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Gökçe E, Milot E, Langeard A, Quarck G. Impact of repetitive home-based galvanic vestibular stimulation on cognitive skills in healthy older adults. Exp Gerontol 2024; 194:112504. [PMID: 38936440 DOI: 10.1016/j.exger.2024.112504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/12/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024]
Abstract
The human vestibular system is adversely affected by the aging process. Recent evidence indicates that vestibular information and cognitive functions are related, suggesting that age-related vestibular loss may contribute to cognitive impairment. In this study, we aimed to investigate the effects of repetitive, home-based galvanic vestibular stimulation (GVS) on cognitive functions in healthy older adults. Twenty-one participants (age = 64.66 ± 2.97 years, 12 females) were randomly allocated to either a home-based GVS or an active control group. The GVS intervention lasted 20 min per session, five times a week, for two weeks (10 sessions). Cognitive functions were assessed before and after the intervention using the Stroop Test, Trail Making Test A&B, and Dual-Task (digit recall and paper-pencil tracking test). Our findings revealed a significant group-by-time interaction effect for the tracking accuracy (F(1,18) = 7.713, p = 0.012, η p2 = 0.30), with only the home-based GVS group showing significant improvement (t = -2.544, p = 0.029). The proposed home-based GVS protocol offers a promising non-pharmacological avenue for enhancing visuospatial ability in healthy older adults. Further research is needed to investigate the effects of different GVS protocols on various cognitive functions, particularly in older individuals with different health conditions.
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Affiliation(s)
- Evrim Gökçe
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France.
| | - Emma Milot
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Antoine Langeard
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Gaëlle Quarck
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
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Clément G, Kuldavletova O, Macaulay TR, Wood SJ, Navarro Morales DC, Toupet M, Hautefort C, Van Nechel C, Quarck G, Denise P. Cognitive and balance functions of astronauts after spaceflight are comparable to those of individuals with bilateral vestibulopathy. Front Neurol 2023; 14:1284029. [PMID: 37965165 PMCID: PMC10641777 DOI: 10.3389/fneur.2023.1284029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/06/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction This study compares the balance control and cognitive responses of subjects with bilateral vestibulopathy (BVP) to those of astronauts immediately after they return from long-duration spaceflight on board the International Space Station. Methods Twenty-eight astronauts and thirty subjects with BVP performed five tests using the same procedures: sit-to-stand, walk-and-turn, tandem walk, duration judgment, and reaction time. Results Compared to the astronauts' preflight responses, the BVP subjects' responses were impaired in all five tests. However, the BVP subjects' performance during the walk-and-turn and the tandem walk tests were comparable to the astronauts' performance on the day they returned from space. Moreover, the BVP subjects' time perception and reaction time were comparable to those of the astronauts during spaceflight. The BVP subjects performed the sit-to-stand test at a level that fell between the astronauts' performance on the day of landing and 1 day later. Discussion These results indicate that the alterations in dynamic balance control, time perception, and reaction time that astronauts experience after spaceflight are likely driven by central vestibular adaptations. Vestibular and somatosensory training in orbit and vestibular rehabilitation after spaceflight could be effective countermeasures for mitigating these post-flight performance decrements.
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Affiliation(s)
- Gilles Clément
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
- KBR, Houston, TX, United States
| | - Olga Kuldavletova
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | | | - Scott J Wood
- NASA Johnson Space Center, Houston, TX, United States
| | - Deborah C Navarro Morales
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Michel Toupet
- Centre d'Explorations Fonctionnelles Oto-Neurologiques, Paris, France
| | - Charlotte Hautefort
- Université de Paris Cité, INSERM U1141, Paris, France
- Department of Otorhinolaryngology, Assistance Publique, Hôpitaux de Paris, Lariboisière Hospital, Paris, France
| | | | - Gaëlle Quarck
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
| | - Pierre Denise
- Université de Caen Normandie, INSERM, COMETE U1075, CYCERON, CHU de Caen, Normandie Université, Caen, France
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Smith PF. Interpreting the meaning of changes in hippocampal volume associated with vestibular loss. Front Integr Neurosci 2023; 17:1254972. [PMID: 37608860 PMCID: PMC10440551 DOI: 10.3389/fnint.2023.1254972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/21/2023] [Indexed: 08/24/2023] Open
Abstract
Many studies have documented cognitive deficits, especially spatial cognitive deficits, in patients with some form of vestibular loss. Almost 20 years ago, hippocampal (HPC) atrophy was reported to be correlated with spatial memory deficits in such patients and the idea has gradually emerged that HPC atrophy may be causally responsible for the cognitive deficits. However, the results of studies of HPC volume following vestibular loss have not always been consistent, and a number of studies have reported no evidence of HPC atrophy. This paper argues that HPC atrophy, if it does occur following vestibular loss, may not be directly, causally responsible for the cognitive deficits, and that it is more likely that rapid functional changes in the HPC are responsible, due to the interruption of the transmission of vestibular information to the HPC. The argument presented here rests on 3 tranches of evidence: (1) Cognitive deficits have been observed in humans even in the absence of HPC atrophy; (2) HPC atrophy has not been reported in animal studies following vestibular loss, despite cognitive deficits; and (3) Animal studies have shown that the interruption of the transmission of vestibular information to the HPC has immediate consequences for HPC place cells, far too quickly to be explained by HPC atrophy. It is possible that HPC atrophy, when it does occur, is related to the longer-term consquences of living with vestibular loss, which are likely to increase circulating cortisol.
