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Li J, Cheng Q, Leng Y, Ma H, Yang F, Liu B, Fan W. Neuroimaging Insights: Structural Changes and Classification in Ménière's Disease. Ear Hear 2024; 45:1284-1295. [PMID: 38783421 DOI: 10.1097/aud.0000000000001519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVES This study aimed to comprehensively investigate the neuroanatomical alterations associated with idiopathic Ménière's disease (MD) using voxel-based morphometry and surface-based morphometry techniques. The primary objective was to explore nuanced changes in gray matter volume, cortical thickness, fractal dimension, gyrification index, and sulcal depth in MD patients compared with healthy controls (HC). Additionally, we sought to develop a machine learning classification model utilizing these neuroimaging features to effectively discriminate between MD patients and HC. DESIGN A total of 55 patients diagnosed with unilateral MD and 70 HC were enrolled in this study. Voxel-based morphometry and surface-based morphometry were employed to analyze neuroimaging data and identify structural differences between the two groups. The selected neuroimaging features were used to build a machine learning classification model for distinguishing MD patients from HC. RESULTS Our analysis revealed significant reductions in gray matter volume in MD patients, particularly in frontal and cingulate gyri. Distinctive patterns of alterations in cortical thickness were observed in brain regions associated with emotional processing and sensory integration. Notably, the machine learning classification model achieved an impressive accuracy of 84% in distinguishing MD patients from HC. The model's precision and recall for MD and HC demonstrated robust performance, resulting in balanced F1-scores. Receiver operating characteristic curve analysis further confirmed the discriminative power of the model, supported by an area under the curve value of 0.92. CONCLUSIONS This comprehensive investigation sheds light on the intricate neuroanatomical alterations in MD. The observed gray matter volume reductions and distinct cortical thickness patterns emphasize the disease's impact on neural structure. The high accuracy of our machine learning classification model underscores its diagnostic potential, providing a promising avenue for identifying MD patients. These findings contribute to our understanding of MD's neural underpinnings and offer insights for further research exploring the functional implications of structural changes.
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Affiliation(s)
- Jing Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- These authors contributed equally to this work and share their first authorship
| | - Qing Cheng
- Department of Otorhinolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- These authors contributed equally to this work and share their first authorship
| | - Yangming Leng
- Department of Otorhinolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Ma
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Bo Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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Li X, Li X, Lyu Y, Jian H, Li Y, Wang J, Li W, Wang R, Hu Y, Fan Z, Wang H, Zhang D. Hearing, balance, and imaging assessment in adolescent Menière's disease: A retrospective analysis. Laryngoscope Investig Otolaryngol 2024; 9:e1313. [PMID: 39171095 PMCID: PMC11337912 DOI: 10.1002/lio2.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 06/22/2024] [Accepted: 07/20/2024] [Indexed: 08/23/2024] Open
Abstract
Objective To retrospectively analyze clinical features in adolescent Menière's disease (MD). Methods The medical records of adolescents with MD (11-17 years old) from May 2014 to March 2023 in Shandong Provincial ENT Hospital were retrospectively analyzed, including clinical features, a battery of auditory and vestibular function tests, sensory organization test, and imaging assessments. Patients with recurrent vertigo of childhood (RVC) were as controls. Results Compared with RVC, adolescent MD showed higher pure tone average threshold (p < .001), lower speech discrimination score (p = .014), and lower otoacoustic emission pass rates (p = .005). Adolescents with MD exhibited significant reduction in equilibrium score (Conditions 1, 5, and 6; p1 = .035; p5 = .033; p6 = .003), composite sensory score (p = .014), and vestibular sensory score (p = .029). Adolescents with bilateral MD exhibited worse performance in equilibrium score and strategy score compared to adolescents with unilateral MD. For the affected ear, the more severe endolymphatic hydrops detected by gadolinium-enhanced magnetic resonance imaging, the higher the auditory brainstem response threshold (r = .850, p = .007), and the lower the otoacoustic emission pass rate (r = -.976, p < .001). Conclusion Adolescent MD has similar vestibular information inputs with that of RVC, but the ability for the nerve center to use these clues to maintain balance is worse in adolescents with MD. There were potential differences in vestibular weights in adolescents with unilateral and bilateral MD, also potential effects on vision and proprioception. Level of Evidence Level 4.
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Affiliation(s)
- Xiaofei Li
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Xiaoyi Li
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Yafeng Lyu
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Huirong Jian
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Yawei Li
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Jing Wang
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Wenjuan Li
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Ruyan Wang
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Yinghui Hu
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Zhaomin Fan
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Haibo Wang
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
| | - Daogong Zhang
- Department of Otolaryngology—Head and Neck Surgery, Shandong Provincial ENT HospitalShandong UniversityJinanShandongChina
- Shandong Provincial Vertigo, Dizziness Medical CenterJinanShandongChina
- Shandong Medical Health Key Laboratory of Vertigo and Vestibular MedicineJinanChina
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Li Y, Li J, Wang P, Yu D, Chen Z, Shi Z, Wu Y, Qi W, Lu W, Shi H. Electroencephalography microstate alterations reflect potential double-edged cognitive adaptation in Ménière's disease. CNS Neurosci Ther 2024; 30:e14896. [PMID: 39107944 PMCID: PMC11303265 DOI: 10.1111/cns.14896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 07/11/2024] [Accepted: 07/19/2024] [Indexed: 08/10/2024] Open
Abstract
PURPOSE To explore the microstate characteristics and underlying brain network activity of Ménière's disease (MD) patients based on high-density electroencephalography (EEG), elucidate the association between microstate dynamics and clinical manifestation, and explore the potential of EEG microstate features as future neurobiomarkers for MD. METHODS Thirty-two patients diagnosed with MD and 29 healthy controls (HC) matched for demographic characteristics were included in the study. Dysfunction and subjective symptom severity were assessed by neuropsychological questionnaires, pure tone audiometry, and vestibular function tests. Resting-state EEG recordings were obtained using a 256-channel EEG system, and the electric field topographies were clustered into four dominant microstate classes (A, B, C, and D). The dynamic parameters of each microstate were analyzed and utilized as input for a support vector machine (SVM) classifier to identify significant microstate signatures associated with MD. The clinical significance was further explored through Spearman correlation analysis. RESULTS MD patients exhibited an increased presence of microstate class C and a decreased frequency of transitions between microstate class A and B, as well as between class A and D. The transitions from microstate class A to C were also elevated. Further analysis revealed a positive correlation between equilibrium scores and the transitions from microstate class A to C under somatosensory challenging conditions. Conversely, transitions between class A and B were negatively correlated with vertigo symptoms. No significant correlations were detected between these characteristics and auditory test results or emotional scores. Utilizing the microstate features identified via sequential backward selection, the linear SVM classifier achieved a sensitivity of 86.21% and a specificity of 90.61% in distinguishing MD patients from HC. CONCLUSIONS We identified several EEG microstate characteristics in MD patients that facilitate postural control yet exacerbate subjective symptoms, and effectively discriminate MD from HC. The microstate features may offer a new approach for optimizing cognitive compensation strategies and exploring potential neurobiological markers in MD.
