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Wang S, Wang H, Liu X, Yan W, Wang M, Zhao R. A resting-state functional MRI study in patients with vestibular migraine during interictal period. Acta Neurol Belg 2023; 123:99-105. [PMID: 33683634 DOI: 10.1007/s13760-021-01639-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 02/26/2021] [Indexed: 12/21/2022]
Abstract
To evaluate the spontaneous neuronal activities and the changes of brain functional network in patients with vestibular migraine (VM). Three groups including18 patients with VM, 21 patients with migraine without aura (MWoA) and 21 healthy controls (HCs) underwent the scanning of the resting-state fMRI. Covariance analysis and bonferroni multiple comparisons were used to obtain brain regions with significant differences in amplitude of low-frequency fluctuation (ALFF) values. Furthermore, the brain regions with the most significant differences of ALFF values were recognized as a region of interest (ROI) and functional connectivity (FC) analysis was performed in these regions. (1) ALFF: Compared with HCs, patients with VM showed significantly lower ALFF in the right putamen (P < 0.05), and significantly higher ALFF in the right lingual gyrus (P < 0.05). In addition, compared with MWoA patients, patients with VM showed significantly higher ALFF in the right lingual gyrus (P < 0.05). (2) Compared with HCs, VM patients showed significantly higher FC among the cerebellum, the left dorsolateral superior frontal gyrus and the right putamen (P < 0.05) but significantly lower FC among the left median cingulate, paracingulate gyri and the right putamen (P < 0.05). Compared with MWoA patients, VM patients showed significantly higher FC between the cerebellum and the right putamen (P < 0.05) but significantly lower FC among the left median cingulate, paracingulate gyri and the right putamen (P < 0.05). There are functional abnormalities in nociceptive, vestibular and visual cortex regions in patients with VM during the interictal period.
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Affiliation(s)
- Shuqing Wang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266003, China
| | - Haiping Wang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266003, China.
| | - Xuejun Liu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266003, China
| | - Wenjing Yan
- Department of Neurology, The Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266003, China
| | - Minghui Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266003, China
| | - Renliang Zhao
- Department of Neurology, The Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266003, China
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Oh SY, Kang JJ, Kim S, Lee JM, Kim JS, Dieterich M. A preliminary trial of botulinum toxin type A in patients with vestibular migraine: A longitudinal fMRI study. Front Neurol 2022; 13:955158. [PMID: 35959394 PMCID: PMC9358216 DOI: 10.3389/fneur.2022.955158] [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: 05/28/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study aims to investigate the efficacy of botulinum toxin type A (BTX-A) in the prophylactic management of vestibular migraine (VM) and to determine whether this treatment modulates intrinsic functional brain network. Methods Vestibular migraine patients (n = 20, mean age 45.4 years) who were resistant to conventional prophylactic therapies had BTX-A injection and rs-fMRI before and 2 months after the injection. We also measured the changes in the frequency of vertigo and migraine attacks, symptomatic functional disability scores, and neuropsychiatric inventories. Results After BTX-A injection, the mean monthly frequencies of migraine and vertigo episodes decreased significantly compared with the baseline (p < 0.01, paired t-test). The Headache Impact Test-6 score and the Migraine Disability Assessment, and the vertigo parameters, measured by the Dizziness Handicap Inventory and the Vertigo Symptom Scale, showed an improvement, as did the anxiety and depression scores 2 months after BTX-A treatment. The low-frequency fluctuation analysis of the rs-fMRI data found significant changes in the functional connectivity of the right superior temporal gyrus. Adoption of this cluster as the seed region increased the functional connectivity with the left post-central gyrus, right supramarginal gyrus, and right middle temporal gyrus after BTX-A treatment. Conclusion This prospective study suggests that BTX-A treatment is effective at ameliorating migraine and vertigo symptoms in VM patients who were resistant to conventional therapies. Along with symptomatic improvements, changes in the functional connectivity within the multisensory vestibular and pain networks suggest a dysmodulation of multimodal sensory integration and abnormal cortical processing of the vestibular and pain signals in VM patients.
