the NIH Toolbox

    PubMed Central

    Schubert, Michael C.; Whitney, Susan L.; Roberts, Dale; Redfern, Mark S.; Musolino, Mark C.; Roche, Jennica L.; Steed, Daniel P.; Corbin, Bree; Lin, Chia-Cheng; Marchetti, Greg F.; Beaumont, Jennifer; Carey, John P.; Shepard, Neil P.; Jacobson, Gary P.; Wrisley, Diane M.; Hoffman, Howard J.; Furman, Gabriel; Slotkin, Jerry

    2013-01-01

    Objective: Development of an easy to administer, low-cost test of vestibular function. Methods: Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was performed to examine reliability. Results: The DVA and BAM tests are affordable and appropriate for use for individuals 3 through 85 years of age. The DVA had fair to good reliability (0.41–0.94) and sensitivity and specificity (50%–73%), depending on age and optotype chosen. The BAM test was moderately correlated with center of pressure (r = 0.42–0.48) and dynamic posturography (r = −0.48), depending on age and test condition. Both tests differentiated those with and without vestibular impairment and the young from the old. Each test was reliable. Conclusion: The newly created DVA test provides a valid measure of visual acuity with the head still and moving quickly. The novel BAM is a valid measure of balance. Both tests are sensitive to age-related changes and are able to screen for impairment of the vestibular system. PMID:23479540

  4. On the recall of vestibular sensations.

    PubMed

    zu Eulenburg, Peter; Müller-Forell, W; Dieterich, M

    2013-01-01

    Functional neuroimaging studies on the recall or imagination of a distinctive task in the motor network or of sensations in sensory systems (visual, acoustic, nociceptive, gustatory, and olfactory) demonstrated that the respective primary cortex is often involved in the mental imagery process. Our aim was to examine this phenomenon in the vestibular system using fMRI. Sixteen healthy subjects were asked to remember the feeling of a rotatory chair procedure in contrast to an identical situation at rest. Shortly afterwards they were asked to recall the vestibular experience in a 1.5-T scanner. The resulting activations were then compared with the responses of a galvanic vestibular control experiment and a rest condition. The vestibular recall showed significant bihemispheric activations in the inferior frontal gyri, the anterior operculum, the middle cingulate, the putamen, the globus pallidus, the premotor motor cortex, and the anterior insula. We found activations in regions known to play a role in spatial referencing, motor programs, and attention in the recall of vestibular sensations. But important known relay stations for the cortical processing of vestibular information showed neither relevant activations nor deactivations.

  5. Vestibular stimulation affects optic-flow sensitivity.

    PubMed

    Edwards, Mark; O'Mahony, Simon; Ibbotson, Michael R; Kohlhagen, Stuart

    2010-01-01

    Typically, multiple cues can be used to generate a particular percept. Our area of interest is the extent to which humans are able to synergistically combine cues that are generated when moving through an environment. For example, movement through the environment leads to both visual (optic-flow) and vestibular stimulation, and studies have shown that non-human primates are able to combine these cues to generate a more accurate perception of heading than can be obtained with either cue in isolation. Here we investigate whether humans show a similar ability to synergistically combine optic-flow and vestibular cues. This was achieved by determining the sensitivity to optic-flow stimuli while physically moving the observer, and hence producing a vestibular signal, that was either consistent with the optic-flow signal, eg a radially expanding pattern coupled with forward motion, or inconsistent with it, eg a radially expanding pattern with backward motion. Results indicate that humans are more sensitive to motion-in-depth optic-flow stimuli when they are combined with complementary vestibular signals than when they are combined with conflicting vestibular signals. These results indicate that in humans, like in nonhuman primates, there is perceptual integration of visual and vestibular signals. PMID:21180352

  6. Dynamic transformation of vestibular signals for orientation.

    PubMed

    Osler, Callum J; Reynolds, Raymond F

    2012-11-01

    The same pattern of vestibular afferent feedback may signify a loss of balance or a change in body orientation, depending upon the initial head posture. To resolve this ambiguity and generate an appropriate motor response, the CNS must transform vestibular information from a head-centred reference frame into relevant motor coordinates. But what if the reference frame is continuously moving? Here, we ask if this neural transformation process is continuously updated during a voluntary change in head posture. Galvanic vestibular stimulation (GVS) was used to induce a sensation of head roll motion in blindfolded subjects marching on the spot. When head orientation was fixed, this caused unconscious turning behaviour that was maximal during neck flexion, minimal with the head level and reversed direction with neck extension. Subjects were then asked to produce a continuous voluntary change in head pitch, while GVS was applied. As the neck moved from full flexion into extension, turn velocity was continuously modulated and even reversed direction, reflecting the pattern observed during the head-fixed condition. Hence, an identical vestibular input resulted in motor output which was dynamically modulated by changes in head pitch. However, response magnitude was significantly reduced, suggesting possible suppression of vestibular input during voluntary head movement. Nevertheless, these results show that the CNS continuously reinterprets vestibular exafference to account for ongoing voluntary changes in head posture. This may explain why the head can be moved freely without losing the sense of balance and orientation.

  7. Vestibular ontogeny: Measuring the influence of the dynamic environment

    NASA Technical Reports Server (NTRS)

    Jones, Timothy A.; Devries, Sherri M.; Dubois, Linda M.; Nelson, Rick C.

    1993-01-01

    In comparison to other special senses, we are only meagerly informed about the development of vestibular function and the mechanisms that may operate to control or influence the course of vestibular ontogeny. Perhaps one contributing factor to this disparity is the difficulty of evaluating vestibular sense organs directly and noninvasively. The present report describes a recently developed direct noninvasive vestibular function test that can be used to address many basic questions about the developing vestibular system. More particularly, the test can be used to examine the effects of the dynamic environment (e.g. gravitational field and vibration) on vestibular ontogeny.

  8. Subliminal galvanic-vestibular stimulation influences ego- and object-centred components of visual neglect.

    PubMed

    Oppenländer, Karin; Keller, Ingo; Karbach, Julia; Schindler, Igor; Kerkhoff, Georg; Reinhart, Stefan

    2015-07-01

    Neglect patients show contralesional deficits in egocentric and object-centred visuospatial tasks. The extent to which these different phenomena are modulated by sensory stimulation remains to be clarified. Subliminal galvanic vestibular stimulation (GVS) induces imperceptible, polarity-specific changes in the cortical vestibular systems without the unpleasant side effects (nystagmus, vertigo) induced by caloric vestibular stimulation. While previous studies showed vestibular stimulation effects on egocentric spatial neglect phenomena, such effects were rarely demonstrated in object-centred neglect. Here, we applied bipolar subsensory GVS over the mastoids (mean intensity: 0.7mA) to investigate its influence on egocentric (digit cancellation, text copying), object-centred (copy of symmetrical figures), or both (line bisection) components of visual neglect in 24 patients with unilateral right hemisphere stroke. Patients were assigned to two patient groups (impaired vs. normal in the respective task) on the basis of cut-off scores derived from the literature or from normal controls. Both groups performed all tasks under three experimental conditions carried out on three separate days: (a) sham/baseline GVS where no electric current was applied, (b) left cathodal/right anodal (CL/AR) GVS and (c) left anodal/right cathodal (AL/CR) GVS, for a period of 20min per session. CL/AR GVS significantly improved line bisection and text copying whereas AL/CR GVS significantly ameliorated figure copying and digit cancellation. These GVS effects were selectively observed in the impaired- but not in the unimpaired patient group. In conclusion, subliminal GVS modulates ego- and object-centred components of visual neglect rapidly. Implications for neurorehabilitation are discussed. PMID:25445776

  9. Vestibular short latency responses to pulsed linear acceleration in unanesthetized animals

    NASA Technical Reports Server (NTRS)

    Jones, T. A.

    1992-01-01

    Linear acceleration transients were used to elicit vestibular compound action potentials in non-invasively prepared, unanesthetized animals for the first time (chicks, Gallus domesticus, n = 33). Responses were composed of a series of up to 8 dominant peaks occurring within 8 msec of the stimulus. Response amplitudes for 1.0 g stimulus ranged from 1 to 10 microV. A late, slow, triphasic, anesthesia-labile component was identified as a dominant response feature in unanesthetized animals. Amplitudes increased and latencies decreased as stimulus intensity was increased (MANOVA P less than 0.05). Linear regression slope ranges were: amplitudes = 1.0-5.0 microV/g; latencies = -300 to -1100 microseconds/g. Thresholds for single polarity stimuli (0.035 +/- 0.022 g, n = 11) were significantly lower than those of alternating polarity (0.074 +/- 0.028 g, n = 18, P less than 0.001). Bilateral labyrinthectomy eliminated responses whereas bilateral extirpation of cochleae did not significantly change response thresholds. Intense acoustic masking (100/104 dB SL) produced no effect in 2 animals, but did produce small to moderate effects on response amplitudes in 7 others. Changes were attributed to effects on vestibular end organs. Results of unilateral labyrinth blockade (tetrodotoxin) suggest that P1 and N1 preferentially reflect ipsilateral eighth nerve compound action potentials whereas components beyond approximately 2 msec reflect activity from vestibular neurons that depend on both labyrinths. The results demonstrate that short latency vestibular compound action potentials can be measured in unanesthetized, non-invasively prepared animals.

  10. Acute Vision Loss.

    PubMed

    Bagheri, Nika; Mehta, Sonia

    2015-09-01

    Acute vision loss can be transient (lasting <24 hours) or persistent (lasting >24 hours). When patients present with acute vision loss, it is important to ascertain the duration of vision loss and whether it is a unilateral process affecting one eye or a bilateral process affecting both eyes. This article focuses on causes of acute vision loss in the nontraumatic setting and provides management pearls to help health care providers better triage these patients.

  11. Acute Vision Loss.

    PubMed

    Bagheri, Nika; Mehta, Sonia

    2015-09-01

    Acute vision loss can be transient (lasting <24 hours) or persistent (lasting >24 hours). When patients present with acute vision loss, it is important to ascertain the duration of vision loss and whether it is a unilateral process affecting one eye or a bilateral process affecting both eyes. This article focuses on causes of acute vision loss in the nontraumatic setting and provides management pearls to help health care providers better triage these patients. PMID:26319342

  12. Top-down approach to vestibular compensation: translational lessons from vestibular rehabilitation

    PubMed Central

    Balaban, Carey D.; Hoffer, Michael E.; Gottshall, Kim R.

    2012-01-01

    This review examines vestibular compensation and vestibular rehabilitation from a unified translational research perspective. Laboratory studies illustrate neurobiological principles of vestibular compensation at the molecular, cellular and systems levels in animal models that inform vestibular rehabilitation practice. However, basic research has been hampered by an emphasis on ‘naturalistic’ recovery, with time after insult and drug interventions as primary dependent variables. The vestibular rehabilitation literature, on the other hand, provides information on how the degree of compensation can be shaped by specific activity regimens. The milestones of the early spontaneous static compensation mark the re-establishment of static gaze stability, which provides a common coordinate frame for the brain to interpret residual vestibular information in the context of visual, somatosensory and visceral signals that convey gravitoinertial information. Stabilization of the head orientation and the eye orientation (suppression of spontaneous nystagmus) appear to be necessary by not sufficient conditions for successful rehabilitation, and define a baseline for initiating retraining. The lessons from vestibular rehabilitation in animal models offer the possibility of shaping the recovery trajectory to identify molecular and genetic factors that can improve vestibular compensation. PMID:22981400

  13. The Components of Vestibular Cognition--Motion Versus Spatial Perception.

    PubMed

    Seemungal, Barry M

    2015-01-01

    Vestibular cognition can be divided into two main functions--a primary vestibular sensation of self-motion and a derived sensation of spatial orientation. Although the vestibular system requires calibration from other senses for optimal functioning, both vestibular spatial and vestibular motion perception are typically employed when navigating without vision. A recent important finding is the cerebellar mediation of the uncoupling of reflex (i.e., the vestibular-ocular reflex) from vestibular motion perception (Perceptuo-Reflex Uncoupling). The brain regions that mediate vestibular motion and vestibular spatial perception is an area of on-going research activity. However, there is data to support the notion that vestibular motion perception is mediated by multiple brain regions. In contrast, vestibular spatial perception appears to be mediated by posterior brain areas although currently the exact locus is unclear. I will discuss the experimental evidence that support this functional dichotomy in vestibular cognition (i.e., motion processing vs. spatial orientation). Along the way I will highlight relevant practical technical tips in testing vestibular cognition. PMID:26595954

  14. Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage

    PubMed Central

    Dilwali, Sonam; Landegger, Lukas D.; Soares, Vitor Y. R.; Deschler, Daniel G.; Stankovic, Konstantina M.

    2015-01-01

    Vestibular schwannomas (VSs) are the most common tumours of the cerebellopontine angle. Ninety-five percent of people with VS present with sensorineural hearing loss (SNHL); the mechanism of this SNHL is currently unknown. To establish the first model to study the role of VS-secreted factors in causing SNHL, murine cochlear explant cultures were treated with human tumour secretions from thirteen different unilateral, sporadic VSs of subjects demonstrating varied degrees of ipsilateral SNHL. The extent of cochlear explant damage due to secretion application roughly correlated with the subjects’ degree of SNHL. Secretions from tumours associated with most substantial SNHL resulted in most significant hair cell loss and neuronal fibre disorganization. Secretions from VSs associated with good hearing or from healthy human nerves led to either no effect or solely fibre disorganization. Our results are the first to demonstrate that secreted factors from VSs can lead to cochlear damage. Further, we identified tumour necrosis factor alpha (TNFα) as an ototoxic molecule and fibroblast growth factor 2 (FGF2) as an otoprotective molecule in VS secretions. Antibody-mediated TNFα neutralization in VS secretions partially prevented hair cell loss due to the secretions. Taken together, we have identified a new mechanism responsible for SNHL due to VSs. PMID:26690506

  15. Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage.

    PubMed

    Dilwali, Sonam; Landegger, Lukas D; Soares, Vitor Y R; Deschler, Daniel G; Stankovic, Konstantina M

    2015-12-22

    Vestibular schwannomas (VSs) are the most common tumours of the cerebellopontine angle. Ninety-five percent of people with VS present with sensorineural hearing loss (SNHL); the mechanism of this SNHL is currently unknown. To establish the first model to study the role of VS-secreted factors in causing SNHL, murine cochlear explant cultures were treated with human tumour secretions from thirteen different unilateral, sporadic VSs of subjects demonstrating varied degrees of ipsilateral SNHL. The extent of cochlear explant damage due to secretion application roughly correlated with the subjects' degree of SNHL. Secretions from tumours associated with most substantial SNHL resulted in most significant hair cell loss and neuronal fibre disorganization. Secretions from VSs associated with good hearing or from healthy human nerves led to either no effect or solely fibre disorganization. Our results are the first to demonstrate that secreted factors from VSs can lead to cochlear damage. Further, we identified tumour necrosis factor alpha (TNFα) as an ototoxic molecule and fibroblast growth factor 2 (FGF2) as an otoprotective molecule in VS secretions. Antibody-mediated TNFα neutralization in VS secretions partially prevented hair cell loss due to the secretions. Taken together, we have identified a new mechanism responsible for SNHL due to VSs.

  16. Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage.

    PubMed

    Dilwali, Sonam; Landegger, Lukas D; Soares, Vitor Y R; Deschler, Daniel G; Stankovic, Konstantina M

    2015-01-01

    Vestibular schwannomas (VSs) are the most common tumours of the cerebellopontine angle. Ninety-five percent of people with VS present with sensorineural hearing loss (SNHL); the mechanism of this SNHL is currently unknown. To establish the first model to study the role of VS-secreted factors in causing SNHL, murine cochlear explant cultures were treated with human tumour secretions from thirteen different unilateral, sporadic VSs of subjects demonstrating varied degrees of ipsilateral SNHL. The extent of cochlear explant damage due to secretion application roughly correlated with the subjects' degree of SNHL. Secretions from tumours associated with most substantial SNHL resulted in most significant hair cell loss and neuronal fibre disorganization. Secretions from VSs associated with good hearing or from healthy human nerves led to either no effect or solely fibre disorganization. Our results are the first to demonstrate that secreted factors from VSs can lead to cochlear damage. Further, we identified tumour necrosis factor alpha (TNFα) as an ototoxic molecule and fibroblast growth factor 2 (FGF2) as an otoprotective molecule in VS secretions. Antibody-mediated TNFα neutralization in VS secretions partially prevented hair cell loss due to the secretions. Taken together, we have identified a new mechanism responsible for SNHL due to VSs. PMID:26690506

  17. Cross-axis adaptation improves 3D vestibulo-ocular reflex alignment during chronic stimulation via a head-mounted multichannel vestibular prosthesis.

    PubMed

    Dai, Chenkai; Fridman, Gene Y; Chiang, Bryce; Davidovics, Natan S; Melvin, Thuy-Anh; Cullen, Kathleen E; Della Santina, Charles C

    2011-05-01

    By sensing three-dimensional (3D) head rotation and electrically stimulating the three ampullary branches of a vestibular nerve to encode head angular velocity, a multichannel vestibular prosthesis (MVP) can restore vestibular sensation to individuals disabled by loss of vestibular hair cell function. However, current spread to afferent fibers innervating non-targeted canals and otolith end organs can distort the vestibular nerve activation pattern, causing misalignment between the perceived and actual axis of head rotation. We hypothesized that over time, central neural mechanisms can adapt to correct this misalignment. To test this, we rendered five chinchillas vestibular deficient via bilateral gentamicin treatment and unilaterally implanted them with a head-mounted MVP. Comparison of 3D angular vestibulo-ocular reflex (aVOR) responses during 2 Hz, 50°/s peak horizontal sinusoidal head rotations in darkness on the first, third, and seventh days of continual MVP use revealed that eye responses about the intended axis remained stable (at about 70% of the normal gain) while misalignment improved significantly by the end of 1 week of prosthetic stimulation. A comparable time course of improvement was also observed for head rotations about the other two semicircular canal axes and at every stimulus frequency examined (0.2-5 Hz). In addition, the extent of disconjugacy between the two eyes progressively improved during the same time window. These results indicate that the central nervous system rapidly adapts to multichannel prosthetic vestibular stimulation to markedly improve 3D aVOR alignment within the first week after activation. Similar adaptive improvements are likely to occur in other species, including humans.

  18. Neurotology symptoms at referral to vestibular evaluation

    PubMed Central

    2013-01-01

    Background Dizziness-vertigo is common in adults, but clinical providers may rarely diagnose vestibular impairment and referral could be delayed. To assess neurotology symptoms (including triggers) reported by patients with peripheral vestibular disease, during the year just before their referral to vestibular evaluation. Methods 282 patients with peripheral vestibular disease and 282 control subjects accepted to participate. They had no middle ear, retinal, neurological, psychiatric, autoimmune or autonomic disorders. They reported their symptoms by a standardized questionnaire along with their anxiety/depression symptoms. Results Patients were referred after months or years from the onset of their symptoms, 24% of them reported frequent falls with a long clinical evolution; 10% of them reported no vertigo but instability related to specific triggers; 86% patients and 12% control subjects reported instability when moving the head rapidly and 79% patients and 6% control subjects reported instability when changing posture. Seven out of the 9 symptoms explored by the questionnaire allowed the correct classification of circa 95% of the participants (Discriminant function analysis, p < 0.001). High blood pressure, dyslipidemia and anxiety/depression symptoms showed a mild correlation with the total score of symptoms (multiple R2 =0.18, p < 0.001). Conclusions Late referral to vestibular evaluation may underlie a history of frequent falls; some patients may not report vertigo, but instability related to specific triggers, which could be useful to prompt vestibular evaluation. High blood pressure, dyslipidemia and anxiety/depression symptoms may have a mild influence on the report of symptoms of vestibular disease in both, patients and control subjects. PMID:24279682

  19. Acute Vestibulopathy

    PubMed Central

    Cha, Yoon-Hee

    2011-01-01

    The presentation of acute vertigo may represent both a common benign disorder or a life threatening but rare one. Familiarity with the common peripheral vestibular disorders will allow the clinician to rapidly “rule-in” a benign disorder and recognize when further testing is required. Key features of vertigo required to make an accurate diagnosis are duration, chronicity, associated symptoms, and triggers. Bedside tests that are critical to the diagnosis of acute vertigo include the Dix-Hallpike maneuver and canalith repositioning manuever, occlusive ophthalmoscopy, and the head impulse test. The goal of this review is to provide the clinician with the clinical and pathophysiologic background of the most common disorders that present with vertigo to develop a logical differential diagnosis and management plan. PMID:23983835

  20. Managing advanced unilateral pseudoexfoliative glaucoma.

    PubMed

    Marques, André

    2014-01-01

    The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the "wipe-out phenomenon" in this case. PMID:24850557

  1. Managing advanced unilateral pseudoexfoliative glaucoma.

    PubMed

    Marques, André

    2014-01-01

    The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the "wipe-out phenomenon" in this case.

  2. Computational Approaches to Vestibular Research

    NASA Technical Reports Server (NTRS)

    Ross, Muriel D.; Wade, Charles E. (Technical Monitor)

    1994-01-01

    The Biocomputation Center at NASA Ames Research Center is dedicated to a union between computational, experimental and theoretical approaches to the study of neuroscience and of life sciences in general. The current emphasis is on computer reconstruction and visualization of vestibular macular architecture in three-dimensions (3-D), and on mathematical modeling and computer simulation of neural activity in the functioning system. Our methods are being used to interpret the influence of spaceflight on mammalian vestibular maculas in a model system, that of the adult Sprague-Dawley rat. More than twenty 3-D reconstructions of type I and type II hair cells and their afferents have been completed by digitization of contours traced from serial sections photographed in a transmission electron microscope. This labor-intensive method has now been replace d by a semiautomated method developed in the Biocomputation Center in which conventional photography is eliminated. All viewing, storage and manipulation of original data is done using Silicon Graphics workstations. Recent improvements to the software include a new mesh generation method for connecting contours. This method will permit the investigator to describe any surface, regardless of complexity, including highly branched structures such as are routinely found in neurons. This same mesh can be used for 3-D, finite volume simulation of synapse activation and voltage spread on neuronal surfaces visualized via the reconstruction process. These simulations help the investigator interpret the relationship between neuroarchitecture and physiology, and are of assistance in determining which experiments will best test theoretical interpretations. Data are also used to develop abstract, 3-D models that dynamically display neuronal activity ongoing in the system. Finally, the same data can be used to visualize the neural tissue in a virtual environment. Our exhibit will depict capabilities of our computational approaches and

  3. Excitatory pathways from the vestibular nuclei to the NTS and the PBN and indirect vestibulo-cardiovascular pathway from the vestibular nuclei to the RVLM relayed by the NTS.

    PubMed

    Cai, Yi-Ling; Ma, Wen-Ling; Wang, Jun-Qin; Li, Yi-Qian; Li, Min

    2008-11-13

    Previous studies have confirmed the existence of vestibulo-sympathetic pathways in the central nervous system. However, the exact pathways and neurotransmitters underlying this reflex are unclear. The present study was undertaken to investigate whether the vestibulo-cardiovascular responses are a result of activated glutamate receptors in the caudal vestibular nucleus. We also attempt to verify the indirect excitatory pathways from the vestibular nucleus (VN) to the rostral ventrolateral medulla (RVLM) using a tracing method combined with a vesicular glutamate transporter (VGluTs) immunofluorescence. In anesthetized rats, unilateral injection of l-glutamate (5 nmol) into the medial vestibular nucleus (MVe) and spinal vestibular nucleus (SpVe) slightly increased the mean arterial pressure (MVe: 93.29+/-11.58 to 96.30+/-11.66, SpVe: 91.72+/-15.20 to 95.48+/-17.16). Local pretreatment with the N-methyl-D-aspartate (NMDA)-receptor antagonist MK-801 (2 nmol) significantly attenuated the pressor effect of L-glutamate injected into the MVe compared to the contralateral self-control. After injection of biotinylated dextran amine (BDA) into the MVe and SpVe, and fluorogold (FG) into the RVLM, some BDA-labeled fibres and terminals in the nucleus of solitary tract (NTS) and the parabrachial nucleus (PBN) were immunoreactive for VGluT1 and VGluT2. Several BDA-labeled fibres were closely apposed to FG-labeled neurons in the NTS. These results suggested that activation of caudal vestibular nucleus neurons could induce pressor response and NMDA receptors might contribute to this response in the MVe. The glutamatergic VN-NTS and VN-PBN pathways might exist, and the projections from the VN to the RVLM relayed by the NTS comprise an indirect vestibulo-cardiovascular pathway in the brain stem.

  4. Pulfrich's phenomenon in unilateral cataract

    PubMed Central

    Scotcher, S.; Laidlaw, D; Canning, C.; Weal, M.; Harrad, R.

    1997-01-01

    AIMS—To determine whether unilateral cataract causes a pathological Pulfrich's phenomenon.
METHODS—29 subjects with unilateral cataract and contralateral pseudophakia were assessed on their ability to perceive the Pulfrich phenomenon. Using a computer generated pendulum image, and graded neutral density filters, a series of forced choice trials were performed in which the subject was required to describe the direction of any apparent pendulum rotation. A pathological Pulfrich effect was said to occur when apparent rotation was perceived in the presence of a zero strength neutral density filter. The size of any pathological Pulfrich effect which was present was quantified by neutralising the perceived pendulum rotation with neutral density filters of varying strength placed before the better seeing eye.
RESULTS—20 out of 29 subjects were able to perceive apparent pendulum rotation when uniocular filtering was performed. In the group (n=12) which was tested both before and after cataract extraction with intraocular lens implantation, a statistically significant pathological Pulfrich effect was demonstrated preoperatively, compared with a group of normal control subjects. This effect was abolished after cataract extraction (p=0.009). The median size of the effect was equivalent to a 0.25 log unit neutral density filter over the non-cataractous eye. The subjects who were unable to perceive the Pulfrich phenomenon at all had a significantly greater difference in the visual acuity of each eye (p=0.045) and significantly worse stereoacuity than those who were able to perceive the effect (p=0.002).
CONCLUSIONS—Unilateral cataract can cause a pathological Pulfrich phenomenon. This finding may explain why some patients with unilateral cataract complain of visual symptoms that are not easily accounted for in terms of visual acuity, contrast sensitivity, or stereoacuity.

 PMID:9497463

  5. Auditory and Vestibular Issues Related to Human Spaceflight

    NASA Technical Reports Server (NTRS)

    Danielson, Richard W.; Wood, Scott J.

    2009-01-01

    Human spaceflight provides unique opportunities to study human vestibular and auditory systems. This session will discuss 1) vestibular adaptive processes reflected by pronounced perceptual and motor coordination problems during, and after, space missions; 2) vestibular diagnostic and rehabilitative techniques (used to promote recovery after living in altered gravity environments) that may be relevant to treatment of vestibular disorders on earth; and 3) unique acoustical challenges to hearing loss prevention and crew performance during spaceflight missions.

  6. Subliminal galvanic-vestibular stimulation recalibrates the distorted visual and tactile subjective vertical in right-sided stroke.

    PubMed

    Oppenländer, Karin; Utz, Kathrin S; Reinhart, Stefan; Keller, Ingo; Kerkhoff, Georg; Schaadt, Anna-Katharina

    2015-07-01

    Stroke of the right cerebral hemisphere often causes deficits in the judgement of the subjective visual vertical (SVV) and subjective tactile vertical (STV) which are related to central vestibular functioning. Clinically, deficits in the SVV/STV are linked to balance problems and poor functional outcome. Galvanic Vestibular Stimulation (GVS) is a non-invasive, save stimulation technique that induces polarity-specific changes in the cortical vestibular systems. Subliminal GVS induces imperceptible vestibular stimulation without unpleasant side effects. Here, we applied bipolar subliminal GVS over the mastoids (mean intensity: 0.7 mA, 20 min duration per session) to investigate its online-influence on constant errors, difference thresholds and range values in the SVV and STV. 24 patients with subacute, single, unilateral right hemisphere stroke were studied and assigned to two patient groups (impaired vs. normal in the SVV and STV) on the basis of cut-off scores from healthy controls. Both groups performed these tasks under three experimental conditions on three different days: a) sham GVS where electric current was applied only for 30s and then turned off, b) left-cathodal GVS and c) right-cathodal GVS, for a period of 20 min per session. Left-cathodal GVS, but not right-cathodal GVS significantly reduced all parameters in the SVV. Concerning STV GVS also reduced constant error and range numerically, though not significantly. These effects occurred selectively in the impaired patient group. In conclusion, we found that GVS rapidly influences poststroke verticality deficits in the visual and tactile modality, thus highlighting the importance of the vestibular system in the multimodal elaboration of the subjective vertical. PMID:25744870

  7. Caloric vestibular stimulation modulates nociceptive evoked potentials.

    PubMed

    Ferrè, Elisa Raffaella; Haggard, Patrick; Bottini, Gabriella; Iannetti, Gian Domenico

    2015-12-01

    Vestibular stimulation has been reported to alleviate central pain. Clinical and physiological studies confirm pervasive interactions between vestibular signals and somatosensory circuits, including nociception. However, the neural mechanisms underlying vestibular-induced analgesia remain unclear, and previous clinical studies cannot rule out explanations based on alternative, non-specific effects such as distraction or placebo. To investigate how vestibular inputs influence nociception, we combined caloric vestibular stimulation (CVS) with psychophysical and electrocortical responses elicited by nociceptive-specific laser stimulation in humans (laser-evoked potentials, LEPs). Cold water CVS applied to the left ear resulted in significantly lower subjective pain intensity for experimental laser pain to the left hand immediately after CVS, relative both to before CVS and to 1 h after CVS. This transient reduction in pain perception was associated with reduced amplitude of all LEP components, including the early N1 wave reflecting the first arrival of nociceptive input to primary somatosensory cortex. We conclude that cold left ear CVS elicits a modulation of both nociceptive processing and pain perception. The analgesic effect induced by CVS could be mediated either by subcortical gating of the ascending nociceptive input, or by direct modulation of the primary somatosensory cortex.

  8. Longitudinal performance of an implantable vestibular prosthesis

    PubMed Central

    Phillips, Christopher; Ling, Leo; Oxford, Trey; Nowack, Amy; Nie, Kaibao; Rubinstein, Jay T.; Phillips, James O.

    2014-01-01

    Loss of vestibular function may be treatable with an implantable vestibular prosthesis that stimulates semicircular canal afferents with biphasic pulse trains. Several studies have demonstrated short-term activation of the vestibulo-ocular reflex (VOR) with electrical stimulation. Fewer long-term studies have been restricted to small numbers of animals and stimulation designed to produce adaptive changes in the electrically elicited response. This study is the first large consecutive series of implanted rhesus macaque to be studied longitudinally using brief stimuli designed to limit adaptive changes in response, so that the efficacy of electrical activation can be studied over time, across surgeries, canals and animals. The implantation of a vestibular prosthesis in animals with intact vestibular end organs produces variable responses to electrical stimulation across canals and animals, which change in threshold for electrical activation of eye movements and in elicited slow phase velocities over time. These thresholds are consistently lower, and the slow phase velocities higher, than those obtained in human subjects. The changes do not appear to be correlated with changes in electrode impedance. The variability in response suggests that empirically derived transfer functions may be required to optimize the response of individual canals to a vestibular prosthesis, and that this function may need to be remapped over time. PMID:25245586

  9. [Is the sense of verticality vestibular?].

    PubMed

    Barra, J; Pérennou, D

    2013-06-01

    The vestibular system constitutes an inertial sensor, which detects linear (otoliths) and angular (semicircular canals) accelerations of the head in the three dimensions. The otoliths are specialized in the detection of linear accelerations and can be used by the brain as a "plumb line" coding earth gravity acceleration (direction). This property of otolithic system suggested that the sense of verticality is supported by the vestibular system. The preeminence of vestibular involvement in the sense of verticality stated in the 1900s was progressively supplanted by the notion of internal models of verticality. The internal models of verticality involve rules and properties of integration of vestibular graviception, somaesthesic graviception, and vision. The construction of a mental representation of verticality was mainly modeled as a bottom-up organization integrating visual, somatosensory and vestibular information without any cognitive modulations. Recent studies reported that the construction of internal models of verticality is not an automatic multi-sensory integration process but corresponds to more complex mechanisms including top-down influences such as awareness of body orientation or spatial representations. PMID:23856176

  10. [Is the sense of verticality vestibular?].