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Affiliation(s)
- Yi‐Ni Li
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jie Li
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Peng‐Jun Wang
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Dong‐Zhen Yu
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zheng‐Nong Chen
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zheng‐Yu Shi
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Ya‐Qin Wu
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Wei‐Dong Qi
- Department of Otolaryngology Head and Neck SurgeryHuashan Hospital Fudan UniversityShanghaiChina
| | - Wen Lu
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Hai‐Bo Shi
- Department of Otolaryngology‐Head and Neck SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
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Bhattacharyya R, Barman A, Antony F. Influence of BPPV and Meniere's Disease on Cognitive Abilities: A Questionnaire-Based Study. J Otol 2024; 19:10-18. [PMID: 38313758 PMCID: PMC10837562 DOI: 10.1016/j.joto.2023.11.001] [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: 08/04/2023] [Revised: 11/01/2023] [Accepted: 11/05/2023] [Indexed: 02/06/2024] Open
Abstract
The vestibular system connects the inner ear to the midbrain and subcortical structures and can affect cognition. Patients with vertigo often experience cognitive symptoms such as attention deficits, memory problems, and spatial perception difficulties. This study aimed to explore the cognitive impairments associated with Benign paroxysmal positional vertigo (BPPV) and Meniere's Disease (MD). A non-experimental group comparison design was used with 107 participants divided into three groups: Group I (clinically normal), Group II (BPPV), and Group III (MD). Participants completed a questionnaire with 10 cognition-related questions, and their responses were scored. The data were found to be non-normally distributed. The analysis revealed a significant difference in scores between Group I and both Group II and Group III. Chi-square tests showed that the responses to cognition-related questions varied among the groups, with Group II exhibiting more cognitive problems. Associated conditions like hypertension, diabetes, and hearing loss did not significantly influence the responses within each group. This study suggests a significant relationship between cognitive problems and patients with BPPV and MD. However, there was no association found between the cognitive problems experienced in BPPV and MD patients. These findings align with previous research indicating that vestibular disorders can lead to deficits in spatial memory, attention, and other cognitive functions. By understanding the link between cognition and vestibular disorders, we can improve diagnosis and rehabilitation services to enhance the quality of life for these patients.
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Affiliation(s)
| | - Animesh Barman
- All India Institute of Speech and Hearing, Mysore, Mysuru, India
| | - Freddy Antony
- All India Institute of Speech and Hearing, Mysore, Mysuru, India
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Jian H, Wang S, Li X, Zhao H, Liu S, Lyu Y, Fan Z, Wang H, Zhang D. Effect of Late-Stage Meniere's Disease and Vestibular Functional Impairment on Hippocampal Atrophy. Laryngoscope 2024; 134:410-418. [PMID: 37314111 DOI: 10.1002/lary.30816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We investigated correlations among clinical features, degree of inner ear endolymphatic hydrops (EH), and hippocampal volume (HV) in different stages of Meniere's disease (MD). METHODS From February 2021 to April 2022, clinical data were collected from 99 patients (39 males, 60 females, mean age: 50.4 ± 10.0 [range: 26-69] years) with unilateral MD admitted to the Department of Vertigo Disease of Shandong ENT Hospital. The left and right ears were affected in 64 and 35 patients, respectively. There were 50 and 49 cases in early (Stages 1, 2) and late stages (Stages 3, 4), respectively. Fifty healthy participants were included as controls. Audiovestibular function test results, EH grading using gadolinium-enhanced magnetic resonance imaging (MRI), and HV determined on MRI were analyzed for patients at different stages of MD. RESULTS Between-group comparisons of early and late MD revealed significant differences in the disease course, vestibular function (VF), degree of EH, and HV. There were no significant between-group differences based on age, sex, affected side, subjective degree of dizziness, hospital anxiety, or depression. Mean HV in patients with early-stage MD was correlated with the canal paresis value of the caloric test and pure tone hearing threshold, HV in late-stage patients was correlated with vestibular EH. CONCLUSION Patients with late-stage MD exhibited severe auditory and VF impairments, increased EH, and atrophy of the HV. More advanced disease was associated with greater vestibular damage and degree of EH. LEVEL OF EVIDENCE 3 Laryngoscope, 134:410-418, 2024.