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Affiliation(s)
- Sun-Young Oh
- Department of Neurology, Jeonbuk National University Hospital and School of Medicine, Jeonju-si, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju-si, South Korea
- *Correspondence: Sun-Young Oh
| | - Jin-Ju Kang
- Department of Neurology, Jeonbuk National University Hospital and School of Medicine, Jeonju-si, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju-si, South Korea
| | - Sohui Kim
- Department of Electronic Engineering, Hanyang University, Seoul, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
- Jong-Min Lee
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neurology, Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Marianne Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Integration of Vestibular and Auditory Information in Ontogenesis. CHILDREN 2022; 9:children9030401. [PMID: 35327775 PMCID: PMC8947488 DOI: 10.3390/children9030401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/15/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
Background: We analyzed the hypothesis that the vestibular and auditory systems are integrative functions. Methods: The study involved 383 children (5.5 ± 2.4 years old). We assessed the conduct of auditory information by recording the auditory brain stem response (ABR), post-rotational nystagmus (PRN), and cervical vestibular evoked myogenic potentials (cVEMP), and calculated the integration of the parameters. All procedures were carried out using the JACOBI 4 software package. Results: We have found out that PRN, ABR, and cVEMP represent three different groups of integrative functions, each of which is conditioned by its own integrative mechanism. We have proven that PRN and ABR are associated with age, but no relationship was found between cVEMP and age. Conclusion: According to our data, the severity of ABR and PRN depended on age, while cVEMP was not associated with age. The functional immaturity of the child’s vestibular system, which probably arose in utero, often becomes apparent only at school when reading and writing must be mastered. These skills require maturity of both the vestibule ocular and vestibule spinal functions of the vestibular system.
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Nakul E, Bartolomei F, Lopez C. Vestibular-Evoked Cerebral Potentials. Front Neurol 2021; 12:674100. [PMID: 34621231 PMCID: PMC8490637 DOI: 10.3389/fneur.2021.674100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022] Open
Abstract
The human vestibular cortex has mostly been approached using functional magnetic resonance imaging and positron emission tomography combined with artificial stimulation of the vestibular receptors or nerve. Few studies have used electroencephalography and benefited from its high temporal resolution to describe the spatiotemporal dynamics of vestibular information processing from the first milliseconds following vestibular stimulation. Evoked potentials (EPs) are largely used to describe neural processing of other sensory signals, but they remain poorly developed and standardized in vestibular neuroscience and neuro-otology. Yet, vestibular EPs of brainstem, cerebellar, and cortical origin have been reported as early as the 1960s. This review article summarizes and compares results from studies that have used a large range of vestibular stimulation, including natural vestibular stimulation on rotating chairs and motion platforms, as well as artificial vestibular stimulation (e.g., sounds, impulsive acceleration stimulation, galvanic stimulation). These studies identified vestibular EPs with short latency (<20 ms), middle latency (from 20 to 50 ms), and late latency (>50 ms). Analysis of the generators (source analysis) of these responses offers new insights into the neuroimaging of the vestibular system. Generators were consistently found in the parieto-insular and temporo-parietal junction-the core of the vestibular cortex-as well as in the prefrontal and frontal areas, superior parietal, and temporal areas. We discuss the relevance of vestibular EPs for basic research and clinical neuroscience and highlight their limitations.
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Affiliation(s)
- Estelle Nakul
- Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Cognitives (LNC), FR3C, Aix Marseille Univ, Marseille, France
| | - Fabrice Bartolomei
- Institut de Neurosciences des Systèmes, Inserm, Aix Marseille Univ, Marseille, France
- Service de Neurophysiologie Clinique, Hôpital Timone, Aix Marseille Univ, Marseille, France
| | - Christophe Lopez
- Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Cognitives (LNC), FR3C, Aix Marseille Univ, Marseille, France
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Black RD, Bell RP, Riska KM, Spankovich C, Peters RW, Lascola CD, Whitlow CT. The Acute Effects of Time-Varying Caloric Vestibular Stimulation as Assessed With fMRI. Front Syst Neurosci 2021; 15:648928. [PMID: 34434093 PMCID: PMC8381736 DOI: 10.3389/fnsys.2021.648928] [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: 01/02/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
We describe preliminary results from the application of time-varying caloric vestibular stimulation (tvCVS) to volunteers during a continuous blood oxygen level dependent (BOLD) functional MRI (fMRI) acquisition, recording baseline, during-tvCVS and post-tvCVS epochs. The modifications necessary to enable the use of this novel device in a 3-Tesla magnetic field are discussed. Independent component analysis (ICA) was used as a model-free method to highlight spatially and temporally coherent brain networks. The ICA results are consistent with tvCVS induction being mediated principally by thermoconvection in the vestibular labyrinth and not by direct thermal effects. The activation of hub networks identified by ICA is consistent with the concept of sensory neuromodulation, which posits that a modulatory signal introduced to a sensory organ is able to traverse the regions innervated (directly and indirectly) by that organ, while being transformed so as to be “matched” to regional neuronal dynamics. The data suggest that regional neurovascular coupling and a systemic cerebral blood flow component account for the BOLD contrast observed. The ability to modulate cerebral hemodynamics is of significant interest. The implications of these initial findings for the use of tvCVS therapeutically are discussed.