    PubMed

    Barra, J; Pérennou, D

    2013-06-01

    The vestibular system constitutes an inertial sensor, which detects linear (otoliths) and angular (semicircular canals) accelerations of the head in the three dimensions. The otoliths are specialized in the detection of linear accelerations and can be used by the brain as a "plumb line" coding earth gravity acceleration (direction). This property of otolithic system suggested that the sense of verticality is supported by the vestibular system. The preeminence of vestibular involvement in the sense of verticality stated in the 1900s was progressively supplanted by the notion of internal models of verticality. The internal models of verticality involve rules and properties of integration of vestibular graviception, somaesthesic graviception, and vision. The construction of a mental representation of verticality was mainly modeled as a bottom-up organization integrating visual, somatosensory and vestibular information without any cognitive modulations. Recent studies reported that the construction of internal models of verticality is not an automatic multi-sensory integration process but corresponds to more complex mechanisms including top-down influences such as awareness of body orientation or spatial representations.

  11. Spontaneous shrinkage of vestibular schwannoma

    PubMed Central

    Romani, Rossana; Pollock, Jonathan

    2016-01-01

    Background: “Watch, wait, and rescan” (WWR) has an established place as a successful management option for a significant proportion of vestibular schwannomas (VS) as an alternative to microsurgical removal or stereotactic radiotherapy. VS may grow slowly and continuously, followed by stagnation or even shrinkage. We present two case reports of spontaneous shrinkage of VS along with a review of the literature. Case Description: A 29-year-old female presented with a progressive history of visual blurring and intermittent diplopia over 2 months. A 29 mm of maximum intracranial diameter (ICD) VS with secondary obstructive hydrocephalus was diagnosed. The patient underwent a ventriculo-peritoneal shunt with resolution of her symptoms and opted for initial WWR management. Interval scanning between 2007 and 2014 showed progressive reduction in the maximum ICD together with reduction in the degree of central tumor enhancement. Maximum ICD at most recent follow up was 22 mm. A 28-year-old female was referred with right sensorineural deafness. A right VS of maximum ICD of 27 mm was diagnosed. Initial WWR management was planned after discussion. Serial imaging showed an initial increase in the size of the tumor followed by progressive reduction in size. The most recent follow up showed a maximum ICD of 20 mm. Conclusion: Early WWR management can be associated with spontaneous shrinkage of VS over time. Prospective clinical study of larger numbers of such cases using the UK VS database may help to identify predictive factors for the spontaneous regression of VS. PMID:27280055

  12. Internal models of self-motion: computations that suppress vestibular reafference in early vestibular processing.

    PubMed

    Cullen, Kathleen E; Brooks, Jessica X; Jamali, Mohsen; Carriot, Jerome; Massot, Corentin

    2011-05-01

    In everyday life, vestibular sensors are activated by both self-generated and externally applied head movements. The ability to distinguish inputs that are a consequence of our own actions (i.e., active motion) from those that result from changes in the external world (i.e., passive or unexpected motion) is essential for perceptual stability and accurate motor control. Recent work has made progress toward understanding how the brain distinguishes between these two kinds of sensory inputs. We have performed a series of experiments in which single-unit recordings were made from vestibular afferents and central neurons in alert macaque monkeys during rotation and translation. Vestibular afferents showed no differences in firing variability or sensitivity during active movements when compared to passive movements. In contrast, the analyses of neuronal firing rates revealed that neurons at the first central stage of vestibular processing (i.e., in the vestibular nuclei) were effectively less sensitive to active motion. Notably, however, this ability to distinguish between active and passive motion was not a general feature of early central processing, but rather was a characteristic of a distinct group of neurons known to contribute to postural control and spatial orientation. Our most recent studies have addressed how vestibular and proprioceptive inputs are integrated in the vestibular cerebellum, a region likely to be involved in generating an internal model of self-motion. We propose that this multimodal integration within the vestibular cerebellum is required for eliminating self-generated vestibular information from the subsequent computation of orientation and posture control at the first central stage of processing.

  13. Chronic unilateral locked facet joint with spinal cord injury in a 26-month-old child: A case report

    PubMed Central

    Wu, Ai-Min; Wang, Xiang-Yang; Luo, Peng; Xu, Hua-Zi; Chi, Yong-Long

    2015-01-01

    Objectives This study presents the successful posterior surgical reduction and fusion on a 26-month-old child with chronic unilateral locked facet joint and spinal cord injury (SCI). Methods A 26-month-old child with chronic unilateral locked facet joint and SCI treated by posterior surgical reduction and fusion. Plaster external fixation was applied and rehabilitation exercise was trained post-operatively. Results Chronic unilateral locked facet joint was reduced successfully and bone fusion of C4/5 was achieved 3 months after surgery. The function of both lower limbs was improved 1 year after surgery, aided with physical rehabilitation. Conclusion Unilateral locked facet joint in pediatric population is rare. Few clinical experiences were found in the literature. Non-surgical treatment has advantages of not being invasive and is preferred for acute patients; however, it may not be suitable for chronic unilateral locked facet joint with SCI, in which surgical intervention is needed. PMID:24673578

  14. Vestibular failure in children with congenital deafness.

    PubMed

    Kaga, Kimitaka; Shinjo, Yukiko; Jin, Yulian; Takegoshi, Hideki

    2008-09-01

    Congenitally deaf infants and children commonly suffer vestibular failure in both ears, and impairment of postural control, locomotion, and gait. The development of gross motor functions, such as head control, sitting, and walking is likely to be delayed, but fine motor function is usually preserved unless disorders of the central nervous system are present. These children can eventually catch up with their normal peers in terms of development and growth as a result of central vestibular compensation. The visual and somatosensory systems, pyramidal and extrapyramidal motor system (cerebellum, basal ganglia, cerebrum) and intellectual development, compensate for vestibular failure in infants and children with congenitally hypoactive or absent function of the semicircular canals and otolith organs. PMID:18821229

  15. Optical nerve stimulation for a vestibular prosthesis

    NASA Astrophysics Data System (ADS)

    Harris, David M.; Bierer, Steven M.; Wells, Jonathon D.; Phillips, James O.

    2009-02-01

    Infrared Nerve Stimulation (INS) offers several advantages over electrical stimulation, including more precise spatial selectivity and improved surgical access. In this study, INS and electrical stimulation were compared in their ability to activate the vestibular branch of the VIIIth nerve, as a potential way to treat balance disorders. The superior and lateral canals of the vestibular system of Guinea pigs were identified and approached with the aid of precise 3-D reconstructions. A monopolar platinum stimulating electrode was positioned near the ampullae of the canals, and biphasic current pulses were used to stimulate vestibular evoked potentials and eye movements. Thresholds and input/output functions were measured for various stimulus conditions. A short pulsed diode laser (Capella, Lockheed Martin-Aculight, Inc., Bothell WA) was placed in the same anatomical position and various stimulus conditions were evaluated in their ability to evoke similar potentials and eye movements.

  16. Vestibular failure in children with congenital deafness.

    PubMed

    Kaga, Kimitaka; Shinjo, Yukiko; Jin, Yulian; Takegoshi, Hideki

    2008-09-01

    Congenitally deaf infants and children commonly suffer vestibular failure in both ears, and impairment of postural control, locomotion, and gait. The development of gross motor functions, such as head control, sitting, and walking is likely to be delayed, but fine motor function is usually preserved unless disorders of the central nervous system are present. These children can eventually catch up with their normal peers in terms of development and growth as a result of central vestibular compensation. The visual and somatosensory systems, pyramidal and extrapyramidal motor system (cerebellum, basal ganglia, cerebrum) and intellectual development, compensate for vestibular failure in infants and children with congenitally hypoactive or absent function of the semicircular canals and otolith organs.

  17. Dynamic visual acuity during passive and self-generated transient head rotation in normal and unilaterally vestibulopathic humans.

    PubMed

    Tian, Jun-ru; Shubayev, Igor; Demer, Joseph L

    2002-02-01

    To determine whether dynamic visual acuity (DVA) during head rotations on the stationary body can lateralize unilateral vestibular deafferentation and detect non-labyrinthine compensation mechanisms, 15 normal and 11 subjects with unilateral vestibular deafferentation underwent manually imposed and self-generated transient yaw head rotations during measurement of binocular DVA. DVA was measured by a four-alternative, forced choice, staircase procedure with optotype presentation only when head velocity exceeded thresholds of 50 degree or 75 degree/s. Eye and head movements were recorded using search coils to characterize ocular motor strategies. During directionally unpredictable, manually imposed contralesional rotation, unilaterally deafferented subjects had decreases in DVA from the static condition of 0.36 +/- 0.22 and 0.47 +/- 0.53 log of the minimum angle resolvable (logMAR, mean +/- SD), respectively, for 50 degree and 75 degree/s thresholds, not significantly greater than those of normal subjects (0.26 +/- 0.13 and 0.36 +/- 0.14, P>0.05). However, during manually imposed ipsilesional rotation, vestibulopathic subjects had decreases in DVA of 0.66 +/- 0.36 and 1.08 +/- 0.47 logMAR, significantly greater than during contralesional rotation ( P<0.01). The DVA reduction difference for the ipsi- and contralesional directions was less during self-generated than during manually imposed head rotations. The directional difference for manually administered head rotations yielded a robust diagnostic measure with essentially no overlap in performance with normal subjects. Diagnostic performance for DVA during self-generated head rotation was poorer. Recordings of eye and head movements made using search coils during DVA testing confirmed a deficient vestibulo-ocular reflex (VOR) during ipsilesional rotation, with most unilaterally vestibulopathic subjects employing predictive smooth eye movements and vestibular catch-up saccades. Measurement of DVA during transient head

  18. Acute Diagnosis and Management of Stroke Presenting Dizziness or Vertigo.

    PubMed

    Lee, Seung-Han; Kim, Ji-Soo

    2015-08-01

    Stroke involving the brainstem and cerebellum frequently presents acute vestibular syndrome. Although vascular vertigo is known to usually accompany other neurologic symptoms and signs, isolated vertigo from small infarcts involving the cerebellum or brainstem has been increasingly recognized. Bedside neuro-otologic examination can reliably differentiate acute vestibular syndrome due to stroke from more benign inner ear disease. Sometimes acute isolated audiovestibular loss may herald impending infarction in the territory of the anterior inferior cerebellar artery. Accurate identification of isolated vascular vertigo is very important because misdiagnosis of acute stroke may result in significant morbidity and mortality.

  19. Effects of unilateral selective hypergravity stimulation on gait

    NASA Astrophysics Data System (ADS)

    Lazerges, M.; Bessou, P.

    The purpose of this work is to analyse the neural mechanisms of human motor perturbations induced by dynamic changes in gravity. A unilateral selective hypergravity stimulation (USHS) was produced by stretching an elastic band between the right shoulder and foot. The consequences of the extensor muscle tone change due to the positioning (increased muscular loading) and to its removal (decreased muscular loading) by the elastic band were observed on motor gait skill. Gait spatio-temporal parameters (horizontal displacement of both feet) and lower limb functional length variations (efficiency of flexion and extension movements of the lower limbs) were measured. The latter measure was performed using a device specially designed for that purpose. The main results were: (1) during and after USHS, gait perturbations appeared on the left—the body side not directly stimulated, (2) just after the end of USHS, perturbations were present on the right (homolateral) side evidencing a post treatment effect which caused a decrease in functional shortening of the lower limb during extension and an increase of functional shortening of the lower limb during stance (opposite in sense to the modification observed during swing). Such results afford evidence that, in addition to vestibular receptors, the mechanoreceptors of extensor muscles are involved in determining the changes in motor skills observed at the beginning and at the end of space flights.

  20. Vestibular system paresis due to emergency endovascular catheterization.

    PubMed

    Simoceli, Lucinda; Sguillar, Danilo Anunciatto; Santos, Henrique Mendes Paiva; Caputti, Camilla

    2012-04-01

    Objetivo: O objetivo deste relato de caso é descrever uma causa incomum de vestibulopatia periférica associada à perda auditiva unilateral em paciente idoso pós- cateterismo de urgência.Relato de caso: Paciente do gênero masculino, 82 anos, submetido à correção de aneurisma roto de aorta abdominal, no intra-operatório sofreu infarto agudo do miocárdio necessitando de angioplastia primária. Após alta hospitalar refere queixa de hipoacusia acentuada à direita e vertigem incapacitante, sem sinais neurológicos focais. Ao exame clínico otorrinolaringológico apresentava: Teste de Weber lateralizado para a esquerda, nistagmo espontâneo para a esquerda , marcha oscilante, leve disbasia e ataxia, índex-nariz e diadococinesia normais, Teste de Romberg com oscilação sem queda e Fukuda com desvio lateral para a direita. O exame audiométrico evidenciava anacusia à direita e perda neurossensorial à esquerda em agudos, arreflexia vestibular à direita na prova calórica e, na tomografia computadorizada dos ossos temporais e tronco-encefálico, presença de haste metálica atravessando o osso temporal direito, a partir da veia jugular interna e bulbo jugular, atravessando os canais semicirculares posterior, superior e vestíbulo, projetando-se em lobo temporal. O diagnóstico radiológico foi lesão traumática por guia endovascular metálico durante cateterismo de urgência e a conduta, considerando que o paciente não havia compensado o equilíbrio, foi reabilitação vestibular.Conclusão: Queixas de tontura no paciente idoso devem ser criteriosamente avaliadas diante do seu histórico clínico patológico pois os antecedentes de doenças e tratamentos prévios, em geral, direcionam as hipóteses diagnósticas porém podem trazer alterações inesperadas.

  1. Physiological principles of vestibular function on earth and in space

    NASA Technical Reports Server (NTRS)

    Minor, L. B.

    1998-01-01

    Physiological mechanisms underlying vestibular function have important implications for our ability to understand, predict, and modify balance processes during and after spaceflight. The microgravity environment of space provides many unique opportunities for studying the effects of changes in gravitoinertial force on structure and function of the vestibular system. Investigations of basic vestibular physiology and of changes in reflexes occurring as a consequence of exposure to microgravity have important implications for diagnosis and treatment of vestibular disorders in human beings. This report reviews physiological principles underlying control of vestibular processes on earth and in space. Information is presented from a functional perspective with emphasis on signals arising from labyrinthine receptors. Changes induced by microgravity in linear acceleration detected by the vestibulo-ocular reflexes. Alterations of the functional requirements for postural control in space are described. Areas of direct correlation between studies of vestibular reflexes in microgravity and vestibular disorders in human beings are discussed.

  2. Obliteration of vestibular and cochlear aqueducts in animals.

    PubMed

    Suh, K W; Cody, D T

    1977-01-01

    The right vestibular aqueduct was obliterated in guinea pigs, chinchillas, and monkeys, and the right cochlear aqueduct and both the right vestibular and right cochlear aqueducts were obliterated in guinea pigs and chinchilas. Changes in auditory acuity were monitored by determining averaged temporal-response thresholds, and temporal-bone histologic studies were performed. Obliteration of the vestibular aqueduct or both the vestibular and cochlear aqueducts consistently produced endolymphatic hydrops in guinea pigs. In these animals, the auditory acuity gradually deteriorated. The low tones consistently were depressed more than the high tones. The auditory changes corresponded to the severity of endolymphatic hydrops. On the other hand, no significant histologic or audiometric changes were demonstrated in monkeys after obliteration of the vestibular aqueduct or in chinchillas after obliteration of the vestibular aqueduct or of both the vestibular and cochlear aqueducts. No significant histologic or audiometric changes were demonstrated in guinea pigs and chinchillas after obliteration of the cochlear aqueduct. PMID:408954

  3. From ear to uncertainty: vestibular contributions to cognitive function

    PubMed Central

    Smith, Paul F.; Zheng, Yiwen

    2013-01-01

    In addition to the deficits in the vestibulo-ocular and vestibulo-spinal reflexes that occur following vestibular dysfunction, there is substantial evidence that vestibular loss also causes cognitive disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in spatial orientation. In this review we summarize the evidence that vestibular loss causes cognitive disorders, especially spatial memory deficits, in animals and humans and critically evaluate the evidence that these deficits are not due to hearing loss, problems with motor control, oscillopsia or anxiety and depression. We review the evidence that vestibular lesions affect head direction and place cells as well as the emerging evidence that artificial activation of the vestibular system, using galvanic vestibular stimulation (GVS), can modulate cognitive function. PMID:24324413

  4. Vestibular convergence patterns in vestibular nuclei neurons of alert primates

    NASA Technical Reports Server (NTRS)

    Dickman, J. David; Angelaki, Dora E.

    2002-01-01

    Sensory signal convergence is a fundamental and important aspect of brain function. Such convergence may often involve complex multidimensional interactions as those proposed for the processing of otolith and semicircular canal (SCC) information for the detection of translational head movements and the effective discrimination from physically congruent gravity signals. In the present study, we have examined the responses of primate rostral vestibular nuclei (VN) neurons that do not exhibit any eye movement-related activity using 0.5-Hz translational and three-dimensional (3D) rotational motion. Three distinct neural populations were identified. Approximately one-fourth of the cells exclusively encoded rotational movements (canal-only neurons) and were unresponsive to translation. The canal-only central neurons encoded head rotation in SCC coordinates, exhibited little orthogonal canal convergence, and were characterized with significantly higher sensitivities to rotation as compared to primary SCC afferents. Another fourth of the neurons modulated their firing rates during translation (otolith-only cells). During rotations, these neurons only responded when the axis of rotation was earth-horizontal and the head was changing orientation relative to gravity. The remaining one-half of VN neurons were sensitive to both rotations and translations (otolith + canal neurons). Unlike primary otolith afferents, however, central neurons often exhibited significant spatiotemporal (noncosine) tuning properties and a wide variety of response dynamics to translation. To characterize the pattern of SCC inputs to otolith + canal neurons, their rotational maximum sensitivity vectors were computed using exclusively responses during earth-vertical axis rotations (EVA). Maximum sensitivity vectors were distributed throughout the 3D space, suggesting strong convergence from multiple SCCs. These neurons were also tested with earth-horizontal axis rotations (EHA), which would activate

  5. Loss of Afferent Vestibular Input Produces Central Adaptation and Increased Gain of Vestibular Prosthetic Stimulation.

    PubMed

    Phillips, Christopher; Shepherd, Sarah J; Nowack, Amy; Nie, Kaibao; Kaneko, Chris R S; Rubinstein, Jay T; Ling, Leo; Phillips, James O

    2016-02-01

    Implanted vestibular neurostimulators are effective in driving slow phase eye movements in monkeys and humans. Furthermore, increases in slow phase velocity and electrically evoked compound action potential (vECAP) amplitudes occur with increasing current amplitude of electrical stimulation. In intact monkeys, protracted intermittent stimulation continues to produce robust behavioral responses and preserved vECAPs. In lesioned monkeys, shorter duration studies show preserved but with somewhat lower or higher velocity behavioral responses. It has been proposed that such changes are due to central adaptive changes in the electrically elicited vestibulo-ocular reflex (VOR). It is equally possible that these differences are due to changes in the vestibular periphery in response to activation of the vestibular efferent system. In order to investigate the site of adaptive change in response to electrical stimulation, we performed transtympanic gentamicin perfusions to induce rapid changes in vestibular input in monkeys with long-standing stably functioning vestibular neurostimulators, disambiguating the effects of implantation from the effects of ototoxic lesion. Gentamicin injection was effective in producing a large reduction in natural VOR only when it was performed in the non-implanted ear, suggesting that the implanted ear contributed little to the natural rotational response before injection. Injection of the implanted ear produced a reduction in the vECAP responses in that ear, suggesting that the intact hair cells in the non-functional ipsilateral ear were successfully lesioned by gentamicin, reducing the efficacy of stimulation in that ear. Despite this, injection of both ears produced central plastic changes that resulted in a dramatically increased slow phase velocity nystagmus elicited by electrical stimulation. These results suggest that loss of vestibular afferent activity, and a concurrent loss of electrically elicited vestibular input, produces an

  6. Loss of Afferent Vestibular Input Produces Central Adaptation and Increased Gain of Vestibular Prosthetic Stimulation.

    PubMed

    Phillips, Christopher; Shepherd, Sarah J; Nowack, Amy; Nie, Kaibao; Kaneko, Chris R S; Rubinstein, Jay T; Ling, Leo; Phillips, James O

    2016-02-01

    Implanted vestibular neurostimulators are effective in driving slow phase eye movements in monkeys and humans. Furthermore, increases in slow phase velocity and electrically evoked compound action potential (vECAP) amplitudes occur with increasing current amplitude of electrical stimulation. In intact monkeys, protracted intermittent stimulation continues to produce robust behavioral responses and preserved vECAPs. In lesioned monkeys, shorter duration studies show preserved but with somewhat lower or higher velocity behavioral responses. It has been proposed that such changes are due to central adaptive changes in the electrically elicited vestibulo-ocular reflex (VOR). It is equally possible that these differences are due to changes in the vestibular periphery in response to activation of the vestibular efferent system. In order to investigate the site of adaptive change in response to electrical stimulation, we performed transtympanic gentamicin perfusions to induce rapid changes in vestibular input in monkeys with long-standing stably functioning vestibular neurostimulators, disambiguating the effects of implantation from the effects of ototoxic lesion. Gentamicin injection was effective in producing a large reduction in natural VOR only when it was performed in the non-implanted ear, suggesting that the implanted ear contributed little to the natural rotational response before injection. Injection of the implanted ear produced a reduction in the vECAP responses in that ear, suggesting that the intact hair cells in the non-functional ipsilateral ear were successfully lesioned by gentamicin, reducing the efficacy of stimulation in that ear. Despite this, injection of both ears produced central plastic changes that resulted in a dramatically increased slow phase velocity nystagmus elicited by electrical stimulation. These results suggest that loss of vestibular afferent activity, and a concurrent loss of electrically elicited vestibular input, produces an

  7. Responses of primary vestibular neurons to galvanic vestibular stimulation (GVS) in the anaesthetised guinea pig.

    PubMed

    Kim, Juno; Curthoys, Ian S

    2004-09-30

    Previous studies in humans and animals which have shown that DC galvanic vestibular stimulation (GVS) induces horizontal and torsional eye movements have been interpreted as being due to a preferential activation of primary vestibular afferents innervating the horizontal semicircular canals and otoliths by GVS. The present study sought to determine in guinea pigs whether GVS does indeed selectively activate primary horizontal canal and otolith afferents. Constant-current GVS was passed between electrodes implanted in the tensor-tympani muscle of each middle ear or between electrodes on the skin over the mastoid. During this stimulation, responses from single primary vestibular neurons were recorded extracellularly by glass microelectrodes in Scarpa's ganglion. Afferents from all vestibular sensory regions were activated by both surface and tensor-tympani galvanic stimulation. Tensor tympani GVS was approximately 10 times more effective than surface GVS. At larger current intensities irregularly discharging afferents showed an asymmetrical response: cathodal stimulation resulted in a larger change in firing (increase) than anodal stimulation (decrease), whereas regularly discharging afferents responded symmetrically to the two polarities of GVS. Across all afferents tuned for different types of natural vestibular stimulation, neuronal sensitivity for GVS was found to increase with discharge variability (as indexed by CV*). Anterior canal afferents showed a slightly higher sensitivity than afferents from other vestibular sensory regions. Hence, the present study concluded that GVS activates primary vestibular afferents innervating all sensory regions in a uniform fashion. Therefore, the specific pattern of GVS-induced eye movements reported in previous studies are not due to differential sensitivity between different vestibular sensory regions, but are likely to reflect an involvement of central processing.

  8. Fos expression in the vestibular brainstem: what one marker can tell us about the network.

    PubMed

    Kaufman, Galen D

    2005-12-01

    Fos inducible transcription factor expression in rodent brains (rats and gerbils) during manipulations of vestibular input is reviewed. Stimuli included centripetal hypergravity, unilateral labyrinth lesion or semicircular canal plugging, rotational axis cross-coupling (Coriolis forces), high and low rotational vestibulo-ocular reflex gain adaptation, translabyrinth galvanic stimulation, pharmacological manipulation, and combinations thereof. Each type of stimulation elicited unique but partially redundant response patterns in the vestibulo-olivo-cerebellar (VOC) network that reflect the origin and interaction of the labyrinth inputs. On the basis of these patterns, a trained observer can predict what the animal experienced during testing; the patterns of VOC Fos expression reveal a trace of recent genomic activity. Based on principal component analysis, VOC network modules associated with lesion recovery, spatial representation and the calibration of gravity, and optokinetic influences are proposed. Probable and possible gene targets of the Fos protein are also reviewed.

  9. Evolution of techniques for the resection of vestibular schwannomas: from saving life to saving function.

    PubMed

    Akard, William; Tubbs, R Shane; Seymour, Zachary A; Hitselberger, William E; Cohen-Gadol, Aaron A

    2009-04-01

    The current state of surgery for vestibular schwannomas (VSs) is the result of a century of step-by-step technical progress by groundbreaking surgeons who transformed the procedure from its hazardous infancy and high mortality rate to its current state of safety and low morbidity rate. Harvey Cushing advocated bilateral suboccipital decompression and developed the method of intracapsular tumor enucleation. Walter Dandy supported the unilateral suboccipital approach and developed the technique of gross-total tumor resection. Microsurgical techniques revolutionized VS surgery to its current status. In this article, the authors review the early history of surgery for VSs with an emphasis on contributions from pioneering surgeons. The authors examined the Cushing Brain Tumor Registry for clues regarding the bona fide intention of Cushing for the resection of these tumors. PMID:18991500

  10. Activation of the hypothalamic-pituitary-adrenal axis following vestibular deafferentation in pigmented guinea pig.

    PubMed

    Gliddon, Catherine M; Darlington, Cynthia L; Smith, Paul F

    2003-02-28

    Twelve male pigmented guinea pigs underwent either a unilateral vestibular deafferentation (UVD) (n=6) or sham operation (n=6). Compared to the pre-operated salivary cortisol concentrations, the UVD operation resulted in a significant increase in night cortisol concentrations (P<0.05) and a significant interaction between the night cortisol concentration and time (P<0.05). There was no significant difference between the pre- and post-UVD morning salivary cortisol concentrations; nor between the pre- and post-sham morning or night salivary cortisol concentrations. This study suggests that the ocular-motor and postural syndrome is causing the activation of the hypothalamic-pituitary-adrenal (HPA) axis. PMID:12576192

  11. Unilateral mandibular condylectomy in lambs.

    PubMed

    Miyamoto, H; Matsuura, H; Jones, R H; Kurita, K; Goss, A N

    2001-08-01

    The purpose of this experimental study was to investigate the degree of regeneration of the mandibular condyle after unilateral condylectomy in 10-week-old lambs. The lambs were killed three months after the operation, and the joints examined radiologically and histologically. Scoring systems were used to assess the radiological changes and histological regeneration of the condyle. All joints showed regeneration of the condylar head postoperatively. The maximum degree of regeneration occurred on the medial side rather than the central or lateral areas. There was a significant correlation among the medial, central, and lateral planes (P<0.05). The reformed articular cartilage was irregular and thin (P<0.01), and the disc was thick in the central plane (P<0.01) compared with the control joints. The temporal bone was normal. This study shows that unilateral condylectomy in the growing period results in some condylar regeneration particularly on the medial side and reformation of some irregular and thin articular cartilage. PMID:11437430

  12. Immunological Influences on the Vestibular System

    NASA Technical Reports Server (NTRS)

    Warchol, Mark E.

    2003-01-01

    The goals of this project were to examine the influence of immune signaling molecules on the survival and replacement of sensory hair cells in the vestibular organs. We have made considerable progress toward that goal, particularly in the characterization of mechanisms that underlie hair cell death.

  13. Perspectives in vestibular diagnostics and therapy

    PubMed Central

    Ernst, Arneborg

    2012-01-01

    Vestibular diagnostics and therapy ist the mirror of technological, scientific and socio-economics trends as are other fields of clinical medicine. These trends have led to a substantial diversification of the field of neurotology. The improvements in diagnostics have been characterized by the introduction of new receptor testing tools (e.g., VEMPs), progress in imaging (e.g., the endolymphatic hydrops) and in the description of central-vestibular neuroplasticity. The etiopathology of vestibular disorders has been updated by geneticists (e.g., the description of the COCH gene mutations), the detection of structural abnormalities (e.g., dehiscence syndromes) and related disorders (e.g. migraine-associated vertigo). The therapeutic options were extended by re-evaluation of techniques known a long time ago (e.g., saccus exposure), the development of new approaches (e.g., dehiscence repair) and the introduction of new drug therapy concepts (e.g., local drug delivery). Implantable, neuroprosthetic solutions have not yet reached experimental safety and validity and are still far away. However, externally worn neuroprosthetic solution were introduced in the rehab of vestibular disorders (e.g., VertiGuard system). These and related trends point into a medical future which is characterized by presbyvertigo as classical sign of the demographic changes ahead, by shortage of financial resources and a medico-legally over-regulated, even hostile environment for physicians in clinical medicine. PMID:22558055

  14. The geriatric auditory and vestibular systems.

    PubMed

    Kennedy, R; Clemis, J D

    1990-12-01

    Age-related declines in auditory and vestibular function are becoming more prevalent and better understood. The personal and societal impact of these disorders is impressive, and present techniques of amplification or balance training can be of great benefit. However, many issues await investigation, and continued integration of ever-increasing technologies promises many new answers, and questions, in the future. PMID:2074981

  15. Response to Vestibular Sensory Events in Autism

    ERIC Educational Resources Information Center

    Kern, Janet K.; Garver, Carolyn R.; Grannemann, Bruce D.; Trivedi, Madhukar H.; Carmody, Thomas; Andrews, Alonzo A.; Mehta, Jyutika A.

    2007-01-01

    The purpose of this study was to examine the response to vestibular sensory events in persons with autism. The data for this study was collected as part of a cross-sectional study that examined sensory processing (using the Sensory Profile) in 103 persons with autism, 3-43 years of age, compared to age- and gender-matched community controls. The…

  16. Vesibulotoxicity and Management of Vestibular Disorders

    ERIC Educational Resources Information Center

    Carey, John P.

    2005-01-01

    The toxicity of certain aminoglycoside antibiotics for vestibular hair cells has been used to special advantage in the treatment of Meniere's disease. Intratympanic (middle ear) injections of these drugs are being increasingly used to control vertigo in this disorder when it has not responded to medical therapy. The mechanisms by which these drugs…

  17. Widespread vestibular activation of the rodent cortex.

    PubMed

    Rancz, Ede A; Moya, Javier; Drawitsch, Florian; Brichta, Alan M; Canals, Santiago; Margrie, Troy W

    2015-04-15

    Much of our understanding of the neuronal mechanisms of spatial navigation is derived from chronic recordings in rodents in which head-direction, place, and grid cells have all been described. However, despite the proposed importance of self-reference information to these internal representations of space, their congruence with vestibular signaling remains unclear. Here we have undertaken brain-wide functional mapping using both fMRI and electrophysiological methods to directly determine the spatial extent, strength, and time course of vestibular signaling across the rat forebrain. We find distributed activity throughout thalamic, limbic, and particularly primary sensory cortical areas in addition to known head-direction pathways. We also observe activation of frontal regions, including infralimbic and cingulate cortices, indicating integration of vestibular information throughout functionally diverse cortical regions. These whole-brain activity maps therefore suggest a widespread contribution of vestibular signaling to a self-centered framework for multimodal sensorimotor integration in support of movement planning, execution, spatial navigation, and autonomic responses to gravito-inertial changes. PMID:25878265

  18. Cholinergic nicotinic receptors in the vestibular epithelia.

    PubMed

    Thornhill, R A

    1991-10-01

    Receptor binding studies specific for nicotinic cholinergic receptors have been carried out on isolated vestibular epithelia of the frogs Rana catesbiana and Rana temporaria. Evidence is presented for the presence of nicotinic-like cholinergic receptors specifically associated with the sensory areas. PMID:1797345

  19. Vestibular stimulation leads to distinct hemodynamic patterning

    NASA Technical Reports Server (NTRS)

    Kerman, I. A.; Emanuel, B. A.; Yates, B. J.