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Affiliation(s)
- Paul F. Smith
- Department of Pharmacology and Toxicology, Brain Health Research Centre, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- The Brain Research New Zealand Centre of Research Excellence, Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
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Karabulut M, Van Laer L, Hallemans A, Vereeck L, Van Rompaey V, Viechtbauer W, Melliti A, van Stiphout L, Mohamad A, Pérez Fornos A, Guinand N, van de Berg R. Chronic symptoms in patients with unilateral vestibular hypofunction: systematic review and meta-analysis. Front Neurol 2023; 14:1177314. [PMID: 37483440 PMCID: PMC10360052 DOI: 10.3389/fneur.2023.1177314] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To systematically evaluate the full spectrum of self-reported chronic symptoms in patients with unilateral vestibular hypofunction (UVH) and to investigate the effect of interventions on these symptoms. Methods A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement (PRISMA). A literature search was performed in Pubmed, Web of Science, Embase, and Scopus to investigate self-reported symptoms and self-report questionnaires in patients with UVH. All original studies ranging from full-text clinical trials to case reports, written in English, German, and French, were included. The frequency of self-reported symptoms was presented. For self-report questionnaires, a meta-analysis was carried out to synthesize scale means by the pre- and post-intervention means and mean changes for studies that investigated interventions. Results A total of 2,110 studies were retrieved. Forty-seven studies were included after title-abstract selection and full-text selection by two independent reviewers. The symptoms of UVH patients included chronic dizziness (98%), imbalance (81%), symptoms worsened by head movements (75%), visually induced dizziness (61%), symptoms worsened in darkness (51%), and oscillopsia (22%). Additionally, UVH could be accompanied by recurrent vertigo (77%), tiredness (68%), cognitive symptoms (58%), and autonomic symptoms (46%). Regarding self-report questionnaires, UVH resulted on average in a moderate handicap, with an estimated mean total score on the Dizziness Handicap Inventory (DHI) and the Vertigo Symptom Scale (VSS) of 46.31 (95% CI: 41.17-51.44) and 15.50 (95% CI: 12.59-18.41), respectively. In studies that investigated the effect of vestibular intervention, a significant decrease in the estimated mean total DHI scores from 51.79 (95% CI: 46.61-56.97) (pre-intervention) to 27.39 (95% CI: 23.16-31.62) (post intervention) was found (p < 0.0001). In three studies, the estimated mean total Visual Analog Scale (VAS) scores were 7.05 (95% CI, 5.64-8.46) (pre-intervention) and 2.56 (95% CI, 1.15-3.97) (post-intervention). Finally, a subgroup of patients (≥32%) persists with at least a moderate handicap, despite vestibular rehabilitation. Conclusion A spectrum of symptoms is associated with UVH, of which chronic dizziness and imbalance are most frequently reported. However, semi-structured interviews should be conducted to define the whole spectrum of UVH symptoms more precisely, in order to establish a validated patient-reported outcome measure (PROM) for UVH patients. Furthermore, vestibular interventions can significantly decrease self-reported handicap, although this is insufficient for a subgroup of patients. It could therefore be considered for this subgroup of patients to explore new intervention strategies like vibrotactile feedback or the vestibular implant. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42023389185].
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Affiliation(s)
- Mustafa Karabulut
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands
| | - Lien Van Laer
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Luc Vereeck
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Ali Melliti
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands
| | - Lisa van Stiphout
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands
| | - Alfarghal Mohamad
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | | | - Nils Guinand
- Department of Ear Nose Throat, King Abdul Aziz Medical City, Jeddah, Saudi Arabia
| | - Raymond van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands
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Huang Y, Zhang X, Tang J, Xia Y, Yang X, Zhang Y, Wei C, Ruan R, Ying H, Liu Y. Vestibular cognition assessment system: Tablet-based computerized visuospatial abilities test battery. Front Psychol 2023; 14:1095777. [PMID: 36910755 PMCID: PMC9992172 DOI: 10.3389/fpsyg.2023.1095777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
Introduction The vestibular system is anatomically connected to extensive regions of the cerebral cortex, hippocampus, and amygdala. However, studies focusing on the impact of vestibular impairment on visuospatial cognition ability are limited. This study aimed to develop a mobile tablet-based vestibular cognitive assessment system (VCAS), enhance the dynamic and three-dimensional (3D) nature of the test conditions, and comprehensively evaluate the visuospatial cognitive ability of patients with vestibular dysfunction. Materials and methods First, the VCAS assessment dimensions (spatial memory, spatial navigation, and mental rotation) and test content (weeding, maze, card rotation, and 3D driving tests) were determined based on expert interviews. Second, VCAS was developed based on Unity3D, using the C# language and ILruntime hot update framework development technology, combined with the A* algorithm, prime tree algorithm, and dynamic route rendering. Further, the online test was built using relevant game business logic. Finally, healthy controls (HC) and 78 patients with vertigo (VP) were recruited for the VCAS test. The validity of VCAS was verified using the test results of random controls. Results In the weeding test, the HC group had a significantly longer span and faster velocity backward than did the VP group. In the 12 × 12 maze, statistically significant differences in step and time were observed between the two groups, with VP taking longer time and more steps. In the mental rotation task, no significant difference was observed between the two groups. Similarly, no significant difference was found in the performance of the two groups on maps 2, 3, and 4 in the 3D driving task. Discussion Thus, impaired visuospatial cognition in patients with vestibular dysfunction is primarily related to spatial memory and navigation. VCAS is a clinically applicable visuospatial cognitive ability test for VP.