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Affiliation(s)
- Huirong Jian
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Provincial Vertigo & Dizziness Medical Center, Jinan, China
- Laboratory of Vertigo Disease, Shandong Institute of Otorhinolaryngology, Jinan, China
- Shandong Medical Health Key Laboratory of Vertigo & Vestibular Medicine, Jinan, China
| | - Siyue Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Provincial Vertigo & Dizziness Medical Center, Jinan, China
- Laboratory of Vertigo Disease, Shandong Institute of Otorhinolaryngology, Jinan, China
- Shandong Medical Health Key Laboratory of Vertigo & Vestibular Medicine, Jinan, China
| | - Xiaofei Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Provincial Vertigo & Dizziness Medical Center, Jinan, China
- Laboratory of Vertigo Disease, Shandong Institute of Otorhinolaryngology, Jinan, China
- Shandong Medical Health Key Laboratory of Vertigo & Vestibular Medicine, Jinan, China
| | - Hui Zhao
- Medical Imaging Center, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Shanfeng Liu
- Medical Imaging Center, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Yafeng Lyu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Provincial Vertigo & Dizziness Medical Center, Jinan, China
- Laboratory of Vertigo Disease, Shandong Institute of Otorhinolaryngology, Jinan, China
- Shandong Medical Health Key Laboratory of Vertigo & Vestibular Medicine, Jinan, China
| | - Zhaomin Fan
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Provincial Vertigo & Dizziness Medical Center, Jinan, China
- Laboratory of Vertigo Disease, Shandong Institute of Otorhinolaryngology, Jinan, China
- Shandong Medical Health Key Laboratory of Vertigo & Vestibular Medicine, Jinan, China
| | - Haibo Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Provincial Vertigo & Dizziness Medical Center, Jinan, China
- Laboratory of Vertigo Disease, Shandong Institute of Otorhinolaryngology, Jinan, China
- Shandong Medical Health Key Laboratory of Vertigo & Vestibular Medicine, Jinan, China
| | - Daogong Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Shandong Provincial Vertigo & Dizziness Medical Center, Jinan, China
- Laboratory of Vertigo Disease, Shandong Institute of Otorhinolaryngology, Jinan, China
- Shandong Medical Health Key Laboratory of Vertigo & Vestibular Medicine, Jinan, China
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Li J, Leng Y, Ma H, Yang F, Liu B, Fan W. Functional reorganization of intranetwork and internetwork connectivity in patients with Ménière's disease. Sci Rep 2023; 13:16775. [PMID: 37798378 PMCID: PMC10556034 DOI: 10.1038/s41598-023-44090-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023] Open
Abstract
Ménière's disease (MD) is associated with functional reorganization not only in the auditory or sensory cortex but also in other control and cognitive areas. In this study, we examined intranetwork and internetwork connectivity differences between 55 MD patients and 70 healthy controls (HC) in 9 well-defined resting-state networks. Functional connectivity degree was lower in MD compared to HC in 19 brain areas involved in the somatomotor, auditory, ventral attention, default mode, limbic, and deep gray matter networks. In addition, we observed lower intranetwork connectivity in the auditory, ventral attention, and limbic networks, as well as lower internetwork connectivity between the somatomotor and limbic networks, and between the auditory and somatomotor, deep gray matter, and ventral attention networks, and between the deep gray matter and default mode network. Furthermore, we identified 81 pairs of brain areas with significant differences in functional connectivity between MD patients and HC at the edge level. Notably, the left amygdala's functional connectivity degree was positively correlated with MD's disease stage, and the ventral attention network's intranetwork connectivity was positively correlated with the healthy side vestibular ratio. Our findings suggest that these functional network reorganization alterations may serve as potential biomarkers for predicting clinical progression, evaluating disease severity, and gaining a better understanding of MD's pathophysiology. Large-scale network studies using neuroimaging techniques can provide additional insights into the underlying mechanisms of MD.
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Affiliation(s)
- Jing Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yangming Leng
- Department of Otorhinolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hui Ma
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Bo Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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Schöne CG, Mast FW. High-current galvanic vestibular stimulation impairs working memory span, but not other executive functions. Neuropsychologia 2023; 188:108617. [PMID: 37302752 DOI: 10.1016/j.neuropsychologia.2023.108617] [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: 01/04/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023]
Abstract
Patients with peripheral vestibular dysfunction (PVD) suffer not only from physical problems such as imbalance or vertigo but also from neuropsychological difficulties, including executive deficits. However, it is unclear whether the PVD directly causes executive problems. To examine the causal vestibular influence on executive functions, we induced either high-current (2 mA), low-current (0.8 mA), or sham current (0 mA) galvanic vestibular stimulation (GVS) in 79 healthy participants. Participants solved three tasks, measuring the core executive components (working memory, inhibition, cognitive flexibility) before and during GVS. High-current GVS impaired working memory span, but not inhibition and cognitive flexibility performance. Low-current GVS did not influence executive performance. Results indicate a causal vestibular influence on working memory span. Joint cortical areas of vestibular and working memory processing are discussed. Since high-current GVS in healthy participants serves as a model for an artificial vestibular dysfunction, our results could improve the diagnostics and therapy of patients with PVD.
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Affiliation(s)
- Corina G Schöne
- Department of Psychology, University of Bern, Bern, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland; Doctoral Program for Brain and Behavioral Sciences, University of Bern, Bern, Switzerland.
| | - Fred W Mast
- Department of Psychology, University of Bern, Bern, Switzerland
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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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Zhong J, Li X, Xu J, Chen W, Gao J, Lu X, Liang S, Guo Z, Lu M, Li Y, Yi H. Analysis of cognitive function and its related factors after treatment in Meniere’s disease. Front Neurosci 2023; 17:1137734. [PMID: 37081934 PMCID: PMC10112666 DOI: 10.3389/fnins.2023.1137734] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/14/2023] [Indexed: 04/07/2023] Open
Abstract
A growing body of research recently suggested the association between vestibular dysfunction and cognitive impairment. Meniere’s disease (MD), a common clinical vestibular disorder, is usually accompanied by hearing loss and emotional stress, both of which may mediate the relationship between vestibule dysfunction and cognition. It is currently unknown whether the cognitive decline in MD patients could improve through treatment and how it relates to multiple clinical characteristics, particularly the severity of vertigo. Therefore, in the present study, the MD patients were followed up for 3, 6, and 12 months after treatment, and the cognitive functions, vertigo symptoms, and related physical, functional, and emotional effects of the patients were assessed using the Montreal Cognitive Assessment (MoCA) and Dizziness Handicap Inventory (DHI), aiming to explore the change in cognition before and after therapy and the correlation with various clinical features. It was found that cognitive decline in MD patients compared to healthy controls before therapy. Importantly, this cognitive impairment could improve after effective therapy, which was related to the severity of vertigo, especially in functional and physical impacts. Our results support the view that vestibular dysfunction is a potentially modifiable risk factor for cognitive decline.
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Schöne CG, Rebsamen M, Wyssen G, Rummel C, Wagner F, Vibert D, Mast FW. Hippocampal volume in patients with bilateral and unilateral peripheral vestibular dysfunction. Neuroimage Clin 2022; 36:103212. [PMID: 36209619 PMCID: PMC9668627 DOI: 10.1016/j.nicl.2022.103212] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022]
Abstract
Previous studies have found that peripheral vestibular dysfunction is associated with altered volumes in different brain structures, especially in the hippocampus. However, published evidence is conflicting. Based on previous findings, we compared hippocampal volume, as well as supramarginal, superior temporal, and postcentral gyrus in a sample of 55 patients with different conditions of peripheral vestibular dysfunction (bilateral, chronic unilateral, acute unilateral) to 39 age- and sex-matched healthy controls. In addition, we explored deviations in gray-matter volumes in hippocampal subfields. We also analysed correlations between morphometric data and visuo-spatial performance. Patients with vestibular dysfunction did not differ in total hippocampal volume from healthy controls. However, a reduced volume in the right presubiculum of the hippocampus and the left supramarginal gyrus was observed in patients with chronic and acute unilateral vestibular dysfunction, but not in patients with bilateral vestibular dysfunction. No association of altered volumes with visuo-spatial performance was found. An asymmetric vestibular input due to unilateral vestibular dysfunction might lead to reduced central brain volumes that are involved in vestibular processing.
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Affiliation(s)
- Corina G. Schöne
- Department of Psychology, University of Bern, Bern, Switzerland,Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland,Doctoral Program for Brain and Behavioral Sciences, University of Bern, Bern, Switzerland,Corresponding author.