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Affiliation(s)
| | - Ryan P Bell
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Kristal M Riska
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Christopher Spankovich
- Department of Otolaryngology & Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, United States
| | | | - Christopher D Lascola
- Department of Radiology and Neurobiology, Duke University School of Medicine, Durham, NC, United States
| | - Christopher T Whitlow
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
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Li K, Si L, Cui B, Ling X, Shen B, Yang X. Altered spontaneous functional activity of the right precuneus and cuneus in patients with persistent postural-perceptual dizziness. Brain Imaging Behav 2021; 14:2176-2186. [PMID: 31313022 DOI: 10.1007/s11682-019-00168-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder, and is the most common cause of chronic vestibular syndrome. However, the pathogenesis of PPPD is currently unclear. This study aimed to analyze the changes of brain spontaneous functional activities in PPPD patients during the resting state, and to explore the underlying pathogenesis of PPPD, particularly the abnormal integration of visual and vestibular information. Ten PPPD patients and 10 healthy controls were enrolled from January to June 2018, and baseline data were collected from all subjects. Videonystagmography (VNG), the vestibular caloric test, the video head impulse test (vHIT) and vestibular evoked myogenic potentials (VEMPs) were measured to exclude peripheral vestibular lesions. Functional MRI (fMRI) was conducted in PPPD patients and healthy controls. The amplitude of low frequency fluctuation (ALFF) and regional homogeneity (ReHo), and functional connectivity were calculated to explore changes in brain spontaneous functional activity during the resting state. Compared with healthy controls, ALFF and ReHo values in the right precuneus and cuneus were significantly lower in PPPD patients (both P < 0.05). Further seed-based functional connectivity analysis showed decreased functional connectivity between precuneus, cuneus and left precentral gyrus (P < 0.05). Our findings suggest that the spontaneous functional activity of cuneus and precuneus in PPPD patients were altered, potentially leading to abnormal integration of visual and vestibular information. Weakened functional connectivity between the precuneus and the precentral gyrus may be associated with aggravated symptoms during upright posture, active or passive movements.
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Affiliation(s)
- Kangzhi Li
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, People's Republic of China
| | - Lihong Si
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, People's Republic of China
| | - Bin Cui
- Department of Radiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, People's Republic of China
| | - Xia Ling
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, People's Republic of China
| | - Bo Shen
- Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121001, People's Republic of China
| | - Xu Yang
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, People's Republic of China.
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7
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Abstract
We describe a model of neurological disease based on dysfunctional brain oscillators. This is not a new model, but it is not one that is widely appreciated by clinicians. The value of this model lies in the predictions it makes and the utility it provides in translational applications, in particular for neuromodulation devices. Specifically, we provide a perspective on devices that provide input to sensory receptors and thus stimulate endogenous sensory networks. Current forms of clinically applied neuromodulation, including devices such as (implanted) deep brain stimulators (DBS) and various, noninvasive methods such as transcranial magnetic stimulation (TMS) and transcranial current methods (tACS, tDCS), have been studied extensively. The potential strength of neuromodulation of a sensory organ is access to the same pathways that natural environmental stimuli use and, importantly, the modulatory signal will be transformed as it travels through the brain, allowing the modulation input to be consistent with regional neuronal dynamics. We present specific examples of devices that rely on sensory neuromodulation and evaluate the translational potential of these approaches. We argue that sensory neuromodulation is well suited to, ideally, repair dysfunctional brain oscillators, thus providing a broad therapeutic approach for neurological diseases.
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8
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Li K, Si L, Cui B, Ling X, Shen B, Yang X. Altered intra- and inter-network functional connectivity in patients with persistent postural-perceptual dizziness. NEUROIMAGE-CLINICAL 2020; 26:102216. [PMID: 32097864 PMCID: PMC7037590 DOI: 10.1016/j.nicl.2020.102216] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/09/2020] [Accepted: 02/16/2020] [Indexed: 11/26/2022]
Abstract
Intra-network functional connectivity (FC) in the right precuneus within the posterior default mode network was decreased in PPPD patients. Intra-network FC between the right precuneus and the bilateral precuneus and left premotor cortex was decreased. Intra-network FC between the right precuneus and bilateral corpus callosum was enhanced. Inter-network FC was increased between the visual network and auditory, sensorimotor networks. FC changes were negatively correlated with dizziness handicap inventory functional scores.