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Affiliation(s)
- Yan Huang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xuehao Zhang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jia Tang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Yuqi Xia
- Department of Otolaryngology, Head, and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Xiaotong Yang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yanmei Zhang
- Department of Otolaryngology, Head, and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Chaogang Wei
- Department of Otolaryngology, Head, and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Ruiqi Ruan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hang Ying
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuhe Liu
- Department of Otolaryngology, Head, and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Demirhan MA, Celebisoy N. Cognitive functions in episodic vestibular disorders: Meniere's disease and vestibular migraine. J Vestib Res 2022; 33:63-70. [PMID: 36120750 DOI: 10.3233/ves-220025] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive deficits have been defined in patients with bilateral and unilateral vestibular loss. OBJECTIVE To investigate cognitive functions in patients with episodic vestibular disorders. METHODS Nineteen patients with Meniere's disease (MD), 19 patients with vestibular migraine (VM) and 21 age and education matched healthy controls were studied. Mini Mental State Examination assessing global mental status, Reading Span Test and the Stroop Test evaluating working memory, cognitive processing, reading comprehension and attention, Trail Making Test and Benton's Judgment of Line Orientation Test investigating visual processing, visuospatial skills, processing speed were used. Beck depression and anxiety inventories were given to evaluate the emotional status. RESULTS Cognitive test results of the MD and VM patients were not significantly different from the healthy controls (p > 0.05) as well as Beck depression scores (p = 0.14). Beck anxiety scores showed significant difference (p = 0.003). VM patients had significantly higher scores than the healthy controls (p = 0.002) on pairwise comparisons. The scores of the MD patients did not reach statistical significance (p = 0.15). CONCLUSION Episodic vestibular disorders like MD and VM without inter-ictal vestibular deficits do not seem to be associated with cognitive impairment. Patients with VM have significantly higher anxiety scores than the healthy controls and MD patients.
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Affiliation(s)
- Mehmet Alp Demirhan
- Department of Clinical Neuroscience, Ege University Institute of Health Sciences, Izmir, Turkey
| | - Nese Celebisoy
- Department of Clinical Neuroscience, Ege University Institute of Health Sciences, Izmir, Turkey.,Department of Neurology, Ege University Medical School, Bornova, Izmir, Turkey
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7
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Chari DA, Madhani A, Sharon JD, Lewis RF. Evidence for cognitive impairment in patients with vestibular disorders. J Neurol 2022; 269:5831-5842. [PMID: 35930032 DOI: 10.1007/s00415-022-11289-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Extensive animal research has shown that vestibular damage can be associated with cognitive deficits. More recently, new evidence has emerged linking vestibular disorders to cognitive impairment in humans. Herein, we review contemporary research on the pathophysiology of cognitive-vestibular interactions and discuss its emerging clinical relevance. DATA SOURCES PubMed, Embase, and Cochrane databases. REVIEW METHODS A systematic literature search was performed with combinations of search terms: "cognition," "cognitive impairment," "chronic fatigue," "brain fog," "spatial navigation," "attention," "memory," "executive function," "processing speed," and "vestibular hypofunction." Relevant articles were considered for inclusion, including basic and clinical studies, case series, and major reviews. CONCLUSIONS Patients with vestibular disorders can demonstrate long-term deficits in both spatial and nonspatial cognitive domains. The underlying mechanism(s) linking the vestibular system to cognitive function is not well characterized, but several neuro-biologic correlates have been identified. Additional screening tools are required to identify individuals at risk for cognitive impairment, and further research is needed to determine whether treatment of vestibular dysfunction has the capacity to improve cognitive function. IMPLICATIONS FOR PRACTICE Physicians should be aware of emerging data supporting the presence of cognitive deficits in patients with vestibular disorders. Prevention and treatment of long-term cognitive deficits may be possible through screening and rehabilitation.
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Affiliation(s)
- Divya A Chari
- Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
- Department of Otolaryngology - Head and Neck Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
- Jenks Vestibular Physiology Lab, Massachusetts Eye and Ear, Boston, MA, USA.
| | - Amsal Madhani
- Jenks Vestibular Physiology Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Jeffrey D Sharon
- Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Richard F Lewis
- Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Jenks Vestibular Physiology Lab, Massachusetts Eye and Ear, Boston, MA, USA
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8
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Gammeri R, Léonard J, Toupet M, Hautefort C, van Nechel C, Besnard S, Machado ML, Nakul E, Montava M, Lavieille JP, Lopez C. Navigation strategies in patients with vestibular loss tested in a virtual reality T-maze. J Neurol 2022; 269:4333-4348. [PMID: 35306619 DOI: 10.1007/s00415-022-11069-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 01/09/2023]
Abstract
During navigation, humans mainly rely on egocentric and allocentric spatial strategies, two different frames of reference working together to build a coherent representation of the environment. Spatial memory deficits during navigation have been repeatedly reported in patients with vestibular disorders. However, little is known about how vestibular disorders can change the use of spatial navigation strategies. Here, we used a new reverse T-maze paradigm in virtual reality to explore whether vestibular loss specifically modifies the use of egocentric or allocentric spatial strategies in patients with unilateral (n = 23) and bilateral (n = 23) vestibular loss compared to healthy volunteers (n = 23) matched for age, sex and education level. Results showed that the odds of selecting and using a specific strategy in the T-maze were significantly reduced in both unilateral and bilateral vestibular loss. An exploratory analysis suggests that only right vestibular loss decreased the odds of adopting a spatial strategy, indicating an asymmetry of vestibular functions. When considering patients who used strategies to navigate, we observed that a bilateral vestibular loss reduced the odds to use an allocentric strategy, whereas a unilateral vestibular loss decreased the odds to use an egocentric strategy. Age was significantly associated with an overall lower chance to adopt a navigation strategy and, more specifically, with a decrease in the odds of using an allocentric strategy. We did not observe any sex difference in the ability to select and use a specific navigation strategy. Findings are discussed in light of previous studies on visuo-spatial abilities and studies of vestibulo-hippocampal interactions in peripheral vestibular disorders. We discuss the potential impact of the history of the disease (chronic stage in patients with a bilateral vestibulopathy vs. subacute stage in patients with a unilateral vestibular loss), of hearing impairment and non-specific attentional deficits in patients with vestibular disorders.