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Gerda Wyssen
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Franca Wagner
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Dominique Vibert
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Fred W. Mast
- Department of Psychology, University of Bern, Bern, Switzerland
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11
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Yuan X, Li X, Xu Y, Zhong L, Yan Z, Chen Z. Microstructural changes of the vestibulocochlear nerve in patients with Ménière's disease using diffusion tensor imaging. Front Neurol 2022; 13:915826. [PMID: 36226092 PMCID: PMC9548978 DOI: 10.3389/fneur.2022.915826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/22/2022] [Indexed: 12/01/2022] Open
Abstract
Objective To evaluate the microstructural changes of the vestibulocochlear nerve in patients with Ménière's disease. Methods A total of 26 subjects, 13 patients with MD and 13 healthy controls, underwent diffusion tensor imaging (DTI) on a 3T scanner. The independent sample t-test was used to compare the differences in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) between the two groups. A Pearson correlation was used between DTI and the dizziness handicap inventory (DHI) scores. Results There was a significant decrease in FA and an increase in ADC of the vestibulocochlear nerve in MD patients compared with healthy controls (P = 0.04, P = 0.001). FA had negative correlations with the DHI score (r = −0.62, P = 0.02) and DHI-functional score (r = −0.64, P = 0.02). Conclusion These results are the first evidence of possible changes in the microstructure of the vestibulocochlear nerves in patients with MD. DTI is a potential technique for evaluating the vestibulocochlear nerve in patients with MD.
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Affiliation(s)
- Xiaojia Yuan
- Department of Chinese Medicine, Zhang Zhongjing College of Chinese Medicine, Nanyang Institute of Technology, Nan Yang, China
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaozhen Li
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Xiaozhen Li
| | - Yu Xu
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Liqun Zhong
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhanfeng Yan
- Department of Otolaryngology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhengguang Chen
- Department of Radiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Zhengguang Chen
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12
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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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13
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An unbiased algorithm for objective separation of Alzheimer's, Alzheimer's mixed with cerebrovascular symptomology, and healthy controls from one another using electrovestibulography (EVestG). Med Biol Eng Comput 2022; 60:797-810. [PMID: 35102489 DOI: 10.1007/s11517-022-02507-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
Abstract
Diagnosis of Alzheimer's disease (AD) from AD with cerebrovascular disease pathology (AD-CVD) is a rising challenge. Using electrovestibulography (EVestG) measured signals, we develop an automated feature extraction and selection algorithm for an unbiased identification of AD and AD-CVD from healthy controls as well as their separation from each other. EVestG signals of 24 healthy controls, 16 individuals with AD, and 13 with AD-CVD were analyzed within two separate groupings: One-versus-One and One-versus-All. A multistage feature selection process was conducted over the training dataset using linear support vector machine (SVM) classification with 10-fold cross-validation, k nearest neighbors/averaging imputation, and exhaustive search. The most frequently selected features that achieved highest classification performance were selected. 10-fold cross-validation was applied via a linear SVM classification on the entire dataset. Multivariate analysis was run to test the between population differences while controlling for the covariates. Classification accuracies of ≥ 80% and 78% were achieved for the One-versus-All classification approach and AD versus AD-CVD separation, respectively. The results also held true after controlling for the effect of covariates. AD/AD-CVD participants showed smaller/larger EVestG averaged field potential signals compared to healthy controls and AD-CVD/AD participants. These characteristics are in line with our previous study results.
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14
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Association between Late-Onset Ménière's Disease and the Risk of Incident All-Cause Dementia. J Pers Med 2021; 12:jpm12010019. [PMID: 35055334 PMCID: PMC8780200 DOI: 10.3390/jpm12010019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 12/05/2022] Open
Abstract
Studies reported an association between impaired hearing and vestibular function with the risk of dementia. This study investigated the association between Ménière’s disease (MD) and the risk of dementia using a nationwide cohort sample of data obtained from the South Korea National Health Insurance Service. The MD group (n = 496) included patients aged over 55 years and diagnosed between 2003 and 2006. The comparison group was selected using propensity score matching (n = 1984). Cox proportional hazards regression models were used to calculate incidence and hazard ratios for dementia events. The incidence of dementia was 14.3 per 1000 person–years in the MD group. After adjustment for certain variables, the incidence of dementia was higher in the MD group than in the comparison group (adjusted hazard ratio (HR) = 1.57, 95% confidence interval = 1.17–2.12). Subgroup analysis showed a significantly increased adjusted HR for developing Alzheimer’s disease (1.69, 95% confidence interval = 1.20–2.37) and vascular dementia (1.99, 95% confidence interval = 1.10–3.57) in the MD group. Patients with dementia experienced a higher frequency of MD episodes than those without dementia. Our findings suggest that late-onset MD is associated with an increased incidence of all-cause dementia, and it might be used as a basis for an earlier diagnosis of dementia.
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15
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Dornhoffer JR, Liu YF, Zhao EE, Rizk HG. Does Cognitive Dysfunction Correlate With Dizziness Severity in Meniére's Disease Patients. Otol Neurotol 2021; 42:e323-e331. [PMID: 33555758 DOI: 10.1097/mao.0000000000002958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Characterize the relationship between cognitive dysfunction and the dizziness severity in Meniére's disease (MD) patients. STUDY DESIGN Retrospective review. SETTING University-based tertiary medical center. PATIENTS Three hundred patients were evaluated for MD from 2015 to 2019. Excluding comorbid or alternative vestibular disorders, 29 patients with definite MD and available pre- and postintervention data were included for analysis. INTERVENTIONS A progressive protocol of salt restriction, diuretics, steroid and/or gentamycin injection, and endolymphatic sac decompression for those refractory to medical therapy. MAIN OUTCOME MEASURES Quality of life measured with the Dizziness Handicap Inventory (DHI) and cognitive function measured with the Cognitive Failures Questionnaire (CFQ). Pre- and posttreatment DHI and DHI subscale scores and change in these scores were correlated with pre- and posttreatment CFQ scores and change in CFQ with therapy. RESULTS Analysis showed a number of limited associations between improvement in DHI and improvement in CFQ. Total DHI scores failed to correlate scores or variation in scores with change in CFQ (p = 0.091 and p = 0.085, respectively). Improvement in the CFQ false-triggering domain was significantly associated with improvement in the DHI physical subscale (r = 0.491, p = 0.007) and was nonsignificantly associated with improvement in total DHI and DHI emotional subscale scores (r = 0.422, p = 0.016 and r = 0.399, p = 0.032). CONCLUSIONS The DHI correlates with several pre- and posttreatment measures of cognitive dysfunction (CFQ) in MD patients. However, change in DHI and CFQ with therapy correlate poorly. Overall, the commonly used DHI may fail to adequately assess cognitive dysfunction in MD patients possibly due to factors not directly implicated by measures of vestibular dysfunction, such as central nervous system or cognitive dysfunction; however, the specific physical and emotional subscales may offer helpful insight into cognitive dysfunction change/improvement with treatment.