Background Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder characterized by persistent dizziness, unsteadiness, and non-spinning vertigo. It is the most common cause of chronic vestibular syndrome, but its pathogenesis is currently unclear. Recent studies have indicated that sensory integration may be altered in PPPD patients. Objective Using independent component analysis (ICA) combined with seed-based functional connectivity analysis, we aimed to analyze changes in brain network functional connectivity (FC) in PPPD patients during the resting state and to explore the underlying pathogenesis of PPPD, particularly the abnormal integration of multiple sensations. Methods Study subjects included 12 PPPD patients and 12 healthy controls and were recruited from January to August 2018. Detailed medical data were collected from all participants. Vestibular function, neurological and medical examinations were conducted to exclude other diseases associated with chronic dizziness. Functional MRI was performed on all subjects. ICA and seed-based functional connectivity analysis were performed to examine changes in intra- and inter-network FC in PPPD patients. Results In total, 13 independent components were identified using ICA. Compared with healthy controls, PPPD patients showed decreased intra-network FC in the right precuneus within the posterior default mode network. Moreover, seed-based functional connectivity analysis showed decreased intra-network FC between the right precuneus and the bilateral precuneus and left premotor cortex, and enhanced FC between the right precuneus and bilateral corpus callosum. With respect to the inter-network, FC in PPPD patients was increased between the occipital pole visual network and auditory, sensorimotor networks, as well as the lateral visual and auditory networks. Additional analyses showed that FC changes were negatively correlated with dizziness handicap inventory functional scores. Conclusion In PPPD patients, dysfunction in the precuneus may cause abnormalities in external environment monitoring and in posture and movement regulation. Compensatory strategies may then be adopted to maintain balance. At the local level, information exchange between the two cerebral hemispheres is enhanced via the corpus callosum. At the whole brain level, through enhancement of functional activities of the visual network, the integration of multiple sensations and the regulation of posture and movement are primarily driven by visual information.
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Affiliation(s)
- Kangzhi Li
- Peking University Aerospace School of Clinical Medicine, Beijing 100049, PR China
| | - Lihong Si
- Peking University Aerospace School of Clinical Medicine, Beijing 100049, PR China
| | - Bin Cui
- Peking University Aerospace School of Clinical Medicine, Beijing 100049, PR China
| | - Xia Ling
- Peking University Aerospace School of Clinical Medicine, Beijing 100049, PR China
| | - Bo Shen
- Peking University Aerospace School of Clinical Medicine, Beijing 100049, PR China
| | - Xu Yang
- Peking University Aerospace School of Clinical Medicine, Beijing 100049, PR China.
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Ertl M, Boegle R. Investigating the vestibular system using modern imaging techniques-A review on the available stimulation and imaging methods. J Neurosci Methods 2019; 326:108363. [PMID: 31351972 DOI: 10.1016/j.jneumeth.2019.108363] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 02/06/2023]
Abstract
The vestibular organs, located in the inner ear, sense linear and rotational acceleration of the head and its position relative to the gravitational field of the earth. These signals are essential for many fundamental skills such as the coordination of eye and head movements in the three-dimensional space or the bipedal locomotion of humans. Furthermore, the vestibular signals have been shown to contribute to higher cognitive functions such as navigation. As the main aim of the vestibular system is the sensation of motion it is a challenging system to be studied in combination with modern imaging methods. Over the last years various different methods were used for stimulating the vestibular system. These methods range from artificial approaches like galvanic or caloric vestibular stimulation to passive full body accelerations using hexapod motion platforms, or rotatory chairs. In the first section of this review we provide an overview over all methods used in vestibular stimulation in combination with imaging methods (fMRI, PET, E/MEG, fNIRS). The advantages and disadvantages of every method are discussed, and we summarize typical settings and parameters used in previous studies. In the second section the role of the four imaging techniques are discussed in the context of vestibular research and their potential strengths and interactions with the presented stimulation methods are outlined.