    2000-01-01

    Previous studies demonstrated that responses of a particular sympathetic nerve to vestibular stimulation depend on the type of tissue the nerve innervates as well as its anatomic location. In the present study, we sought to determine whether such precise patterning of vestibulosympathetic reflexes could lead to specific hemodynamic alterations in response to vestibular afferent activation. We simultaneously measured changes in systemic blood pressure and blood flow (with the use of Doppler flowmetry) to the hindlimb (femoral artery), forelimb (brachial artery), and kidney (renal artery) in chloralose-urethane-anesthetized, baroreceptor-denervated cats. Electrical vestibular stimulation led to depressor responses, 8 +/- 2 mmHg (mean +/- SE) in magnitude, that were accompanied by decreases in femoral vasoconstriction (23 +/- 4% decrease in vascular resistance or 36 +/- 7% increase in vascular conductance) and increases in brachial vascular tone (resistance increase of 10 +/- 6% and conductance decrease of 11 +/- 4%). Relatively small changes (<5%) in renal vascular tone were observed. In contrast, electrical stimulation of muscle and cutaneous afferents produced pressor responses (20 +/- 6 mmHg) that were accompanied by vasoconstriction in all three beds. These data suggest that vestibular inputs lead to a complex pattern of cardiovascular changes that is distinct from that which occurs in response to activation of other types of somatic afferents.

  20. What does galvanic vestibular stimulation stimulate?

    PubMed

    Wardman, Daniel L; Fitzpatrick, Richard C

    2002-01-01

    The technique of galvanic vestibular stimulation (GVS) has been used for a long time. The stimulus produces stereotyped automatic postural and ocular responses. The mechanisms underlying these responses are not understood although they are commonly attributed to altered otolith output. Based on animal studies, it seems reasonable to assume that vestibular afferents from the otoliths and semicircular canals are affected similarly by GVS. With this assumption, and anatomical knowledge of the vestibular apparatus, a model is developed to describe the expected responses of vestibular afferents to percutaneous GVS and the physiological implications of this altered sensory signal. Bilateral bipolar GVS, the most commonly used technique, should produce a canal signal consistent with a strong ear-down roll towards the cathodal side, a smaller nose-to-cathode yaw, but no pitch signal. Bilateral bipolar GVS should also produce an otolith signal consistent with tilt towards the cathodal side or a translational acceleration towards the anodal side. The expected responses for other configurations of GVS are also described. The model appears consistent with published data on the ocular and postural responses to GVS, and suggests other testable hypotheses concerning postural, ocular and perceptual responses to GVS.

  1. Perspectives in vestibular diagnostics and therapy.

    PubMed

    Ernst, Arneborg

    2011-01-01

    Vestibular diagnostics and therapy ist the mirror of technological, scientific and socio-economics trends as are other fields of clinical medicine. These trends have led to a substantial diversification of the field of neurotology.The improvements in diagnostics have been characterized by the introduction of new receptor testing tools (e.g., VEMPs), progress in imaging (e.g., the endolymphatic hydrops) and in the description of central-vestibular neuroplasticity. The etiopathology of vestibular disorders has been updated by geneticists (e.g., the description of the COCH gene mutations), the detection of structural abnormalities (e.g., dehiscence syndromes) and related disorders (e.g. migraine-associated vertigo). The therapeutic options were extended by re-evaluation of techniques known a long time ago (e.g., saccus exposure), the development of new approaches (e.g., dehiscence repair) and the introduction of new drug therapy concepts (e.g., local drug delivery). Implantable, neuroprosthetic solutions have not yet reached experimental safety and validity and are still far away. However, externally worn neuroprosthetic solution were introduced in the rehab of vestibular disorders (e.g., VertiGuard system).These and related trends point into a medical future which is characterized by presbyvertigo as classical sign of the demographic changes ahead, by shortage of financial resources and a medico-legally over-regulated, even hostile environment for physicians in clinical medicine.

  2. Phase-plane analysis of gaze stabilization to high acceleration head thrusts: a continuum across normal subjects and patients with loss of vestibular function.

    PubMed

    Peng, Grace C Y; Zee, David S; Minor, Lloyd B

    2004-04-01

    We investigated the vestibulo-ocular reflex (VOR) during high-acceleration, yaw-axis, head rotations in 12 normals and 15 patients with vestibular loss [7 unilateral vestibular deficient (UVD) and 8 bilateral vestibular deficient (BVD)]. We analyzed gaze stabilization within a 200-ms window after head rotation began, using phase planes, which allowed simultaneous analysis of gaze velocity and gaze position. These "gaze planes" revealed critical dynamic information not easily gleaned from traditional gain measurements. We found linear relationships between peak gaze-velocity and peak gaze-position error when normalized to peak head speed and position, respectively. Values fell on a continuum, increasing from normals, to normals tested with very high acceleration (VHA = 10,000-20,000 degrees/s2), to UVD patients during rotations toward the intact side, to UVD patients during rotations toward the lesioned side, to BVD patients. We classified compensatory gaze corrections as gaze-position corrections (GPCs) or gaze-velocity error corrections (GVCs). We defined patients as better-compensated when the value of their end gaze position was low relative to peak gaze position. In the gaze plane this criterion corresponded to relatively stereotyped patterns over many rotations, and appearance of high velocity (100-400 degrees/s) GPCs in the gaze plane ending quadrant (150-200 ms after head movement onset). In less-compensated patients, and normals at VHA, more GVCs were generated, and GPCs were generated only after gaze-velocity error was minimized. These findings suggest that challenges to compensatory vestibular function can be from vestibular deficiency or novel stimuli not previously experienced. Similar patterns of challenge and compensation were observed in both patients with vestibular loss and normal subjects.

  3. Facial functional outcome in monitored versus not-monitored patients in vestibular schwannomas surgery

    PubMed Central

    Taddei, Graziano; Marrelli, Alfonso; Trovarelli, Donatella; Ricci, Alessandro; Galzio, Renato J.

    2016-01-01

    Objective: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. Materials and Methods: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution. In according to the type of neurophysiological tool used during surgical procedures, two patients groups were identified: Group 1 (facial stimulator only) and Group 2 (stimulator and facial monitoring). Statistical comparison of the two groups was made with the t- test, and facial function results were evaluated with the Fisher's exact test. Results: In the Group 1, of the 22 patients with anatomically preserved facial nerves, 3 (13.6%) showed excellent facial nerve function, 14 (63.6%) showed intermediate function, and 5 (22.7%) showed poor function. In the Group 2, all the 27 patients got anatomically preserved facial nerves, and 18 (66.7%) showed excellent facial nerve function, 9 (33.3%) showed intermediate function, and no one showed poor function. Conclusions: We found that retrosigmoid approach associated with continuous EMG facial monitoring combined with the use of bipolar stimulation is a safe and effective treatment for vestibular schwannomas. PMID:27695545

  4. Facial functional outcome in monitored versus not-monitored patients in vestibular schwannomas surgery

    PubMed Central

    Taddei, Graziano; Marrelli, Alfonso; Trovarelli, Donatella; Ricci, Alessandro; Galzio, Renato J.

    2016-01-01

    Objective: Even though advances in surgical techniques have improved facial nerve outcomes, functional preservation is still an issue because injury to the facial nerve has significant physical and psychological consequences for the patient. We retrospectively review our data in VS surgery to compare the facial outcome in intraoperative facial monitored versus not-monitored patients. Materials and Methods: 51 consecutive patients with unilateral vestibular schwannoma in the period from 2005 to 2010 were treated in our Institution. In according to the type of neurophysiological tool used during surgical procedures, two patients groups were identified: Group 1 (facial stimulator only) and Group 2 (stimulator and facial monitoring). Statistical comparison of the two groups was made with the t- test, and facial function results were evaluated with the Fisher's exact test. Results: In the Group 1, of the 22 patients with anatomically preserved facial nerves, 3 (13.6%) showed excellent facial nerve function, 14 (63.6%) showed intermediate function, and 5 (22.7%) showed poor function. In the Group 2, all the 27 patients got anatomically preserved facial nerves, and 18 (66.7%) showed excellent facial nerve function, 9 (33.3%) showed intermediate function, and no one showed poor function. Conclusions: We found that retrosigmoid approach associated with continuous EMG facial monitoring combined with the use of bipolar stimulation is a safe and effective treatment for vestibular schwannomas.

  5. Discoid lupus erythematosus presenting as unilateral blepharitis.

    PubMed

    Au, Leon

    2006-01-01

    A 39-year-old man presented with a 4-month history of unilateral blepharitis that did not respond to conventional treatment. Punch biopsy confirmed the diagnosis of discoid lupus erythematosus. Unilateral blepharitis as the only presenting sign of discoid lupus erythematosus is uncommon but should be considered in the differential diagnosis in patients with asymmetric blepharitis.

  6. A Case of Unilateral Ashy Dermatosis

    PubMed Central

    Chun, Ji-Sung; Hong, Soon-Kwan; Seo, Jong-Keun; Lee, Deborah; Sung, Ho-Suk

    2009-01-01

    Ashy dermatosis, also known as erythema dyschromicum perstans, is a peculiar, slowly progressive, idiopathic dermal melanosis. In most cases, slate gray- to lead-colored patches are symmetrically distributed over the body. Ashy dermatosis with a unilateral distribution is rare. We report a case of unilateral ashy dermatosis in a 27-year-old Korean man. PMID:20523842

  7. Ocular Vestibular Evoked Myogenic Potentials Using Head Striker Stimulation

    NASA Technical Reports Server (NTRS)

    De Dios, Y. E.; Gadd, N. E.; Kofman, I. S.; Peters, B. T.; Reschke, M.; Bloomberg, J. J.; Wood, S. J.; Noohibezanjani, F.; Kinnaird, C.; Seidler, R. D.; Mulavara, A. P.

    2016-01-01

    Introduction: Over the last two decades, several studies have been published on the impact of long-duration (i.e., 22 days or longer) spaceflight on the central nervous system (CNS). In consideration of the health and performance of crewmembers in flight and post-flight, we are conducting a controlled prospective longitudinal study to investigate the effects of spaceflight on the extent, longevity and neural bases of sensorimotor, cognitive, and neural changes. Multiple studies have demonstrated the effects of spaceflight on the vestibular system. One of the supporting tests conducted in this protocol is the Vestibular Evoked Myogenic Potential (VEMP) test that provides a unilateral measure of otolith (saccule and utricle) function. A different approach was taken for ocular VEMP (oVEMP) testing using a head striker system (Wackym et al. 2012). The oVEMP is generally considered to be a measure of utricle function. The the otolithic input to the inferior oblique muscle is predominately from the utricular macula. Thus, quantitatively, oVEMP tests utricular function. Another practical extension of these relationships is that the oVEMP reflects the superior vestibular nerve function. Methods: Ground testing was administered on 16 control subjects and for 8 subjects over four repeated sessions spanning 70 days. The oVEMP was elicitied via a hand held striker by a vibrotactile pulse presented at the rate of 1 Hz for 24 seconds on the side of the head as subjects lay supine on a gurney. Subjects were directed to gaze approximately 25 degrees above straight ahead in semi-darkness. For the oVEMP electromyograms will be recorded with active bipolar electrodes (Delsys Inc., Boston, MA) on the infra-orbital ridge 1 cm below the eyelid with a reference electrode on the below the knee cap. The EMG potentials were amplified; band-pass filtered using a BagnoliTM Desktop EMG System (Delsys Inc., Boston, MA, USA). This EMG signal is sampled at 10 kHz and the data stimulus onset to

  8. Neural correlates of motor learning in the vestibulo-ocular reflex: dynamic regulation of multimodal integration in the macaque vestibular system.

    PubMed

    Sadeghi, Soroush G; Minor, Lloyd B; Cullen, Kathleen E

    2010-07-28

    Motor learning is required for the reacquisition of skills that have been compromised as a result of brain lesion or disease, as well as for the acquisition of new skills. Behaviors with well characterized anatomy and physiology are required to yield significant insight into changes that occur in the brain during motor learning. The vestibulo-ocular reflex (VOR) is well suited to establish connections between neurons, neural circuits, and motor performance during learning. Here, we examined the linkage between neuronal and behavioral VOR responses in alert behaving monkeys (Macaca mulatta) during the impressive recovery that occurs after unilateral vestibular loss. We show, for the first time, that motor learning is characterized by the dynamic reweighting of inputs from different modalities (i.e., vestibular vs extravestibular) at the level of the single neurons that constitute the first central stage of vestibular processing. Specifically, two types of information, which did not influence neuronal responses before the lesion, had an important role during compensation. First, unmasked neck proprioceptive inputs played a critical role in the early stages of this process demonstrated by faster and more substantial recovery of vestibular responses in proprioceptive sensitive neurons. Second, neuronal and VOR responses were significantly enhanced during active relative to passive head motion later in the compensation process (>3 weeks). Together, our findings provide evidence linking the dynamic regulation of multimodal integration at the level of single neurons and behavioral recovery, suggesting a role for homeostatic mechanisms in VOR motor learning.

  9. Exhibition of Stochastic Resonance in Vestibular Perception

    NASA Technical Reports Server (NTRS)

    Galvan-Garza, R. C.; Clark, T. K.; Merfeld, D. M.; Bloomberg, J. J.; Oman, C. M.; Mulavara, A. P.

    2016-01-01

    Astronauts experience sensorimotor changes during spaceflight, particularly during G-transitions. Post flight sensorimotor changes include spatial disorientation, along with postural and gait instability that may degrade operational capabilities of the astronauts and endanger the crew. A sensorimotor countermeasure that mitigates these effects would improve crewmember safety and decrease risk. The goal of this research is to investigate the potential use of stochastic vestibular stimulation (SVS) as a technology to improve sensorimotor function. We hypothesize that low levels of SVS will improve sensorimotor perception through the phenomenon of stochastic resonance (SR), when the response of a nonlinear system to a weak input signal is enhanced by the application of a particular nonzero level of noise. This study aims to advance the development of SVS as a potential countermeasure by 1) demonstrating the exhibition of stochastic resonance in vestibular perception, a vital component of sensorimotor function, 2) investigating the repeatability of SR exhibition, and 3) determining the relative contribution of the semicircular canals (SCC) and otolith (OTO) organs to vestibular perceptual SR. A constant current stimulator was used to deliver bilateral bipolar SVS via electrodes placed on each of the mastoid processes, as previously done. Vestibular perceptual motion recognition thresholds were measured using a 6-degree of freedom MOOG platform and a 150 trial 3-down/1-up staircase procedure. In the first test session, we measured vestibular perceptual thresholds in upright roll-tilt at 0.2 Hz (SCC+OTO) with SVS ranging from 0-700 µA. In a second test session a week later, we re-measured roll-tilt thresholds with 0, optimal (from test session 1), and 1500 µA SVS levels. A subset of these subjects, plus naive subjects, participated in two additional test sessions in which we measured thresholds in supine roll-rotation at 0.2 Hz (SCC) and upright y-translation at 1 Hz

  10. Recovery of vestibular function following hair cell destruction by streptomycin

    NASA Technical Reports Server (NTRS)

    Jones, T. A.; Nelson, R. C.

    1992-01-01

    Can the vestibular periphery of warm-blooded vertebrates recover functionally from severe sensory hair cell loss? Recent findings in birds suggest a mechanism for recovery but in fact no direct functional evidence has been reported. We produced vestibular hair cell lesions using the ototoxic agent streptomycin sulfate (600 mg/kg/day, 8 days, chicks, Gallus domesticus). Compound action potentials of the vestibular nerve were used as a direct measure of peripheral vestibular function. Vestibular thresholds, neural activation latencies and amplitudes were documented. Eight days of drug treatment elevated thresholds significantly (P < 0.001) and eliminated all but remnants of vestibular activity. Virtually complete physiological recovery occurred in all animals studied over a period of 70 days following treatment. Thresholds recovered within two weeks of drug treatment whereas the return of response morphologies including activation latencies and amplitudes required an additional 6-8 weeks.

  11. The vestibular contribution to the head direction signal and navigation

    PubMed Central

    Yoder, Ryan M.; Taube, Jeffrey S.

    2014-01-01

    Spatial learning and navigation depend on neural representations of location and direction within the environment. These representations, encoded by place cells and head direction (HD) cells, respectively, are dominantly controlled by visual cues, but require input from the vestibular system. Vestibular signals play an important role in forming spatial representations in both visual and non-visual environments, but the details of this vestibular contribution are not fully understood. Here, we review the role of the vestibular system in generating various spatial signals in rodents, focusing primarily on HD cells. We also examine the vestibular system’s role in navigation and the possible pathways by which vestibular information is conveyed to higher navigation centers. PMID:24795578

  12. Diverse spatial reference frames of vestibular signals in parietal cortex

    PubMed Central

    Chen, Xiaodong; DeAngelis, Gregory C; Angelaki, Dora E

    2013-01-01

    Summary Reference frames are important for understanding how sensory cues from different modalities are coordinated to guide behavior, and the parietal cortex is critical to these functions. We compare reference frames of vestibular self-motion signals in the ventral intraparietal area (VIP), parietoinsular vestibular cortex (PIVC), and dorsal medial superior temporal area (MSTd). Vestibular heading tuning in VIP is invariant to changes in both eye and head positions, indicating a body (or world)-centered reference frame. Vestibular signals in PIVC have reference frames that are intermediate between head- and body-centered. In contrast, MSTd neurons show reference frames between head- and eye-centered, but not body-centered. Eye and head position gain fields were strongest in MSTd and weakest in PIVC. Our findings reveal distinct spatial reference frames for representing vestibular signals, and pose new challenges for understanding the respective roles of these areas in potentially diverse vestibular functions. PMID:24239126

  13. Effect of noise on the vestibular system - Vestibular evoked potential studies in rats.

    PubMed

    Sohmer, H.; Elidan, J.; Plotnik, M.; Freeman, S.; Sockalingam, R.; Berkowitz, Z.; Mager, M.

    1999-01-01

    Studies have shown that in order for sound to affect the vestibular end organs in the inner ear, very high intensities are required. Furthermore, in patients with noise induced hearing loss, vestibular signs, if present, are subclinical. In order to study possible auditory-vestibular interactions in a more controlled fashion, using physiological sound intensities, the present study used short latency vestibular evoked potentials (VsEPs) to impulses of angular (15,000 degrees /sec(2), risetime 1.5 msec) and linear (3-5 g, risetime 1.5 msec) acceleration were used to study the possible effects of sound on peripheral vestibular function in rats. Four different paradigms were used: a - an intense (135 dB pe SPL) click stimulus was presented 5 msec before the linear acceleration impulse and the VsEP to 128 stimuli were recorded with and without this click stimulus. There was no effect of the preceding intense click on the first wave (reflecting end organ activity) of the linear VsEP. b - 113 dB SPL white noise "masking" was presented while the VsEPs were elicited. A 10-20% reduction in the amplitude of the first VsEP wave was seen during the noise exposure, but 5 minutes after this exposure, there was almost complete recovery to pre-exposure amplitude. c - 113 dB SPL noise was presented for one hour and VsEPs were recorded within 15 minutes of cessation of the noise. The auditory nerve-brainstem-evoked response showed a temporary threshold shift while there was no effect on the VsEP. d - 113 dB SPL white noise was presented for 12 hours per day for 21 consecutive days. Auditory nerve-brainstem-evoked responses and vestibular (VsEPs) function were studied one week after the conclusion of the noise exposure. Auditory function was severely permanently depressed (40 dB threshold elevation and clear histological damage) while the amplitude of wave 1 of the VsEP was not affected. It seems therefore that even though intense noise clearly affects the cochlea and may have a

  14. The Frog Vestibular System as a Model for Lesion-Induced Plasticity: Basic Neural Principles and Implications for Posture Control

    PubMed Central

    Lambert, François M.; Straka, Hans

    2011-01-01

    Studies of behavioral consequences after unilateral labyrinthectomy have a long tradition in the quest of determining rules and limitations of the central nervous system (CNS) to exert plastic changes that assist the recuperation from the loss of sensory inputs. Frogs were among the first animal models to illustrate general principles of regenerative capacity and reorganizational neural flexibility after a vestibular lesion. The continuous successful use of the latter animals is in part based on the easy access and identifiability of nerve branches to inner ear organs for surgical intervention, the possibility to employ whole brain preparations for in vitro studies and the limited degree of freedom of postural reflexes for quantification of behavioral impairments and subsequent improvements. Major discoveries that increased the knowledge of post-lesional reactive mechanisms in the CNS include alterations in vestibular commissural signal processing and activation of cooperative changes in excitatory and inhibitory inputs to disfacilitated neurons. Moreover, the observed increase of synaptic efficacy in propriospinal circuits illustrates the importance of limb proprioceptive inputs for postural recovery. Accumulated evidence suggests that the lesion-induced neural plasticity is not a goal-directed process that aims toward a meaningful restoration of vestibular reflexes but rather attempts a survival of those neurons that have lost their excitatory inputs. Accordingly, the reaction mechanism causes an improvement of some components but also a deterioration of other aspects as seen by spatio-temporally inappropriate vestibulo-motor responses, similar to the consequences of plasticity processes in various sensory systems and species. The generality of the findings indicate that frogs continue to form a highly amenable vertebrate model system for exploring molecular and physiological events during cellular and network reorganization after a loss of vestibular function

  15. Estimation of Optical Stimulus Amplitude for Balance Training Using Electrical Stimulation of the Vestibular System

    NASA Technical Reports Server (NTRS)

    Goel, R.; De Dios, Y. E.; Cohen, H. S.; Bloomberg, J. J.; Mulavara, A. P.

    2016-01-01

    gravitational environments. This combination may help to significantly reduce the time to recover functional performance after long-duration spaceflight or after landing in a novel gravitational environment (e.g. Moon or Mars). Another application of using electrical stimulation of the vestibular system is in the evaluation of tests for vestibular function by simulating acute deterioration of vestibular sensory inputs.

  16. New methods for diagnosis and treatment of vestibular diseases

    PubMed Central

    Palla, Antonella

    2010-01-01

    Dizziness and vertigo are common complaints, with a lifetime prevalence of over 30%. This review provides a brief summary of the recent diagnostic and therapeutic advances in the field of neuro-otology. A special focus is placed on the clinical usefulness of vestibular tests. While these have markedly improved over the years, treatment options for vestibular disorders still remain limited. Available therapies for selected vestibular diseases are discussed. PMID:21173877

  17. Ernst Mach on the vestibular organ 100 years ago

    NASA Technical Reports Server (NTRS)

    Henn, V.; Young, L. R.

    1975-01-01

    The paper reviews the contributions of Ernst Mach to vestibular research. His experiments, mainly psychophysical in nature, included measurements of threshold and investigation of the vestibular-visual interaction. Among his conclusions are that the adequate stimulus for the semicircular canals must be pressure, and that the sustained endolymph flow theory of Breuer (1874) and Crum Brown (1874) is erroneous. Excerpts are given of Mach's publications on vestibular functions.-

  18. Influence of temperature on the sound-evoked vestibular potential.

    PubMed

    Wit, H P; Dijkgraaf, E

    1985-01-01

    The sound-evoked vestibular potential, measured with gross electrodes after fenestration of a lateral semicircular canal in pigeons, is delayed with respect to the acoustic stimulus. The influence of temperature of the vestibular system on this delay can most easily be explained by assuming chemically mediated transmission to take place between vestibular hair cells and their primary afferents. The possibility of electrotonic transmission, however, cannot be excluded. PMID:3878654

  19. The clinical characteristics and treatment for sudden sensorineural hearing loss with vestibular schwannoma.

    PubMed

    Lin, Chang; Gong, Qilin; Zuo, Wenjing; Zhang, Rong; Zhou, Aidong

    2015-04-01

    The aim of this study is to analyze the clinical characteristics and treatment of sudden sensorineural hearing loss (SSNHL) patients with vestibular schwannoma (VS). The clinical features of the VS patients were explored by retrospectively analyzing the clinical data from 542 cases of SSNHL patients between January 2008 and March 2013. There were 10 cases (10 ears) diagnosed with VS in 542 cases of SSNHL patients (10 ears, 1.85 %), 3 males, 7 females, with a range of 28-57 years. Among all the cases, eight patients with abnormal ABR, ten with ear ipsilateral stapedius reflexes which were completely not elicited and seven patients with healthy ear contralateral stapedius reflexes which were completely not elicited. Neuromas were classified by Koos grades according to size (8 of grade I, 1 of grade II, 1 of grade IV). Eight small VS  patients were taken waiting and MRI therapy strategies. Meanwhile, we used glucocorticoid treatment and timely and short-term medication to improve the microcirculation of the inner ear for these patients. And four cases' hearing was improved. Some vestibular schwannomas have SSNHL as initial symptoms, especially the small ones in internal auditory canal. To prevent misdiagnosis or leak-diagnosis, MRI should be performed as a routine test for SSNHL, and ABR is sometimes necessary for SSNHL patients. It is also necessary to give appropriate treatment to protect hearing of the small vestibular schwannoma patients whose first symptoms are diagnosed as SSNHL in acute phase.

  20. Direction specific biases in human visual and vestibular heading perception.

    PubMed

    Crane, Benjamin T

    2012-01-01

    Heading direction is determined from visual and vestibular cues. Both sensory modalities have been shown to have better direction discrimination for headings near straight ahead. Previous studies of visual heading estimation have not used the full range of stimuli, and vestibular heading estimation has not previously been reported. The current experiments measure human heading estimation in the horizontal plane to vestibular, visual, and spoken stimuli. The vestibular and visual tasks involved 16 cm of platform or visual motion. The spoken stimulus was a voice command speaking a heading angle. All conditions demonstrated direction dependent biases in perceived headings such that biases increased with headings further from the fore-aft axis. The bias was larger with the visual stimulus when compared with the vestibular stimulus in all 10 subjects. For the visual and vestibular tasks precision was best for headings near fore-aft. The spoken headings had the least bias, and the variation in precision was less dependent on direction. In a separate experiment when headings were limited to ± 45°, the biases were much less, demonstrating the range of headings influences perception. There was a strong and highly significant correlation between the bias curves for visual and spoken stimuli in every subject. The correlation between visual-vestibular and vestibular-spoken biases were weaker but remained significant. The observed biases in both visual and vestibular heading perception qualitatively resembled predictions of a recent population vector decoder model (Gu et al., 2010) based on the known distribution of neuronal sensitivities.

  1. Periosteal Pedicle Flap Harvested during Vestibular Extension for Root Coverage.

    PubMed

    Kumar, Shubham; Gupta, Krishna Kumar; Agrawal, Rahul; Srivastava, Pratima; Soni, Shalabh

    2015-01-01

    Root exposure along with inadequate vestibular depth is a common clinical finding. Treatment option includes many techniques to treat such defects for obtaining predictable root coverage. Normally, the vestibular depth is increased first followed by a second surgery for root coverage. The present case report describes a single-stage technique for vestibular extension and root coverage in a single tooth by using the Periosteal Pedicle Flap (PPF). This technique involves no donor site morbidity and allows for reflection of sufficient amount of periosteal flap tissue with its own blood supply at the surgical site, thus increasing the chances of success of root coverage with simultaneous increase in vestibular depth. PMID:26788377

  2. Task, muscle and frequency dependent vestibular control of posture

    PubMed Central

    Forbes, Patrick A.; Siegmund, Gunter P.; Schouten, Alfred C.; Blouin, Jean-Sébastien

    2015-01-01

    The vestibular system is crucial for postural control; however there are considerable differences in the task dependence and frequency response of vestibular reflexes in appendicular and axial muscles. For example, vestibular reflexes are only evoked in appendicular muscles when vestibular information is relevant to postural control, while in neck muscles they are maintained regardless of the requirement to maintain head on trunk balance. Recent investigations have also shown that the bandwidth of vestibular input on neck muscles is much broader than appendicular muscles (up to a factor of 3). This result challenges the notion that vestibular reflexes only contribute to postural control across the behavioral and physiological frequency range of the vestibular organ (i.e., 0–20 Hz). In this review, we explore and integrate these task-, muscle- and frequency-related differences in the vestibular system’s contribution to posture, and propose that the human nervous system has adapted vestibular signals to match the mechanical properties of the system that each group of muscles controls. PMID:25620919

  3. Direction Specific Biases in Human Visual and Vestibular Heading Perception

    PubMed Central

    Crane, Benjamin T.

    2012-01-01

    Heading direction is determined from visual and vestibular cues. Both sensory modalities have been shown to have better direction discrimination for headings near straight ahead. Previous studies of visual heading estimation have not used the full range of stimuli, and vestibular heading estimation has not previously been reported. The current experiments measure human heading estimation in the horizontal plane to vestibular, visual, and spoken stimuli. The vestibular and visual tasks involved 16 cm of platform or visual motion. The spoken stimulus was a voice command speaking a heading angle. All conditions demonstrated direction dependent biases in perceived headings such that biases increased with headings further from the fore-aft axis. The bias was larger with the visual stimulus when compared with the vestibular stimulus in all 10 subjects. For the visual and vestibular tasks precision was best for headings near fore-aft. The spoken headings had the least bias, and the variation in precision was less dependent on direction. In a separate experiment when headings were limited to ±45°, the biases were much less, demonstrating the range of headings influences perception. There was a strong and highly significant correlation between the bias curves for visual and spoken stimuli in every subject. The correlation between visual-vestibular and vestibular-spoken biases were weaker but remained significant. The observed biases in both visual and vestibular heading perception qualitatively resembled predictions of a recent population vector decoder model (Gu et al., 2010) based on the known distribution of neuronal sensitivities. PMID:23236490

  4. Task, muscle and frequency dependent vestibular control of posture.

    PubMed

    Forbes, Patrick A; Siegmund, Gunter P; Schouten, Alfred C; Blouin, Jean-Sébastien

    2014-01-01

    The vestibular system is crucial for postural control; however there are considerable differences in the task dependence and frequency response of vestibular reflexes in appendicular and axial muscles. For example, vestibular reflexes are only evoked in appendicular muscles when vestibular information is relevant to postural control, while in neck muscles they are maintained regardless of the requirement to maintain head on trunk balance. Recent investigations have also shown that the bandwidth of vestibular input on neck muscles is much broader than appendicular muscles (up to a factor of 3). This result challenges the notion that vestibular reflexes only contribute to postural control across the behavioral and physiological frequency range of the vestibular organ (i.e., 0-20 Hz). In this review, we explore and integrate these task-, muscle- and frequency-related differences in the vestibular system's contribution to posture, and propose that the human nervous system has adapted vestibular signals to match the mechanical properties of the system that each group of muscles controls.

  5. Bilateral segmental aplasia with unilateral uterine horn torsion in a Pomeranian bitch.

    PubMed

    Nakamura, Kensuke; Yamasaki, Masahiro; Osaki, Tomohiro; Ohta, Hiroshi; Sasaki, Noboru; Aoshima, Keisuke; Kimura, Takashi; Takiguchi, Mitsuyoshi

    2012-01-01

    Bilateral segmental aplasia of the uterine horns with unilateral pyometra and uterine horn torsion were diagnosed in a Pomeranian bitch that presented with chronic abdominal distension and an acute onset of anorexia and lethargy. Because radiographic and ultrasonographic findings revealed the presence of markedly enlarged bilateral uterine horns filled with fluid in the caudal abdomen, a tentative diagnosis of either pyometra or hydrometra with uterine horn torsion was made. Exploratory laparotomy showed bilateral, segmentally distended uterine horns with unilateral uterine horn torsion. Ovariohysterectomy was performed, and bilateral segmental aplasia of the uterine horns with the development of unilateral uterine horn torsion was diagnosed histopathologically. To the authors' knowledge, this is the first report of uterine horn torsion in conjunction with segmental aplasia of the uterine horn in a bitch. PMID:22843825

  6. Vestibular-ocular accommodation reflex in man

    NASA Technical Reports Server (NTRS)

    Clark, B.; Randle, R. J.; Stewart, J. D.

