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Pan S, Hu Y, Zhang H, He Y, Tian C, Lei J. The Current Status and Trends of Research Related to Vestibular Disorders, Vertigo, and Cognitive Impairment in the Elderly Population: A Bibliometric Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241257396. [PMID: 38818829 DOI: 10.1177/01455613241257396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Background: The vestibular system not only supports reflex function at the brainstem level, but is also associated with higher levels of cognitive function. Vertigo due to vestibular disorders may lead to or be associated with cognitive dysfunction. Patients with deficits of both vestibular as well as cognitive function may be at particularly high risk for events like falls or certain diseases, such as Alzheimer's. Objective: To analyze the current state of research and trends in the global research literature regarding the correlation between vestibular disorders, vertigo, and cognitive impairment. Methods: We utilized Bibliometrix package to search databases including PubMed, Web of Science, etc for search terms. Results: Databases were searched up to December 15, 2022, and a total of 2222 publications were retrieved. Ultimately, 53 studies were included. A total of 261 authors published in 38 journals and conferences with an overall increasing annual growth rate of 6.94%. The most-published journal was Frontiers in Neurology. The most-published country was the United States, followed by Italy and Brazil. The most-published institution was Johns Hopkins University with a total of 13 articles. On performing trend analysis, we found that the most frequent focus of research in this field include the testing of vestibular perception, activation of the brain-related cortex, and the influence of stimulus-triggered vestibular snail reflex on visual space. The potential focal points are the risk of falling and the ability to extract spatial memory information, and the focus of research in recent decades has revolved around balance, falling, and Alzheimer's disease. Conclusions: Vestibular impairment in older adults affects cognitive function, particularly immediate memory, visuospatial cognition, and attention, with spatial cognition being the most significantly affected. In the future, virtual reality-based vestibular rehabilitation techniques and caloric stimulation could be potential interventions for the treatment of cognitive impairment.
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Affiliation(s)
- Sijia Pan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanjia Hu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Huiying Zhang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yunfan He
- School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chenghua Tian
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jianbo Lei
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China
- School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, Sichuan, China
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Srulijes K, Mack DJ, Klenk J, Schwickert L, Ihlen EAF, Schwenk M, Lindemann U, Meyer M, Srijana KC, Hobert MA, Brockmann K, Wurster I, Pomper JK, Synofzik M, Schneider E, Ilg U, Berg D, Maetzler W, Becker C. Association between vestibulo-ocular reflex suppression, balance, gait, and fall risk in ageing and neurodegenerative disease: protocol of a one-year prospective follow-up study. BMC Neurol 2015; 15:192. [PMID: 26452640 PMCID: PMC4600299 DOI: 10.1186/s12883-015-0447-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 09/29/2015] [Indexed: 11/26/2022] Open
Abstract
Background Falls frequency increases with age and particularly in neurogeriatric cohorts. The interplay between eye movements and locomotion may contribute substantially to the occurrence of falls, but is hardly investigated. This paper provides an overview of current approaches to simultaneously measure eye and body movements, particularly for analyzing the association of vestibulo-ocular reflex (VOR) suppression, postural deficits and falls in neurogeriatric risk cohorts. Moreover, VOR suppression is measured during head-fixed target presentation and during gaze shifting while postural control is challenged. Using these approaches, we aim at identifying quantitative parameters of eye-head-coordination during postural balance and gait, as indicators of fall risk. Methods/Design Patients with Progressive Supranuclear Palsy (PSP) or Parkinson’s disease (PD), age- and sex-matched healthy older adults, and a cohort of young healthy adults will be recruited. Baseline assessment will include a detailed clinical assessment, covering medical history, neurological examination, disease specific clinical rating scales, falls-related self-efficacy, activities of daily living, neuro-psychological screening, assessment of mobility function and a questionnaire for retrospective falls. Moreover, participants will simultaneously perform eye and head movements (fixating a head-fixed target vs. shifting gaze to light emitting diodes in order to quantify vestibulo-ocular reflex suppression ability) under different conditions (sitting, standing, or walking). An eye/head tracker synchronized with a 3-D motion analysis system will be used to quantify parameters related to eye-head-coordination, postural balance, and gait. Established outcome parameters related to VOR suppression ability (e.g., gain, saccadic reaction time, frequency of saccades) and motor related fall risk (e.g., step-time variability, postural sway) will be calculated. Falls will be assessed prospectively over 12 months via protocols and monthly telephone interviews. Discussion This study protocol describes an experimental setup allowing the analysis of simultaneously assessed eye, head and body movements. Results will improve our understanding of the influence of the interplay between eye, head and body movements on falls in geriatric high-risk cohorts. Electronic supplementary material The online version of this article (doi:10.1186/s12883-015-0447-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Karin Srulijes
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,Department of Geriatrics and Clinic of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany. .,German Research Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany.