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Affiliation(s)
- Roberto Gammeri
- Aix Marseille University, CNRS, LNC, FR3C, Marseille, France.,Department of Psychology, University of Turin, Torino, Italy
| | - Jacques Léonard
- Aix Marseille University, CNRS, LNC, FR3C, Marseille, France
| | - Michel Toupet
- IRON, Institut de Recherche en Oto-Neurologie, Paris, France.,Centre d'Explorations Fonctionnelles Oto-Neurologiques, Paris, France
| | - Charlotte Hautefort
- IRON, Institut de Recherche en Oto-Neurologie, Paris, France.,Service ORL, Hôpital Lariboisière, Paris, France
| | - Christian van Nechel
- IRON, Institut de Recherche en Oto-Neurologie, Paris, France.,Unité Troubles de L'Équilibre Et Vertiges, CHU Brugmann, Bruxelles, Belgium.,Unité de Neuro-Ophtalmologie, CHU Erasme, Bruxelles, Belgium.,Clinique Des Vertiges, Bruxelles, Belgium
| | | | | | - Estelle Nakul
- Aix Marseille University, CNRS, LNC, FR3C, Marseille, France
| | - Marion Montava
- Department of Otorhinolaryngology, Head and Neck Surgery, Hôpital La Conception, APHM, Marseille, France
| | - Jean-Pierre Lavieille
- Department of Otorhinolaryngology, Head and Neck Surgery, Hôpital La Conception, APHM, Marseille, France
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9
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Tekgün E, Erdeniz B. Contributions of Body-Orientation to Mental Ball Dropping Task During Out-of-Body Experiences. Front Integr Neurosci 2022; 15:781935. [PMID: 35058754 PMCID: PMC8764241 DOI: 10.3389/fnint.2021.781935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022] Open
Abstract
Out-of-body experiences (OBEs) provide fascinating insights into our understanding of bodily self-consciousness and the workings of the brain. Studies that examined individuals with brain lesions reported that OBEs are generally characterized by participants experiencing themselves outside their physical body (i.e., disembodied feeling) (Blanke and Arzy, 2005). Based on such a characterization, it has been shown that it is possible to create virtual OBEs in immersive virtual environments (Ehrsson, 2007; Ionta et al., 2011b; Bourdin et al., 2017). However, the extent to which body-orientation influences virtual OBEs is not well-understood. Thus, in the present study, 30 participants (within group design) experienced a full-body ownership illusion (synchronous visuo-tactile stimulation only) induced with a gender-matched full-body virtual avatar seen from the first-person perspective (1PP). At the beginning of the experiment, participants performed a mental ball dropping (MBD) task, seen from the location of their virtual avatar, to provide a baseline measurement. After this, a full-body ownership illusion (embodiment phase) was induced in all participants. This was followed by the virtual OBE illusion phase of the experiment (disembodiment phase) in which the first-person viewpoint was switched to a third-person perspective (3PP), and participants' disembodied viewpoint was gradually raised to 14 m above the virtual avatar, from which altitude they repeated the MBD task. During the experiment, this procedure was conducted twice, and the participants were allocated first to the supine or the standing body position at random. Results of the MBD task showed that the participants experienced increased MBD durations during the supine condition compared to the standing condition. Furthermore, although the findings from the subjective reports confirmed the previous findings of virtual OBEs, no significant difference between the two postures was found for body ownership. Taken together, the findings of the current study make further contributions to our understanding of both the vestibular system and time perception during OBEs.
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10
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Job XE, Kirsch LP, Auvray M. Spatial perspective-taking: insights from sensory impairments. Exp Brain Res 2022; 240:27-37. [PMID: 34716457 PMCID: PMC8803716 DOI: 10.1007/s00221-021-06221-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/12/2021] [Indexed: 11/03/2022]
Abstract
Information can be perceived from a multiplicity of spatial perspectives, which is central to effectively understanding and interacting with our environment and other people. Sensory impairments such as blindness are known to impact spatial representations and perspective-taking is often thought of as a visual process. However, disturbed functioning of other sensory systems (e.g., vestibular, proprioceptive and auditory) can also influence spatial perspective-taking. These lines of research remain largely separate, yet together they may shed new light on the role that each sensory modality plays in this core cognitive ability. The findings to date reveal that spatial cognitive processes may be differently affected by various types of sensory loss. The visual system may be crucial for the development of efficient allocentric (object-to-object) representation; however, the role of vision in adopting another's spatial perspective remains unclear. On the other hand, the vestibular and the proprioceptive systems likely play an important role in anchoring the perceived self to the physical body, thus facilitating imagined self-rotations required to adopt another's spatial perspective. Findings regarding the influence of disturbed auditory functioning on perspective-taking are so far inconclusive and thus await further data. This review highlights that spatial perspective-taking is a highly plastic cognitive ability, as the brain is often able to compensate in the face of different sensory loss.
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Affiliation(s)
- Xavier E Job
- Department of Neuroscience, Karolinska Institutet, Solnavägen 9, 17165, Stockholm, Sweden.
- Institut des Systèmes Intelligents et de Robotique (ISIR), Sorbonne Université, Paris, France.
| | - Louise P Kirsch
- Institut des Systèmes Intelligents et de Robotique (ISIR), Sorbonne Université, Paris, France.