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Affiliation(s)
- Matthias Ertl
- Department of Psychology, University of Bern, Switzerland; Sleep-Wake-Epilepsy Center, Department of Neurology, University Hospital (Inselspital) Bern, Switzerland.
| | - Rainer Boegle
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany; German Center for Vertigo and Balance Disorders, IFB-LMU, Ludwig-Maximilians Universität, Munich, Germany
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Wilson R, Mullinger KJ, Francis ST, Mayhew SD. The relationship between negative BOLD responses and ERS and ERD of alpha/beta oscillations in visual and motor cortex. Neuroimage 2019; 199:635-650. [PMID: 31189075 DOI: 10.1016/j.neuroimage.2019.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 04/10/2019] [Accepted: 06/03/2019] [Indexed: 01/06/2023] Open
Abstract
Previous work has investigated the electrophysiological origins of the intra-modal (within the stimulated sensory cortex) negative BOLD fMRI response (NBR, decrease from baseline) but little attention has been paid to the origin of cross-modal NBRs, those in a different sensory cortex. In the current study we use simultaneous EEG-fMRI recordings to assess the neural correlates of both intra- and cross-modal responses to left-hemifield visual stimuli and right-hand motor tasks, and evaluate the balance of activation and deactivation between the visual and motor systems. Within- and between-subject covariations of EEG and fMRI responses to both tasks are assessed to determine how patterns of event-related desynchronization/synchronisation (ERD/ERS) of alpha/beta frequency oscillations relate to the NBR in the two sensory cortices. We show that both visual and motor tasks induce intra-modal NBR and cross-modal NBR (e.g. visual stimuli evoked NBRs in both visual and motor cortices). In the EEG data, bilateral intra-modal alpha/beta ERD were consistently observed to both tasks, whilst the cross-modal EEG response varied across subjects between alpha/beta ERD and ERS. Both the mean cross-modal EEG and fMRI response amplitudes showed a small increase in magnitude with increasing task intensity. In response to the visual stimuli, subjects displaying cross-modal ERS of motor beta power displayed a significantly larger magnitude of cross-modal NBR in motor cortex. However, in contrast to the motor stimuli, larger cross-modal ERD of visual alpha power was associated with larger cross-modal visual NBR. Single-trial correlation analysis provided further evidence of relationship between EEG signals and the NBR, motor cortex beta responses to motor tasks were significantly negatively correlated with cross-modal visual cortex NBR amplitude, and positively correlated with intra-modal motor cortex PBR. This study provides a new body of evidence that the coupling between BOLD and low-frequency (alpha/beta) sensory cortex EEG responses extends to cross-modal NBR.
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Affiliation(s)
- Ross Wilson
- Centre for Human Brain Health (CHBH), University of Birmingham, Birmingham, UK
| | - Karen J Mullinger
- Centre for Human Brain Health (CHBH), University of Birmingham, Birmingham, UK; SPMIC, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Susan T Francis
- SPMIC, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Stephen D Mayhew
- Centre for Human Brain Health (CHBH), University of Birmingham, Birmingham, UK.
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11
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Balaban CD, Black RD, Silberstein SD. Vestibular Neuroscience for the Headache Specialist. Headache 2019; 59:1109-1127. [DOI: 10.1111/head.13550] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Carey D. Balaban
- Department of Otolaryngology University of Pittsburgh Pittsburgh PA USA
- Department of Neurobiology University of Pittsburgh Pittsburgh PA USA
- Department of Communication Sciences and Disorders University of Pittsburgh Pittsburgh PA USA
- Department of Bioengineering University of Pittsburgh Pittsburgh PA USA
| | | | - Stephen D. Silberstein
- Jefferson Headache Center, Department of Neurology Thomas Jefferson University Philadelphia PA USA
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12
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Kirsch V, Boegle R, Keeser D, Kierig E, Ertl-Wagner B, Brandt T, Dieterich M. Handedness-dependent functional organizational patterns within the bilateral vestibular cortical network revealed by fMRI connectivity based parcellation. Neuroimage 2018; 178:224-237. [DOI: 10.1016/j.neuroimage.2018.05.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/02/2018] [Accepted: 05/05/2018] [Indexed: 12/19/2022] Open
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Wirth AM, Frank SM, Greenlee MW, Beer AL. White Matter Connectivity of the Visual-Vestibular Cortex Examined by Diffusion-Weighted Imaging. Brain Connect 2018; 8:235-244. [PMID: 29571264 DOI: 10.1089/brain.2017.0544] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