    1975-01-01

    Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present paper studies a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 sec of rotating. Accommodation was recorded continuously on an infrared optometer for 110 sec under two conditions: while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

  7. Vestibular activation of sympathetic nerve activity

    NASA Technical Reports Server (NTRS)

    Ray, C. A.; Carter, J. R.

    2003-01-01

    AIM: The vestibulosympathetic reflex refers to sympathetic nerve activation by the vestibular system. Animal studies indicate that the vestibular system assists in blood pressure regulation during orthostasis. Although human studies clearly demonstrate activation of muscle sympathetic nerve activity (MSNA) during engagement of the otolith organs, the role of the vestibulosympathetic reflex in maintaining blood pressure during orthostasis is not well-established. Examination of the vestibulosympathetic reflex with other cardiovascular reflexes indicates that it is a powerful and independent reflex. Ageing, which is associated with an increased risk for orthostatic hypotension, attenuates the vestibulosympathetic reflex. The attenuated reflex is associated with a reduction in arterial pressure. CONCLUSION: These findings suggest that the vestibulosympathetic reflex assists in blood pressure regulation in humans, but future studies examining this reflex in other orthostatically intolerant populations are necessary to address this hypothesis.

  8. The vestibular system of the owl

    NASA Technical Reports Server (NTRS)

    Money, K. E.; Correia, M. J.

    1973-01-01

    Five owls were given vestibular examinations, and two of them were sacrificed to provide serial histological sections of the temporal bones. The owls exhibited a curious variability in the postrotatory head nystagmus following abrupt deceleration; sometimes a brisk nystagnus with direction opposite to that appropriate to the stimulus would occur promptly after deceleration. It was found also that owls can exhibit a remarkable head stability during angular movement of the body about any axis passing through the skull. The vestibular apparatus in the owl is larger than in man, and a prominent crista neglecta is present. The tectorial membrane, the cupula, and the otolithic membranes of the utricle, saccule, and lagena are all attached to surfaces in addition to the surfaces hearing hair cells. These attachments are very substantial in the utricular otolithic membrane and in the cupula.

  9. Experiment M131. Human vestibular function

    NASA Technical Reports Server (NTRS)

    Graybiel, A.; Miller, E. F., II; Homick, J. L.

    1977-01-01

    The lower susceptibility to vestibular stimulation aloft, compared with that on ground under experimental conditions, is attributed to a precondition, namely, either there is no need to adapt, or, as exemplified by the Skylab 3 pilot, adaptation to weightlessness is achieved. Findings in some of the astronauts emphasize the distinction between two categories of vestibular side effects: immediate reflex phenomena (illusions, sensations of turning, etc.), and delayed epiphenomena that include the constellation of symptoms and syndromes comprising motion sickness. The drug combinations 1-scopolamine and d-amphetamine and promethazine hydrochloride and ephedrine sulfate are effective in prevention and treatment of motion sickness. It is concluded that prevention of motion sickness in any stressful motion environment involves selection, adaptation, and the use of drugs.

  10. Galvanic vestibular stimulation: a novel modulatory countermeasure for vestibular-associated movement disorders.

    PubMed

    Rizzo-Sierra, Carlos V; Gonzalez-Castaño, Alexander; Leon-Sarmiento, Fidias E

    2014-01-01

    Motion sickness or kinetosis is the result of the abnormal neural output originated by visual, proprioceptive and vestibular mismatch, which reverses once the dysfunctional sensory information becomes coherent. The space adaptation syndrome or space sickness relates to motion sickness; it is considered to be due to yaw, pith, and roll coordinates mismatch. Several behavioural and pharmacological measures have been proposed to control these vestibular-associated movement disorders with no success. Galvanic vestibular stimulation has the potential of up-regulating disturbed sensory-motor mismatch originated by kinetosis and space sickness by modulating the GABA-related ion channels neural transmission in the inner ear. It improves the signal-to-noise ratio of the afferent proprioceptive volleys, which would ultimately modulate the motor output restoring the disordered gait, balance and human locomotion due to kinetosis, as well as the spatial disorientation generated by gravity transition. PMID:24637984

  11. Enhanced vestibulo-ocular reflex to electrical vestibular stimulation in Meniere's disease.

    PubMed

    Aw, Swee T; Aw, Grace E; Todd, Michael J; Halmagyi, G Michael

    2013-02-01

    Meniere's disease is characterized by sporadic episodes of vertigo, nystagmus, fluctuating sensorineural hearing loss, tinnitus and aural pressure. Since Meniere's disease can affect different regions of the vestibular labyrinth, we investigated if electrical vestibular stimulation (EVS) which excites the entire vestibular labyrinth may be useful to reveal patchy endorgan pathology. We recorded three-dimensional electrically evoked vestibulo-ocular reflex (eVOR) to transient EVS using bilateral, bipolar 100-ms current steps at intensities of 0.9, 2.5, 5.0, 7.5 and 10.0 mA with dual-search coils in 12 unilateral Meniere's patients. Their results were compared to 17 normal subjects. Normal eVOR had tonic and phasic spatiotemporal properties best described by the torsional component, which was four times larger than horizontal and vertical components. At EVS onset and offset of 8.9 ms latency, there were phasic eVOR initiation (M = 1,267 °/s(2)) and cessation (M = -1,675 °/s(2)) acceleration pulses, whereas during the constant portion of the EVS, there was a maintained tonic eVOR (M = 9.1 °/s) at 10 mA. However in Meniere's disease, whilst latency of EVS onset and offset was normal at 9.0 ms, phasic eVOR initiation (M = 1,720 °/s(2)) and cessation (M = -2,523 °/s(2)) were enlarged at 10 mA. The initiation profile was a bimodal response, whilst the cessation profile frequently did not return to baseline. The tonic eVOR (M = 20.5 °/s) exhibited a ramped enhancement of about twice normal at 10 mA. Tonic eVOR enhancement was present for EVS >0.9 mA and disproportionately enhanced the torsional, vertical and horizontal components. These eVOR abnormalities may be a diagnostic indicator of Meniere's disease and may explain the vertigo attacks in the presence of declining mechanically evoked vestibular responses.

  12. Audiovestibular Function Deficits in Vestibular Schwannoma

    PubMed Central

    2016-01-01

    Introduction. Vestibular schwannomas (VS) are benign tumours of the vestibular nerve and can lead to hearing loss, tinnitus, vertigo, facial palsy, and brainstem compression. Audiovestibular diagnostic tests are essential for detection and treatment planning. Methods. Medline was used to perform a systematic literature review with regard to how audiovestibular test parameters correlate with symptoms, tumour size, and tumour location. Results. The auditory brainstem response can be used to diagnose retrocochlear lesions caused by VS. Since hearing loss correlates poorly with tumour size, a retrocochlear lesion is probably not the only cause for hearing loss. Also cochlear mechanisms seem to play a role. This can be revealed by abnormal otoacoustic emissions, despite normal ABR and new MRI techniques which have demonstrated endolymphatic hydrops of the inner ear. Caloric and head impulse tests show frequency specific dynamics and vestibular evoked myogenic potentials may help to identify the location of the tumour regarding the involved nerve parts. Conclusion. In order to preserve audiovestibular function in VS, it is important to stop the growth of the tumour and to avoid degenerative changes in the inner ear. A detailed neurotological workup helps to diagnose VS of all sizes and can also provide useful prognostic information. PMID:27747231

  13. Vestibular compensation and orientation during locomotion

    NASA Technical Reports Server (NTRS)

    Raphan, T.; Imai, T.; Moore, S. T.; Cohen, B.

    2001-01-01

    Body, head, and eye movements were studied in three dimensions while walking and turning to determine the role of the vestibular system in directing gaze and maintaining spatial orientation. The body, head, and eyes were represented as three-dimensional coordinate frames, and the movement of these frames was related to a trajectory frame that described the motion of the body on a terrestrial plane. The axis-angle of the body, head, and eye rotation were then compared to the axis-angle of the rotation of the gravitoinertial acceleration (GIA). We inferred the role of the vestibular system during locomotion and the contributions of the VCR and VOR by examining the interrelationship between these coordinate frames. Straight walking induced head and eye rotations in a compensatory manner to the linear accelerations, maintaining head pointing and gaze along the direction of forward motion. Turning generated a combination of compensation and orientation responses. The head leads and steers the turn while the eyes compensate to maintain stable horizontal gaze in space. Saccades shift horizontal gaze as the turn is executed. The head pitches, as during straight walking. It also rolls so that the head tends to align with the orientation of the GIA. Head orientation changes anticipate orientation changes of the GIA. Eye orientation follows the changes in GIA orientation so that the net orientation gaze is closer to the orientation of the GIA. The study indicates that the vestibular system utilizes compensatory and orienting mechanisms to stabilize spatial orientation and gaze during walking and turning.

  14. Radiotherapy for Vestibular Schwannomas: A Critical Review

    SciTech Connect

    Murphy, Erin S.; Suh, John H.

    2011-03-15

    Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation to >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.

  15. 48 CFR 30.603-2 - Unilateral and desirable changes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... changes. 30.603-2 Section 30.603-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... Unilateral and desirable changes. (a) Unilateral changes. (1) The contractor may unilaterally change its... the aggregate, as a result of the unilateral change. (2) Prior to making any contract price or...

  16. Integration of vestibular and head movement signals in the vestibular nuclei during whole-body rotation

    NASA Technical Reports Server (NTRS)

    Gdowski, G. T.; McCrea, R. A.; Peterson, B. W. (Principal Investigator)

    1999-01-01

    Single-unit recordings were obtained from 107 horizontal semicircular canal-related central vestibular neurons in three alert squirrel monkeys during passive sinusoidal whole-body rotation (WBR) while the head was free to move in the yaw plane (2.3 Hz, 20 degrees /s). Most of the units were identified as secondary vestibular neurons by electrical stimulation of the ipsilateral vestibular nerve (61/80 tested). Both non-eye-movement (n = 52) and eye-movement-related (n = 55) units were studied. Unit responses recorded when the head was free to move were compared with responses recorded when the head was restrained from moving. WBR in the absence of a visual target evoked a compensatory vestibulocollic reflex (VCR) that effectively reduced the head velocity in space by an average of 33 +/- 14%. In 73 units, the compensatory head movements were sufficiently large to permit the effect of the VCR on vestibular signal processing to be assessed quantitatively. The VCR affected the rotational responses of different vestibular neurons in different ways. Approximately one-half of the units (34/73, 47%) had responses that decreased as head velocity decreased. However, the responses of many other units (24/73) showed little change. These cells had signals that were better correlated with trunk velocity than with head velocity. The remaining units had responses that were significantly larger (15/73, 21%) when the VCR produced a decrease in head velocity. Eye-movement-related units tended to have rotational responses that were correlated with head velocity. On the other hand, non-eye-movement units tended to have rotational responses that were better correlated with trunk velocity. We conclude that sensory vestibular signals are transformed from head-in-space coordinates to trunk-in-space coordinates on many secondary vestibular neurons in the vestibular nuclei by the addition of inputs related to head rotation on the trunk. This coordinate transformation is presumably important

  17. Differential central projections of vestibular afferents in pigeons

    NASA Technical Reports Server (NTRS)

    Dickman, J. D.; Fang, Q.

    1996-01-01

    The question of whether a differential distribution of vestibular afferent information to central nuclear neurons is present in pigeons was studied using neural tracer compounds. Discrete tracing of afferent fibers innervating the individual semicircular canal and otolith organs was produced by sectioning individual branches of the vestibular nerve that innervate the different receptor organs and applying crystals of horseradish peroxidase, or a horseradish peroxidase/cholera toxin mixture, or a biocytin compound for neuronal uptake and transport. Afferent fibers and their terminal distributions within the brainstem and cerebellum were visualized subsequently. Discrete areas in the pigeon central nervous system that receive primary vestibular input include the superior, dorsal lateral, ventral lateral, medial, descending, and tangential vestibular nuclei; the A and B groups; the intermediate, medial, and lateral cerebellar nuclei; and the nodulus, the uvula, and the paraflocculus. Generally, the vertical canal afferents projected heavily to medial regions in the superior and descending vestibular nuclei as well as the A group. Vertical canal projections to the medial and lateral vestibular nuclei were observed but were less prominent. Horizontal canal projections to the superior and descending vestibular nuclei were much more centrally located than those of the vertical canals. A more substantial projection to the medial and lateral vestibular nuclei was seen with horizontal canal afferents compared to vertical canal fibers. Afferents innervating the utricle and saccule terminated generally in the lateral regions of all vestibular nuclei in areas that were separate from the projections of the semicircular canals. In addition, utricular fibers projected to regions in the vestibular nuclei that overlapped with the horizontal semicircular canal terminal fields, whereas saccular afferents projected to regions that received vertical canal fiber terminations. Lagenar

  18. Unilateral Radiotherapy for the Treatment of Tonsil Cancer

    SciTech Connect

    Chronowski, Gregory M.; Garden, Adam S.; Morrison, William H.; Frank, Steven J.; Schwartz, David L.; Shah, Shalin J.; Beadle, Beth M.; Gunn, G. Brandon; Kupferman, Michael E.; Ang, Kian K.; Rosenthal, David I.

    2012-05-01

    Purpose: To assess, through a retrospective review, clinical outcomes of patients with squamous cell carcinoma of the tonsil treated at the M. D. Anderson Cancer Center with unilateral radiotherapy techniques that irradiate the involved tonsil region and ipsilateral neck only. Methods and Materials: Of 901 patients with newly diagnosed squamous cell carcinoma of the tonsil treated with radiotherapy at our institution, we identified 102 that were treated using unilateral radiotherapy techniques. All patients had their primary site of disease restricted to the tonsillar fossa or anterior pillar, with <1 cm involvement of the soft palate. Patients had TX (n = 17 patients), T1 (n = 52), or T2 (n = 33) disease, with Nx (n = 3), N0 (n = 33), N1 (n = 23), N2a (n = 21), or N2b (n = 22) neck disease. Results: Sixty-one patients (60%) underwent diagnostic tonsillectomy before radiotherapy. Twenty-seven patients (26%) underwent excision of a cervical lymph node or neck dissection before radiotherapy. Median follow-up for surviving patients was 38 months. Locoregional control at the primary site and ipsilateral neck was 100%. Two patients experienced contralateral nodal recurrence (2%). The 5-year overall survival and disease-free survival rates were 95% and 96%, respectively. The 5-year freedom from contralateral nodal recurrence rate was 96%. Nine patients required feeding tubes during therapy. Of the 2 patients with contralateral recurrence, 1 experienced an isolated neck recurrence and was salvaged with contralateral neck dissection only and remains alive and free of disease. The other patient presented with a contralateral base of tongue tumor and involved cervical lymph node, which may have represented a second primary tumor, and died of disease. Conclusions: Unilateral radiotherapy for patients with TX-T2, N0-N2b primary tonsil carcinoma results in high rates of disease control, with low rates of contralateral nodal failure and a low incidence of acute toxicity

  19. A study of whirlin isoforms in the mouse vestibular system suggests potential vestibular dysfunction in DFNB31-deficient patients.

    PubMed

    Mathur, Pranav Dinesh; Vijayakumar, Sarath; Vashist, Deepti; Jones, Sherri M; Jones, Timothy A; Yang, Jun

    2015-12-15

    The DFNB31 gene plays an indispensable role in the cochlea and retina. Mutations in this gene disrupt its various isoforms and lead to non-syndromic deafness, blindness and deaf-blindness. However, the known expression of Dfnb31, the mouse ortholog of DFNB31, in vestibular organs and the potential vestibular-deficient phenotype observed in one Dfnb31 mutant mouse (Dfnb31(wi/wi)) suggest that DFNB31 may also be important for vestibular function. In this study, we find that full-length (FL-) and C-terminal (C-) whirlin isoforms are expressed in the vestibular organs, where their stereociliary localizations are similar to those of developing cochlear inner hair cells. No whirlin is detected in Dfnb31(wi/wi) vestibular organs, while only C-whirlin is expressed in Dfnb31(neo/neo) vestibular organs. Both FL- and C-whirlin isoforms are required for normal vestibular stereociliary growth, although they may play slightly different roles in the central and peripheral zones of the crista ampullaris. Vestibular sensory-evoked potentials demonstrate severe to profound vestibular deficits in Dfnb31(neo/neo) and Dfnb31(wi/wi) mice. Swimming and rotarod tests demonstrate that the two Dfnb31 mutants have balance problems, with Dfnb31(wi/wi) mice being more affected than Dfnb31(neo/neo) mice. Because Dfnb31(wi/wi) and Dfnb31(neo/neo) mice faithfully recapitulate hearing and vision symptoms in patients, our findings of vestibular dysfunction in these Dfnb31 mutants raise the question of whether DFNB31-deficient patients may acquire vestibular as well as hearing and vision loss.

  20. A study of whirlin isoforms in the mouse vestibular system suggests potential vestibular dysfunction in DFNB31-deficient patients.

    PubMed

    Mathur, Pranav Dinesh; Vijayakumar, Sarath; Vashist, Deepti; Jones, Sherri M; Jones, Timothy A; Yang, Jun

    2015-12-15

    The DFNB31 gene plays an indispensable role in the cochlea and retina. Mutations in this gene disrupt its various isoforms and lead to non-syndromic deafness, blindness and deaf-blindness. However, the known expression of Dfnb31, the mouse ortholog of DFNB31, in vestibular organs and the potential vestibular-deficient phenotype observed in one Dfnb31 mutant mouse (Dfnb31(wi/wi)) suggest that DFNB31 may also be important for vestibular function. In this study, we find that full-length (FL-) and C-terminal (C-) whirlin isoforms are expressed in the vestibular organs, where their stereociliary localizations are similar to those of developing cochlear inner hair cells. No whirlin is detected in Dfnb31(wi/wi) vestibular organs, while only C-whirlin is expressed in Dfnb31(neo/neo) vestibular organs. Both FL- and C-whirlin isoforms are required for normal vestibular stereociliary growth, although they may play slightly different roles in the central and peripheral zones of the crista ampullaris. Vestibular sensory-evoked potentials demonstrate severe to profound vestibular deficits in Dfnb31(neo/neo) and Dfnb31(wi/wi) mice. Swimming and rotarod tests demonstrate that the two Dfnb31 mutants have balance problems, with Dfnb31(wi/wi) mice being more affected than Dfnb31(neo/neo) mice. Because Dfnb31(wi/wi) and Dfnb31(neo/neo) mice faithfully recapitulate hearing and vision symptoms in patients, our findings of vestibular dysfunction in these Dfnb31 mutants raise the question of whether DFNB31-deficient patients may acquire vestibular as well as hearing and vision loss. PMID:26420843

  1. Vestibular and optokinetic responses of the white cat.

    PubMed

    Waldorf, R A; Polsinelli, D J; Knister, J R; Kohut, R I

    1977-01-01

    The vestibular and optokinetic responses of a group of white cats were evaluated and compared with the responses from a control group of pigmented animals. The results indicate that in all cases the white cats exhibited varying degrees of vestibular and/or optokinetic dysfunction, which in some animals varied from test session to test session.

  2. Sensory processing in the vestibular nuclei during active head movements

    NASA Technical Reports Server (NTRS)

    Gdowski, G. T.; Boyle, R.; McCrea, R. A.; Peterson, B. W. (Principal Investigator)

    2000-01-01

    Many secondary vestibular neurons are sensitive to head on trunk rotation during reflex-induced and voluntary head movements. During passive whole body rotation the interaction of head on trunk signals related to the vestibulo-collic reflex with vestibular signals increases the rotational gain of many secondary vestibular neurons, including many that project to the spinal cord. In some units, the sensitivity to head on trunk and vestibular input is matched and the resulting interaction produces an output that is related to the trunk velocity in space. In other units the head on trunk inputs are stronger and the resulting interaction produces an output that is larger during the reflex. During voluntary head movements, inputs related to head on trunk movement combine destructively with vestibular signals, and often cancel the sensory reafferent consequences of self-generated movements. Cancellation of sensory vestibular signals was observed in all of the antidromically identified secondary vestibulospinal units, even though many of these units were not significantly affected by reflexive head on trunk movements. The results imply that the inputs to vestibular neurons related to head on trunk rotation during reflexive and voluntary movements arise from different sources. We suggest that the relative strength of reflexive head on trunk input to different vestibular neurons might reflect the different functional roles they have in controlling the posture of the neck and body.

  3. Vestibular and visual responses in human posterior insular cortex.

    PubMed

    Frank, Sebastian M; Baumann, Oliver; Mattingley, Jason B; Greenlee, Mark W

    2014-11-15

    The central hub of the cortical vestibular network in humans is likely localized in the region of posterior lateral sulcus. An area characterized by responsiveness to visual motion has previously been described at a similar location and named posterior insular cortex (PIC). Currently it is not known whether PIC processes vestibular information as well. We localized PIC using visual motion stimulation in functional magnetic resonance imaging (fMRI) and investigated whether PIC also responds to vestibular stimuli. To this end, we designed an MRI-compatible caloric stimulation device that allowed us to stimulate bithermally with hot temperature in one ear and simultaneously cold temperature in the other or with warm temperatures in both ears for baseline. During each trial, participants indicated the presence or absence of self-motion sensations. We found activation in PIC during periods of self motion when vestibular stimulation was carried out with minimal visual input. In combined visual-vestibular stimulation area PIC was activated in a similar fashion during congruent and incongruent stimulation conditions. Our results show that PIC not only responds to visual motion but also to vestibular stimuli related to the sensation of self motion. We suggest that PIC is part of the cortical vestibular network and plays a role in the integration of visual and vestibular stimuli for the perception of self motion.

  4. Effect of meprobamate on the vestibulosensory and vestibular somatic reaction

    NASA Technical Reports Server (NTRS)

    Khinchikashvili, N. V.

    1980-01-01

    The influence of meprobamate on the vestibular illusion of counter-rotation, movement coordination and vertical writing was investigated by a double blind trial method and placebo. The results confirm the possibility of the meprobamate application for prophylaxis and correction of vestibular disturbances.

  5. Vestibular influences on autonomic cardiovascular control in humans

    NASA Technical Reports Server (NTRS)

    Biaggioni, I.; Costa, F.; Kaufmann, H.; Robertson, D. (Principal Investigator)

    1998-01-01

    There is substantial evidence that anatomical connections exist between vestibular and autonomic nuclei. Animal studies have shown functional interactions between the vestibular and autonomic systems. The nature of these interactions, however, is complex and has not been fully defined. Vestibular stimulation has been consistently found to reduce blood pressure in animals. Given the potential interaction between vestibular and autonomic pathways this finding could be explained by a reduction in sympathetic activity. However, rather than sympathetic inhibition, vestibular stimulation has consistently been shown to increase sympathetic outflow in cardiac and splanchnic vascular beds in most experimental models. Several clinical observations suggest that a link between vestibular and autonomic systems may also exist in humans. However, direct evidence for vestibular/autonomic interactions in humans is sparse. Motion sickness has been found to induce forearm vasodilation and reduce baroreflex gain, and head down neck flexion induces transient forearm and calf vasoconstriction. On the other hand, studies using optokinetic stimulation have found either very small, variable, or inconsistent changes in heart rate and blood pressure, despite substantial symptoms of motion sickness. Furthermore, caloric stimulation severe enough to produce nystagmus, dizziness, and nausea had no effect on sympathetic nerve activity measured directly with microneurography. No effect was observed on heart rate, blood pressure, or plasma norepinephrine. Several factors may explain the apparent discordance of these results, but more research is needed before we can define the potential importance of vestibular input to cardiovascular regulation and orthostatic tolerance in humans.

  6. Body ownership and embodiment: vestibular and multisensory mechanisms.

    PubMed

    Lopez, C; Halje, P; Blanke, O

    2008-06-01

    Body ownership and embodiment are two fundamental mechanisms of self-consciousness. The present article reviews neurological data about paroxysmal illusions during which body ownership and embodiment are affected differentially: autoscopic phenomena (out-of-body experience, heautoscopy, autoscopic hallucination, feeling-of-a-presence) and the room tilt illusion. We suggest that autoscopic phenomena and room tilt illusion are related to different types of failures to integrate body-related information (vestibular, proprioceptive and tactile cues) in addition to a mismatch between vestibular and visual references. In these patients, altered body ownership and embodiment has been shown to occur due to pathological activity at the temporoparietal junction and other vestibular-related areas arguing for a key importance of vestibular processing. We also review the possibilities of manipulating body ownership and embodiment in healthy subjects through exposition to weightlessness as well as caloric and galvanic stimulation of the peripheral vestibular apparatus. In healthy subjects, disturbed self-processing might be related to interference of vestibular stimulation with vestibular cortex leading to disintegration of bodily information and altered body ownership and embodiment. We finally propose a differential contribution of the vestibular cortical areas to the different forms of altered body ownership and embodiment.

  7. A Computational Framework for Electrical Stimulation of Vestibular Nerve.

    PubMed

    Marianelli, Prisca; Capogrosso, Marco; Bassi Luciani, Lorenzo; Panarese, Alessandro; Micera, Silvestro

    2015-09-01

    The vestibular organs are very important to generate reflexes critical for stabilizing gaze and body posture. Vestibular diseases significantly reduce the quality of life of people who are affected by them. Some research groups have recently started developing vestibular neuroprostheses to mitigate these symptoms. However, many scientific and technological issues need to be addressed to optimise their use in clinical trials. We developed a computational model able to mimic the response of human vestibular nerves and which can be exploited for "in-silico" testing of new strategies to design implantable vestibular prostheses. First, a digital model of the vestibular system was reconstructed from anatomical data. Monopolar stimulation was delivered at different positions and distances from ampullary nerves. The electrical potential induced by the injected current was computed through finite-element methods and drove extra-cellular stimulation of fibers in the vestibular, facial, and cochlear nerves. The electrical activity of vestibular nerves and the resulting eye movements elicited by different stimulation protocols were investigated. A set of electrode configurations was analyzed in terms of selectivity at increasing injected current. Electrode position along the nerve plays a major role in producing undesired activity in other nontargeted nerves, whereas distance from the fiber does not significantly affect selectivity. Indications are provided to minimize misalignment in nonoptimal electrode locations. Eye movements elicited by the different stimulation protocols are calculated and compared to experimental values, for the purpose of model validation. PMID:25751868

  8. Making Sense of the Body: the Role of Vestibular Signals.

    PubMed

    Lopez, Christophe

    2015-01-01

    The role of the vestibular system in posture and eye movement control has been extensively described. By contrast, how vestibular signals contribute to bodily perceptions is a more recent research area in the field of cognitive neuroscience. In the present review article, I will summarize recent findings showing that vestibular signals play a crucial role in making sense of the body. First, data will be presented showing that vestibular signals contribute to bodily perceptions ranging from low-level bodily perceptions, such as touch, pain, and the processing of the body's metric properties, to higher level bodily perceptions, such as the sense of owning a body, the sense of being located within this body (embodiment), and the anchoring of the visuo-spatial perspective to this body. In the second part of the review article, I will show that vestibular information seems to be crucially involved in the visual perception of biological motion and in the visual perception of human body structure. Reciprocally, observing human bodies in motion influences vestibular self-motion perception, presumably due to sensorimotor resonance between the self and others. I will argue that recent advances in the mapping of the human vestibular cortex afford neuroscientific models of the vestibular contributions to human bodily self-consciousness.

  9. Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas.

    PubMed

    Ozkur, Ezgi; Falay, Tugba; Turgut Erdemir, Asli Vefa; Gurel, Mehmet Salih; Leblebici, Cem

    2016-01-01

    Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva. PMID:27136629

  10. Regeneration of hair cells in the mammalian vestibular system.

    PubMed

    Li, Wenyan; You, Dan; Chen, Yan; Chai, Renjie; Li, Huawei

    2016-06-01

    Hair cells regenerate throughout the lifetime of non-mammalian vertebrates, allowing these animals to recover from hearing and balance deficits. Such regeneration does not occur efficiently in humans and other mammals. Thus, balance deficits become permanent and is a common sensory disorder all over the world. Since Forge and Warchol discovered the limited spontaneous regeneration of vestibular hair cells after gentamicininduced damage in mature mammals, significant efforts have been exerted to trace the origin of the limited vestibular regeneration in mammals after hair cell loss. Moreover, recently many strategies have been developed to promote the hair cell regeneration and subsequent functional recovery of the vestibular system, including manipulating the Wnt, Notch and Atoh1. This article provides an overview of the recent advances in hair cell regeneration in mammalian vestibular epithelia. Furthermore, this review highlights the current limitations of hair cell regeneration and provides the possible solutions to regenerate functional hair cells and to partially restore vestibular function.

  11. Vestibular disorders following different types of head and neck trauma

    PubMed Central

    Kolev, Ognyan I.; Sergeeva, Michaela

    2016-01-01

    Summary This review focuses on the published literature on vestibular disorders following different types of head and neck trauma. Current knowledge of the different causes and underlying mechanisms of vestibular disorders, as well as the sites of organic damage, is presented. Non-organic mechanisms are also surveyed. The frequency of occurrence of vestibular symptoms, and of other accompanying subjective complaints, associated with different types of trauma is presented and related to the specific causes. Hypotheses about the pathogenesis of traumatic vestibular disorders are presented, and the knowledge derived from animal experiments is also discussed. We believe this to be a very important topic, since vestibular complaints in traumatic patients often remain undiagnosed or underestimated in clinical practice. This review article aims to suggest directions for additional research and to provide guidance to both the scientific and clinical practice communities. PMID:27358219

  12. Congenital and compensated vestibular dysfunction in childhood: an overlooked entity.

    PubMed

    Weiss, Avery H; Phillips, James O

    2006-07-01

    We report five children with previously unrecognized vestibular dysfunction detected by clinical examination and confirmed by quantitative vestibular testing. Patient 1 presented with fluctuating visual acuity and intermittent nystagmus. Patient 2 had congenital hearing loss associated with imbalance, delayed motor development, and cyclic vomiting. Patient 3 had neurotrophic keratitis with an intermittent head tilt, imbalance, and motor delays. Patient 4 showed ataxia and eye movement abnormalities following traumatic brain injury and had reading difficulties. Patient 5 had episodic vertigo and eye movement abnormalities from infancy. Clinical vestibular testing emphasized spontaneous nystagmus, rapid head thrust, and assessment of post-rotatory nystagmus. Quantitative vestibular testing included the sinusoidal chair rotation and velocity step tests, measurement of dynamic visual acuity, post-head-shake nystagmus, and computerized platform posturography. Pediatric neurologists encounter children with congenital and compensated vestibular dysfunction, which can be recognized on the basis of relevant history and clinical abnormalities of the ocular-ocular reflex.