- Integrative Neuroscience and Cognition Center (INCC), Université de Paris, Paris, France.
| | - Malika Auvray
- Institut des Systèmes Intelligents et de Robotique (ISIR), Sorbonne Université, Paris, France
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11
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Hearing loss versus vestibular loss as contributors to cognitive dysfunction. J Neurol 2022; 269:87-99. [PMID: 33387012 DOI: 10.1007/s00415-020-10343-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/23/2020] [Accepted: 12/04/2020] [Indexed: 02/02/2023]
Abstract
In the last 5 years, there has been a surge in evidence that hearing loss (HL) may be a risk factor for cognitive dysfunction, including dementia. At the same time, there has been an increase in the number of studies implicating vestibular loss in cognitive dysfunction. Due to the fact that vestibular disorders often present with HL and other auditory disorders such as tinnitus, it has been suggested that, in many cases, what appears to be vestibular-related cognitive dysfunction may be due to HL (e.g., Dobbels et al. Front Neurol 11:710, 2020). This review analyses the studies of vestibular-related cognitive dysfunction which have controlled HL. It is suggested that despite the fact that many studies in the area have not controlled HL, many other studies have (~ 19/44 studies or 43%). Therefore, although there is certainly a need for further studies controlling HL, there is evidence to suggest that vestibular loss is associated with cognitive dysfunction, especially related to spatial memory. This is consistent with the overwhelming evidence from animal studies that the vestibular system transmits specific types of information about self-motion to structures such as the hippocampus.
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Nguyen TT, Nam GS, Kang JJ, Han GC, Kim JS, Dieterich M, Oh SY. The Differential Effects of Acute Right- vs. Left-Sided Vestibular Deafferentation on Spatial Cognition in Unilateral Labyrinthectomized Mice. Front Neurol 2021; 12:789487. [PMID: 34956067 PMCID: PMC8692718 DOI: 10.3389/fneur.2021.789487] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/29/2021] [Indexed: 12/02/2022] Open
Abstract
This study aimed to investigate the disparity in locomotor and spatial memory deficits caused by left- or right-sided unilateral vestibular deafferentation (UVD) using a mouse model of unilateral labyrinthectomy (UL) and to examine the effects of galvanic vestibular stimulation (GVS) on the deficits over 14 days. Five experimental groups were established: the left-sided and right-sided UL (Lt.-UL and Rt.-UL) groups, left-sided and right-sided UL with bipolar GVS with the cathode on the lesion side (Lt.-GVS and Rt.-GVS) groups, and a control group with sham surgery. We assessed the locomotor and cognitive-behavioral functions using the open field (OF), Y maze, and Morris water maze (MWM) tests before (baseline) and 3, 7, and 14 days after surgical UL in each group. On postoperative day (POD) 3, locomotion and spatial working memory were more impaired in the Lt.-UL group compared with the Rt.-UL group (p < 0.01, Tamhane test). On POD 7, there was a substantial difference between the groups; the locomotion and spatial navigation of the Lt.-UL group recovered significantly more slowly compared with those of the Rt.-UL group. Although the differences in the short-term spatial cognition and motor coordination were resolved by POD 14, the long-term spatial navigation deficits assessed by the MWM were significantly worse in the Lt.-UL group compared with the Rt.-UL group. GVS intervention accelerated the vestibular compensation in both the Lt.-GVS and Rt.-GVS groups in terms of improvement of locomotion and spatial cognition. The current data imply that right- and left-sided UVD impair spatial cognition and locomotion differently and result in different compensatory patterns. Sequential bipolar GVS when the cathode (stimulating) was assigned to the lesion side accelerated recovery for UVD-induced spatial cognition, which may have implications for managing the patients with spatial cognitive impairment, especially that induced by unilateral peripheral vestibular damage on the dominant side.
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Affiliation(s)
- Thanh Tin Nguyen
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Department of Pharmacology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Gi-Sung Nam
- Department of Otorhinolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
| | - Jin-Ju Kang
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
| | - Gyu Cheol Han
- Department of Otolaryngology-Head and Neck Surgery, Gachon University of Medicine and Science, Graduate School of Medicine, Incheon, South Korea
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University Bundang Hospital & School of Medicine, Seoul, South Korea
| | - Marianne Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Sun-Young Oh
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
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13
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Borel L, Honoré J, Bachelard-Serra M, Lavieille JP, Saj A. Representation of Body Orientation in Vestibular-Defective Patients Before and After Unilateral Vestibular Loss. Front Syst Neurosci 2021; 15:733684. [PMID: 34776883 PMCID: PMC8580062 DOI: 10.3389/fnsys.2021.733684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The unilateral vestibular syndrome results in postural, oculomotor, perceptive, and cognitive symptoms. This study was designed to investigate the role of vestibular signals in body orientation representation, which remains poorly considered in vestibular patients. Methods: The subjective straight ahead (SSA) was investigated using a method disentangling translation and rotation components of error. Participants were required to align a rod with their body midline in the horizontal plane. Patients with right vestibular neurotomy (RVN; n =8) or left vestibular neurotomy (LVN; n = 13) or vestibular schwannoma resection were compared with 12 healthy controls. Patients were tested the day before surgery and during the recovery period, 7 days and 2 months after the surgery. Results: Before and after unilateral vestibular neurotomy, i.e., in the chronic phases, patients showed a rightward translation bias of their SSA, without rotation bias, whatever the side of the vestibular loss. However, the data show that the lower the translation error before neurotomy, the greater its increase 2 months after a total unilateral vestibular loss, therefore leading to a rightward translation of similar amplitude in the two groups of patients. In the early phase after surgery, SSA moved toward the operated side both in translation and in rotation, as typically found for biases occurring after unilateral vestibular loss, such as the subjective visual vertical (SVV) bias. Discussion and Conclusion: This study gives the first description of the immediate consequences and of the recovery time course of body orientation representation after a complete unilateral vestibular loss. The overall evolution differed according to the side of the lesion with more extensive changes over time before and after left vestibular loss. It is noteworthy that representational disturbances of self-orientation were highly unusual in the chronic stage after vestibular loss and similar to those reported after hemispheric lesions causing spatial neglect, while classical ipsilesional biases were reported in the acute stage. This study strongly supports the notion that the vestibular system plays a major role in body representation processes and more broadly in spatial cognition. From a clinical point of view, SSA appeared to be a reliable indicator for the presence of a vestibular disorder.