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Affiliation(s)
- James R Dornhoffer
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Yuan F Liu
- Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, California
| | - Elise E Zhao
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Habib G Rizk
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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16
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Quantification of Cognitive Dysfunction in Dizzy Patients Using the Neuropsychological Vertigo Inventory. Otol Neurotol 2020; 40:e723-e731. [PMID: 31295206 DOI: 10.1097/mao.0000000000002311] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Currently available patient reported outcomes questionnaires for dizzy patients give limited insight into the cognitive dysfunction patients often report. Using the newly developed English version of the neuropsychological vertigo inventory (NVI), we aimed to quantify the cognitive impairment of dizzy patients. STUDY DESIGN Prospective cohort study. SETTING Tertiary neurotology clinic. PATIENTS Adults with vestibular diagnoses seen between June 2018 and October 2018. Patients with neurologic disorders affecting cognition were excluded. INTERVENTIONS None. MAIN OUTCOME MEASURE NVI score. Secondary measures: dizziness handicap inventory (DHI) score, cognitive failure questionnaire (CFQ) score, 20-item short form health survey scores (SF20). RESULTS Of 67 subjects, 13 had BPPV, 11 had Menière's disease (MD), and 20 had vestibular migraine (VM). VM patients were significantly younger (43.5 versus 61.1 yrs, p = 0.016), and had significantly higher NVI (67.5 versus 51.0, p = 0.040) scores than BPPV patients. MD patients had significantly higher CFQ scores (44.8 versus 23.4, p = 0.015) than BPPV patients. NVI scores were similar between MD (67.3) and VM (67.5) patients (p = 1.000). DHI scores were similar for all patients (p = 0.102). NVI scores were highly correlated to CFQ scores (r = 0.864, p < 0.001). CONCLUSIONS VM patients have levels of cognitive dysfunction similar to MD patients, but greater than BPPV patients. A lack of difference in DHI scores among these patients reflects its limitation in assessing the cognitive domain.
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17
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Mehrjoo Z, Kahrizi K, Mohseni M, Akbari M, Arzhangi S, Jalalvand K, Najmabadi H, Farhadi M, Mohseni M, Asghari A, Mohebbi S, Daneshi A. Limbic System Associated Membrane Protein Mutation in an Iranian Family Diagnosed with Ménière's Disease. ARCHIVES OF IRANIAN MEDICINE 2020; 23:319-325. [PMID: 32383616 DOI: 10.34172/aim.2020.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 01/26/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Ménière's disease (MD) is a common inner ear disorder which is characterized by recurrent attacks of vertigo, fluctuating sensorineural hearing loss (SNHL), tinnitus, and a sense of fullness in the affected ear. MD is a complex disorder; although six genes have been linked to familial autosomal dominant form of the disease, in many cases, the exact genetic etiology remains elusive. METHODS To elucidate the genetic causes of MD in an Iranian family, we performed exome sequencing on all members of the family: consanguineous parents and four children (two affected and two unaffected). Variant filtering was completed using a customized workflow keeping variants based on segregation with MD in autosomal recessive (AR) inheritance pattern, minor allele frequency (MAF), and in-silico prediction of pathogenicity. RESULTS Analysis revealed that in this family, 970 variants co-segregated with MD in AR pattern, out of which eight variants (one intergenic, four intronic, and three exonic) were extremely rare. The exonic variants included a synonymous substitution in USP3 gene, an in-frame deletion in ZBED2 gene, and a rare, highly conserved deleterious missense alteration in LSAMP gene. CONCLUSION The phenotype observed in the proband described here, i.e. vertigo, poor sense of smell, tinnitus, and borderline hearing ability, may originate from aberrant changes in the cerebellum and limbic system due to a deleterious mutation in the LSAMP gene; hence, LSAMP mutation is a possible candidate for the etiology of MD in this family.
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Affiliation(s)
- Zohreh Mehrjoo
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kimia Kahrizi
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Mohseni
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mojdeh Akbari
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Sanaz Arzhangi
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Khadijeh Jalalvand
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hossein Najmabadi
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Farhadi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohseni
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Alimohamad Asghari
- Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Saleh Mohebbi
- Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Daneshi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
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18
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Dobbels B, Mertens G, Gilles A, Claes A, Moyaert J, van de Berg R, Van de Heyning P, Vanderveken O, Van Rompaey V. Cognitive Function in Acquired Bilateral Vestibulopathy: A Cross-Sectional Study on Cognition, Hearing, and Vestibular Loss. Front Neurosci 2019; 13:340. [PMID: 31105513 PMCID: PMC6492511 DOI: 10.3389/fnins.2019.00340] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/25/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Several studies have demonstrated cognitive deficits in patients with bilateral vestibulopathy (BVP). So far, little attention has been paid to the hearing status of vestibular patients when evaluating their cognition. Given the well-established link between sensorineural hearing loss (SNHL) and cognitive decline and the high prevalence of SNHL in BVP patients, it is therefore uncertain if the cognitive deficits in BVP patients are solely due to their vestibular loss or might be, partially, explained by a concomitant SNHL. OBJECTIVE To evaluate the link between cognition, hearing, and vestibular loss in BVP patients. DESIGN Prospective cross-sectional analysis of cognitive performance in patients with BVP and control participants without vestibular loss. Both groups included subjects with a variety of hearing (dys)function. Cognition was assessed by means of the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H). RESULTS Sixty-four BVP patients were evaluated and compared with 83 control participants. For each subscale and the totale RBANS-H scale a multiple linear regression model was fitted with the following variables: vestibular loss, hearing loss, age, gender, and education. Hearing loss seemed to be associated with worse outcome on the total RBANS-H scale and subscales immediate memory and language. Vestibular loss, on the other hand, was linked to worse performance on the attention subscale of the RBANS-H. Furthermore, we did not observe a correlation between saccular function and cognition. CONCLUSION This study has found general cognitive deficits in a large sample size of BVP patients. Multiple linear regression models revealed that both vestibular and hearing dysfunction were associated with different subscales of the cognitive test battery, the RBANS-H. Whereas hearing loss was associated with worse performance on total RBANS-H score, immediate memory and language, vestibular loss was observed to negatively affect attention performance.