  13. Anatomical and Physiological Considerations in Vestibular Dysfunction and Compensation

    PubMed Central

    Jones, Sherri M.; Jones, Timothy A.; Mills, Kristal N.; Gaines, G. Christopher

    2010-01-01

    Sensory information from the vestibular, visual, and somatosensory/proprioceptive systems are integrated in the brain in complex ways to produce a final motor output to muscle groups for maintaining gaze, head and body posture, and controlling static and dynamic balance. The balance system is complex, which can make differential diagnosis of dizziness quite challenging. On the other hand, this complex system is organized anatomically in a variety of pathways and some of these pathways have been well studied. The vestibulo-ocular reflex (VOR) is one such pathway. Understanding the anatomy and physiology of the VOR facilitates our understanding of normal and abnormal eye movements and research is advancing our understanding of the plasticity of the vestibular system. This review highlights anatomical and physiological features of the normal vestibular system, applies these concepts to explain some clinical findings in some common peripheral vestibular disorders, and discusses some of the research investigating the anatomical and physiological basis for vestibular compensation. PMID:21072129

  14. The Computerized Table Setting Test for Detecting Unilateral Neglect

    PubMed Central

    Ye, Byoung Seok; Lee, Hye Sun; Chang, Hyuk-Jae; Song, Dongbeom; Kim, Young Dae; Heo, Ji Hoe; Nam, Hyo Suk

    2016-01-01

    Background Patients with unilateral neglect fail to respond normally to stimuli on the left side. To facilitate the evaluation of unilateral spatial neglect, we developed a new application that runs on a tablet device and investigated its feasibility in stroke patients. Methods We made the computerized table setting test (CTST) to run on the tablet computer. Forty acute ischemic stroke patients (20 patients with right hemispheric infarction with neglect, 10 patients with right hemispheric infarction without neglect, and 10 patients with left hemispheric infarction) and 10 healthy controls were prospectively enrolled to validate the CTST. The test requires subjects to set a table by dragging 12 dishes located below the table on the tablet screen. The horizontal deviation of the 12 dishes from the midline of the table, the selection tendency measured by the sequence of the dish selection, and the elapsed time for table setting were calculated automatically. Results Parameters measured by the CTST were correlated with the results of conventional neglect tests. The horizontal deviation was significantly higher in patients with right hemispheric infarction with neglect compared with the other groups. The selection tendency and elapsed time also were significantly different in patients with right hemispheric infarction with neglect compared with the left hemispheric infarction and control groups, but were similar to those with right hemispheric infarction without neglect. Conclusions The CTST is feasible to administer and comparable with conventional neglect tests. This new application may be useful for the initial diagnosis and follow-up of neglect patients. PMID:26771512

  15. The role of the vestibular system in manual target localization

    NASA Technical Reports Server (NTRS)

    Barry, Susan R.; Mueller, S. Alyssa

    1995-01-01

    Astronauts experience perceptual and sensory-motor disturbances during spaceflight and immediately after return to the 1-g environment of Earth. During spaceflight, sensory information from the eyes, limbs and vestibular organs is reinterpreted by the central nervous system so that astronauts can produce appropriate body movements in microgravity. Alterations in sensory-motor function may affect eye-head-hand coordination and, thus, the crewmember's ability to manually locate objects in extrapersonal space. Previous reports have demonstrated that crewmembers have difficulty in estimating joint and limb position and in pointing to memorized target positions on orbit and immediately postflight. One set of internal cues that may assist in the manual localization of objects is information from the vestibular system. This system contributes to our sense of the body's position in space by providing information on head position and movement and the orientation of the body with respect to gravity. Research on the vestibular system has concentrated on its role in oculo-motor control. Little is known about the role that vestibular information plays in manual motor control, such as reaching and pointing movements. Since central interpretation of vestibular information is altered in microgravity, it is important to determine its role in this process. This summer, we determined the importance of vestibular information in a subject's ability to point accurately toward a target in extrapersonal space. Subjects were passively rotated across the earth-vertical axis and then asked to point back to a previously-seen target. In the first paradigm, the subjects used both visual and vestibular cues for the pointing response, while, in the second paradigm, subjects used only vestibular information. Subjects were able to point with 85 percent accuracy to a target using vestibular information alone. We infer from this result that vestibular input plays a role in the spatial programming of

  16. Isolated Unilateral Ptosis due to Paramedian Midbrain Infarction.

    PubMed

    Sugawara, Eriko; Nakamura, Haruko; Endo, Masanao; Tanaka, Fumiaki; Takahashi, Tatsuya

    2015-05-01

    A 59-year-old man who had hypertension, dyslipidemia, diabetes mellitus, and left eye glaucoma developed sudden vertigo and left ptosis; he did not notice diplopia. He visited our hospital on day 3 after onset and neurologic examination showed left ptosis. His left visual acuity was counting fingers, and the light reflex was sluggish owing to glaucoma. Pupil sizes were equal, and eye movements and the lower lid were unremarkable. Magnetic resonance images revealed an acute infarction of the left paramedian midbrain. We considered that selective damage to the oculomotor fascicles innervating the left levator palpebrae superioris caused ipsilateral ptosis. As the fascicles for this ocular muscle run in the small area adjacent to those for the medial rectus, inferior rectus and superior rectus muscles, this is an extremely rare case of midbrain infarction presenting with isolated unilateral ptosis.

  17. Human Vestibular Function - Skylab Experiment M131

    NASA Technical Reports Server (NTRS)

    1972-01-01

    This set of photographs details Skylab's Human Vestibular Function experiment (M131). This experiment was a set of medical studies designed to determine the effect of long-duration space missions on astronauts' coordination abilities. This experiment tested the astronauts susceptibility to motion sickness in the Skylab environment, acquired data fundamental to an understanding of the functions of human gravity reception under prolonged absence of gravity, and tested for changes in the sensitivity of the semicircular canals. Data from this experiment was collected before, during, and after flight. The Marshall Space Flight Center had program management responsibility for the development of Skylab hardware and experiments.

  18. Experiment M-131 - Human vestibular function.

    NASA Technical Reports Server (NTRS)

    Miller, E. F., II; Graybiel, A.

    1973-01-01

    The purpose of the M-131 experiment is to measure responses in astronauts throughout orbital flight that reflect vestibular function and compare them with measurements made before and after flight. Three subtasks require measurement of (1) susceptibility to motion sickness, (2) thresholds of response to stimulation of the semicircular canals, and (3) space perception, viz, visual and nonvisual localization, using external spacecraft and internal morphological frames of reference. Four astronauts will be available for all measurements in Skylab 2 and 3 and two additional astronauts for only the 'static' measurements during the flights.

  19. Vestibular function in the space environment

    NASA Technical Reports Server (NTRS)

    Von Baumgarten, R. J.; Harth, O.; Thuemler, R.; Baldrighi, G.; Shillinger, G. L., Jr.

    1975-01-01

    The present work presents new results about the interdependence of optical illusory sensations and eye movements in man. To establish to what degree certain illusions previously obtained during centrifugation and parabolic flight can be explained by eye movements and by neuronal integration in the brain, real eye movements were measured as they occurred in the dark without optical fixation, during rectilinear accelerations on the ground, and during weightlessness in parabolic flight. Results provide valuable insight into normal vestibular function as well as resolution of within-the-eye and behind-the-eye contributions to the above illusions.

  20. Causative factors in unilateral giant papillary conjunctivitis.

    PubMed

    Palmisano, P C; Ehlers, W H; Donshik, P C

    1993-04-01

    Giant papillary conjunctivitis (GPC) is usually a bilateral disease. However, in a small number of cases, GPC can be manifested as a unilateral, or a markedly asymmetrical disease in patients wearing bilateral contact lenses. We reviewed the clinical records of 148 patients with GPC to determine the incidence of unilateral GPC and its causative factors. Specifically, charts were reviewed for data on refractive error, keratometry, lens fit, lens care, lens replacement, and the presence or absence of associated ocular abnormalities (dry eyes, blepharitis, previous injury, or surgery). Fourteen patients with unilateral or markedly asymmetrical disease were identified. Overall, no statistically significant difference was found in lens care, refractive error, or keratometric measurements in the affected and unaffected eyes. While not statistically significant, infrequent lens replacement appears to be an important factor in the development of unilateral GPC. Three patients had a history of wearing an older lens in the GPC eye. Two patients were found with unilateral meibomian gland dysfunction involving the affected eye, and one patient had undergone surgery on the affected eye. No causative factor was identified in eight cases.

  1. Altered vestibular function in fetal and newborn rats gestated in space

    NASA Technical Reports Server (NTRS)

    Ronca, A. E.; Alberts, J. R.

    1997-01-01

    Researchers evaluated vestibular development and function in rat pups flown during gestation on the NASA-NIH R1 and R2 missions. Fetal and postnatal vestibular function were examined. Altered vestibular-mediated responses in the experimental fetal pups are attributed to either direct effect of gravity on the vestibular system or indirect effects of microgravity transduced through the mother. The postnatal tests confirmed the hypothesis that the vestibular system continually adapts and responds to tonic stimulation.

  2. A unique case of unilateral synophthalmia.

    PubMed

    Proia, Alan D

    2011-01-01

    Developmental anomalies resulting in a single eye (cyclopia) or fusion of the eyes (synophthalmia) are rare. Examples of unilateral synophthalmia-in which there are 1 normal and 2 fused eyes from 3 anlagen in 2 orbits, 1 lateral proboscis, and 3 optic nerves-are even more rare. Herein, I report a unique fetus with unilateral synophthalmia that was not associated with a lateral proboscis but instead had an extra cerebral hemisphere. I postulate that the unilateral synophthalmia, accessory cerebral hemisphere, and minor structural abnormalities in the skull base were the result of failure in separating a monozygous twin, a situation similar to that postulated as the cause of fetus in fetu. PMID:20528261

  3. Unilateral hyperhydrosis in Pourfour du Petit syndrome.

    PubMed

    Kara, Murat; Dikmen, Erkan; Akarsu, Cengiz; Birol, Ahu

    2004-08-01

    Upper limp hyperhydrosis is an idiopathic disease with bilateral involvement. However, Pourfour du Petit syndrome, the opposite of Horner syndrome, may result in unilateral upper limb hyperhydrosis. It occurs following hyperactivity of the sympathetic cervical chain as a consequence of irritation secondary to trauma. We report herein two cases with Pourfour du Petit syndrome showing unilateral upper limb hyperhydrosis. The patients presented with right-sided mydriasis and ipsilateral hemifacial hyperhydrosis. The onset of disease was followed by a trauma in both patients. They underwent upper thoracic sympathectomy with favorable outcome. A history of an antecedent trauma in patients with unilateral upper limb hyperhydrosis and anisocoria may imply a possible diagnosis of Pourfour du Petit syndrome. PMID:15296919

  4. Unilateral asterixis, thalamic astasia and vertical one and half syndrome in a unilateral posterior thalamo-subthalamic paramedian infarct: An interesting case report.

    PubMed

    Ramakrishnan, Subasree; Narayanaswamy, Veera Rajkumar

    2013-04-01

    A 42-year-old young lady presented with acute onset of dizziness, drooping of left eye with binocular diplopia and inability to walk unassisted. She had past history of uncontrolled diabetes mellitus and hypertension. On examination, she had left fascicular type of third nerve palsy, vertical one and half syndrome (VOHS), left internuclear ophthalmoplegia and skew deviation with ipsilesional hypertropia. She also had thalamic astasia and right unilateral asterixis. Her MRI revealed T2 and Flair hyper intense signal changes with restricted diffusion in the left thalamus, subthalamus and left midbrain. MR Angiography was normal. Thalamic-subthalamic paramedian territory infarct is relatively uncommon. It can present with oculomotor abnormalities including vertical one and half syndrome, skew deviation, thalamic astasia and asterixis. This case is reported for the rarity of the presenting clinical findings in unilateral thalamo-mesencephalic infarcts.

  5. Biomimetic smart sensors for autonomous robotic behavior II: vestibular processing

    NASA Astrophysics Data System (ADS)

    Xue, Shuwan; Deligeorges, Socrates; Soloway, Aaron; Lichtenstein, Lee; Gore, Tyler; Hubbard, Allyn

    2009-05-01

    Limited autonomous behaviors are fast becoming a critical capability in the field of robotics as robotic applications are used in more complicated and interactive environments. As additional sensory capabilities are added to robotic platforms, sensor fusion to enhance and facilitate autonomous behavior becomes increasingly important. Using biology as a model, the equivalent of a vestibular system needs to be created in order to orient the system within its environment and allow multi-modal sensor fusion. In mammals, the vestibular system plays a central role in physiological homeostasis and sensory information integration (Fuller et al, Neuroscience 129 (2004) 461-471). At the level of the Superior Colliculus in the brain, there is multimodal sensory integration across visual, auditory, somatosensory, and vestibular inputs (Wallace et al, J Neurophysiol 80 (1998) 1006-1010), with the vestibular component contributing a strong reference frame gating input. Using a simple model for the deep layers of the Superior Colliculus, an off-the-shelf 3-axis solid state gyroscope and accelerometer was used as the equivalent representation of the vestibular system. The acceleration and rotational measurements are used to determine the relationship between a local reference frame of a robotic platform (an iRobot Packbot®) and the inertial reference frame (the outside world), with the simulated vestibular input tightly coupled with the acoustic and optical inputs. Field testing of the robotic platform using acoustics to cue optical sensors coupled through a biomimetic vestibular model for "slew to cue" gunfire detection have shown great promise.

  6. Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns

    PubMed Central

    Bush, Matthew L.; Dougherty, William

    2015-01-01

    Objective Vestibular rehabilitation therapy (VRT) can benefit patients with a variety of balance and vestibular disorders. This expanding field requires knowledgeable and experienced therapists; however, the practice and experience of those providing this care may vary greatly. The purpose of this study was to analyze variations in training and practice patterns among practicing vestibular rehabilitation therapists. Study Design Case-controlled cohort study Setting Investigation of outpatient physical therapy and audiology practices that offer vestibular rehabilitation conducted by a tertiary academic referral center. Main Outcome Measure Questionnaire-based investigation of level of training in vestibular disorders and therapy, practice patterns of vestibular rehabilitation, and referral sources for VRT patients. Results We identified 27 subjects within the state of Kentucky who practice vestibular rehabilitation and the questionnaire response rate was 63%. Responses indicated that 53% of respondents had no training in VRT during their professional degree program. Attendance of a course requiring demonstration of competence and techniques was 24% of participants. The development of VRT certification was significantly more favored by those who attended such courses compared with those who did not (p=0.01). 50% of therapists have direct access to patients without physician referrals. Conclusions There is a wide range of educational background and training among those practicing VRT. This variability in experience may affect care provided within some communities. Certification is not necessary for the practice of VRT but the development of certification is favored among some therapists to improve standardization of practice of this important specialty. PMID:25700790

  7. Cross-Modal Calibration of Vestibular Afference for Human Balance.

    PubMed

    Héroux, Martin E; Law, Tammy C Y; Fitzpatrick, Richard C; Blouin, Jean-Sébastien

    2015-01-01

    To determine how the vestibular sense controls balance, we used instantaneous head angular velocity to drive a galvanic vestibular stimulus so that afference would signal that head movement was faster or slower than actual. In effect, this changed vestibular afferent gain. This increased sway 4-fold when subjects (N = 8) stood without vision. However, after a 240 s conditioning period with stable balance achieved through reliable visual or somatosensory cues, sway returned to normal. An equivalent galvanic stimulus unrelated to sway (not driven by head motion) was equally destabilising but in this situation the conditioning period of stable balance did not reduce sway. Reflex muscle responses evoked by an independent, higher bandwidth vestibular stimulus were initially reduced in amplitude by the galvanic stimulus but returned to normal levels after the conditioning period, contrary to predictions that they would decrease after adaptation to increased sensory gain and increase after adaptation to decreased sensory gain. We conclude that an erroneous vestibular signal of head motion during standing has profound effects on balance control. If it is unrelated to current head motion, the CNS has no immediate mechanism of ignoring the vestibular signal to reduce its influence on destabilising balance. This result is inconsistent with sensory reweighting based on disturbances. The increase in sway with increased sensory gain is also inconsistent with a simple feedback model of vestibular reflex action. Thus, we propose that recalibration of a forward sensory model best explains the reinterpretation of an altered reafferent signal of head motion during stable balance. PMID:25894558

  8. Diversity of vestibular nuclei neurons targeted by cerebellar nodulus inhibition

    PubMed Central

    Meng, Hui; Blázquez, Pablo M; Dickman, J David; Angelaki, Dora E

    2014-01-01

    Abstract A functional role of the cerebellar nodulus and ventral uvula (lobules X and IXc,d of the vermis) for vestibular processing has been strongly suggested by direct reciprocal connections with the vestibular nuclei, as well as direct vestibular afferent inputs as mossy fibres. Here we have explored the types of neurons in the macaque vestibular nuclei targeted by nodulus/ventral uvula inhibition using orthodromic identification from the caudal vermis. We found that all nodulus-target neurons are tuned to vestibular stimuli, and most are insensitive to eye movements. Such non-eye-movement neurons are thought to project to vestibulo-spinal and/or thalamo-cortical pathways. Less than 20% of nodulus-target neurons were sensitive to eye movements, suggesting that the caudal vermis can also directly influence vestibulo-ocular pathways. In general, response properties of nodulus-target neurons were diverse, spanning the whole continuum previously described in the vestibular nuclei. Most nodulus-target cells responded to both rotation and translation stimuli and only a few were selectively tuned to translation motion only. Other neurons were sensitive to net linear acceleration, similar to otolith afferents. These results demonstrate that, unlike the flocculus and ventral paraflocculus which target a particular cell group, nodulus/ventral uvula inhibition targets a large diversity of cell types in the vestibular nuclei, consistent with a broad functional significance contributing to vestibulo-ocular, vestibulo-thalamic and vestibulo-spinal pathways. PMID:24127616

  9. Adaptive plasticity in vestibular influences on cardiovascular control

    NASA Technical Reports Server (NTRS)

    Yates, B. J.; Holmes, M. J.; Jian, B. J.

    2000-01-01

    Data collected in both human subjects and animal models indicate that the vestibular system influences the control of blood pressure. In animals, peripheral vestibular lesions diminish the capacity to rapidly and accurately make cardiovascular adjustments to changes in posture. Thus, one role of vestibulo-cardiovascular influences is to elicit changes in blood distribution in the body so that stable blood pressure is maintained during movement. However, deficits in correcting blood pressure following vestibular lesions diminish over time, and are less severe when non-labyrinthine sensory cues regarding body position in space are provided. These observations show that pathways that mediate vestibulo-sympathetic reflexes can be subject to plastic changes. This review considers the adaptive plasticity in cardiovascular responses elicited by the central vestibular system. Recent data indicate that the posterior cerebellar vermis may play an important role in adaptation of these responses, such that ablation of the posterior vermis impairs recovery of orthostatic tolerance following subsequent vestibular lesions. Furthermore, recent experiments suggest that non-labyrinthine inputs to the central vestibular system may be important in controlling blood pressure during movement, particularly following vestibular dysfunction. A number of sensory inputs appear to be integrated to produce cardiovascular adjustments during changes in posture. Although loss of any one of these inputs does not induce lability in blood pressure, it is likely that maximal blood pressure stability is achieved by the integration of a variety of sensory cues signaling body position in space.

  10. Assessment of Vestibular Rehabilitation Therapy Training and Practice Patterns.

    PubMed

    Bush, Matthew L; Dougherty, William

    2015-08-01

    Vestibular rehabilitation therapy (VRT) can benefit patients with a variety of balance and vestibular disorders. This expanding field requires knowledgeable and experienced therapists; however, the practice and experience of those providing this care may vary greatly. The purpose of this study was to analyze variations in training and practice patterns among practicing vestibular rehabilitation therapists. Case-controlled cohort study. Investigation of outpatient physical therapy and audiology practices that offer vestibular rehabilitation conducted by a tertiary academic referral center. Questionnaire-based investigation of level of training in vestibular disorders and therapy, practice patterns of vestibular rehabilitation, and referral sources for VRT patients. We identified 27 subjects within the state of Kentucky who practice vestibular rehabilitation and the questionnaire response rate was 63%. Responses indicated that 53% of respondents had no training in VRT during their professional degree program. Attendance of a course requiring demonstration of competence and techniques was 24% of participants. The development of VRT certification was significantly more favored by those who attended such courses compared with those who did not (p = 0.01). 50% of therapists have direct access to patients without physician referrals. There is a wide range of educational background and training among those practicing VRT. This variability in experience may affect care provided within some communities. Certification is not necessary for the practice of VRT but the development of certification is favored among some therapists to improve standardization of practice of this important specialty. PMID:25700790

  11. Cross-Modal Calibration of Vestibular Afference for Human Balance

    PubMed Central

    Héroux, Martin E; Law, Tammy C. Y.; Fitzpatrick, Richard C.; Blouin, Jean-Sébastien

    2015-01-01

    To determine how the vestibular sense controls balance, we used instantaneous head angular velocity to drive a galvanic vestibular stimulus so that afference would signal that head movement was faster or slower than actual. In effect, this changed vestibular afferent gain. This increased sway 4-fold when subjects (N = 8) stood without vision. However, after a 240 s conditioning period with stable balance achieved through reliable visual or somatosensory cues, sway returned to normal. An equivalent galvanic stimulus unrelated to sway (not driven by head motion) was equally destabilising but in this situation the conditioning period of stable balance did not reduce sway. Reflex muscle responses evoked by an independent, higher bandwidth vestibular stimulus were initially reduced in amplitude by the galvanic stimulus but returned to normal levels after the conditioning period, contrary to predictions that they would decrease after adaptation to increased sensory gain and increase after adaptation to decreased sensory gain. We conclude that an erroneous vestibular signal of head motion during standing has profound effects on balance control. If it is unrelated to current head motion, the CNS has no immediate mechanism of ignoring the vestibular signal to reduce its influence on destabilising balance. This result is inconsistent with sensory reweighting based on disturbances. The increase in sway with increased sensory gain is also inconsistent with a simple feedback model of vestibular reflex action. Thus, we propose that recalibration of a forward sensory model best explains the reinterpretation of an altered reafferent signal of head motion during stable balance. PMID:25894558

  12. Betahistine treatment in managing vertigo and improving vestibular compensation: clarification.

    PubMed

    Lacour, Michel

    2013-01-01

    Betahistine dihydrochloride (betahistine) is currently used in the management of vertigo and vestibular pathologies with different aetiologies. The main goal of this review is to clarify the mechanisms of action of this drug, responsible for the symptomatic relief of vertigo and the improvement of vestibular compensation. The review starts with a brief summary recalling the role of histamine as a neuromodulator/neurotransmitter in the control of the vestibular functions, and the role of the histaminergic system in vestibular compensation. Then are presented data recorded in animal models demonstrating that betahistine efficacy can be explained by mechanisms targeting the histamine receptors (HRs) at three different levels: the vascular tree, with an increase of cochlear and vestibular blood flow involving the H1R; the central nervous system, with an increase of histamine turnover implicating the H3R, and the peripheral labyrinth, with a decrease of vestibular input implying the H3R/H4R. Clinical data from vestibular loss patients show the impact of betahistine treatment for the long-term control of vertigo, improvement of balance and quality of life that can be explained by these mechanisms of action. However, two conditions, at least, are required for reaching the betahistine therapeutic effect: the dose and the duration of treatment. Experimental and clinical data supporting these requirements are exposed in the last part of this review.

  13. Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

    PubMed Central

    Song, Hyun Seok; Kim, Ji Soo

    2011-01-01

    Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals. PMID:22259614

  14. Case report: unilateral mydriasis following nasal cautery.

    PubMed

    Koo Ng, Nigel K F; Calder, Nick

    2010-12-01

    We report a case of unilateral mydriasis following nasal electrocautery presumed to be the result of retrograde flow of adrenaline and/or xylometazoline hydrochloride (Otrivine) through the nasolacrimal duct into the eye. We review the literature and highlight the importance of correct interpretation of finding a dilated pupil post-operatively. To our knowledge. we report the first such case involving xylometazoline hydrochloride and also following nasal electrocautery. Unilateral mydriasis is alarming after nasal surgery but must be interpreted with caution. During minimally invasive procedures it is likely to be due to the effects of topical medication to the nose rather than surgical trauma. PMID:21158576

  15. Unilateral Isolated Proximal Femoral Focal Deficiency

    PubMed Central

    Doğer, Emek; Köpük, Şule Y.; Çakıroğlu, Yiğit; Çakır, Özgür; Yücesoy, Gülseren

    2013-01-01

    Objective. To discuss a patient with a prenatal diagnosis of unilateral isolated femoral focal deficiency. Case. Antenatal diagnosis of unilateral isolated femoral focal deficiency was made at 20 weeks of gestation. The length of left femur was shorter than the right, and fetal femur length was below the fifth percentile. Proximal femoral focal deficiency was diagnosed. After delivery, the diagnosis was confirmed with skeletal radiographs and magnetic resonance imaging. In prenatal ultrasonographic examination, the early recognition and exclusion of skeletal dysplasias is important; moreover, treatment plans should be initiated, and valuable information should be provided to the family. PMID:23984135

  16. Asymmetric and Unilateral Hearing Loss in Children

    PubMed Central

    Vila, Peter; Lieu, Judith E. C.

    2015-01-01

    Asymmetric and unilateral hearing losses in children have traditionally been underappreciated, but health care practitioners are now beginning to understand their effect on development and the underlying pathophysiologic mechanisms. The common wisdom among medical and educational professionals has been that at least one normal hearing or near-normal hearing ear was sufficient for typical speech and language development in children. The objective of this review is to illustrate to the non-otolaryngologist the consequences of asymmetric and unilateral hearing loss in children on developmental and educational outcomes. In the process, etiology, detection, and management are discussed. Lastly, implications for further research are considered. PMID:26004144

  17. Unilateral acrokeratoelastoidosis--second reported case.

    PubMed

    Klekowski, Nicole; Shwayder, Tor

    2011-01-01

    Acrokeratoelastoidosis (AKE) is a rare disease that manifests as wartlike papules along the dorsal palmar junction. It is characterized by orthohyperkeratosis in the horny layer and elastorrhexis in the reticular dermis. Both sporadic and familial cases following autosomal dominant inheritance have been reported. Currently, no effective treatments exist for AKE, which can have a significant cosmetic impact. Here we present the second reported case of unilateral AKE in a 5-year-old African American girl and hypothesize that the mechanism for the unilateral nature of AKE in this patient is genetic mosaicism.

  18. Improving Sensorimotor Function Using Stochastic Vestibular Stimulation

    NASA Technical Reports Server (NTRS)

    Galvan, R. C.; Clark, T. K.; Merfeld, D. M.; Bloomberg, J. J.; Mulavara, A. P.; Oman, C. M.

    2014-01-01

    Astronauts experience sensorimotor changes during spaceflight, particularly during G-transition phases. Post flight sensorimotor changes may include postural and gait instability, spatial disorientation, and visual performance decrements, all of which can degrade operational capabilities of the astronauts and endanger the crew. Crewmember safety would be improved if these detrimental effects of spaceflight could be mitigated by a sensorimotor countermeasure and even further if adaptation to baseline could be facilitated. The goal of this research is to investigate the potential use of stochastic vestibular stimulation (SVS) as a technology to improve sensorimotor function. We hypothesize that low levels of SVS will improve sensorimotor performance through stochastic resonance (SR). The SR phenomenon occurs when the response of a nonlinear system to a weak input signal is optimized by the application of a particular nonzero level of noise. Two studies have been initiated to investigate the beneficial effects and potential practical usage of SVS. In both studies, electrical vestibular stimulation is applied via electrodes on the mastoid processes using a constant current stimulator. The first study aims to determine the repeatability of the effect of vestibular stimulation on sensorimotor performance and perception in order to better understand the practical use of SVS. The beneficial effect of low levels of SVS on balance performance has been shown in the past. This research uses the same balance task repeated multiple times within a day and across days to study the repeatability of the stimulation effects. The balance test consists of 50 sec trials in which the subject stands with his or her feet together, arms crossed, and eyes closed on compliant foam. Varying levels of SVS, ranging from 0-700 micro A, are applied across different trials. The subject-specific optimal SVS level is that which results in the best balance performance as measured by inertial

  19. The Development of the Vestibular Apparatus Under Conditions of Weightlessness

    NASA Technical Reports Server (NTRS)

    Vinnikov, Y. A.; Gazenko, O. G.; Lychakov, D. V.; Palmbakh, L. R.

    1984-01-01

    A series of experiments has been carried out on the effect of space flight conditions on morphogenesis and the structure of the vestibular apparatus in amphibian and fish larvae. Larval development proceeded in weightlessness without serious morphological defects. The vestibular apparatus developed; its organization in the experimental animals did not differ qualitatively from that in the controls. The specific external stimulus (gravitation) appears not to be a necessary condition for the development of a gravitation receptor in ontogenesis although the appearance of the vestibular apparatus in phylogenesis was apparently related to this stimulus.

  20. Long-term follow-up of vestibular neuritis.

    PubMed

    Mandalà, Marco; Nuti, Daniele

    2009-05-01

    The long-term outcome of vestibular neuritis was evaluated in 35 patients using 4 bedside tests (head impulse, head heave, head shake, vibration), the caloric test and two surveys that explored the degree of disability (Dizziness Handicap Inventory [DHI]) and the anxiety and depression levels (Hospital Anxiety and Depression Scale [HADS]). Sixty-six percent of patients showed a positive bedside clinical test or calorics abnormalities. DHI scores were significantly higher in the patients group, while HADS scores were comparable between patients and controls. Disability from vestibular neuritis is primarily due to the vestibular disturbance itself, rather than purely psychological factors.

  1. Chronic vestibulo-ocular reflexes evoked by a vestibular prosthesis.

    PubMed

    Merfeld, Daniel M; Haburcakova, Csilla; Gong, Wangsong; Lewis, Richard F

    2007-06-01

    We are developing prosthetics for patients suffering from peripheral vestibular dysfunction. We tested a sensory-replacement prosthesis that stimulates neurons innervating the vestibular system by providing chronic pulsatile stimulation to electrodes placed in monkeys' lateral semicircular canals, which were plugged bilaterally, and used head angular velocity to modulate the current pulse rate. As an encouraging finding, we observed vestibulo-ocular reflexes that continued to be evoked by the motion-modulated stimulation months after the nystagmus evoked by the constant-rate baseline stimulation had dissipated. This suggests that long-term functional replacement of absent vestibular function is feasible.

  2. Importance of spontaneous nystagmus detection in the differential diagnosis of acute vertigo.

    PubMed

    Pavlin-Premrl, Davor; Waterston, John; McGuigan, Sean; Infeld, Bernard; Sultana, Ron; O'Sullivan, Richard; Gerraty, Richard P

    2015-03-01

    Vertigo is a common cause of emergency department attendance. Detection of spontaneous nystagmus may be a useful sign in distinguishing vestibular neuritis from other vestibular diagnoses. We aimed to assess the contribution of spontaneous nystagmus in the diagnosis of acute vertigo. We enrolled consecutive consenting patients arriving at a single emergency department with acute vertigo. There was no declared protocol for the emergency department staff. A standardized history and examination was conducted by the investigators. Observation for spontaneous nystagmus, its response to visual fixation, and testing the vestibulo-ocular reflex with the horizontal head impulse test were the chief examination components. MRI was obtained within 24 hours. Clinical criteria and MRI were used to reach the final diagnosis. The investigators' physical findings and final neurological diagnosis were compared with the initial emergency department examination findings and the referral diagnosis. There were 28 patients, 15 with vestibular neuritis, six with benign paroxysmal positional vertigo, one with stroke, suspected clinically, and three with migraine. In three the diagnosis remained uncertain. Spontaneous nystagmus was seen in all 15 patients with vestibular neuritis, fixation-suppressed in eight of 11 tested for this. The head impulse test was positive in 12 of 15 with vestibular neuritis. The emergency department referral diagnosis was correct in six of 23 patients. The ability to detect spontaneous nystagmus is useful in vestibular diagnosis, both in support of a diagnosis of vestibular neuritis and in avoiding false positive diagnoses of benign paroxysmal positional vertigo.

  3. Vestibular contributions to a right-hemisphere network for bodily awareness: combining galvanic vestibular stimulation and the "Rubber Hand Illusion".

    PubMed

    Ferrè, Elisa Raffaella; Berlot, Eva; Haggard, Patrick

    2015-03-01

    An altered sense of one's own body is a common consequence of vestibular damage, and also of damage to vestibular networks in the right hemisphere. However, few experimental studies have investigated whether vestibular signals contribute to bodily awareness. We addressed this issue by combining an established experimental model of bodily awareness (Rubber Hand Illusion -RHI) with galvanic vestibular stimulation (GVS) in healthy participants. Brief left anodal and right cathodal GVS (which predominantly activates vestibular networks in the right hemisphere), or right anodal and left cathodal GVS, or sham stimulation were delivered at random, while participants experienced either synchronous or asynchronous visuo-tactile stimulation of a rubber hand and their own hand. The drift in the perceived position of the participant's hand towards the rubber hand was used as a proxy measure of the resulting multisensory illusion of body ownership. GVS induced strong polarity-dependent effects on this measure of RHI: left anodal and right cathodal GVS produced significantly lower proprioceptive drift than right anodal and left cathodal GVS. We suggest that vestibular inputs influence the multisensory weighting functions that underlie bodily awareness: the right hemisphere vestibular projections activated by the left anodal and right cathodal GVS increased the weight of intrinsic proprioceptive signals about hand position, and decreased the weight of visual information responsible for visual capture during the RHI.