| | - David J Mack
- Department of Cognitive Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,Clinic for Neurology, University Hospital Zurich, Zurich, Switzerland.
| | - Jochen Klenk
- Department of Geriatrics and Clinic of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany. .,Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Lars Schwickert
- Department of Geriatrics and Clinic of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany.
| | - Espen A F Ihlen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Michael Schwenk
- Department of Geriatrics and Clinic of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany.
| | - Ulrich Lindemann
- Department of Geriatrics and Clinic of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany.
| | - Miriam Meyer
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
| | - K C Srijana
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. srijana.k.c.@student.uni-tuebingen.de
| | - Markus A Hobert
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,German Research Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany.
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,German Research Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany.
| | - Isabel Wurster
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,German Research Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany.
| | - Jörn K Pomper
- Department of Cognitive Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
| | - Matthis Synofzik
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,German Research Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany.
| | - Erich Schneider
- Institute of Medical Technology, Brandenburg University of Technology Cottbus -Senftenberg, Cottbus, Germany.
| | - Uwe Ilg
- Department of Cognitive Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,German Research Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany.
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany. .,German Research Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany.
| | - Clemens Becker
- Department of Geriatrics and Clinic of Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany.
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Chiu CM, Huang SF, Tsai PY, Wang RY, Chuang TY, Sung WH. Computer-aided vestibular autorotational testing of the vestibulo-ocular reflex in senile vestibular dysfunction. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2010; 97:92-98. [PMID: 20036438 DOI: 10.1016/j.cmpb.2009.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 10/31/2009] [Accepted: 11/10/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND AND OBJECTIVE Studies have already investigated vestibulo-ocular reflex (VOR) responses in elderly subjects, mostly at low frequencies (<1 Hz) during passive head turns, or continuous active head turns in a rotational chair. However, natural head movements usually occur at frequencies above 1 Hz and at varying rates, rather than at continuously increasing rates as tested in most studies to date. The aim of this study was to compare VOR responses within or between normal and bilateral peripheral vestibular hypofunction (BPVH) elderly subjects with a computer base program incorporating random active high-frequency head movements. SUBJECTS Seventeen senior patients with bilateral peripheral vestibular hypofunction and 13 age-matched paid healthy subjects participated in this study. DESIGN All the subjects performed 8s of active, side-to-side head motions at 1 Hz, 2 Hz and 3 Hz in response to four experimental conditions: (A) a stationary visual target; (B) a stationary visual target and a moving target with a horizontal trajectory; (C) a stationary visual target and a moving target with a spiral trajectory; and (D) a stationary visual target with combined horizontal- and vertical-spiral moving targets. RESULTS Repeated-measures ANOVA showed that across the different frequencies of headshaking, a significant increase took place in the phase lag of the BPVH subjects (p<0.001) compared with the normal controls. Post hoc analysis showed significant within-group differences in BPVH subjects (1 Hz vs 2 Hz, 2 Hz vs 3 Hz) and normal controls (1 Hz vs 2 Hz, 1 Hz vs 3 Hz). A significant VOR gain took place among the BPVH subjects at 3 Hz VAT (p<0.001) as compared with 1 Hz VAT and no significant differences in VOR gain could be detected among the controls at either of these frequencies. Repeated-measures ANOVA revealed that under our test conditions, significant main effect was noted for VOR asymmetry (F=4.45, p<0.05). Post hoc analysis showed significant within-group differences in the BPVH subjects (test A vs test B, test A vs test C, and test A vs test D). CONCLUSIONS Our results showed that the VAT paradigm can be improved by using concurrent horizontal and vertical moving targets. The VOR phase may be useful for differentiating VAT responses between BPVH and healthy elderly subjects. Moreover, the results of this study demonstrate that gains in VOR at different frequencies of headshaking and asymmetry during different test conditions can be useful parameters for within-group assessment.