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Affiliation(s)
- Bieke Dobbels
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Griet Mertens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annes Claes
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Julie Moyaert
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Raymond van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands
- Faculty of Physics, Tomsk State University, Tomsk, Russia
| | - Paul Van de Heyning
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Olivier Vanderveken
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
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19
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Wei EX, Oh ES, Harun A, Ehrenburg M, Xue QL, Simonsick E, Agrawal Y. Increased Prevalence of Vestibular Loss in Mild Cognitive Impairment and Alzheimer's Disease. Curr Alzheimer Res 2019; 16:1143-1150. [PMID: 31418661 PMCID: PMC10696591 DOI: 10.2174/1567205016666190816114838] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND/AIMS Recent evidence has shown that Alzheimer's Disease (AD) patients have reduced vestibular function relative to healthy controls. In this study, we evaluated whether patients with Mild Cognitive Impairment (MCI) also have reduced vestibular function relative to controls, and compared the level of vestibular impairment between MCI and AD patients. METHODS Vestibular physiologic function was assessed in 77 patients (26 MCI, 51 AD) and 295 matched controls using 3 clinical vestibular tests. The association between vestibular loss and cognitive impairment was evaluated using conditional logistic regression models. RESULTS Individuals with vestibular impairment had a 3 to 4-fold increased odds of being in the MCI vs. control group (p-values < 0.05). MCI patients had a level of vestibular impairment that was intermediate between controls and AD. CONCLUSION These findings suggest a dose-response relationship between vestibular loss and cognitive status, and support the hypothesis that vestibular loss contributes to cognitive decline.
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Affiliation(s)
- Eric X. Wei
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University, School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287, USA
| | - Esther S. Oh
- Department of Medicine, Johns Hopkins University, School of Medicine, 5200 Eastern Ave, Seventh Floor, Baltimore, MD 21224, USA
| | - Aisha Harun
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University, School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287, USA
| | - Matthew Ehrenburg
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University, School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287, USA
| | - Qian-Li Xue
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, School of Medicine, 2024 E. Monument Street, Suite 2-722, Baltimore, MD 21205, USA
| | - Eleanor Simonsick
- National Institute on Aging, National Institutes of Health, 3001 S. Hanover Street, 5th Floor, Baltimore, MD 21225, USA
| | - Yuri Agrawal
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University, School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287, USA
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20
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Suh MJ, Jeong J, Kim HJ, Jung J, Kim SH. Clinical Characteristics of Bilateral Meniere's Disease in a Single Asian Ethnic Group. Laryngoscope 2018; 129:1191-1196. [PMID: 30284277 DOI: 10.1002/lary.27423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES/HYPOTHESIS To identify the clinical characteristics of patients with bilateral Meniere's disease (MD) in an Asian population. STUDY DESIGN Cross-sectional retrospective study. METHODS We compared the clinical features of bilateral MD (BMD) and unilateral MD (UMD) in 320 Asian patients with single ethnicity. Demographic variables; age of onset; inner ear function; the coexistence of related disorders such as vestibular migraine, delayed MD, systemic autoimmune diseases, and familial MD; and prognoses were analyzed and compared. RESULTS The overall prevalence of BMD was 5.6%. The mean age of disease onset was 40.3 ± 14.8 and 47.0 ± 14.1 years for patients with BMD and UMD, respectively (P = .07). Demographic variables were not significantly different between patients with BMD and UMD (P > .05). Inner ear function, evaluated by hearing thresholds, caloric tests, and cervical vestibular evoked myogenic potentials, was significantly more deteriorated in the first involved ear of patients with BMD than in the second involved ear or the affected side of patients with UMD (P < .05). Among the comorbid conditions, only the prevalence of delayed MD was significantly higher in patients with BMD than in patients with UMD. Systemic autoimmune disease was found in only three patients with UMD. There was no significant prognostic difference between patients with UMD and BMD (P > .05). CONCLUSIONS A low prevalence of BMD, a higher frequency of delayed MD in BMD patients, and a low frequency of systemic autoimmune diseases in both UMD and BMD patients are significant findings in an Asian population. LEVEL OF EVIDENCE 4 Laryngoscope, 129:1191-1196, 2019.
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Affiliation(s)
- Michelle J Suh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Hyun Ji Kim
- Department of Otorhinolaryngology, Inha University College of Medicine, Incheon, South Korea
| | - Jinsei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Huhn Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.,Airway Mucus Institute, Yonsei University College of Medicine, Seoul, South Korea
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21
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Kamil RJ, Jacob A, Ratnanather JT, Resnick SM, Agrawal Y. Vestibular Function and Hippocampal Volume in the Baltimore Longitudinal Study of Aging (BLSA). Otol Neurotol 2018; 39:765-771. [PMID: 29889787 PMCID: PMC5999049 DOI: 10.1097/mao.0000000000001838] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study evaluated whether reduced vestibular function in aging adults is associated with lower hippocampal volume. STUDY DESIGN Cross-sectional study. SETTING Baltimore Longitudinal Study of Aging, a long-running longitudinal cohort study of healthy aging. PATIENTS Eligible participants were aged ≥ 60 years and had both vestibular physiological testing and brain magnetic resonance imaging at the same visit. INTERVENTION Vestibular function testing consisted of the cervical vestibular-evoked myogenic potential (cVEMP) to assess saccular function, ocular VEMP to assess utricular function, and video head-impulse testing to assess the horizontal semicircular canal vestibulo-ocular reflex. MAIN OUTCOME MEASURE Hippocampal volume calculated using diffeomorphometry. RESULTS The study sample included 103 participants (range of 35-90 participants in subanalyses) with mean (±SD) age 77.2 years (±8.71). Multivariate linear models including age, intracranial volume, sex, and race showed that 1 μV amplitude increase of cVEMP was associated with an increase of 319.1 mm (p = 0.003) in mean hippocampal volume. We did not observe a significant relationship between ocular VEMP amplitude or vestibulo-ocular reflex gain and mean hippocampal volume. CONCLUSIONS Lower cVEMP amplitude (i.e., reduced saccular function) was significantly associated with lower mean hippocampal volume. This is in line with previous work demonstrating a link between saccular function and spatial cognition. Hippocampal atrophy may be a mechanism by which vestibular loss contributes to impaired spatial cognition in older adults. Future work using longitudinal data will be needed to evaluate the causal nature of the association between vestibular loss and hippocampal atrophy.