  4. Vestibular Function Tests for Vestibular Migraine: Clinical Implication of Video Head Impulse and Caloric Tests

    PubMed Central

    Kang, Woo Seok; Lee, Sang Hun; Yang, Chan Joo; Ahn, Joong Ho; Chung, Jong Woo; Park, Hong Ju

    2016-01-01

    Vestibular migraine (VM) is one of the most common causes of episodic vertigo. We reviewed the results of multiple vestibular function tests in a cohort of VM patients who were diagnosed with VM according to the diagnostic criteria of the Barany Society and the International Headache Society and assessed the efficacy of each for predicting the prognosis in VM patients. A retrospective chart analysis was performed on 81 VM patients at a tertiary care center from June 2014 to July 2015. Patients were assessed by the video head impulse test (vHIT), caloric test, vestibular-evoked myogenic potentials (VEMPs), and sensory organization test (SOT) at the initial visit and then evaluated for symptomatic improvement after 6 months. Complete response (CR) was defined as no need for continued medication, partial response (PR) as improved symptoms but need for continued medication, and no response (NR) as no symptomatic improvement and requiring increased dosage or change in medications. At the initial evaluation, 9 of 81 patients (11%) exhibited abnormal vHIT results, 14 of 73 (19%) exhibited abnormal caloric test results, 25 of 65 (38%) exhibited abnormal SOT results, 8 of 75 (11%) exhibited abnormal cervical VEMP results, and 20 of 75 (27%) exhibited abnormal ocular VEMP results. Six months later, 63 of 81 patients (78%) no longer required medication (CR), while 18 (22%) still required medication, including 7 PR and 11 NR patients. Abnormal vHIT gain and abnormal caloric results were significantly related to the necessity for continued medication at 6-month follow-up (OR = 5.67 and 4.36, respectively). Abnormal vHIT and caloric test results revealed semicircular canal dysfunction in VM patients and predicted prolonged preventive medication requirement. These results suggest that peripheral vestibular abnormalities are closely related to the development of vertigo in VM patients. PMID:27746761

  5. Optokinetic and Vestibular Responsiveness in the Macaque Rostral Vestibular and Fastigial Nuclei

    PubMed Central

    Bryan, Ayanna S.; Angelaki, Dora E.

    2009-01-01

    We recorded from rostral vestibular (VN) and rostral fastigial nuclei (FN) neurons that did not respond to eye movements during three-dimensional (3D) vestibular and optokinetic stimulation (OKS). The majority of neurons in both areas (76 and 69% in VN and FN, respectively) responded during both rotational and translational motion. Preferred directions scattered throughout 3D space for translation but showed some preference for pitch/roll over yaw for rotation. VN/FN neurons were also tested during OKS while monkeys suppressed their optokinetic nystagmus by fixating a head-fixed target. Only a handful of cells (VN: 17%, FN: 6%) modulated during 0.5-Hz OKS suppression, but the number of responsive cells increased (VN: 40%, FN: 48%) during 0.02-Hz OKS. Preferred directions for rotation and OKS were not matched on individual neurons, and OKS gains were smaller than the respective gains during rotation. These results were generally similar for VN and FN neurons. We conclude that optokinetic-vestibular convergence might not be as prevalent as earlier studies have suggested. PMID:19073813

  6. Microanatomic features of unilateral condylar hyperplasia.

    PubMed

    Luz, J G; de Rezende, J R; Jaeger, R G; de Araújo, V C

    1994-01-01

    Microanatomic features of unilateral condylar hyperplasia (UCH) are described. The articular surface exhibited clefts with surrounding elevations, and globules varying 0.5-2 microns in diameter. The articular zone presented giant coiled fibers, and the proliferative zone was composed of small round cells. The findings suggest that degenerative changes occur in UCH, both in adult and juvenile forms. PMID:8000234

  7. Condylar hyperplasia following unilateral temporomandibular joint replacement.

    PubMed

    Machon, V; Levorova, J; Hirjak, D; Foltan, R

    2015-06-01

    Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement. PMID:25662429

  8. Multisensory effects on somatosensation: a trimodal visuo-vestibular-tactile interaction.

    PubMed

    Kaliuzhna, Mariia; Ferrè, Elisa Raffaella; Herbelin, Bruno; Blanke, Olaf; Haggard, Patrick

    2016-01-01

    Vestibular information about self-motion is combined with other sensory signals. Previous research described both visuo-vestibular and vestibular-tactile bilateral interactions, but the simultaneous interaction between all three sensory modalities has not been explored. Here we exploit a previously reported visuo-vestibular integration to investigate multisensory effects on tactile sensitivity in humans. Tactile sensitivity was measured during passive whole body rotations alone or in conjunction with optic flow, creating either purely vestibular or visuo-vestibular sensations of self-motion. Our results demonstrate that tactile sensitivity is modulated by perceived self-motion, as provided by a combined visuo-vestibular percept, and not by the visual and vestibular cues independently. We propose a hierarchical multisensory interaction that underpins somatosensory modulation: visual and vestibular cues are first combined to produce a multisensory self-motion percept. Somatosensory processing is then enhanced according to the degree of perceived self-motion. PMID:27198907

  9. Multisensory effects on somatosensation: a trimodal visuo-vestibular-tactile interaction

    PubMed Central

    Kaliuzhna, Mariia; Ferrè, Elisa Raffaella; Herbelin, Bruno; Blanke, Olaf; Haggard, Patrick

    2016-01-01

    Vestibular information about self-motion is combined with other sensory signals. Previous research described both visuo-vestibular and vestibular-tactile bilateral interactions, but the simultaneous interaction between all three sensory modalities has not been explored. Here we exploit a previously reported visuo-vestibular integration to investigate multisensory effects on tactile sensitivity in humans. Tactile sensitivity was measured during passive whole body rotations alone or in conjunction with optic flow, creating either purely vestibular or visuo-vestibular sensations of self-motion. Our results demonstrate that tactile sensitivity is modulated by perceived self-motion, as provided by a combined visuo-vestibular percept, and not by the visual and vestibular cues independently. We propose a hierarchical multisensory interaction that underpins somatosensory modulation: visual and vestibular cues are first combined to produce a multisensory self-motion percept. Somatosensory processing is then enhanced according to the degree of perceived self-motion. PMID:27198907

  10. Balancing awareness: Vestibular signals modulate visual consciousness in the absence of awareness.

    PubMed

    Salomon, Roy; Kaliuzhna, Mariia; Herbelin, Bruno; Blanke, Olaf

    2015-11-01

    The processing of visual and vestibular information is crucial for perceiving self-motion. Visual cues, such as optic flow, have been shown to induce and alter vestibular percepts, yet the role of vestibular information in shaping visual awareness remains unclear. Here we investigated if vestibular signals influence the access to awareness of invisible visual signals. Using natural vestibular stimulation (passive yaw rotations) on a vestibular self-motion platform, and optic flow masked through continuous flash suppression (CFS) we tested if congruent visual-vestibular information would break interocular suppression more rapidly than incongruent information. We found that when the unseen optic flow was congruent with the vestibular signals perceptual suppression as quantified with the CFS paradigm was broken more rapidly than when it was incongruent. We argue that vestibular signals impact the formation of visual awareness through enhanced access to awareness for congruent multisensory stimulation.

  11. [Childhood peripheral vestibular disorders: a report of three cases].

    PubMed

    Akdoğan, Mehmet Volkan; Tarhan, Erkan; Ozgirgin, Osman Nuri; Ozlüoğlu, Levent Naci

    2006-01-01

    Vertigo is uncommon in childhood. Its etiology is different from that of adults. Both central and peripheral disorders may give rise to vertigo symptoms in pediatric patients. The evaluation of vertigo in children requires a detailed history taking, clinical examination, audiometric assessment, and vestibular function tests. We present three pediatric patients with vertigo symptoms, together with treatment methods and results of treatment. Their ages ranged from 10 to 14 years. The diagnoses were vestibular neuritis in one patient, and benign paroxismal positional vertigo in two patients. Treatment was comprised of vestibular rehabilitation for vestibular neuritis, and canalith repositioning maneuver for benign paroxismal positional vertigo. All the patients benefited well from the procedures applied. PMID:17124444

  12. Vestibular function and temporal bone imaging in DFNB1.

    PubMed

    Oonk, A M M; Beynon, A J; Peters, T A; Kunst, H P M; Admiraal, R J C; Kremer, H; Verbist, B; Pennings, R J E

    2015-09-01

    DFNB1 is the most prevalent type of hereditary hearing impairment known nowadays and the audiometric phenotype is very heterogeneous. There is, however, no consensus in literature on vestibular and imaging characteristics. Vestibular function and imaging results of 44 DFNB1 patients were evaluated in this retrospective study. All patients displayed a response during rotational velocity step testing. In 65% of the cases, the caloric results were within normal range bilaterally. The video head impulse test was normal in all patients. In 34.4% of the CT scans one or more temporal bone anomalies were found. The various anomalies found, were present in small numbers and none seemed convincingly linked to a specific DFNB1genotype. The group of DFNB1 patients presented here is the largest thus far evaluated for their vestibular function. From this study, it can be assumed that DFNB1 is not associated with vestibular dysfunction or specific temporal bone anomalies. PMID:26188104

  13. [Presbyastasis and application of vestibular rehabilitation in geriatrics].

    PubMed

    Costa de Araujo, P; Demanez, L; Lechien, J; Bauvir, P; Petermans, J

    2011-03-01

    Balance disorders can have a major functional impact among the elderly. The main risk is falling. Three elements are implicated in the loss of balance: vision, proprioception and the vestibular system. This article will discuss mainly vestibular damage and its implications. The assessment of balance disorders, particularly in geriatric patients, is based on validated scales composed of several items. These provide scores and are based on the results of chronometric measurements. They can be useful for the application of Vestibular Rehabilitation (VR), a technique improving the adaptation and autonomy of these patients. Vestibular rehabilitation is therefore part of an overall support, the goal of therapy being to improve daily life and to reduce the risk of falls. PMID:21560428

  14. Certain aspects of the vestibular problem in space medicine

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Vestibulovegetative disorders on manned space flights are discussed. A study relating to the vestibular stimuli in respiration, diaphoresis cardiac rhythm and a broad complex of hemodynamic indices was conducted. Certain tests for astronaut candidates are discussed.

  15. Anatomy, physiology, and physics of the peripheral vestibular system.

    PubMed

    Kingma, H; van de Berg, R

    2016-01-01

    Many medical doctors consider vertigo and dizziness as the major, almost obligatory complaints in patients with vestibular disorders. In this chapter, we will explain that vestibular disorders result in much more diverse and complex complaints. Many of these other complaints are unfortunately often misinterpreted and incorrectly classified as psychogenic. When we really understand the function of the vestibular system, it becomes quite obvious why patients with vestibular disorders complain about a loss of visual acuity, imbalance, fear of falling, cognitive and attentional problems, fatigue that persists even when the vertigo attacks and dizziness decreases or even disappears. Another interesting new aspect in this chapter is that we explain why the function of the otolith system is so important, and that it is a mistake to focus on the function of the semicircular canals only, especially when we want to understand why some patients seem to suffer more than others from the loss of canal function as objectified by reduced caloric responses. PMID:27638059

  16. What are the Symptoms of a Vestibular Disorder?

    MedlinePlus

    ... distance Increased night blindness; difficulty walking in the dark Poor depth perception Visit the Neuro-Optometric Association's ... vestibular disorders can be. Your support of VEDA matters. Please help us continue this important work by ...

  17. Surgical access to separate branches of the cat vestibular nerve

    NASA Technical Reports Server (NTRS)

    Radkevich, L. A.; Ayzikov, G. S.

    1981-01-01

    A posteroventral approach for access to separate branches of the cat vestibular nerve is presented which permits simultaneous surgical access to the ampullary and otolithic nerves. Surgical procedures are discussed.

  18. Behavioral Assessment of the Aging Mouse Vestibular System

    PubMed Central

    Tung, Victoria W. K.; Burton, Thomas J.; Dababneh, Edward; Quail, Stephanie L.; Camp, Aaron J.

    2014-01-01

    Age related decline in balance performance is associated with deteriorating muscle strength, motor coordination and vestibular function. While a number of studies show changes in balance phenotype with age in rodents, very few isolate the vestibular contribution to balance under either normal conditions or during senescence. We use two standard behavioral tests to characterize the balance performance of mice at defined age points over the lifespan: the rotarod test and the inclined balance beam test. Importantly though, a custom built rotator is also used to stimulate the vestibular system of mice (without inducing overt signs of motion sickness). These two tests have been used to show that changes in vestibular mediated-balance performance are present over the murine lifespan. Preliminary results show that both the rotarod test and the modified balance beam test can be used to identify changes in balance performance during aging as an alternative to more difficult and invasive techniques such as vestibulo-ocular (VOR) measurements. PMID:25045963

  19. Oculomotor disturbances during visual-vestibular interaction in Wallenberg's lateral medullary syndrome.

    PubMed

    Waespe, W; Wichmann, W

    1990-06-01

    Transient and lasting oculomotor disturbances during visual-vestibular interaction are described in 9 patients with Wallenberg's lateral medullary syndrome. In all patients magnetic resonance imaging (MRI) demonstrated a single focal area of pathological signal intensity in the (dorso)-lateral medulla suggesting infarction. In 2 of these 9 patients and in 3 further patients with no medullary signs, the infarction involved the cerebellar territory of the posterior inferior cerebellar artery (PICA). Acutely, all patients with Wallenberg's syndrome (except 1) had saccadic lateropulsion and spontaneous nystagmus in light with the horizontal fast component beating to the contralateral normal side. The velocity of the slow drift to the side of the lesion was dependent on eye position and induced a characteristic asymmetry of the visually and vestibularly elicited slow eye movements. In most patients smooth pursuit, optokinetic nystagmus and visual suppression of the vestibulo-ocular reflex were still impaired when this spontaneous drift was minimal or absent. The oculomotor disturbances in patients with and without cerebellar infarction are compared. The following conclusions are made. (1) The spontaneous drift that is dependent on eye position is mostly created by 'ocular lateropulsion', that is, a tonic bias within the oculomotor system which may have several sources. (2) The abnormalities and asymmetries of oculomotor responses during visual-vestibular stimulation cannot solely be explained by this spontaneous drift and its interaction with otherwise normal eye movements. Instead, structures and pathways are damaged in Wallenberg's syndrome which mediate visual and/or motor signals important for the cerebellar control of visually-guided slow eye movements. (3) Damage to these pathways occurs in the lateral medulla, as the MRI findings show that in most patients the cerebellum is rarely involved, but no definite conclusion can be made as to which of the fibres

  20. The European vestibular experiments in spacelab-1

    NASA Astrophysics Data System (ADS)

    Kass, J.; von Baumgarten, R.; Vogel, H.; Wetzig, J.; Benson, A.; Berthoz, A.; Vieville, Th.; Brandt, Th.; Probst, Th.; Brand, U.; Bruzek, W.; Dichgans, J.; Scherer, H.

    A series of experiments /1/ were performed in the Spacelab-1 mission on November/December, 1983, pre-, in-, and postflight. These experiments covered various aspects of the functions of the vestibular system, the inflight tests comprising threshold measurements for linear movements in three orthogonal axes, optokinetic stimulation, vestibulo-ocular reflexes under linear and angular accelerations, caloric stimulation with and without linear accelerations; pre- and postflight tests repeated the inflight protocol with the addition of subjective vertical and eye counter-rotation measurements using a tilt table. One of the most surprising and significant results was the caloric test: strong caloric nystagmus on the two subjects tested was recorded inflight; this was contrary to what was expected from Barany's convection hypothesis for caloric nystagmus.

  1. Effect of gravity on vestibular neural development

    NASA Technical Reports Server (NTRS)

    Ross, M. D.; Tomko, D. L.

    1998-01-01

    The timing, molecular basis, and morphophysiological and behavioral consequences of the interaction between external environment and the internal genetic pool that shapes the nervous system over a lifetime remain important questions in basic neuroscientific research. Space station offers the opportunity to study this interaction over several life cycles in a variety of organisms. This short review considers past work in altered gravity, particularly on the vestibular system, as the basis for proposing future research on space station, and discusses the equipment necessary to achieve goals. It is stressed that, in keeping with the international investment being made in this research endeavor, both the questions asked and the technologies to be developed should be bold. Advantage must be taken of this unique research environment to expand the frontiers of neuroscience. Copyright 1998 Published by Elsevier Science B.V.

  2. Vestibular response in denatured rape oil intoxication.

    PubMed

    Gavilán, C; Gavilán, J; Abril, A

    1985-10-01

    During the spring of 1981 a massive intoxication broke out in Spain, which is presently attributed to the ingestion of denatured rape oil, and which has been called 'Toxic Syndrome' (TS). We studied 51 patients affected by the TS one year after the onset of their disease, analyzing their vestibular responses in the caloric test with the help of an analog-digital computer. A significant decrease in the number of nystagmic beats of the affected patients can be observed, while the rest of the parameters studied show similar values to those found simultaneously in 30 normal subjects. It is suggested that these differences are yet another manifestation of the polyneuropathy found in intoxication by denatured rape oil. PMID:3877134

  3. Vestibular ataxia and its measurement in man

    NASA Technical Reports Server (NTRS)

    Fregly, A. R.

    1974-01-01

    Methods involved in and results obtained with a new comprehensive ataxia test battery are described, and definitions of spontaneous and induced vestibular ataxia in man are given in terms of these findings. In addition, the topic of alcohol-induced ataxia in relation to labyrinth function is investigated. Items in the test battery comprise a sharpened Romberg test, in which the subject stands on the floor with eyes closed and arms folded against his chest, feet heel-to-toe, for 60 seconds; an eyes-open walking test; an eyes-open standing test; an eyes-closed standing test; an eyes-closed on-leg standing test; an eyes-closed walk a line test; an eyes-closed heel-to-toe walking test; and supplementary ataxia tests such as the classical Romberg test.

  4. Timing of neuron development in the rodent vestibular system

    NASA Technical Reports Server (NTRS)

    Keefe, J. R.

    1982-01-01

    The timing of cell generation (onset and duration) in the developing rat vestibular and proprioceptive systems is investigated. The results clearly indicate a defined time-span for generation of all neurons in the central nervous system nuclei studied. This cytogenetic period in both vestibular and proprioceptive sensory nuclei is determined to occur during and immediately after placentation, a potentially critical period for spaceflight exposure due to alterations in maternal physiology.

  5. [Membrane model of the cupula of the vestibular semicircular canals].

    PubMed

    Kondrachuk, A V; Shipov, A A; Sirenko, S P

    1987-01-01

    A mathematical model of the time-course variations of the cupula of the semicircular canals of the vestibular apparatus is presented. The model is found to be in good agreement with experimental data which suggests that the cupular matter has viscosity-elasticity properties. Their role in the functioning of the vestibular apparatus is discussed in qualitative terms. The applicability of the membrane model to the description of the time-course variations of the cupula is considered.

  6. Vestibular and oculomotor influences on visual dependency

    PubMed Central

    Da Silva Melo, Mariane; Siddiqui, Aazim A.; Arshad, Qadeer; Patel, Mitesh

    2016-01-01

    The degree to which a person relies on visual stimuli for spatial orientation is termed visual dependency (VD). VD is considered a perceptual trait or cognitive style influenced by psychological factors and mediated by central reweighting of the sensory inputs involved in spatial orientation. VD is often measured with the rod-and-disk test, in which participants align a central rod to the subjective visual vertical (SVV) in the presence of a background that is either stationary or rotating around the line of sight—dynamic SVV. Although this task has been employed to assess VD in health and vestibular disease, what effect torsional nystagmic eye movements may have on individual performance is unknown. Using caloric ear irrigation, 3D video-oculography, and the rod-and-disk test, we show that caloric torsional nystagmus modulates measures of VD and demonstrate that increases in tilt after irrigation are positively correlated with changes in ocular torsional eye movements. When the direction of the slow phase of the torsional eye movement induced by the caloric is congruent with that induced by the rotating visual stimulus, there is a significant increase in tilt. When these two torsional components are in opposition, there is a decrease. These findings show that measures of VD can be influenced by oculomotor responses induced by caloric stimulation. The findings are of significance for clinical studies, as they indicate that VD, which often increases in vestibular disorders, is modulated not only by changes in cognitive style but also by eye movements, in particular nystagmus. PMID:27358321

  7. Vestibular adaptation to space in monkeys

    NASA Technical Reports Server (NTRS)

    Dai, M.; Raphan, T.; Kozlovskaya, I.; Cohen, B.

    1998-01-01

    Otolith-induced eye movements of rhesus monkeys were studied before and after the 1989 COSMOS 2044 and the 1992 to 1993 COSMOS 2229 flights. Two animals flew in each mission for approximately 2 weeks. After flight, spatial orientation of the angular vestibulo-ocular reflex was altered. In one animal the time constant of postrotatory nystagmus, which had been shortened by head tilts with regard to gravity before flight, was unaffected by the same head tilts after flight. In another animal, eye velocity, which tended to align with a gravitational axis before flight, moved toward a body axis after flight. This shift of orientation disappeared by 7 days after landing. After flight, the magnitude of compensatory ocular counter-rolling was reduced by about 70% in both dynamic and static tilts. Modulation in vergence in response to naso-occipital linear acceleration during off-vertical axis rotation was reduced by more than 50%. These changes persisted for 11 days after recovery. An up and down asymmetry of vertical nystagmus was diminished for 7 days. Gains of the semicircular canal-induced horizontal and vertical angular vestibulo-ocular reflexes were unaffected in both flights, but the gain of the roll angular vestibulo-ocular reflex was decreased. These data indicate that there are short- and long-term changes in otolith-induced eye movements after adaptation to microgravity. These experiments also demonstrate the unique value of the monkey as a model for studying effects of vestibular adaptation in space. Eye movements can be measured in three dimensions in response to controlled vestibular and visual stimulation, and the results are directly applicable to human beings. Studies in monkeys to determine how otolith afferent input and central processing is altered by adaptation to microgravity should be an essential component of future space-related research.

  8. [Vestibular evoked potentials in "Gallus Domesticus"].

    PubMed

    Weisleder, P; Jones, T A; Rubel, E W

    1989-01-01

    Electrophysiological activity in response to linear acceleration stimuli was recorded from Gallus Domesticus by means of subcutaneous electrodes. This investigation had two purposes: 1) to obtain normative data for our laboratory, and 2) to rule out auditory and somatosensory contributions to the Vestibular Evoked Potentials (VsEP). The stimulus consisted of a sigmoid-shaped voltage function generated by a digital-to-analog converter. This signal was amplified, attenuated, and directed to a shaker (selenoid-based, linear mechanical vibrator). The animal's head was firmly attached to a small platform which in turn was coupled to the transducer. The recorded electrophysiological activity was filtered, amplified, and averaged over 256 stimulus presentations. The VsEP are composed of a positive wave, a prominent negativity, and three to five additional positive waves which occur within the first 10 milliseconds following the stimulus. The first three elements are the most robust components of the response. Latency/acceleration and amplitude/acceleration functions were constructed for each of these three waves. Clear and replicable responses were obtained at an acceleration of 2.00 g. At this level the amplitude of the components ranged between 3 and 5 microvolts. On the average, threshold responses were recorded at 0.0935 g. VsEP were not affected by high intensity white noise. However, bilateral intralabyrinthine injection of tetrodotoxin (TTX), a voltage-gated sodium channel blocker, abolished the responses. These results suggest that the activity recorded in response to linear acceleration stimuli is of vestibular origin. PMID:2635851

  9. Visuo-vestibular contributions to anxiety and fear.

    PubMed

    Coelho, Carlos M; Balaban, Carey D

    2015-01-01

    The interactive roles of the visual and vestibular systems allow for postural control within boundaries of perceived safety. In specific circumstances, visual vestibular and postural interactions act as a cue that trigger fear, similarly to what occurs in motion sickness. Unusual patterns of visuo-vestibular interaction that emerge without warning can elicit fear, which can then become associated to a certain stimuli or situation, creating a CS-US association, (i.e., phobia), or can emerge without warning but also without becoming associated to a particular concomitant event (i.e., panic). Depending on the individual sensitivity to visuo-vestibular unusual patterns and its impact in postural control, individuals will be more or less vulnerable to develop these disorders. As such, the mechanism we here propose is also sufficient to explain the lack of certain fears albeit exposure. Following this rationale, a new subcategory of anxiety disorders, named visuo-vestibular fears can be considered. This model brings important implications for developmental and evolutionary psychological science, and invites to place visuo-vestibular fears in a particular subtype or specification within the DSM-5 diagnostic criteria.

  10. Preservation of auditory and vestibular function after surgical removal of bilateral vestibular schwannomas in a patient with neurofibromatosis type 2

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Brackmann, D. E.; Hitselberger, W. E.; Purdy, J.

    1995-01-01

    The outcome of acoustic neuroma (vestibular schwannoma) surgery continues to improve rapidly. Advances can be attributed to several fields, but the most important contributions have arisen from the identification of the genes responsible for the dominant inheritance of neurofibromatosis types 1 (NF1) and 2 (NF2) and the development of magnetic resonance imaging with gadolinium enhancement for the early anatomic confirmation of the pathognomonic, bilateral vestibular schwannomas in NF2. These advances enable early diagnosis and treatment when the tumors are small in virtually all subjects at risk for NF2. The authors suggest that advising young NF2 patients to wait until complications develop, especially hearing loss, before diagnosing and operating for bilateral eighth nerve schwannomas may not always be in the best interest of the patient. To the authors' knowledge, this is the first reported case of preservation of both auditory and vestibular function in a patient after bilateral vestibular schwannoma excision.

  11. Genome-wide methylation analysis in vestibular schwannomas shows putative mechanisms of gene expression modulation and global hypomethylation at the HOX gene cluster.

    PubMed

    Torres-Martín, Miguel; Lassaletta, Luis; de Campos, Jose M; Isla, Alberto; Pinto, Giovanny R; Burbano, Rommel R; Melendez, Bárbara; Castresana, Javier S; Rey, Juan A

    2015-04-01

    Schwannomas are tumors that develop from Schwann cells in the peripheral nerves and commonly arise from the vestibular nerve. Vestibular schwannomas can present unilaterally and sporadically or bilaterally when the tumor is associated with neurofibromatosis Type 2 (NF2) syndrome. The molecular hallmark of the disease is biallelic inactivation of the NF2 gene. The epigenetic signature of schwannomas remains poorly understood and is mostly limited to DNA methylation of the NF2 gene, whose altered expression due to epigenetic factors in this tumor is controversial. In this study, we tested the genomewide DNA methylation pattern of schwannomas to shed light on this epigenetic alteration in these particular tumors. The methodology used includes Infinium Human Methylation 450K BeadChip microarrays in a series of 36 vestibular schwannomas, 4 nonvestibular schwannomas, and 5 healthy nerves. Our results show a trend toward hypomethylation in schwannomas. Furthermore, homeobox (HOX) genes, located at four clusters in the genome, displayed hypomethylation in several CpG sites in the vestibular schwannomas but not in the nonvestibular schwannomas. Several microRNA (miRNA) and protein-coding genes were also found to be hypomethylated at promoter regions and were confirmed as upregulated by expression analysis; including miRNA-21, Met Proto-Oncogene (MET), and PMEPA1. We also detected methylation patterns that might be involved in alternative transcripts of several genes such as NRXN1 or MBP, which would increase the complexity of the methylation and expression patterns. Overall, our results show specific epigenetic signatures in several coding genes and miRNAs that could potentially be used as therapeutic targets. PMID:25533176

  12. Rapidly fluctuating anosmia: A clinical sign for unilateral smell impairment.

    PubMed

    Negoias, Simona; Friedrich, Hergen; Caversaccio, Marco D; Landis, Basile N

    2016-02-01

    Reports about fluctuating olfactory deficits are rare, as are reports of unilateral olfactory loss. We present a case of unilateral anosmia with contralateral normosmia, presenting as rapidly fluctuating anosmia. The olfactory fluctuation occurred in sync with the average nasal cycle duration. Examination after nasal decongestion, formal smell testing, and imaging revealed unilateral, left-sided anosmia of sinonasal cause, with right-sided normosmia. We hypothesize that the nasal cycle induced transient anosmia when blocking the normosmic side. Fluctuating olfactory deficits might hide a unilateral olfactory loss and require additional unilateral testing and thorough workup.

  13. Torsional Eye Movements Evoked by Unilateral Labyrinthine Galvanic Polarizations in the Squirrel Monkey

    NASA Technical Reports Server (NTRS)

    Minor, Lloyd B.; Tomko, David L.; Paige, Gary D.

    1995-01-01

    Electrical stimulation of vestibular-nerve afferents innervating the semicircular canals has been used to identify the extraocular muscles receiving activation or inhibition by individual ampullary nerves. This technique was originally developed by Szentagothai (1950) and led to the description of three neuron reflex arcs that connect each semicircular canal through an interneuron traversing in the region of the medial longitudinal fasciculus to one ipsilateral and one contralateral eye muscle. Selective ampullary nerve stimulation was subsequently used by Cohen and colleagues (Cohen and Suzuki, 1963; Cohen et al., 1964; Suzuki et al., 1964; Cohen et al., 1966) to study movements of the eyes and activation of individual extraocular muscles in response to stimulation of combinations of ampullary nerves. This work led to a description of the now familiar relationships between activation of a semicircular canal ampullary nerves and the anticipated movement in each eye. Disconjugacy of eye movements induced by individual vertical canal stimulation and dependence of the pulling direction of vertical recti and oblique muscles on eye position were also defined in these experiments. Subsequent studies have defined the mechanisms by which externally applied galvanic currents result in a change in vestibular-nerve afferent discharge. The currents appear to act at the spike trigger site. Perilymphatic cathodal currents depolarize the trigger site and lead to excitation whereas anodal currents hyperpolarize and result in inhibition. Afferents innervating all five vestibular endorgans appear to be affected equally by the currents (Goldberg et al., 1984). Irregularly discharging afferents are about 5-10 times more sensitive than regularly discharging ones because of the steeper slope of the former's faster postspike recovery of excitability in encoder sensitivity (Smith and Goldberg, 1986). Response adaptation similar to that noted during acceleration steps is apparent for

  14. Role of vestibular information in initiation of rapid postural responses

    NASA Technical Reports Server (NTRS)

    Runge, C. F.; Shupert, C. L.; Horak, F. B.; Zajac, F. E.; Peterson, B. W. (Principal Investigator)

    1998-01-01

    Patients with bilateral vestibular loss have difficulty maintaining balance without stepping when standing in tandem, on compliant surfaces, across narrow beams, or on one foot, especially with eyes closed. Normal individuals (with no sensory impairment) maintain balance in these tasks by employing quick, active hip rotation (a "hip strategy"). The absence of a hip strategy in vestibular patients responding to translations of a short support surface has previously been taken as evidence that the use of hip strategy requires an intact vestibular system. However, many tasks requiring hip strategy alter one or a combination of important system characteristics, such as initial state of the body (tandem stance), dynamics (compliant surfaces), or biomechanical limits of stability (narrow beams). Therefore, the balance deficit in these tasks may result from a failure to account for these support surface alterations when planning and executing sensorimotor responses. In this study, we tested the hypothesis that vestibular information is critical to trigger a hip strategy even on an unaltered support surface, which imposes no changes on the system characteristics. We recorded the postural responses of vestibular patients and control subjects with eyes closed to rearward support surface translations of varying velocity, in erect stance on a firm, flat surface. Subjects were instructed to maintain balance without stepping, if possible. Faster translation velocities (25 cm/s or more) produced a consistent pattern of early hip torque (first 400 ms) in control subjects (i.e., a hip strategy). Most of the patients with bilateral vestibular loss responded to the same translation velocities with similar torques. Contrary to our hypothesis, we conclude that vestibular function is not necessary to trigger a hip strategy. We postulate, therefore, that the balance deficit previously observed in vestibular patients during postural tasks that elicit a hip strategy may have been due to

  15. [Unilateral nasal obstruction in children: Pai syndrome].