The parieto-insular vestibular cortex (PIVC) and the posterior insular cortex (PIC) are key regions of the cortical vestibular network, both located in the midposterior section of the lateral sulcus. Little is known about the structural connectivity pattern of these areas. We used probabilistic fiber tracking based on diffusion-weighted magnetic resonance imaging (MRI) and compared the ipsilateral connectivity of PIVC and PIC. Seed areas for the tracking algorithm were identified in each brain by functional MRI activity during caloric and visual motion stimulation, respectively. Cortical track terminations were investigated by a surface-based approach. Both PIVC and PIC shared ipsilateral connections to the insular/lateral sulcus, superior temporal cortex, and inferior frontal gyrus. However, PIVC showed significantly more connections than PIC with the anterior insula and Heschl's gyrus in both hemispheres and with the precuneus, intraparietal sulcus, and posterior callosum of the right hemisphere. In contrast, PIC connectivity was more pronounced with the supramarginal gyrus and superior temporal sulcus. Subcortical tracks were examined by a region-of-interest-based approach, which was validated on cortico-thalamic motor tracts. Both PIVC and PIC were connected with lateral nuclei of the thalamus and the basal ganglia (primarily putamen). PIVC tracks but not PIC tracks showed a right-hemispheric lateralization in cortical and subcortical connectivity. Overall, these results suggest that human PIVC and PIC share cortical and even subcortical connections. Nevertheless, they also differ in their primary connectivity pattern: PIVC is linked with posterior parietal and inferior frontal cortex, whereas PIC is linked with superior temporal and inferior parietal cortex.
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Affiliation(s)
- Anna M Wirth
- 1 Institute of Psychology, University of Regensburg , Regensburg, Germany .,2 Department of Neurology, University Hospital of Regensburg , Regensburg, Germany
| | - Sebastian M Frank
- 1 Institute of Psychology, University of Regensburg , Regensburg, Germany .,3 Department of Psychological and Brain Sciences, Dartmouth College , Hanover, New Hampshire.,4 Department of Cognitive, Linguistic, and Psychological Sciences, Brown University , Providence, Rhode Island
| | - Mark W Greenlee
- 1 Institute of Psychology, University of Regensburg , Regensburg, Germany
| | - Anton L Beer
- 1 Institute of Psychology, University of Regensburg , Regensburg, Germany .,5 Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
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Non-Invasive Neuromodulation Using Time-Varying Caloric Vestibular Stimulation. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2016; 4:2000310. [PMID: 27777829 PMCID: PMC5074346 DOI: 10.1109/jtehm.2016.2615899] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/17/2016] [Accepted: 09/18/2016] [Indexed: 12/14/2022]
Abstract
Caloric vestibular stimulation (CVS) to elicit the vestibulo-ocular reflex has long been used in clinical settings to aid in the diagnosis of balance disorders and to confirm the absence of brainstem function. While a number of studies have hinted at the potential therapeutic applications of CVS, the limitations of existing devices have frustrated that potential. Current CVS irrigators use water or air during short-duration applications; however, this approach is not tenable for longer duration therapeutic protocols or home use. Here, we describe a solid-state CVS device we developed in order to address these limitations. This device delivers tightly controlled time-varying thermal waveforms, which can be programmed through an external control unit. It contains several safety features, which limit patients to the prescribed waveform and prevent the potential for temperature extremes. In this paper, we provide evidence that CVS treatment with time-varying, but not constant temperature waveforms, elicits changes in cerebral blood flow physiology consistent with the neuromodulation of brainstem centers, and we present results from a small pilot study, which demonstrate that the CVS can safely and feasibly be used longitudinally in the home setting to treat episodic migraine. Together, these results indicate that this solid-state CVS device may be a viable tool for non-invasive neuromodulation.
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Maheu M, Fournier P, Landry SP, Houde MS, Champoux F, Saliba I. Structural and functional changes of cortical and subcortical structures following peripheral vestibular damage in humans. Eur Arch Otorhinolaryngol 2016; 274:65-70. [PMID: 26994901 DOI: 10.1007/s00405-016-3986-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/11/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Maxime Maheu
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Philippe Fournier
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Simon P Landry
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Marie-Soleil Houde
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada
| | - François Champoux
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Issam Saliba
- Department of Surgery, Division of Otorhinolaryngology-Head and Neck Surgery, University of Montreal, Montreal, QC, Canada. .,Division of Otolaryngology Head and Neck Surgery, Montreal University Hospital Center (CHUM), Notre-Dame Hospital, 1560 Sherbrooke street East, Montreal, QC H2L 4M1, Canada.