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Affiliation(s)
- Rebecca J. Kamil
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD
| | - Athira Jacob
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD
| | | | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore MD
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD
- Department of Otolaryngology-Head and Neck Surgery, Division of Otology, Neurotology, and Skull Base Surgery, Johns Hopkins University, Baltimore, MD
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22
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Aitken P, Zheng Y, Smith PF. The modulation of hippocampal theta rhythm by the vestibular system. J Neurophysiol 2018; 119:548-562. [DOI: 10.1152/jn.00548.2017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The vestibular system is a sensory system that has evolved over millions of years to detect acceleration of the head, both rotational and translational, in three dimensions. One of its most important functions is to stabilize gaze during unexpected head movement; however, it is also important in the control of posture and autonomic reflexes. Theta rhythm is a 3- to 12-Hz oscillating EEG signal that is intimately linked to self-motion and is also known to be important in learning and memory. Many studies over the last two decades have shown that selective activation of the vestibular system, using either natural rotational or translational stimulation, or electrical stimulation of the peripheral vestibular system, can induce and modulate theta activity. Furthermore, inactivation of the vestibular system has been shown to significantly reduce theta in freely moving animals, which may be linked to its impairment of place cell function as well as spatial learning and memory. The pathways through which vestibular information modulate theta rhythm remain debatable. However, vestibular responses have been found in the pedunculopontine tegmental nucleus (PPTg) and activation of the vestibular system causes an increase in acetylcholine release into the hippocampus, probably from the medial septum. Therefore, a pathway from the vestibular nucleus complex and/or cerebellum to the PPTg, supramammillary nucleus, posterior hypothalamic nucleus, and septum to the hippocampus is likely. The modulation of theta by the vestibular system may have implications for vestibular effects on cognitive function and the contribution of vestibular impairment to the risk of dementia.
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Affiliation(s)
- Phillip Aitken
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
| | - Yiwen Zheng
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand Centre of Research Excellence
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
| | - Paul F. Smith
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- 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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23
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Wei EX, Oh ES, Harun A, Ehrenburg M, Agrawal Y. Vestibular Loss Predicts Poorer Spatial Cognition in Patients with Alzheimer’s Disease. J Alzheimers Dis 2018; 61:995-1003. [DOI: 10.3233/jad-170751] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Eric X. Wei
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Esther S. Oh
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aisha Harun
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew Ehrenburg
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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24
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Abstract
PURPOSE OF REVIEW The last year has seen a great deal of new information published relating vestibular dysfunction to cognitive impairment in humans, especially in the elderly. The objective of this review is to summarize and critically evaluate this new evidence in the context of the previous literature. RECENT FINDINGS This review will address the recent epidemiological/survey studies that link vestibular dysfunction with cognitive impairment in the elderly; recent clinical investigations into cognitive impairment in the context of vestibular dysfunction, both in the elderly and in the cases of otic capsule dehiscence and partial bilateral vestibulopathy; recent evidence that vestibular impairment is associated with hippocampal atrophy; and finally recent evidence relating to the hypothesis that vestibular dysfunction could be a risk factor for dementia. SUMMARY The main implication of these recent studies is that vestibular dysfunction, possibly of any type, may result in cognitive impairment, and this could be especially so for the elderly. Such symptoms will need to be considered in the treatment of patients with vestibular disorders.
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25
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Is hippocampal neurogenesis modulated by the sensation of self-motion encoded by the vestibular system? Neurosci Biobehav Rev 2017; 83:489-495. [DOI: 10.1016/j.neubiorev.2017.09.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 09/10/2017] [Accepted: 09/10/2017] [Indexed: 01/26/2023]
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26
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Li L, Wang Y, An L, Kong X, Huang T. A network-based method using a random walk with restart algorithm and screening tests to identify novel genes associated with Menière's disease. PLoS One 2017; 12:e0182592. [PMID: 28787010 PMCID: PMC5546581 DOI: 10.1371/journal.pone.0182592] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 07/20/2017] [Indexed: 12/28/2022] Open
Abstract
As a chronic illness derived from hair cells of the inner ear, Menière’s disease (MD) negatively influences the quality of life of individuals and leads to a number of symptoms, such as dizziness, temporary hearing loss, and tinnitus. The complete identification of novel genes related to MD would help elucidate its underlying pathological mechanisms and improve its diagnosis and treatment. In this study, a network-based method was developed to identify novel MD-related genes based on known MD-related genes. A human protein-protein interaction (PPI) network was constructed using the PPI information reported in the STRING database. A classic ranking algorithm, the random walk with restart (RWR) algorithm, was employed to search for novel genes using known genes as seed nodes. To make the identified genes more reliable, a series of screening tests, including a permutation test, an interaction test and an enrichment test, were designed to select essential genes from those obtained by the RWR algorithm. As a result, several inferred genes, such as CD4, NOTCH2 and IL6, were discovered. Finally, a detailed biological analysis was performed on fifteen of the important inferred genes, which indicated their strong associations with MD.
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Affiliation(s)
- Lin Li
- Department of Otorhinolaryngology and Head & Neck, China-Japan Union Hospital of Jilin University, Changchun, China
| | - YanShu Wang
- Department of Anesthesia, The First Hospital of Jilin University, Changchun, China
| | - Lifeng An
- Department of Otorhinolaryngology and Head & Neck, China-Japan Union Hospital of Jilin University, Changchun, China
- * E-mail:
| | - XiangYin Kong
- Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Tao Huang
- Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
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27
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Cha WW, Song K, Yu IK, Choi MS, Chang DS, Cho CS, Lee HY. Magnetic resonance imaging predicts chronic dizziness after benign paroxysmal positional vertigo. Am J Otolaryngol 2017; 38:428-432. [PMID: 28390809 DOI: 10.1016/j.amjoto.2017.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 03/01/2017] [Accepted: 04/04/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We aimed to evaluate the clinical implications of magnetic resonance imaging (MRI) findings in patients with benign paroxysmal positional vertigo (BPPV). METHODS A total of 120 patients diagnosed with BPPV completed MRI at the emergency room between December 2012 and June 2015 and met our criteria for inclusion in this study. Epidemiologic characteristics, the results of audio-vestibular testing, and MRI findings were retrospectively analyzed. RESULTS The most common findings were white matter hyperintensities (70.0%), sinusitis (34.2%), and brain atrophy (25.0%). There were no significant differences in MRI findings or epidemiologic characteristics according to BPPV subtype (p>0.05). A multiple regression analysis revealed that BPPV recurrence (odds ratio, 6.88; 95% confidence interval, 1.67-34.48; p=0.009) and brain atrophy (odds ratio, 4.39; 95% confidence interval, 1.11-21.28; p=0.036) were positively associated with dizziness lasting longer than 3months. CONCLUSION Brain atrophy was independently associated with long-lasting dizziness after BPPV. Although the mechanism is unclear, brain atrophy may have relevance to otoneurotologic disease-related changes in brain structure.