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Affiliation(s)
- Cheng-Ming Chiu
- Department of Physical Medicine and Rehabilitation, Far Eastern Memorial Hospital, Taipei, Taiwan, ROC
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Balance and eye movement training to improve gait in people with progressive supranuclear palsy: quasi-randomized clinical trial. Phys Ther 2008; 88:1460-73. [PMID: 18948373 DOI: 10.2522/ptj.20070302] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Although vertical gaze palsy and gait instability are cardinal features of progressive supranuclear palsy (PSP), little research has been done to address oculomotor and gait rehabilitation for PSP. The purpose of this study was to compare the benefits of a program of balance training complemented with eye movement and visual awareness training versus balance training alone to rehabilitate gait in people with PSP. PARTICIPANTS Nineteen people moderately affected by the disease were assigned to either a treatment group (balance plus eye movement exercises, n=10) or a comparison group (balance exercises only, n=9) in a quasi-random fashion. METHODS The baseline characteristics assessed were diagnosis (possible versus probable), sex, age, time of symptom onset, dementia, and severity of symptoms. Within-group, between-group, and effect size analyses were performed on kinematic gait parameters (stance time, swing time, and step length) and clinical tests (8-ft [2.4-m] walk test and Timed "Up & Go" Test). RESULTS The within-group analysis revealed significant improvements in stance time and walking speed for the treatment group, whereas the comparison group showed improvements in step length only. Moderate to large effects of the intervention were observed for the treatment group, and small effects were observed for the comparison group. The between-group analysis did not reveal significant changes for either group. DISCUSSION AND CONCLUSION These preliminary findings support the use of eye movement exercises as a complementary therapy for balance training in the rehabilitation of gait in people with PSP and moderate impairments. Additional studies powered at a higher level are needed to confirm these results.
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Di Fabio RP, Zampieri C, Tuite P. Gaze-shift strategies during functional activity in progressive supranuclear palsy. Exp Brain Res 2006; 178:351-62. [PMID: 17091299 DOI: 10.1007/s00221-006-0737-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Accepted: 09/26/2006] [Indexed: 11/26/2022]
Abstract
The relative sparing of visual fixation in parallel with disruption of saccade function in progressive supranuclear palsy (PSP) creates a unique human model for the study of gaze-shift strategies which are adopted when vertical gaze palsy impairs primarily the eye-movement component of gaze control. It was hypothesized that people with PSP would rely on head pitch as a primary component of gaze shift during a platform stepping task and that there would be a predominance of fixation behavior (counter rotation of the eyes during head pitch) while attempting a down-gaze shift. Fourteen subjects with probable and 5 subjects with possible PSP participated in two experiments to measure visual fixation and gaze shift on the same continuum (using a derived vertical gaze fixation score, vGFS). Experiment #1 required gaze fixation during passive head pitch at 0.1-0.2 Hz, whereas experiment #2 required gaze shifts during a continuous platform step on, over, and off task. The primary gaze-shift strategy involved pitching the head downward to compensate for a loss in vertical saccade function. This strategy produced head pitch velocity that leads vertical eye velocity on the order of 200-500 ms. Gaze shifts during platform stepping showed greater fixation suppression (e.g., lower vGFS) in both groups of PSP compared to the visual stabilization task, but some subjects showed "fixation intrusion" during attempted gaze shift. The amount of eye movement was relatively constant when corrected for orbit height, whereas the extent of head pitch varied in proportion to the task demands. The mechanism controlling gaze in PSP, therefore appears to modulate head pitch independently of eye movement, but the gaze strategy seems dependent upon the extent of gaze dysfunction. These findings support the view that the desired gaze signal is parsed into separate eye and head pathways upstream from the burst neurons.
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Affiliation(s)
- Richard P Di Fabio
- Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, MN 55455, USA.
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