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Espinosa-Sanchez JM, Lopez-Escamez JA. New insights into pathophysiology of vestibular migraine. Front Neurol 2015; 6:12. [PMID: 25705201 PMCID: PMC4319397 DOI: 10.3389/fneur.2015.00012] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 01/19/2015] [Indexed: 11/30/2022] Open
Abstract
Vestibular migraine (VM) is a common disorder in which genetic, epigenetic, and environmental factors probably contribute to its development. The pathophysiology of VM is unknown; nevertheless in the last few years, several studies are contributing to understand the neurophysiological pathways involved in VM. The current hypotheses are mostly based on the knowledge of migraine itself. The evidence of trigeminal innervation of the labyrinth vessels and the localization of vasoactive neuropeptides in the perivascular afferent terminals of these trigeminal fibers support the involvement of the trigemino-vascular system. The neurogenic inflammation triggered by activation of the trigeminal-vestibulocochlear reflex, with the subsequent inner ear plasma protein extravasation and the release of inflammatory mediators, can contribute to a sustained activation and sensitization of the trigeminal primary afferent neurons explaining VM symptoms. The reciprocal connections between brainstem vestibular nuclei and the structures that modulate trigeminal nociceptive inputs (rostral ventromedial medulla, ventrolateral periaqueductal gray, locus coeruleus, and nucleus raphe magnus) are critical to understand the pathophysiology of VM. Although cortical spreading depression can affect cortical areas involved in processing vestibular information, functional neuroimaging techniques suggest a dysmodulation in the multimodal sensory integration and processing of vestibular and nociceptive information, resulting from a vestibulo-thalamo-cortical dysfunction, as the pathogenic mechanism underlying VM. The elevated prevalence of VM suggests that multiple functional variants may confer a genetic susceptibility leading to a dysregulation of excitatory–inhibitory balance in brain structures involved in the processing of sensory information, vestibular inputs, and pain. The interactions among several functional and structural neural networks could explain the pathogenic mechanisms of VM.
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Affiliation(s)
- Juan M Espinosa-Sanchez
- Otology and Neurotology Group CTS495, Human DNA Variability Department, GENYO Centre for Genomics and Oncological Research Pfizer - University of Granada - Junta de Andalucia , Granada , Spain ; Department of Otolaryngology, Hospital San Agustin , Linares , Spain
| | - Jose A Lopez-Escamez
- Otology and Neurotology Group CTS495, Human DNA Variability Department, GENYO Centre for Genomics and Oncological Research Pfizer - University of Granada - Junta de Andalucia , Granada , Spain ; Department of Otolaryngology, Hospital de Poniente , El Ejido , Spain
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Hashimoto T, Taoka M, Obayashi S, Hara Y, Tanaka M, Iriki A. Modulation of cortical vestibular processing by somatosensory inputs in the posterior insula. Brain Inj 2014; 27:1685-91. [PMID: 24266797 PMCID: PMC3854664 DOI: 10.3109/02699052.2013.831128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Primary objective To study the mechanism of somatosensory-vestibular interactions, this study examined the effects of somatosensory inputs on body sway induced by galvanic vestibular stimulation (GVS) in healthy participants and persons with brain injury in the posterior insula, a region constituting a part of the parietoinsular vestibular cortex. Research design This study adopted an experimental, controlled, repeated measures design. Methods and procedures Participants were 11 healthy individuals, two persons with unilateral posterior insular injury and two age-matched controls. Bipolar GVS was applied to the mastoid processes while participants were sitting with their eyes closed, either lightly touching a stable surface with their index finger or not touching the surface with their index finger. Main outcomes and results In healthy participants, tilting was greater with right hemispheric stimulation than with left hemispheric stimulation. Moreover, with right hemispheric stimulation, tilting was greater with a right finger touch than with no touch. The person with right-brain injury showed tilting induced by GVS; however, finger touch had no modulatory effect. In contrast, finger touch enhanced tilting in the person with left-brain injury. Conclusions These preliminary results are discussed in light of a hypothesis of right hemispheric dominance of somatosensory-vestibular interactions in the posterior insula.