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Affiliation(s)
- Wang Woon Cha
- Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Kudamo Song
- Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - In Kyu Yu
- Department of Diagnostic Radiology, Eulji University Medical Center, Eulji University School of Medicine, Eulji University, Daejeon, Republic of Korea
| | - Myoung Su Choi
- Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Dong Sik Chang
- Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Chin-Saeng Cho
- Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Ho Yun Lee
- Department of Otorhinolaryngology, Eulji University Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea.
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28
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Albathi M, Agrawal Y. Vestibular vertigo is associated with abnormal sleep duration. J Vestib Res 2017; 27:127-135. [DOI: 10.3233/ves-170617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Monirah Albathi
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
- Department of Surgery, College of Medicine, Princess Nourah University Riyadh, Riyadh, Saudi Arabia
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
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29
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Effects of bilateral vestibular deafferentation in rat on hippocampal theta response to somatosensory stimulation, acetylcholine release, and cholinergic neurons in the pedunculopontine tegmental nucleus. Brain Struct Funct 2017; 222:3319-3332. [PMID: 28349227 DOI: 10.1007/s00429-017-1407-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 03/14/2017] [Indexed: 12/18/2022]
Abstract
Vestibular dysfunction has been shown to cause spatial memory impairment. Neurophysiological studies indicate that bilateral vestibular loss (BVL), in particular, is associated with an impairment of the response of hippocampal place cells and theta rhythm. However, the specific neural pathways through which vestibular information reaches the hippocampus are yet to be fully elucidated. The aim of the present study was to further investigate the hypothesised 'theta-generating pathway' from the brainstem vestibular nucleus to the hippocampus. BVL, and in some cases, unilateral vestibular loss (UVL), induced by intratympanic sodium arsanilate injections in rats, were used to investigate the effects of vestibular loss on somatosensory-induced type 2 theta rhythm, acetylcholine (ACh) release in the hippocampus, and the number of cholinergic neurons in the pedunculopontine tegmental nucleus (PPTg), an important part of the theta-generating pathway. Under urethane anaesthesia, BVL was found to cause a significant increase in the maximum power of the type 2 theta (3-6 Hz) frequency band compared to UVL and sham animals. Rats with BVL generally exhibited a lower basal level of ACh release than sham rats; however, this difference was not statistically significant. The PPTg of BVL rats exhibited significantly more choline-acetyltransferase (ChAT)-positive neurons than that of sham animals, as did the contralateral PPTg of UVL animals; however, the number of ChAT-positive neurons on the ipsilateral side of UVL animals was not significantly different from sham animals. The results of these studies indicate that parts of the theta-generating pathway undergo a significant reorganisation following vestibular loss, which suggests that this pathway is important for the interaction between the vestibular system and the hippocampus.
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30
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Kim BG, Kim JY, Jung J, Moon IS, Yoon JH, Choi JY, Kim SH. β 1- and β 2-adrenergic stimulation-induced electrogenic transport by human endolymphatic sac epithelium and its clinical implications. Sci Rep 2017; 7:42217. [PMID: 28165045 PMCID: PMC5292703 DOI: 10.1038/srep42217] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/03/2017] [Indexed: 01/02/2023] Open
Abstract
The endolymphatic sac (ES) is a cystic structure of the inner ear connected to the cochlea and vestibule, which plays a role in regulating ion homeostasis in inner ear fluid. Disruption of ion homeostasis can cause inner ear disorders with hearing loss and dizziness, such as Meniere's disease. Herein, we found, for the first time, functional evidence for the involvement of β1- and β2-adrenergic receptors in apical electrogenic ion transport by human ES epithelium by using electrophysiological/pharmacological and molecular biological methods, which were dependent on K+ and Cl- ion transport. The apical electrogenic transport was absent or very weak in ES epithelia of patients with Meniere's disease. These results suggested that adrenergic stimulation via β1- and β2-adrenergic receptors in the human ES was involved in regulation of inner ear fluid ion homeostasis and impairment of this response could be a pathological mechanism of Meniere's disease.
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Affiliation(s)
- Bo Gyung Kim
- Department of Otorhinolaryngology, Soonchunhyang University College of Medicine, Bucheon, 420-767, Republic of Korea
| | - Jin Young Kim
- Research Center for Natural Human Defense System, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Republic of Korea
| | - JinSei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine
| | - In Seok Moon
- Department of Otorhinolaryngology, Yonsei University College of Medicine
| | - Joo-Heon Yoon
- Research Center for Natural Human Defense System, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Republic of Korea.,Department of Otorhinolaryngology, Yonsei University College of Medicine.,The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine.,The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Sung Huhn Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine.,The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
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31
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Aitken P, Benoit A, Zheng Y, Philoxene B, Le Gall A, Denise P, Besnard S, Smith PF. Hippocampal and striatal M1-muscarinic acetylcholine receptors are down-regulated following bilateral vestibular loss in rats. Hippocampus 2016; 26:1509-1514. [DOI: 10.1002/hipo.22651] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/17/2016] [Accepted: 08/25/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Phillip Aitken
- Department of Pharmacology and Toxicology; Brain Health Research Centre University of Otago; Dunedin New Zealand
| | - Alice Benoit
- Normandie Univ, UNICAEN, INSERM, COMETE, CHU Caen; 14000 Caen France
| | - Yiwen Zheng
- Department of Pharmacology and Toxicology; Brain Health Research Centre University of Otago; Dunedin New Zealand
- Brain Research New Zealand Centre of Research Excellence; New Zealand
| | - Bruno Philoxene
- Normandie Univ, UNICAEN, INSERM, COMETE, CHU Caen; 14000 Caen France
| | - Anne Le Gall
- Normandie Univ, UNICAEN, INSERM, COMETE, CHU Caen; 14000 Caen France
| | - Pierre Denise
- Normandie Univ, UNICAEN, INSERM, COMETE, CHU Caen; 14000 Caen France
| | - Stephane Besnard
- Normandie Univ, UNICAEN, INSERM, COMETE, CHU Caen; 14000 Caen France
| | - Paul F. Smith
- Department of Pharmacology and Toxicology; Brain Health Research Centre University of Otago; Dunedin New Zealand
- Brain Research New Zealand Centre of Research Excellence; New Zealand
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32
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Basal dendritic length is reduced in the rat hippocampus following bilateral vestibular deafferentation. Neurobiol Learn Mem 2016; 131:56-60. [DOI: 10.1016/j.nlm.2016.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/02/2016] [Accepted: 03/02/2016] [Indexed: 12/18/2022]
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