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Affiliation(s)
- Liliane Borel
- Cognitive Neurosciences Laboratory, UMR 7291, Aix Marseille University, CNRS, Marseille, France
| | - Jacques Honoré
- SCALab, UMR 9193, University of Lille, CNRS, Lille, France
| | - Mathilde Bachelard-Serra
- Department of Otorhinolaryngology, Head and Neck Surgery, Hôpital La Conception, APHM, Marseille, France.,Department of Otorhinolaryngology, Head and Neck Surgery, CHP Clairval, Marseille, France
| | - Jean-Pierre Lavieille
- Cognitive Neurosciences Laboratory, UMR 7291, Aix Marseille University, CNRS, Marseille, France.,Department of Otorhinolaryngology, Head and Neck Surgery, Hôpital La Conception, APHM, Marseille, France
| | - Arnaud Saj
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Geneva, Switzerland.,Department of Psychology, University of Montréal, Montreal, QC, Canada.,Centre of Interdisciplinary Research in Rehabiliation of Montréal, CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
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14
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Lacroix E, Deggouj N, Edwards MG, Van Cutsem J, Van Puyvelde M, Pattyn N. The Cognitive-Vestibular Compensation Hypothesis: How Cognitive Impairments Might Be the Cost of Coping With Compensation. Front Hum Neurosci 2021; 15:732974. [PMID: 34658819 PMCID: PMC8517512 DOI: 10.3389/fnhum.2021.732974] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/10/2021] [Indexed: 11/13/2022] Open
Abstract
Previous research in vestibular cognition has clearly demonstrated a link between the vestibular system and several cognitive and emotional functions. However, the most coherent results supporting this link come from rodent models and healthy human participants artificial stimulation models. Human research with vestibular-damaged patients shows much more variability in the observed results, mostly because of the heterogeneity of vestibular loss (VL), and the interindividual differences in the natural vestibular compensation process. The link between the physiological consequences of VL (such as postural difficulties), and specific cognitive or emotional dysfunction is not clear yet. We suggest that a neuropsychological model, based on Kahneman's Capacity Model of Attention, could contribute to the understanding of the vestibular compensation process, and partially explain the variability of results observed in vestibular-damaged patients. Several findings in the literature support the idea of a limited quantity of cognitive resources that can be allocated to cognitive tasks during the compensation stages. This basic mechanism of attentional limitations may lead to different compensation profiles in patients, with or without cognitive dysfunction, depending on the compensation stage. We suggest several objective and subjective measures to evaluate this cognitive-vestibular compensation hypothesis.
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Affiliation(s)
- Emilie Lacroix
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Institute for Research in Psychological Science (IPSY), Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Naïma Deggouj
- Institute for Research in Psychological Science (IPSY), Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Institute of Neuroscience (IONS), Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Otorhinolaryngology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Martin Gareth Edwards
- Institute for Research in Psychological Science (IPSY), Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Institute of Neuroscience (IONS), Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Jeroen Van Cutsem
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Martine Van Puyvelde
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Brain Body and Cognition Research Group, Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.,Clinical and Lifespan Psychology, Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nathalie Pattyn
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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15
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Nguyen TT, Nam GS, Kang JJ, Han GC, Kim JS, Dieterich M, Oh SY. Galvanic Vestibular Stimulation Improves Spatial Cognition After Unilateral Labyrinthectomy in Mice. Front Neurol 2021; 12:716795. [PMID: 34393985 PMCID: PMC8358680 DOI: 10.3389/fneur.2021.716795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives: To investigate the deficits of spatial memory and navigation from unilateral vestibular deafferentation (UVD) and to determine the efficacy of galvanic vestibular stimulation (GVS) for recovery from these deficits using a mouse model of unilateral labyrinthectomy (UL). Methods: Thirty-six male C57BL/6 mice were allocated into three groups that comprise a control group and two experimental groups, UVD with (GVS group) and without GVS intervention (non-GVS group). In the experimental groups, we assessed the locomotor and cognitive behavioral function before (baseline) and 3, 7, and 14 days after surgical UL, using the open field (OF), Y maze, and Morris water maze (MWM) tests. In the GVS group, the stimulations were applied for 30 min daily from postoperative day (POD) 0–4 via the electrodes inserted subcutaneously close to both bony labyrinths. Results: Locomotion and spatial cognition were significantly impaired in the mice with UVD non-GVS group compared to the control group. GVS significantly accelerated recovery of locomotion compared to the control and non-GVS groups on PODs 3 (p < 0.001) and 7 (p < 0.05, Kruskal–Wallis and Mann–Whitney U tests) in the OF and Y maze tests. The mice in the GVS group were better in spatial working memory assessed with spontaneous alternation performance and spatial reference memory assessed with place recognition during the Y maze test than those in the non-GVS group on POD 3 (p < 0.001). In addition, the recovery of long-term spatial navigation deficits during the MWM, as indicated by the escape latency and the probe trial, was significantly better in the GVS group than in the non-GVS group 2 weeks after UVD (p < 0.01). Conclusions: UVD impairs spatial memory, navigation, and motor coordination. GVS accelerated recoveries in short- and long-term spatial memory and navigation, as well as locomotor function in mice with UVD, and may be applied to the patients with acute unilateral vestibular failure.