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Affiliation(s)
- Teruo Hashimoto
- Laboratory for Symbolic Cognitive Development, RIKEN Brain Science Institute , Wako , Japan and
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Klingner CM, Volk GF, Brodoehl S, Witte OW, Guntinas-Lichius O. Disrupted functional connectivity of the default mode network due to acute vestibular deficit. NEUROIMAGE-CLINICAL 2014; 6:109-14. [PMID: 25379422 PMCID: PMC4215422 DOI: 10.1016/j.nicl.2014.08.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/22/2014] [Accepted: 08/22/2014] [Indexed: 11/17/2022]
Abstract
Vestibular neuritis is defined as a sudden unilateral partial failure of the vestibular nerve that impairs the forwarding of vestibular information from the labyrinth. The patient suffers from vertigo, horizontal nystagmus and postural instability with a tendency toward ipsilesional falls. Although vestibular neuritis is a common disease, the central mechanisms to compensate for the loss of precise vestibular information remain poorly understood. It was hypothesized that symptoms following acute vestibular neuritis originate from difficulties in the processing of diverging sensory information between the responsible brain networks. Accordingly an altered resting activity was shown in multiple brain areas of the task-positive network. Because of the known balance between the task-positive and task-negative networks (default mode network; DMN) we hypothesize that also the DMN is involved. Here, we employ functional magnetic resonance imaging (fMRI) in the resting state to investigate changes in the functional connectivity between the DMN and task-positive networks, in a longitudinal design combined with measurements of caloric function. We demonstrate an initially disturbed connectedness of the DMN after vestibular neuritis. We hypothesize that the disturbed connectivity between the default mode network and particular parts of the task-positive network might be related to a sustained utilization of processing capacity by diverging sensory information. The current results provide some insights into mechanisms of central compensation following an acute vestibular deficit and the importance of the DMN in this disease. fMRI connectivity analyses after vestibular neuritis in a longitudinal design Initially disturbed connectedness between the DMN and task positive networks Connectivity restoration after complete clinical recovery of patients
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Affiliation(s)
| | - Gerd F Volk
- Department for Otorhinolaryngology, University of Jena, Germany
| | | | - Otto W Witte
- Department of Neurology, University of Jena, Germany
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Noll-Hussong M, Holzapfel S, Pokorny D, Herberger S. Caloric vestibular stimulation as a treatment for conversion disorder: a case report and medical hypothesis. Front Psychiatry 2014; 5:63. [PMID: 24917828 PMCID: PMC4040883 DOI: 10.3389/fpsyt.2014.00063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 05/19/2014] [Indexed: 12/12/2022] Open
Abstract
Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation has been demonstrated to modulate a variety of cognitive functions associated with brain activations, especially in the temporal-parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure.
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Affiliation(s)
- Michael Noll-Hussong
- Klinik und Poliklinik fuer Psychosomatische Medizin und Psychotherapie des Universitaetsklinikums Ulm, Ulm, Germany
| | - Sabrina Holzapfel
- Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Dan Pokorny
- Klinik und Poliklinik fuer Psychosomatische Medizin und Psychotherapie des Universitaetsklinikums Ulm, Ulm, Germany
| | - Simone Herberger
- Klinik fuer Psychosomatische Medizin und Psychotherapie des Klinikums Muenchen-Harlaching, Muenchen, Germany
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Cousins S, Kaski D, Cutfield N, Seemungal B, Golding JF, Gresty M, Glasauer S, Bronstein AM. Vestibular perception following acute unilateral vestibular lesions. PLoS One 2013; 8:e61862. [PMID: 23671577 PMCID: PMC3650015 DOI: 10.1371/journal.pone.0061862] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/14/2013] [Indexed: 11/18/2022] Open
Abstract
Little is known about the vestibulo-perceptual (VP) system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO) and VP function in 25 patients with vestibular neuritis (VN) acutely (2 days after onset) and after compensation (recovery phase, 10 weeks). Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2) and velocity steps of 90°/s (acceleration 180°/s(2)). We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of perceptual processes (ultimately cortical) participating in vestibular compensation, suppressing asymmetry acutely in unilateral vestibular lesions.
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Affiliation(s)
- Sian Cousins
- Neuro-otology Unit, Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Diego Kaski
- Neuro-otology Unit, Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Nicholas Cutfield
- Neurology, Dunedin Hospital, University of Otago, Dunedin, New Zealand
| | - Barry Seemungal
- Neuro-otology Unit, Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - John F. Golding
- Department of Psychology, University of Westminster, London, United Kingdom
| | - Michael Gresty
- Neuro-otology Unit, Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Stefan Glasauer
- Sensorimotor Research and German Vertigo Center, Ludwig-Maximilian University, Munich, Germany
| | - Adolfo M. Bronstein
- Neuro-otology Unit, Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, United Kingdom
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