    PubMed

    Zanetta, Adrián; Cuestas, Giselle; Oviedo, Maricruz; Tiscorni, Carlos

    2011-10-01

    Unilateral obstruction of the nasal cavity in children is mainly caused by the introduction of foreign bodies further stated with rhinorrhea and fetid odor. Less commonly, it can be traumatic, neoplastic, due to congenital malformation or iatrogenic. Symptoms of congenital intranasal mass may present at birth, or go unnoticed and be a finding in a routine pediatric examination. Patient evaluation should include imaging studies to guide the diagnosis and rule out intracranial extension. A syndrome associated with congenital nasal tumor should be suspected when other abnormalities are present. Pai syndrome is a rare genetic disorder. Its manifestations are craniofacial being congenital nasal polyp his main marker. We present a patient with unilateral nasal respiratory failure secondary to congenital nasal lipoma, with craniofacial anomalies belonging to Pai syndrome. Nasal obstruction was successfully surgically resolved. PMID:22042063

  16. Unilateral Punctate Keratitis Secondary to Wallenberg Syndrome

    PubMed Central

    Boto, Ana; Del Hierro, Almudena; Capote, Maria; Noval, Susana; Garcia, Amanda; Santiago, Susana

    2014-01-01

    We studied three patients who developed left unilateral punctate keratitis after suffering left-sided Wallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiological studies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvement secondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The loss of corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequently unobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility of superinfection. Neurophysiological studies can help to locate the anatomical level of damage at the ophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstrating that prior vascular involvement coincides with the location of trigeminal nerve damage. In some of these patients, oculofacial pain is a distinctive feature. PMID:24882965

  17. Passive motion reduces vestibular balance and perceptual responses

    PubMed Central

    Fitzpatrick, Richard C; Watson, Shaun R D

    2015-01-01

    With the hypothesis that vestibular sensitivity is regulated to deal with a range of environmental motion conditions, we explored the effects of passive whole-body motion on vestibular perceptual and balance responses. In 10 subjects, vestibular responses were measured before and after a period of imposed passive motion. Vestibulospinal balance reflexes during standing evoked by galvanic vestibular stimulation (GVS) were measured as shear reaction forces. Perceptual tests measured thresholds for detecting angular motion, perceptions of suprathreshold rotation and perceptions of GVS-evoked illusory rotation. The imposed conditioning motion was 10 min of stochastic yaw rotation (0.5–2.5 Hz ≤ 300 deg s−2) with subjects seated. This conditioning markedly reduced reflexive and perceptual responses. The medium latency galvanic reflex (300–350 ms) was halved in amplitude (48%; P = 0.011) but the short latency response was unaffected. Thresholds for detecting imposed rotation more than doubled (248%; P < 0.001) and remained elevated after 30 min. Over-estimation of whole-body rotation (30–180 deg every 5 s) before conditioning was significantly reduced (41.1 to 21.5%; P = 0.033). Conditioning reduced illusory vestibular sensations of rotation evoked by GVS (mean 113 deg for 10 s at 1 mA) by 44% (P < 0.01) and the effect persisted for at least 1 h (24% reduction; P < 0.05). We conclude that a system of vestibular sensory autoregulation exists and that this probably involves central and peripheral mechanisms, possibly through vestibular efferent regulation. We propose that failure of these regulatory mechanisms at different levels could lead to disorders of movement perception and balance control during standing. Key points Human activity exposes the vestibular organs to a wide dynamic range of motion. We aimed to discover whether the CNS regulates sensitivity to vestibular afference during exposure to ambient motion. Balance and perceptual

  18. Unilateral musical hallucinations and all that jazz.

    PubMed

    Couper, J

    1994-09-01

    A 78-year-old hearing-impaired woman who presented to hospital with a stroke and a subsequent epileptic seizure later developed unilateral musical hallucinations in her better hearing (right) ear. She was found to have a left-sided temporal epileptic focus and the music ceased after a second anti-convulsant was introduced. Comments are made on unusual features of the hallucination and its probable causation.

  19. Functioning unilateral adrenocortical carcinoma in a dog.

    PubMed

    Gójska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech

    2012-06-01

    An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery.

  20. Older adults demonstrate superior vestibular perception for virtual rotations.

    PubMed

    Peters, Ryan M; Blouin, Jean-Sébastien; Dalton, Brian H; Inglis, J Timothy

    2016-09-01

    Adult ageing results in a progressive loss of vestibular hair cell receptors and afferent fibres. Given the robustness of vestibulo-ocular and vestibular-evoked whole-body responses to age-related deterioration, it was proposed that the vestibular system compensates centrally. Here we examine the potential for central compensation in vestibular sensitivity with adult ageing by using a combination of real and virtual rotation-based psychophysical testing at two stimulus frequencies (0.1 & 1Hz). Real rotations activate semi-circular canal hair cell receptors naturally via mechanotransduction, while electrical current used to evoke virtual rotations does not rely on mechanical deformation of hair cell receptors to activate vestibular afferents. This two-pronged approach allows us to determine the independent effects of age-related peripheral afferent receptor loss and potential compensatory mechanisms. Older adults had thresholds for discriminating real rotations that were significantly greater than young adults at 0.1Hz (7.2 vs. 3°/s), but the effect of age was weaker (non-significant) at 1Hz (2.4 vs. 1.3°/s). For virtual rotations, older adults had greater thresholds than young adults at 0.1Hz (1.2 vs. 0.5mA), however, older adults outperformed young adults at 1Hz (0.6 vs. 1.1mA). Based on these thresholds, we argue that central vestibular processing gain is enhanced in older adults for 1Hz real and virtual rotations, partially offsetting the negative impact of normal age-related hair cell receptor and primary afferent loss. We propose that the frequency dependence of this compensation reflects the physiological importance of the 1-5Hz range in natural vestibular input.

  1. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness

    PubMed Central

    Chau, Allan T.; Menant, Jasmine C.; Hübner, Patrick P.; Lord, Stephen R.; Migliaccio, Americo A.

    2015-01-01

    Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51–92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1–2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s2 to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5–1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940

  2. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness.

    PubMed

    Chau, Allan T; Menant, Jasmine C; Hübner, Patrick P; Lord, Stephen R; Migliaccio, Americo A

    2015-01-01

    Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51-92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1-2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s(2) to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5-1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940

  3. Genetics of Peripheral Vestibular Dysfunction: Lessons from Mutant Mouse Strains

    PubMed Central

    Jones, Sherri M.; Jones, Timothy A.

    2015-01-01

    Background A considerable amount of research has been published about genetic hearing impairment. Fifty to sixty percent of hearing loss is thought to have a genetic cause. Genes may also play a significant role in acquired hearing loss due to aging, noise exposure, or ototoxic medications. Between 1995 and 2012, over 100 causative genes have been identified for syndromic and nonsyndromic forms of hereditary hearing loss (see Hereditary Hearing Loss Homepage http://hereditaryhearingloss.org). Mouse models have been extremely valuable in facilitating the discovery of hearing loss genes, and in understanding inner ear pathology due to genetic mutations or elucidating fundamental mechanisms of inner ear development. Purpose Whereas much is being learned about hereditary hearing loss and the genetics of cochlear disorders, relatively little is known about the role genes may play in peripheral vestibular impairment. Here we review the literature with regard to genetics of vestibular dysfunction and discuss what we have learned from studies using mutant mouse models and direct measures of peripheral vestibular neural function. Results Several genes are considered that when mutated lead to varying degrees of inner ear vestibular dysfunction due to deficits in otoconia, stereocilia, hair cells, or neurons. Behavior often does not reveal the inner ear deficit. Many of the examples presented are also known to cause human disorders. Conclusions Knowledge regarding the roles of particular genes in the operation of the vestibular sensory apparatus is growing and it is clear that gene products co-expressed in the cochlea and vestibule may play different roles in the respective end organs. The discovery of new genes mediating critical inner ear vestibular function carries the promise of new strategies in diagnosing, treating and managing patients as well as predicting the course and level of morbidity in human vestibular disease. PMID:25032973

  4. Enhancement of Otolith Specific Ocular Responses Using Vestibular Stochastic Resonance

    NASA Technical Reports Server (NTRS)

    Fiedler, Matthew; De Dios, Yiri E.; Esteves, Julie; Galvan, Raquel; Wood, Scott; Bloomberg, Jacob; Mulavara, Ajitkumar

    2011-01-01

    Introduction: Astronauts experience disturbances in sensorimotor function after spaceflight during the initial introduction to a gravitational environment, especially after long-duration missions. Our goal is to develop a countermeasure based on vestibular stochastic resonance (SR) that could improve central interpretation of vestibular input and mitigate these risks. SR is a mechanism by which noise can assist and enhance the response of neural systems to relevant, imperceptible sensory signals. We have previously shown that imperceptible electrical stimulation of the vestibular system enhances balance performance while standing on an unstable surface. Methods: Eye movement data were collected from 10 subjects during variable radius centrifugation (VRC). Subjects performed 11 trials of VRC that provided equivalent tilt stimuli from otolith and other graviceptor input without the normal concordant canal cues. Bipolar stochastic electrical stimulation, in the range of 0-1500 microamperes, was applied to the vestibular system using a constant current stimulator through electrodes placed over the mastoid process behind the ears. In the VRC paradigm, subjects were accelerated to 216 deg./s. After the subjects no longer sensed rotation, the chair oscillated along a track at 0.1 Hz to provide tilt stimuli of 10 deg. Eye movements were recorded for 6 cycles while subjects fixated on a target in darkness. Ocular counter roll (OCR) movement was calculated from the eye movement data during periods of chair oscillations. Results: Preliminary analysis of the data revealed that 9 of 10 subjects showed an average increase of 28% in the magnitude of OCR responses to the equivalent tilt stimuli while experiencing vestibular SR. The signal amplitude at which performance was maximized was in the range of 100-900 microamperes. Discussion: These results indicate that stochastic electrical stimulation of the vestibular system can improve otolith specific responses. This will have a

  5. Passive motion reduces vestibular balance and perceptual responses.

    PubMed

    Fitzpatrick, Richard C; Watson, Shaun R D

    2015-05-15

    With the hypothesis that vestibular sensitivity is regulated to deal with a range of environmental motion conditions, we explored the effects of passive whole-body motion on vestibular perceptual and balance responses. In 10 subjects, vestibular responses were measured before and after a period of imposed passive motion. Vestibulospinal balance reflexes during standing evoked by galvanic vestibular stimulation (GVS) were measured as shear reaction forces. Perceptual tests measured thresholds for detecting angular motion, perceptions of suprathreshold rotation and perceptions of GVS-evoked illusory rotation. The imposed conditioning motion was 10 min of stochastic yaw rotation (0.5-2.5 Hz ≤ 300 deg s(-2) ) with subjects seated. This conditioning markedly reduced reflexive and perceptual responses. The medium latency galvanic reflex (300-350 ms) was halved in amplitude (48%; P = 0.011) but the short latency response was unaffected. Thresholds for detecting imposed rotation more than doubled (248%; P < 0.001) and remained elevated after 30 min. Over-estimation of whole-body rotation (30-180 deg every 5 s) before conditioning was significantly reduced (41.1 to 21.5%; P = 0.033). Conditioning reduced illusory vestibular sensations of rotation evoked by GVS (mean 113 deg for 10 s at 1 mA) by 44% (P < 0.01) and the effect persisted for at least 1 h (24% reduction; P < 0.05). We conclude that a system of vestibular sensory autoregulation exists and that this probably involves central and peripheral mechanisms, possibly through vestibular efferent regulation. We propose that failure of these regulatory mechanisms at different levels could lead to disorders of movement perception and balance control during standing.

  6. Fifth Symposium on the Role of the Vestibular Organs in Space Exploration

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Vestibular problems of manned space flight are investigated for weightlessness and reduced gravity conditions with emphasis on space station development. Intensive morphological studies on the vestibular system and its central nervous system connections are included.

  7. Vestibular Migraine (a.k.a.Migraine Associated Vertigo or [MAV])

    MedlinePlus

    ... is a Top Rated Nonprofit! Volunteer. Donate. Review. Vestibular Migraine (a.k.a. Migraine Associated Vertigo or ... Wackym on his You Tube Channel. Migraine and vestibular dysfunction Approximately 40% of migraine patients have some ...

  8. Effects of microgravity on vestibular ontogeny: direct physiological and anatomical measurements following space flight (STS-29)

    NASA Technical Reports Server (NTRS)

    Jones, T. A.; Fermin, C.; Hester, P. Y.; Vellinger, J.

    1993-01-01

    Does space flight change gravity receptor development? The present study measured vestibular form and function in birds flown as embryos for 5 days in earth orbit (STS-29). No major changes in vestibular gross morphology were found. Vestibular response mean amplitudes and latencies were unaffected by space flight. However, the results of measuring vestibular thresholds were mixed and abnormal responses in 3 of the 8 flight animals raise important questions.

  9. Biomedical performance monitoring and assessment of astronauts by means of an ocular vestibular monitoring system

    NASA Astrophysics Data System (ADS)

    Souvestre, Philippe A.; Landrock, Clinton

    2007-02-01

    The paper focuses on the strong correlation between unmitigated symptoms exhibited by post Space flight astronauts, and symptoms associated with postural deficiency syndrome (PDS) that can be correctly assessed, identified, and monitored via a neurophysiological ocular-vestibular monitoring system (OVMS). From examining clinical data taken over a 10-year period from patients experiencing PDS related acute and chronic post-traumatic medical conditions, the authors show the potential for current assessment and monitoring techniques to examine better the impacts on astronaut neurophysiology. The data presented provide strong evidence that this biomedical monitoring and assessment methodology along with appropriate technology can lead to a better understanding of astronaut post-flight neurophysiology, which is necessary if human exploration in Space is to continue on a successful path.

  10. Right Hemispatial Neglect: Frequency and Characterization Following Acute Left Hemisphere Stroke

    ERIC Educational Resources Information Center

    Kleinman, Jonathan T.; Newhart, Melissa; Davis, Cameron; Heidler-Gary, Jennifer; Gottesman, Rebecca F.; Hillis, Argye E.

    2007-01-01

    The frequency of various types of unilateral spatial neglect and associated areas of neural dysfunction after left hemisphere stroke are not well characterized. Unilateral spatial neglect (USN) in distinct spatial reference frames have been identified after acute right, but not left hemisphere stroke. We studied 47 consecutive right handed…

  11. A Critical Look at Vestibular Dysfunction in Learning-Disabled Children.

    ERIC Educational Resources Information Center

    Polatajko, Helene J.

    1985-01-01

    The vestibular function was examined in 40 learning disabled and 40 non LD children. Data indicated no significant difference between normal and LD Ss, no significant correlation between vestibular function and academic achievement, and no significant educational relevance in categorizing LD Ss according to vestibular dimensions. (CL)

  12. Screening people in the waiting room for vestibular impairments

    PubMed Central

    Cohen, Helen S.; Mulavara, Ajitkumar P.; Sangi-Haghpeykar, Haleh; Peters, Brian T.; Bloomberg, Jacob J.; Pavlik, Valory N.

    2014-01-01

    Objective Primary care physicians need good screening tests of the vestibular system to help them determine whether patients who complain of dizziness should be evaluated for vestibular disorders. The goal of this study was to determine if current, widely-used screening tests of the vestibular system predict subsequent performance on objective diagnostic tests of the vestibular system (ENG). Setting and subjects Of 300 subjects who were recruited from the waiting room of a primary care clinic and were screened there 69 subjects subsequently volunteered for ENGs in the otolaryngology department. The screening study included age, history of vertigo, head impulse tests, Dix-Hallpike maneuvers, and Clinical Test of Sensory Integration and Balance (CTSIB) with head still and head pitching at 0.33 Hz. The ENG included Dix-Hallpike tests, vestibular evoked myogenic potentials, bi-thermal water caloric tests, and low frequency sinusoids in the rotatory chair in darkness. Results The scores on the screening were related to the total ENG but odds ratios were not significant for some variables probably due to the small sample size. Conclusions A larger sample may have yielded stronger results but in general the high odds ratios suggest a relationship between the ENG score and Dix-Hallpike responses and between the ENG scores and some CTSIB responses. PMID:25188617

  13. Otolith-Canal Convergence In Vestibular Nuclei Neurons

    NASA Technical Reports Server (NTRS)

    Dickman, J. David; Si, Xiao-Hong

    2002-01-01

    The current final report covers the period from June 1, 1999 to May 31, 2002. The primary objective of the investigation was to determine how information regarding head movements and head position relative to gravity is received and processed by central vestibular nuclei neurons in the brainstem. Specialized receptors in the vestibular labyrinths of the inner ear function to detect angular and linear accelerations of the head, with receptors located in the semicircular canals transducing rotational head movements and receptors located in the otolith organs transducing changes in head position relative to gravity or linear accelerations of the head. The information from these different receptors is then transmitted to central vestibular nuclei neurons which process the input signals, then project the appropriate output information to the eye, head, and body musculature motor neurons to control compensatory reflexes. Although a number of studies have reported on the responsiveness of vestibular nuclei neurons, it has not yet been possible to determine precisely how these cells combine the information from the different angular and linear acceleration receptors into a correct neural output signal. In the present project, rotational and linear motion stimuli were separately delivered while recording responses from vestibular nuclei neurons that were characterized according to direct input from the labyrinth and eye movement sensitivity. Responses from neurons receiving convergent input from the semicircular canals and otolith organs were quantified and compared to non-convergent neurons.

  14. Prediction of Balance Compensation After Vestibular Schwannoma Surgery.

    PubMed

    Parietti-Winkler, Cécile; Lion, Alexis; Frère, Julien; Perrin, Philippe P; Beurton, Renaud; Gauchard, Gérome C

    2016-06-01

    Background Balance compensation after vestibular schwannoma (VS) surgery is under the influence of specific preoperative patient and tumor characteristics. Objective To prospectively identify potential prognostic factors for balance recovery, we compared the respective influence of these preoperative characteristics on balance compensation after VS surgery. Methods In 50 patients scheduled for VS surgical ablation, we measured postural control before surgery (BS), 8 (AS8) days after, and 90 (AS90) days after surgery. Based on factors found previously in the literature, we evaluated age, body mass index and preoperative physical activity (PA), tumor grade, vestibular status, and preference for visual cues to control balance as potential prognostic factors using stepwise multiple regression models. Results An asymmetric vestibular function was the sole significant explanatory factor for impaired balance performance BS, whereas the preoperative PA alone significantly contributed to higher performance at AS8. An evaluation of patients' balance recovery over time showed that PA and vestibular status were the 2 significant predictive factors for short-term postural compensation (BS to AS8), whereas none of these preoperative factors was significantly predictive for medium-term postoperative postural recovery (AS8 to AS90). Conclusions We identified specific preoperative patient and vestibular function characteristics that may predict postoperative balance recovery after VS surgery. Better preoperative characterization of these factors in each patient could inform more personalized presurgical and postsurgical management, leading to a better, more rapid balance recovery, earlier return to normal daily activities and work, improved quality of life, and reduced medical and societal costs.

  15. Binding body and self in visuo-vestibular conflicts.

    PubMed

    Macauda, Gianluca; Bertolini, Giovanni; Palla, Antonella; Straumann, Dominik; Brugger, Peter; Lenggenhager, Bigna

    2015-03-01

    Maintenance of the bodily self relies on the accurate integration of multisensory inputs in which visuo-vestibular cue integration is thought to play an essential role. Here, we tested in healthy volunteers how conflicting visuo-vestibular bodily input might impact on body self-coherence in a full body illusion set-up. Natural passive vestibular stimulation was provided on a motion platform, while visual input was manipulated using virtual reality equipment. Explicit (questionnaire) and implicit (skin temperature) measures were employed to assess illusory self-identification with either a mannequin or a control object. Questionnaire results pointed to a relatively small illusion, but hand skin temperature, plausibly an index of illusory body ownership, showed the predicted drop specifically in the condition when participants saw the mannequin moving in congruence with them. We argue that this implicit measure was accessible to visuo-vestibular modulation of the sense of self, possibly mediated by shared neural processes in the insula involved in vestibular and interoceptive signalling, thermoregulation and multisensory integration.

  16. Oscillatory neural responses evoked by natural vestibular stimuli in humans.

    PubMed

    Gale, Steven; Prsa, Mario; Schurger, Aaron; Gay, Annietta; Paillard, Aurore; Herbelin, Bruno; Guyot, Jean-Philippe; Lopez, Christophe; Blanke, Olaf

    2016-03-01

    While there have been numerous studies of the vestibular system in mammals, less is known about the brain mechanisms of vestibular processing in humans. In particular, of the studies that have been carried out in humans over the last 30 years, none has investigated how vestibular stimulation (VS) affects cortical oscillations. Here we recorded high-density electroencephalography (EEG) in healthy human subjects and a group of bilateral vestibular loss patients (BVPs) undergoing transient and constant-velocity passive whole body yaw rotations, focusing our analyses on the modulation of cortical oscillations in response to natural VS. The present approach overcame significant technical challenges associated with combining natural VS with human electrophysiology and reveals that both transient and constant-velocity VS are associated with a prominent suppression of alpha power (8-13 Hz). Alpha band suppression was localized over bilateral temporo-parietal scalp regions, and these alpha modulations were significantly smaller in BVPs. We propose that suppression of oscillations in the alpha band over temporo-parietal scalp regions reflects cortical vestibular processing, potentially comparable with alpha and mu oscillations in the visual and sensorimotor systems, respectively, opening the door to the investigation of human cortical processing under various experimental conditions during natural VS. PMID:26683063

  17. Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

    PubMed

    Özgür, Abdulkadir; Serdaroğlu Beyazal, Münevver; Terzi, Suat; Coşkun, Zerrin Özergin; Dursun, Engin

    2016-10-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p < 0.001). There was no correlation between the clinical and laboratory findings and VEMP findings in patients with ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.

  18. Effects of galvanic vestibular stimulation on event related potentials

    PubMed Central

    Lee, Jeong-Woo; Park, Woong-Sik; Yoon, Se-Won

    2016-01-01

    [Purpose] The purpose of this study was to examine the effects of galvanic vestibular stimulation on event-related potentials. [Subjects and Methods] Forty normal female adult subjects were randomly distributed to a galvanic vestibular stimulation application group (20 subjects) and sham group (20 subjects). For galvanic vestibular stimulation application, a positive electrode was applied to the right mastoid process, and a negative electrode was applied to the left mastoid process; simulation was applied for 10 minutes. A test was conducted on the N100 and P300 components of the event-related potentials before and after galvanic vestibular stimulation. [Results] The N100 latency showed statistically significant differences in interaction effects between time and group in the F3, F4, Fz, and Pz areas. The P300 latency showed the same results in the Fp1 and Fp2 areas, the N100 amplitude showed the same results in the Fp2, Fz, and Pz areas; and the P300 amplitude showed the same results in the Pz area. [Conclusion] These results suggest that galvanic vestibular stimulation may play a positive role in the N100 and P300 components of the event-related potentials of the cerebral cortex related to decision-making in matching words with images. PMID:27799703

  19. Vestibular afferent responses to microrotational stimuli

    NASA Technical Reports Server (NTRS)

    Myers, Steven F.; Lewis, Edwin R.

    1991-01-01

    Intracellular microelectrode recording/labeling techniques were used to investigate vestibular afferent responses in the bullfrog, to very small amplitude (less than 5 deg p-p) sinusoidal rotations in the vertical plane over the frequency range of 0.063-4 Hz. Robust responses to peak accelerations as low as 0.031 deg/sec per sec were obtained from units subsequently traced to either the central portion of the anterior canal crista or the striolar region of the utricle. All of these microrotationally sensitive afferent neurons had irregular resting discharge rates, and the majority had transfer ratios (relative to rotational velocity) of 1-40 spikes/sec per deg/sec. Individual utricular afferent velocity transfer ratios were nearly constant over the frequency range of 0.125-4 Hz. Canal units displayed decreasing response transfer ratios as stimulus frequencies increased. These findings indicate that, although utricular striolar and central crista afferent velocity transfer ratios to microrotations were very similar, utricular striolar afferent neurons were more faithful sensors of very small amplitude rotational velocity in the vertical plane.

  20. Microgravity vestibular investigations (10-IML-1)

    NASA Technical Reports Server (NTRS)

    Reschke, Millard F.

    1992-01-01

    Our perception of how we are oriented in space is dependent on the interaction of virtually every sensory system. For example, to move about in our environment we integrate inputs in our brain from visual, haptic (kinesthetic, proprioceptive, and cutaneous), auditory systems, and labyrinths. In addition to this multimodal system for orientation, our expectations about the direction and speed of our chosen movement are also important. Changes in our environment and the way we interact with the new stimuli will result in a different interpretation by the nervous system of the incoming sensory information. We will adapt to the change in appropriate ways. Because our orientation system is adaptable and complex, it is often difficult to trace a response or change in behavior to any one source of information in this synergistic orientation system. However, with a carefully designed investigation, it is possible to measure signals at the appropriate level of response (both electrophysiological and perceptual) and determine the effect that stimulus rearrangement has on our sense of orientation. The environment of orbital flight represents the stimulus arrangement that is our immediate concern. The Microgravity Vestibular Investigations (MVI) represent a group of experiments designed to investigate the effects of orbital flight and a return to Earth on our orientation system.

  1. Spatial orientation - Visual-vestibular-somatic interaction

    NASA Technical Reports Server (NTRS)

    Parker, D. E.; Poston, R. L.; Gulledge, W. L.

    1983-01-01

    The compensation signals from somatosensory and vestibular receptors, which act to compensate for disturbances produced by the displacement of our eyes relative to other parts of our bodies and for visual disturbances such as tilted frames or moving visual fields, are investigated. Disturbances were evoked by tilting the head and by rotating a large visual display, while compensation signals related to gravity were altered by placing the subjects horizontally on a board or seating them vertically. The first experiment studied the effects of visual disturbance on the ability of supine observers to set a line to the longitudinal body axis while the head was tilted toward one shoulder or while the head was straight. Results showed that the effects of the visual disturbance were greater when the head was tilted than when it was straight, which indicates that the effects of visual disturbance were greater for a task that required compensation. The second experiment compared the performance of supine and erect observers. No differences were found between the performance of observers on a task requiring the use of compensation signals under these two conditions, which suggests that the enrichment of compensatory signals did not reduce the effects of visual disturbancs.

  2. Effect of 30-min +3 Gz centrifugation on vestibular and autonomic cardiovascular function

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Wood, Scott J.; Brown, Troy E.; Harm, Deborah L.; Rupert, A. H.

    2003-01-01

    INTRODUCTION: Repeated exposure to increased +Gz enhances human baroreflex responsiveness and improves tolerance to cardiovascular stress. However, it is not known whether such enhancements might also result from a single, more prolonged exposure to increased +Gz. Our study was designed to investigate whether baroreflex function and orthostatic tolerance are acutely improved by a single prolonged exposure to +3 Gz, and moreover, whether changes in autonomic cardiovascular function resulting from exposure to increased +Gz are correlated with changes in otolith function. METHODS: We exposed 15 healthy human subjects to +3 Gz centrifugation for up to 30 min or until symptoms of incipient G-induced loss of consciousness (G-LOC) ensued. Tests of autonomic cardiovascular function both before and after centrifugation included: 1) power spectral determinations of beat-to-beat R-R intervals and arterial pressures; 2) carotid-cardiac baroreflex tests; 3) Valsalva tests; and 4) 30-min head-up tilt tests. Otolith function was assessed during centrifugation by the linear vestibulo-ocular reflex and both before and after centrifugation by measurements of ocular counter-rolling and dynamic posturography. RESULTS: Of the 15 subjects who underwent prolonged +3 Gz, 4 were intolerant to 30 min of head-up tilt before centrifugation but became tolerant to such tilt after centrifugation. The Valsalva-related baroreflex as well as a measure of the carotid-cardiac baroreflex were also enhanced after centrifugation. No significant vestibular-autonomic relationships were detected beyond a vestibular-cerebrovascular interaction reported earlier in a subset of seven participants. CONCLUSIONS: A single prolonged exposure to +3 Gz centrifugation acutely improves baroreflex function and orthostatic tolerance.

  3. Effect of Sustained Human Centrifugation on Autonomic Cardiovascular and Vestibular Function

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Wood, Scott J.; Brown, Troy E.; Benavides, Edgar W.; Harm, Deborah L.; Rupert, A. H.

    2002-01-01

    Repeated exposure to +Gz enhances human baroreflex responsiveness and improves tolerance to cardiovascular stress. However, both sustained exposure to +Gx and changes in otolith function resulting from the gravitational changes of space flight and parabolic flight may adversely affect autonomic cardiovascular function and orthostatic tolerance. HYPOTHESES: Baroreflex function and orthostatic tolerance are acutely improved by a single sustained (30 min) exposure to +3Gz but not +3Gx. Moreover, after 30 min of +3Gx, any changes that occur in autonomic cardiovascular function will relate commensurately to changes in otolith function. METHODS: Twenty-two healthy human subjects were first exposed to 5 min of +3 Gz centrifugation and then subsequently up to a total of30 min of either +3Gz (n = 15) or +3Gx (n = 7) centrifugation. Tests of autonomic cardiovascular function both before and after both types of centrifugation included: (a) power spectral determinations of beat-to-beat R-R intervals and arterial pressures; (b) carotid-cardiac baroreflex tests; ( c) Valsalva tests; and (d) 30-min head-up tilt (HUT) tests. Otolith function was assessed during centrifugation by the linear vestibulo-ocular reflex and both before and after centrifugation by measurements of ocular counter-rolling and dynamic posturography. RESULTS: All four +3Gz subjects who were intolerant to HUT before centrifugation became tolerant to HUT after centrifugation. The operational point of the carotid-cardiac baroreflex and the Valsalva-related baroreflex were also enhanced in the +3Gz group but not in the +3Gx group. No significant vestibular-autonomic relationships were detected, other than a significant vestibular-cerebrovascular interaction reported previously. CONCLUSIONS: A single, sustained exposure to +3 Gz centrifugation acutely improves baroreflex function and orthostatic tolerance whereas a similar exposure to +3 Gx centrifugation appears to have less effect.

  4. Visual and proprioceptive contributions to postural control of upright stance in unilateral vestibulopathy.

    PubMed

    Eysel-Gosepath, Katrin; McCrum, Christopher; Epro, Gaspar; Brüggemann, Gert-Peter; Karamanidis, Kiros

    2016-06-01

    Preserving upright stance requires central integration of the sensory systems and appropriate motor output from the neuromuscular system to keep the centre of pressure (COP) within the base of support. Unilateral peripheral vestibular disorder (UPVD) causes diminished stance stability. The aim of this study was to determine the limits of stability and to examine the contribution of multiple sensory systems to upright standing in UPVD patients and healthy subjects. We hypothesized that closure of the eyes and Achilles tendon vibration during upright stance will augment the postural sway in UPVD patients more than in healthy subjects. Seventeen UPVD patients and 17 healthy subjects performed six tasks on a force plate: forwards and backwards leaning, to determine limits of stability, and upright standing with and without Achilles tendon vibration, each with eyes open and closed (with blackout glasses). The COP displacement of the patients was significantly greater in the vibration tasks than the controls and came closer to the posterior base of support boundary than the controls in all tasks. Achilles tendon vibration led to a distinctly more backward sway in both subject groups. Five of the patients could not complete the eyes closed with vibration task. Due to the greater reduction in stance stability when the proprioceptive, compared with the visual, sensory system was disturbed, we suggest that proprioception may be more important for maintaining upright stance than vision. UPVD patients, in particular, showed more difficulty in controlling postural stability in the posterior direction with visual and proprioceptive sensory disturbance.