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Affiliation(s)
- Thanh Tin Nguyen
- Jeonbuk National University College of Medicine, Jeonju, South Korea.,Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Department of Pharmacology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Gi-Sung Nam
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Kwangju, South Korea
| | - Jin-Ju Kang
- Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
| | - Gyu Cheol Han
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Gachon University of Medicine and Science, Incheon, South Korea
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University Hospital & School of Medicine, Seoul, South Korea
| | - Marianne Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Sun-Young Oh
- Jeonbuk National University College of Medicine, Jeonju, South Korea.,Department of Neurology, Jeonbuk National University Hospital & School of Medicine, Jeonju, South Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonju, South Korea
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16
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Ferrè ER, Alsmith AJT, Haggard P, Longo MR. The vestibular system modulates the contributions of head and torso to egocentric spatial judgements. Exp Brain Res 2021; 239:2295-2302. [PMID: 34089070 PMCID: PMC8282570 DOI: 10.1007/s00221-021-06119-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
Egocentric representations allow us to describe the external world as experienced from an individual's bodily location. We recently developed a novel method of quantifying the weight given to different body parts in egocentric judgments (the Misalignment Paradigm). We found that both head and torso contribute to simple alter-egocentric spatial judgments. We hypothesised that artificial stimulation of the vestibular system would provide a head-related signal, which might affect the weighting given to the head in egocentric spatial judgments. Bipolar Galvanic Vestibular Stimulation (GVS) was applied during the Misalignment Paradigm. A Sham stimulation condition was also included to control for non-specific effects. Our data show that the weight given to the head was increased during left anodal and right cathodal GVS, compared to the opposite GVS polarity (right anodal and left cathodal GVS) and Sham stimulation. That is, the polarity of GVS, which preferentially activates vestibular areas in the right cerebral hemisphere, influenced the relative weightings of head and torso in egocentric spatial judgments.
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Affiliation(s)
- Elisa R Ferrè
- Department of Psychology, Royal Holloway, University of London, London, UK.
| | | | - Patrick Haggard
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Matthew R Longo
- Department of Psychological Sciences, Birkbeck, University of London, London, UK.
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17
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Na S, Im JJ, Jeong H, Lee ES, Lee TK, Chung YA, Song IU. Altered Regional Cerebral Blood Perfusion in Mild Cognitive Impairment Patients with Dizziness. Diagnostics (Basel) 2020; 10:diagnostics10100777. [PMID: 33008120 PMCID: PMC7599883 DOI: 10.3390/diagnostics10100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022] Open
Abstract
Dizziness is a common symptom among the general population, especially in the elderly. Previous studies have reported that dizziness may be associated with various cognitive functions including memory impairment. However, few studies have investigated the neural correlates of dizziness in patients with cognitive impairment. The aim of this study was to examine regional cerebral blood flow (rCBF) in mild cognitive impairment (MCI) patients with or without dizziness using single photon emission computed tomography (SPECT). A total of 50 patients with MCI were recruited. All participants underwent technetium-99m ethyl cysteinate dimer brain SPECT and a neuropsychological battery and completed the Dizziness Handicap Inventory (DHI). Participants were divided into a dizziness group (DHI ≥ 1, n = 18) and a non-dizziness group (DHI = 0, n = 32). Voxel wise differences in rCBF between the groups were estimated. SPECT analysis revealed decreased rCBF in the left superior temporal gyrus, left lateral orbital gyrus, and right middle frontal gyrus in the dizziness group compared with the non-dizziness group (p < 0.005). No significant clusters of increased rCBF were observed in the dizziness group compared with the non-dizziness group. Results of the neuropsychological tests showed a significant difference in Controlled Oral Word Association Test performance between MCI patients with and without dizziness. In conclusion, MCI patients with dizziness showed multifocal frontal and left temporal hypoperfusion compared with patients without dizziness. Our results suggest that hypoperfusion in the frontal and temporal cortices might be reflecting the negative impact of dizziness in MCI patients.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea;
| | - Jooyeon Jamie Im
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (J.J.I.); (H.J.)
| | - Hyeonseok Jeong
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (J.J.I.); (H.J.)
- Department of Radiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea
| | - Eek-Sung Lee
- Department of Neurology, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (E.-S.L.); (T.-K.L.)
| | - Tae-Kyeong Lee
- Department of Neurology, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (E.-S.L.); (T.-K.L.)
| | - Yong-An Chung
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (J.J.I.); (H.J.)
- Department of Radiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea
- Correspondence: (Y.-A.C.); (I.-U.S.); Tel.: +82-32-280-5243 (Y.-A.C.); +82-32-280-5010 (I.-U.S.)
| | - In-Uk Song
- Department of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea;
- Correspondence: (Y.-A.C.); (I.-U.S.); Tel.: +82-32-280-5243 (Y.-A.C.); +82-32-280-5010 (I.-U.S.)
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18
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Danneels M, Van Hecke R, Leyssens L, Degeest S, Cambier D, van de Berg R, Van Rompaey V, Maes L. 2BALANCE: a cognitive-motor dual-task protocol for individuals with vestibular dysfunction. BMJ Open 2020; 10:e037138. [PMID: 32665391 PMCID: PMC7365489 DOI: 10.1136/bmjopen-2020-037138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/11/2020] [Accepted: 06/09/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Aside from primary vestibular symptoms such as vertigo and dizziness, persons with vestibular dysfunction frequently express cognitive and motor problems. These symptoms have mainly been assessed in single-task setting, which might not represent activities of daily living accurately. Therefore, a dual-task protocol, consisting of the simultaneous performance of cognitive and motor tasks, was developed. This protocol assesses cognitive and motor performance in general, as well as cognitive-motor interference in specific. METHODS AND ANALYSIS The motor component of the 2BALANCE protocol consists of a static and dynamic postural task. These motor tasks are combined with different cognitive tasks assessing visuospatial cognition, processing speed, working memory and response inhibition. First, test-retest reliability will be assessed with an interval of 2 weeks in a group of young adults. Second, the 2BALANCE protocol will be validated in persons with bilateral vestibulopathy. Finally, the protocol will be implemented in persons with unilateral vestibular loss. DISCUSSION AND CONCLUSIONS The 2BALANCE project aims to elucidate the impact of vestibular dysfunction on cognitive and motor performance in dual-task setting. This protocol represents everyday situations better than single-task protocols, as dual-tasks such as reading street signs while walking are often encountered during daily activities. Ultimately, this project could enable individualised and holistic clinical care in these patients, taking into account single as well as dual-task performance. ETHICS AND DISSEMINATION The current study was approved by the ethics committee of Ghent University Hospital on 5 July 2019 with registration number B670201940465. All research findings will be disseminated in peer-reviewed journals and presented at vestibular as well as multidisciplinary international conferences and meetings. TRIALS REGISTRATION NUMBER NCT04126798, pre-results phase.
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Affiliation(s)
- Maya Danneels
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Ruth Van Hecke
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Laura Leyssens
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Dirk Cambier
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre+, Maastricht, Limburg, The Netherlands
- Faculty of Physics, Tomsk State University, Tomsk, Russian Federation
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, Universiteit Antwerpen, Antwerpen, Belgium
- Department of Otorhinolaryngology and Head & Neck Surgery, University Hospital Antwerp, Edegem, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
- Department of Otorhinolaryngology, University Hospital Ghent, Gent, Belgium
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19
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Cognitive functions in acute unilateral vestibular loss. J Neurol 2020; 267:153-159. [PMID: 32440920 PMCID: PMC7718191 DOI: 10.1007/s00415-020-09829-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 01/04/2023]
Abstract
Cognitive deficits mainly involving visuospatial functions have been defined in patients with bilateral and even unilateral vestibular loss (UVL). We compared the cognitive test results of 21 patients with acute UVL with age- and education-matched healthy controls. The diagnosis of UVL was based on the clinical findings, a normal magnetic resonance imaging with diffusion-weighted sequence and canal paresis on the affected side on caloric testing. Cognitive tests assessing visuospatial functions (Benton’s Judgment of Line Orientation test, Verbal and non-verbal Cancellation tests, Rey–Osterrieth Complex Figure test) and global mental status, verbal memory, learning, retention of information, and recalling (Mini Mental State Examination, Oktem Verbal Memory Process Test, Forward and Backward Digit span) were used in addition to Beck depression and Anxiety inventories. Abnormalities in verbal and non-verbal cancellation tests (p < 0.005), Benton’s Judgment of Line Orientation test (p = 0.042) and backward digit span (p = 0.029) was found. A very prominent difference regarding Beck depression (p = 0.012) and anxiety inventories (p < 0.001) was present. On multiple regression analysis, the abovementioned cognitive tests’ results lost their statistical significance (p > 0.05) when depression and anxiety scores were taken into consideration. The severity of canal paresis was found to be correlated with Benton’s Judgment of Line Orientation test (p = 0.008, r = − 0.5639) and Rey–Osterrieth Complex Figure test copying scores (p = 0.029, r = − 0.477). Comparison of all the results in right- and left-sided lesions did not reveal a significant difference (p > 0.05). Vestibular patients are prone to develop anxiety, and depression. Deficits in visuospatial functions, mental manipulation, psychomotor speed and short-term memory detected in our patients with acute UVL seem to be enhanced by accompanying anxiety and depression. The extent of vestibular dysfunction was correlated with the severity of deficits in visuospatial skills. Lesion side did not cause alterations in cognitive or emotional status.
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20
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Klaus MP, Wyssen GC, Frank SM, Malloni WM, Greenlee MW, Mast FW. Vestibular Stimulation Modulates Neural Correlates of Own-body Mental Imagery. J Cogn Neurosci 2019; 32:484-496. [PMID: 31682567 DOI: 10.1162/jocn_a_01496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
There is growing evidence that vestibular information is not only involved in reflexive eye movements and the control of posture but it also plays an important role in higher order cognitive processes. Previous behavioral research has shown that concomitant vestibular stimuli influence performance in tasks that involve imagined self-rotations. These results suggest that imagined and perceived body rotations share common mechanisms. However, the nature and specificity of these effects remain largely unknown. Here, we investigated the neural mechanisms underlying this vestibulocognitive interaction. Participants (n = 20) solved an imagined self-rotation task during caloric vestibular stimulation. We found robust main effects of caloric vestibular stimulation in the core region of the vestibular network, including the rolandic operculum and insula bilaterally, and of the cognitive task in parietal and frontal regions. Interestingly, we found an interaction of stimulation and task in the left inferior parietal lobe, suggesting that this region represents the modulation of imagined body rotations by vestibular input. This result provides evidence that the inferior parietal lobe plays a crucial role in the neural integration of mental and physical body rotation.
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