  5. [Vestibular dysfunction in the postpartum period following gestosis].

    PubMed

    Likhachev, S A; Astapenko, A V; Osos, E L; Tarasevich, N M

    2010-01-01

    The state of the vestibular system was evaluated in 30 postpartum women following gestosis and 25 controls after uncomplicated pregnancy. Examination using the electronystagmographic technique failed to reveal spontaneous nystagmus (Ny) in the latter group whereas 13.3% and 30% women of the former group had it with the eyes open and closed respectively. Provocative functional tests significantly improved detectability of Ny. Hyperventilation was associated with Ny in 80% and 12% of the women after complicated and uneventful pregnancy respectively while orthostatic test revealed Ny in 63% and 12% of them. Active head rotation with closed eyes produced well-apparent experimental Ny in women of both groups, but it was significantly more pronounced in the former one. Post-gestosis women displayed markedly impaired reaction in vestibular-ocular reflex suppression test. It is concluded that 80% of the women with complicated pregnancy exhibited vestibular dysfunction of central origin in the postpartum period. PMID:20517270

  6. Rapid adaptation of multisensory integration in vestibular pathways.

    PubMed

    Carriot, Jerome; Jamali, Mohsen; Cullen, Kathleen E

    2015-01-01

    Sensing gravity is vital for our perception of spatial orientation, the control of upright posture, and generation of our everyday activities. When an astronaut transitions to microgravity or returns to earth, the vestibular input arising from self-motion will not match the brain's expectation. Our recent neurophysiological studies have provided insight into how the nervous system rapidly reorganizes when vestibular input becomes unreliable by both (1) updating its internal model of the sensory consequences of motion and (2) up-weighting more reliable extra-vestibular information. These neural strategies, in turn, are linked to improvements in sensorimotor performance (e.g., gaze and postural stability, locomotion, orienting) and perception characterized by similar time courses. We suggest that furthering our understanding of the neural mechanisms that underlie sensorimotor adaptation will have important implications for optimizing training programs for astronauts before and after space exploration missions and for the design of goal-oriented rehabilitation for patients. PMID:25932009

  7. Motor Performance is Impaired Following Vestibular Stimulation in Ageing Mice

    PubMed Central

    Tung, Victoria W. K.; Burton, Thomas J.; Quail, Stephanie L.; Mathews, Miranda A.; Camp, Aaron J.

    2016-01-01

    Balance and maintaining postural equilibrium are important during stationary and dynamic movements to prevent falls, particularly in older adults. While our sense of balance is influenced by vestibular, proprioceptive, and visual information, this study focuses primarily on the vestibular component and its age-related effects on balance. C57Bl/6J mice of ages 1, 5–6, 8–9 and 27–28 months were tested using a combination of standard (such as grip strength and rotarod) and newly-developed behavioral tests (including balance beam and walking trajectory tests with a vestibular stimulus). In the current study, we confirm a decline in fore-limb grip strength and gross motor coordination as age increases. We also show that a vestibular stimulus of low frequency (2–3 Hz) and duration can lead to age-dependent changes in balance beam performance, which was evident by increases in latency to begin walking on the beam as well as the number of times hind-feet slip (FS) from the beam. Furthermore, aged mice (27–28 months) that received continuous access to a running wheel for 4 weeks did not improve when retested. Mice of ages 1, 10, 13 and 27–28 months were also tested for changes in walking trajectory as a result of the vestibular stimulus. While no linear relationship was observed between the changes in trajectory and age, 1-month-old mice were considerably less affected than mice of ages 10, 13 and 27–28 months. Conclusion: this study confirms there are age-related declines in grip strength and gross motor coordination. We also demonstrate age-dependent changes to finer motor abilities as a result of a low frequency and duration vestibular stimulus. These changes showed that while the ability to perform the balance beam task remained intact across all ages tested, behavioral changes in task performance were observed. PMID:26869921

  8. Exploration of Circadian Rhythms in Patients with Bilateral Vestibular Loss

    PubMed Central

    Martin, Tristan; Moussay, Sébastien; Bulla, Ingo; Bulla, Jan; Toupet, Michel; Etard, Olivier; Denise, Pierre; Davenne, Damien; Coquerel, Antoine; Quarck, Gaëlle

    2016-01-01

    Background New insights have expanded the influence of the vestibular system to the regulation of circadian rhythmicity. Indeed, hypergravity or bilateral vestibular loss (BVL) in rodents causes a disruption in their daily rhythmicity for several days. The vestibular system thus influences hypothalamic regulation of circadian rhythms on Earth, which raises the question of whether daily rhythms might be altered due to vestibular pathology in humans. The aim of this study was to evaluate human circadian rhythmicity in people presenting a total bilateral vestibular loss (BVL) in comparison with control participants. Methodology and Principal Findings Nine patients presenting a total idiopathic BVL and 8 healthy participants were compared. Their rest-activity cycle was recorded by actigraphy at home over 2 weeks. The daily rhythm of temperature was continuously recorded using a telemetric device and salivary cortisol was recorded every 3 hours from 6:00AM to 9:00PM over 24 hours. BVL patients displayed a similar rest activity cycle during the day to control participants but had higher nocturnal actigraphy, mainly during weekdays. Sleep efficiency was reduced in patients compared to control participants. Patients had a marked temperature rhythm but with a significant phase advance (73 min) and a higher variability of the acrophase (from 2:24 PM to 9:25 PM) with no correlation to rest-activity cycle, contrary to healthy participants. Salivary cortisol levels were higher in patients compared to healthy people at any time of day. Conclusion We observed a marked circadian rhythmicity of temperature in patients with BVL, probably due to the influence of the light dark cycle. However, the lack of synchronization between the temperature and rest-activity cycle supports the hypothesis that the vestibular inputs are salient input to the circadian clock that enhance the stabilization and precision of both external and internal entrainment. PMID:27341473

  9. Visual and proprioceptive interaction in patients with bilateral vestibular loss.

    PubMed

    Cutfield, Nicholas J; Scott, Gregory; Waldman, Adam D; Sharp, David J; Bronstein, Adolfo M

    2014-01-01

    Following bilateral vestibular loss (BVL) patients gradually adapt to the loss of vestibular input and rely more on other sensory inputs. Here we examine changes in the way proprioceptive and visual inputs interact. We used functional magnetic resonance imaging (fMRI) to investigate visual responses in the context of varying levels of proprioceptive input in 12 BVL subjects and 15 normal controls. A novel metal-free vibrator was developed to allow vibrotactile neck proprioceptive input to be delivered in the MRI system. A high level (100 Hz) and low level (30 Hz) control stimulus was applied over the left splenius capitis; only the high frequency stimulus generates a significant proprioceptive stimulus. The neck stimulus was applied in combination with static and moving (optokinetic) visual stimuli, in a factorial fMRI experimental design. We found that high level neck proprioceptive input had more cortical effect on brain activity in the BVL patients. This included a reduction in visual motion responses during high levels of proprioceptive input and differential activation in the midline cerebellum. In early visual cortical areas, the effect of high proprioceptive input was present for both visual conditions but in lateral visual areas, including V5/MT, the effect was only seen in the context of visual motion stimulation. The finding of a cortical visuo-proprioceptive interaction in BVL patients is consistent with behavioural data indicating that, in BVL patients, neck afferents partly replace vestibular input during the CNS-mediated compensatory process. An fMRI cervico-visual interaction may thus substitute the known visuo-vestibular interaction reported in normal subject fMRI studies. The results provide evidence for a cortical mechanism of adaptation to vestibular failure, in the form of an enhanced proprioceptive influence on visual processing. The results may provide the basis for a cortical mechanism involved in proprioceptive substitution of vestibular

  10. Vision and vertigo: some visual aspects of vestibular disorders.

    PubMed

    Bronstein, Adolfo M

    2004-04-01

    This review deals with two syndromes, oscillopsia and visual vertigo. Oscillopsia is the illusion of oscillation of the visual surroundings. For diagnosis purposes one should ask, when does the oscillopsia occur? If oscillopsia is only present during head (or whole body) movements, the likely underlying cause is a bilateral defect in the vestibulo-ocular reflex (VOR). The more common causes are post meningitic vestibular damage, gentamicin ototoxicity or bilateral idiopathic vestibular failure. When oscillopsia develops after specific head positions, it is usually due to a positional nystagmus, usually the result of brainstem-cerebellar disease. When the oscillopsia is largely unrelated to head movements, one should ask, is it fairly constant or is it in attacks (paroxysmal)? If the oscillopsia is constant it is usually due to the presence of a clinically observable nystagmus; the most common is downbeat nystagmus but the most visually disabling is pendular nystagmus. If the oscillopsia comes in brief attacks it is usually due to a paroxysmal nystagmus as observed in irritative VIII nerve and brainstem lesions. However, the most common cause of paroxysmal oscillopsia is a non organic condition called voluntary nystagmus. Treatment of oscillopsia is often pharmacological but disappointing; the best chance of success is carbamazepine for paroxysmal disorders secondary to structural vestibular nerve/nuclear lesions.Visual vertigo should not be confused with oscillopsia. It can be defined as dizziness provoked by visual environments with large size (full field) repetitive or moving visual patterns. Patients with visual vertigo report discomfort in supermarkets and when viewing movement of large visual objects, eg crowds, traffic, clouds or foliage. Visual vertigo is present in many patients with a history of a peripheral vestibular disorder, particularly those who are visually dependent (ie subjects who use vision preferentially for postural and space orientation

  11. Kv1 channels and neural processing in vestibular calyx afferents.

    PubMed

    Meredith, Frances L; Kirk, Matthew E; Rennie, Katherine J

    2015-01-01

    Potassium-selective ion channels are important for accurate transmission of signals from auditory and vestibular sensory end organs to their targets in the central nervous system. During different gravity conditions, astronauts experience altered input signals from the peripheral vestibular system resulting in sensorimotor dysfunction. Adaptation to altered sensory input occurs, but it is not explicitly known whether this involves synaptic modifications within the vestibular epithelia. Future investigations of such potential plasticity require a better understanding of the electrophysiological mechanisms underlying the known heterogeneity of afferent discharge under normal conditions. This study advances this understanding by examining the role of the Kv1 potassium channel family in mediating action potentials in specialized vestibular afferent calyx endings in the gerbil crista and utricle. Pharmacological agents selective for different sub-types of Kv1 channels were tested on membrane responses in whole cell recordings in the crista. Kv1 channels sensitive to α-dendrotoxin and dendrotoxin-K were found to prevail in the central regions, whereas K(+) channels sensitive to margatoxin, which blocks Kv1.3 and 1.6 channels, were more prominent in peripheral regions. Margatoxin-sensitive currents showed voltage-dependent inactivation. Dendrotoxin-sensitive currents showed no inactivation and dampened excitability in calyces in central neuroepithelial regions. The differential distribution of Kv1 potassium channels in vestibular afferents supports their importance in accurately relaying gravitational and head movement signals through specialized lines to the central nervous system. Pharmacological modulation of specific groups of K(+) channels could help alleviate vestibular dysfunction on earth and in space. PMID:26082693

  12. Eye position dependency of nystagmus during constant vestibular stimulation.

    PubMed

    Bockisch, Christopher J; Khojasteh, Elham; Straumann, Dominik; Hegemann, Stefan C A

    2013-04-01

    Alexander's law, the eye position dependency of nystagmus due to peripheral vestibular lesions, has been hypothesized to occur due to adaptive changes in the brainstem velocity-to-position neural integrator in response to non-reciprocal vestibular stimulation. We investigated whether it develops during passive head rotations that produce constant nystagmus for >35 s. The yaw rotation stimulus consisted of a 1-s acceleration (100°/s(2)), followed by a lower acceleration ramp (starting at 7.3°/s(2) and increasing at 0.04°/s(2)/s) until 400°/s was reached after 38 s. This stimulus was designed to offset the ~15 s vestibular ocular reflex time constant (and the 150 s adaptation time constant) and produce constant velocity slow phases. In contrast to peripheral lesions, this vestibular stimulation is the result of real head turns and has the push-pull characteristics of natural movements. The procedure was successful, as the average velocity of 31°/s was unchanged over the final 35 s of the acceleration period. In all 10 healthy human subjects, we found a large and stable Alexander's law, with an average velocity-versus-position slope of -0.366 in the first half that was not significantly different in the second half, -0.347. These slopes correspond to integrator time constants of <3 s, are much less than normal time constants (~25 s), and are similar to those observed in patients with peripheral vestibular lesions. Alexander's law also developed, on average, in 10 s. We conclude that Alexander's law is not simply a consequence of non-reciprocal vestibular stimulation.

  13. Prevalence of vestibular dysfunction and associated factors in South Korea

    PubMed Central

    Koo, Ja-Won; Chang, Mun Young; Woo, Sook-young; Kim, Seonwoo; Cho, Yang-Sun

    2015-01-01

    Objective To report the nationwide prevalence of dizziness and vestibular dysfunction in the Korean population and determine the associated factors. Design Cross-sectional analysis of a nationwide health survey. Methods We obtained data from the 2009 to 2010 Korea National Health and Nutrition Examination Surveys, which were cross-sectional surveys of the South Korean civilian, non-institutionalised population aged 40 years and older (N=3267). A field survey team performed interviews and physical examinations. Structured questionnaires were handed out and balance function tests using the modified Romberg test of standing balance on firm and compliant support surfaces were performed on participants. Failure on the modified Romberg test was regarded to indicate vestibular dysfunction. Results The prevalence of dizziness during the past year was 16.70% (95% CI 14.65% to 18.76%). The presence of vestibular dysfunction was noted in 1.84% (95% CI 1.18% to 2.51%). In addition, the prevalence of experiencing falls and positional dizziness were 1.46% (95% CI 0.87% to 2.06%) and 1.73% (95% CI 1.17% to 2.29%), respectively. Multivariable analysis revealed that dizziness was associated with increased age, female gender, hearing loss and stress. Vestibular dysfunction was associated with increased age, history of dizziness and hearing loss. Conclusions Vertigo and dizziness are the greatest contributors to the burden of disability in the aged population. Screening for dizziness and vestibular dysfunction, and management of associated factors might be important for improving compromised quality of life due to postural imbalance caused by vestibular problems. PMID:26503384

  14. A model analysis of static stress in the vestibular membranes

    PubMed Central

    Pender, Daniel J

    2009-01-01

    Background The scheme of the core vestibular membranes, consisting of serially connected utricle, ampulla and semicircular canal, first appeared hundreds of millions of years ago in primitive fish and has remained largely unchanged during the subsequent course of evolution. The labyrinths of higher organisms build on this core structure, with the addition of the phylogenetically newer membrane structures, namely, saccule, lagena and cochlea. An analysis of static stress in these core vestibular membranes may contribute to a better understanding of the role of stress in the evolution of derivative membrane structures over the long term as well as the short-term membrane distortions seen in Meniere's disease. Methods A model of these core vestibular membranes is proposed in order to analyze the distribution of stress in the walls of the component chambers. The model uses basic geometrical elements of hollow cylinders and spheres to emulate the actual structures. These model elements lend themselves to a mathematical analysis of static stress in their membranes. Results Hoop stress, akin to the stress in hoops used to reinforce barrel walls, is found to be the predominant stress in the model membranes. The level of hoop stress depends not only on pressure but as well on a geometric stress factor that incorporates membrane shape, thickness and curvature. This result implies that hoop stress may be unevenly distributed in the membranes of the several vestibular chambers due to variations in these dimensional parameters. These results provide a theoretical framework for appraising hoop stress levels in any vestibular labyrinth whose dimensions are known. Conclusion Static hoop stress disparities are likely to exist in the vestibular membranes given their complex physical configurations. Such stress disparities may contribute to the development of membrane pathologies as seen in Meniere's Disease. They may also factor in the evolutionary development of other derivative

  15. Magnetic vestibular stimulation modulates default mode network fluctuations.

    PubMed

    Boegle, Rainer; Stephan, Thomas; Ertl, Matthias; Glasauer, Stefan; Dieterich, Marianne

    2016-02-15

    Strong magnetic fields (>1 Tesla) can cause dizziness and it was recently shown that healthy subjects (resting in total darkness) developed a persistent nystagmus even when remaining completely motionless within a MR tomograph. Consequently, it was speculated that this magnetic vestibular stimulation (MVS) might influence fMRI results, as nystagmus is indicative of an imbalance in the vestibular system, potentially influencing other systems via multisensory vestibular interactions. The objective of our study was to investigate whether MVS does indeed modulate BOLD signal fluctuations. We recorded eye movements, as well as, resting-state fMRI of 30 volunteers in darkness at 1.5 T and 3.0 T to answer the question whether MVS modulated parts of the default mode resting-state network (DMN) in accordance with the Lorentz-force model for MVS, while distinguishing this from the known signal increase due to field strength related imaging effects. Our results showed that modulation of the default mode network occurred mainly in areas associated with vestibular and ocular motor function, and was in accordance with the Lorentz-force model, i.e., double than the expected signal scaling due to field strength alone. We discuss the implications of our findings for the interpretation of studies using resting-state fMRI, especially those concerning vestibular research. We conclude that MVS needs to be considered in vestibular research to avoid biased results, but it might also offer the possibility of manipulating network dynamics and may thus help in studying the brain as a dynamical system.

  16. Short latency vestibular evoked potentials in the chicken embryo

    NASA Technical Reports Server (NTRS)

    Jones, S. M.; Jones, T. A.

    1996-01-01

    Electrophysiological responses to pulsed linear acceleration stimuli were recorded in chicken embryos incubated for 19 or 20 days (E19/E20). Responses occurred within the first 16 ms following the stimulus onset. The evoked potentials disappeared following bilateral labyrinthectomy, but persisted following cochlear destruction alone, thus demonstrating that the responses were vestibular. Approximately 8 to 10 response peaks could be identified. The first 4 positive and corresponding negative components (early peaks with latencies < 6.0 ms) were scored and latencies and amplitudes quantified. Vestibular response latencies were significantly longer (P < 0.01) and amplitudes significantly smaller (P < 0.001) than those observed in 2-week-old birds. Mean response threshold for anesthetized embryos was -15.9dBre 1.0 g/ms, which was significantly higher (P < 0.03) than those observed in 2-week-old birds (-23.0dBre 1.0 g/ms). Latency/intensity functions (that is, slopes) were not significantly different between embryos and 2-week-old animals, but amplitude/intensity functions for embryos were significantly shallower than those for 2-week-old birds (P < 0.001). We presume that these differences reflect the refinement of sensory function that occurs following 19 to 20 days of incubation. The recording of vestibular evoked potentials provides an objective, direct and noninvasive measure of peripheral vestibular function in the embryo and, as such, the method shows promise as an investigative tool. The results of the present study form the definitive basis for using vestibular evoked potentials in the detailed study of avian vestibular ontogeny and factors that may influence it.

  17. Direction discrimination thresholds of vestibular and cerebellar nuclei neurons

    PubMed Central

    Liu, Sheng; Yakusheva, Tatyana; Deangelis, Gregory C.; Angelaki, Dora E.

    2009-01-01

    To understand the roles of the vestibular system in perceptual detection and discrimination of self-motion, it is critical to account for response variability in computing the sensitivity of vestibular neurons. Here we study responses of neurons with no eye movement sensitivity in the vestibular (VN) and rostral fastigial (FN) nuclei using high frequency (2 Hz) oscillatory translational motion stimuli. The axis of translation (i.e., heading) varied slowly (1°/s) in the horizontal plane as the animal was translated back and forth. Signal detection theory was used to compute the threshold sensitivity of VN/FN neurons for discriminating small variations in heading around all possible directions of translation. Across the population, minimum heading discrimination thresholds averaged 16.6° ±1° SE for FN neurons and 15.3°±2.2° SE for VN neurons, several-fold larger than perceptual thresholds for heading discrimination. In line with previous studies and theoretical predictions, maximum discriminability was observed for directions where firing rate changed steeply as a function of heading, which occurs at headings approximately perpendicular to the maximum response direction. Forward/backward heading thresholds tended to be lower than lateral motion thresholds, and the ratio of lateral over forward heading thresholds averaged 2.2±6.1 (geometric mean ± SD) for FN neurons and 1.1±4.4 for VN neurons. Our findings suggest that substantial pooling and/or selective decoding of vestibular signals from the vestibular and deep cerebellar nuclei may be important components of further processing. Such a characterization of neural sensitivity is critical for understanding how early stages of vestibular processing limit behavioral performance. PMID:20071508

  18. An uncommon case of dyspnea with unilateral laryngeal paralysis in acromegaly.

    PubMed

    Lerat, Justine; Lacoste, Marie; Prechoux, Jean-Marc; Aubry, Karine; Nadalon, Sylvie; Ly, Kim Heang; Bessede, Jean-Pierre

    2016-02-01

    A 61-year-old man with obstructive sleep apnea syndrome and normal BMI complained of dyspnea. Nasofibroscopy revealed a global and major oedema of the glottis and supraglottis and also a paralysis of the left vocal fold. CT-scan pointed out a spontaneous hyperdensity of the left arytenoid cartilage. A tracheostomy was performed. Clinical examination revealed large hands and macroglossy with high IGF1 rate. MRI confirmed a supracentimetric pituitary adenoma. To our knowledge, this is the first description of a case of acute respiratory distress due to unilateral larynx paralysis leading to acromegaly diagnosis. This is due to submucosal hypertrophy and vocal cord immobility.

  19. An uncommon case of dyspnea with unilateral laryngeal paralysis in acromegaly.

    PubMed

    Lerat, Justine; Lacoste, Marie; Prechoux, Jean-Marc; Aubry, Karine; Nadalon, Sylvie; Ly, Kim Heang; Bessede, Jean-Pierre

    2016-02-01

    A 61-year-old man with obstructive sleep apnea syndrome and normal BMI complained of dyspnea. Nasofibroscopy revealed a global and major oedema of the glottis and supraglottis and also a paralysis of the left vocal fold. CT-scan pointed out a spontaneous hyperdensity of the left arytenoid cartilage. A tracheostomy was performed. Clinical examination revealed large hands and macroglossy with high IGF1 rate. MRI confirmed a supracentimetric pituitary adenoma. To our knowledge, this is the first description of a case of acute respiratory distress due to unilateral larynx paralysis leading to acromegaly diagnosis. This is due to submucosal hypertrophy and vocal cord immobility. PMID:26142980

  20. Some remarks on unilateral matrix equations

    SciTech Connect

    Cerchiai, Bianca L.; Zumino, Bruno

    2001-02-01

    We briefly review the results of our paper LBNL-46775: We study certain solutions of left-unilateral matrix equations. These are algebraic equations where the coefficients and the unknown are square matrices of the same order, or, more abstractly, elements of an associative, but possibly noncommutative algebra, and all coefficients are on the left. Recently such equations have appeared in a discussion of generalized Born-Infeld theories. In particular, two equations, their perturbative solutions and the relation between them are studied, applying a unified approach based on the generalized Bezout theorem for matrix polynomials.

  1. [Unilateral hip arthrosis: expression of joint haemochromatosis].

    PubMed

    Prieto Zancudo, C; Villán Villán, Y F; Tascón Guerra, M F

    2012-10-01

    Hereditary haemochromatosis is the most common genetic disorder in the Caucasian population, with an estimated prevalence of 1/200-1/400 (homozygous) and 1/8-1/10 in carriers (heterozygous). The transmission is recessive and linked to HLA. The clinical expression of disease appears only in homozygous and will depend on the time of diagnosis and the degree of organ involvement. The clinical case presented below describes the process of differential diagnosis made in a young patient with unilateral coxarthrosis and clinical suspicion of hemochromatosis. Early diagnosis of hereditary hemochromatosis in primary care can reduce morbidity and mortality of this disease by detecting homozygous at younger ages.

  2. Diagnosis and management of drop attacks of vestibular origin: Tumarkin's otolithic crisis.

    PubMed

    Black, F O; Effron, M Z; Burns, D S

    1982-01-01

    Erroneous signals of vestibular origin can cause sudden falls without warning. Drop attacks of vestibular origin in our experience most commonly occurred in patients with late or end-stage endolymphatic hydrops (usually idiopathic, ie, Meniere's disease). Eponymically termed Tumarkin's otolithic crisis, drop attacks of vestibular origin must be distinguished from drop attacks due to cardiovascular abnormalities, seizure disorders, vertebral basilar arterial insufficiency (transitory brain stem ischemia), multiple sclerosis, and drug-induced motor control disturbances. The treatment of choice for drop attacks of vestibular origin is either surgical ablation (labyrinthectomy) in the absence of serviceable hearing or middle fossa vestibular nerve section in order to preserve serviceable hearing. PMID:6810273

  3. Interrelated striated elements in vestibular hair cells of the rat

    NASA Technical Reports Server (NTRS)

    Ross, M. D.; Bourne, C.

    1983-01-01

    A series of interrelated striated organelles in types I and II vestibular hair cells of the rat which appear to be less developed in cochlear hair cells have been revealed by unusual fixation procedures, suggesting that contractile elements may play a role in sensory transduction in the inner ear, especially in the vestibular system. Included in the series of interrelated striated elements are the cuticular plate and its basal attachments to the hair cell margins, the connections of the strut array of the kinociliary basal body to the cuticular plate, and striated organelles associated with the plasma membrane and extending below the apical junctional complexes.

  4. [Changes of audio-vestibular parameters in experimental endolymphatic hydrops].

    PubMed

    Zhang, S Z

    1993-01-01

    Endolymphatic hydrops were produced in twenty guinea pigs by obliteration of the endolymphatic sac. Auditory and vestibular functions were investigated before and after the obliteration. Our experimental data showed that: 1) the SPVN (sinusoidal pendular vestibular nystagmus) frequency decreased after the obliteration of the lymphatic sac; 2) the CAP response threshold to filtered clicks and the CAP response threshold to clicks were both elevated after obliteration of the endolymphatic sac; and 3) 2f1-f2 DPO (distortion product otoacoustic emissions) amplitudes, as induced by primary tones of adequate frequency and level rations, decreased as endolymphatic hydrops occurred. PMID:8192928

  5. Sensitization as a Basic Principle of Vestibular Adaptation to Microgravity

    NASA Astrophysics Data System (ADS)

    Horn, Eberhard R.

    2008-06-01

    The analysis of basic mechanisms of physiological adaptation to weightlessness suffers (1) on the rare flight opportunities, and (2) on the collection of data with a rough time resolution. The comparative approach using data from animal and human research might be helpful to overcome these problems even for human research. The advantage of the comparative approach became obvious for vestibular adaptation to microgravity. Neuroanatomical, neurophysiological, behavioural and psychophysical studies in snails, fish, amphibian, rodents, monkey and men clearly revealed vestibular sensitization as a basic mechanism of adaptation to weightlessness.

  6. Neurohumoral reactions to long-term vestibular stimulation in man.

    PubMed

    Nichiporuk, I A; Rapotkov, A N; Orlov, O I; Grigoriev, A I

    1993-02-01

    The main purposes of present work were: 1) to examine neurohumoral reactions to long-term vestibular stimulation provocative for MS symptoms in man; 2) to compare the peculiarities of neuroendocrine reactions to short-term and to long-term vestibular stimulation; 3) to analyze the received results from the position of neuroendocrine adaptive reactions biological conformity to natural laws, and its physiological importance for human organisms; 4) to make some prognostic points of neurohumoral reaction changes on health and capacity for work in subjects influenced by professional conditions, provocative for MS manifestation development.

  7. Protective Effect of RNase on Unilateral Nephrectomy-Induced Postoperative Cognitive Dysfunction in Aged Mice

    PubMed Central

    Gan, Lu; Dong, Yuanlin; Zhu, Tao; Ma, Gang; Li, Tao; Zhang, Xiyang; Li, Qian; Cheng, Xu; Wu, Chaomeng; Yang, Jing; Zuo, Yunxia; Liu, Jin

    2015-01-01

    Postoperative cognitive dysfunction (POCD) is a common complication after surgery, especially for elderly patients. Administration of RNase has been reported to exhibit neuroprotective effects in acute stroke. However, the potential role of RNase on POCD is unknown. Therefore, we sought to investigate whether RNase treatment could mitigate unilateral nephrectomy induced-cognitive deficit in aged mice. In the present study, twelve-month-old mice were administered RNase or an equal amount of normal saline perioperatively. All mice underwent Morris Water Maze (MWM) training 3 times per day for 7 days to acclimatize them to the water maze before surgical operation, and testing on days 1, 3 and 7 after surgery. We found that perioperative administration of RNase: 1) attenuated unilateral nephrectomy-induced cognitive impairment at day 3 after surgery; 2) reduced the hippocampal cytokines mRNA production and serum cytokines protein production at day 1 and day 7 (for MCP-1) after surgery, and; 3) inhibited hippocampal apoptosis as indicated by cleaved caspase-3 western blot and TUNEL staining at day 1 after surgery. In addition, a trend decrease of total serum RNA levels was detected in the RNase treated group after surgery compared with the untreated group. Further, our protocol of RNase administration had no impact on the arterial blood gas analysis right after surgery, kidney function and mortality rate at the observed days postoperatively. In conclusion, perioperative RNase treatment attenuated unilateral nephrectomy-induced cognitive impairment in aged mice. PMID:26225860

  8. Surgical outcome in cystic vestibular schwannomas

    PubMed Central

    Nair, Suresh; Baldawa, Sachin S.; Gopalakrishnan, Chittur Viswanathan; Menon, Girish; Vikas, Vazhayil; Sudhir, Jayanand B.

    2016-01-01

    Background: Cystic vestibular schwannomas (VS) form a rare subgroup that differs from the solid variant clinically, radiologically, and histopathologically. These tumors also vary in their surgical outcome and carry a different risk of post-operative complications. We analyzed our series of 64 patients with cystic VS and discuss the technical difficulties related to total excision of these tumors and focus on complication avoidance. Materials and Methods: A retrospective review of cystic VS surgically managed over a span of 11 years. The case records were evaluated to record the clinical symptoms and signs, imaging findings, surgical procedure, complications, and follow-up data. Post-operative facial nerve palsy was analyzed with respect to tumor size and tumor type. Results: Progressive hearing impairment was the most common initial symptom (76.6%). Atypical initial symptoms were present in 15 patients (23.4%). Preoperatively, 78% patients had good facial nerve function (HB grade 1, 2) and 22% had intermediate (HB grade 3, 4) to poor (HB grade 5 and 6) function. Mean tumor size was 4.1 cm. Complete tumor removal was achieved in 53 patients (83%). The facial nerve was anatomically intact but thinned out after tumor excision in 38 patients (59.4%). Ninety percent patients had either intermediate or poor facial nerve function at follow-up. Poor facial nerve outcome was associated with giant tumors and peripherally located, thin-walled cystic tumors. Conclusion: Resection of cystic VS is complicated by peritumoral adhesions of the capsule to the nerve. Extensive manipulation of the nerve in order to dissect the tumor–nerve barrier results in worse facial nerve outcome. The outcome is worse in peripherally located, thin-walled cystic VS as compared to centrally located, thick-walled cystic tumors. Subtotal excision may be justified, especially in tumors with dense adhesion of the cyst wall to the facial nerve in order to preserve nerve integrity. PMID:27366248

  9. Distinct vestibular effects on early and late somatosensory cortical processing in humans.

    PubMed

    Pfeiffer, Christian; van Elk, Michiel; Bernasconi, Fosco; Blanke, Olaf

    2016-01-15

    In non-human primates several brain areas contain neurons that respond to both vestibular and somatosensory stimulation. In humans, vestibular stimulation activates several somatosensory brain regions and improves tactile perception. However, less is known about the spatio-temporal dynamics of such vestibular-somatosensory interactions in the human brain. To address this issue, we recorded high-density electroencephalography during left median nerve electrical stimulation to obtain Somatosensory Evoked Potentials (SEPs). We analyzed SEPs during vestibular activ