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Bosmans J, Gommeren H, Gilles A, Mertens G, Van Ombergen A, Cras P, Engelborghs S, Vereeck L, Lammers MJW, Van Rompaey V. Evidence of Vestibular and Balance Dysfunction in Patients With Mild Cognitive Impairment and Alzheimer's Disease. Ear Hear 2024; 45:53-61. [PMID: 37482637 DOI: 10.1097/aud.0000000000001401] [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: 07/25/2023]
Abstract
OBJECTIVES Given the expected rise in dementia prevalence, early diagnosis is vital. As a growing body of literature has identified a potential association between vestibular function and cognition, vestibular assessment may aid in early screening. The aim of the study was to better comprehend the proposed association between vestibular function and Alzheimer's disease (AD) by comparing vestibular parameters (vestibular function testing and clinical balance measures) between a group with mild cognitive impairment (MCI), AD, and healthy controls with age-normal cognition. DESIGN Cross-sectional analysis of the GECkO study, an ongoing prospective single-center longitudinal cohort study. This study included 100 older adults (55 to 84 years). A total of 33 participants with MCI, 17 participants with AD, and 50 participants of age, sex, and hearing-matched healthy controls were included. RESULTS Participants with AD demonstrated a delayed latency of the p13 component measured by cervical vestibular-evoked myogenic potentials (cVEMP) compared with healthy controls and participants with MCI. Other measures including n23 latency, presence of intact responses, rectified amplitude, mean rectified voltage (measured by cVEMP) and lateral vestibulo-ocular reflex gain (measured by video Head Impulse Test [vHIT]) did not differ between groups. The Timed Up and Go (TUG), Performance-Oriented Mobility Assessment-Balance subscale (POMA-B), and Functional Gait Assessment (FGA) differed significantly between the three groups. Here, more cognitively impaired groups were associated with worse clinical balance scores. CONCLUSIONS Vestibular and balance deficits were more prevalent in groups with increasing cognitive decline. Regarding vestibular function testing, p13 latency as measured by cVEMP was delayed in participants with AD. Other cVEMP or vHIT measures did not differ between groups. All three clinical balance assessments (TUG, POMA-B, and FGA) resulted in worse scores along the AD continuum. Future research integrating vestibular parameters that add value (including otolith function testing, balance, and spatial navigation) is recommended to validate the association between vestibular function and cognition while avoiding redundant testing.
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Affiliation(s)
- Joyce Bosmans
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hanne Gommeren
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
- Department of Neurology, Antwerp University Hospital and Born-Bunge Institute, University of Antwerp, Antwerp, Belgium
- Department of Neurology, Universitair Ziekenhuis Brussel and Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Griet Mertens
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Angelique Van Ombergen
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Patrick Cras
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital and Born-Bunge Institute, University of Antwerp, Antwerp, Belgium
| | - Sebastiaan Engelborghs
- Department of Neurology, Universitair Ziekenhuis Brussel and Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Luc Vereeck
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Marc J W Lammers
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
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Bosmans J, Gommeren H, Zu Eulenburg P, Gilles A, Mertens G, Van Ombergen A, Cras P, Engelborghs S, Van Rompaey V. Is vestibular function related to human hippocampal volume? J Vestib Res 2024; 34:3-13. [PMID: 37927291 DOI: 10.3233/ves-230076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Recent studies implicate the effect of vestibular loss on cognitive decline, including hippocampal volume loss. As hippocampal atrophy is an important biomarker of Alzheimer's disease, exploring vestibular dysfunction as a risk factor for dementia and its role in hippocampal atrophy is of interest. OBJECTIVE To replicate previous literature on whole-brain and hippocampal volume in semicircular canal dysfunction (bilateral vestibulopathy; BV) and explore the association between otolith function and hippocampal volume. METHODS Hippocampal and whole-brain MRI volumes were compared in adults aged between 55 and 83 years. Participants with BV (n = 16) were compared to controls individually matched on age, sex, and hearing status (n = 16). Otolith influence on hippocampal volume in preserved semicircular canal function was evaluated (n = 34). RESULTS Whole-brain and targeted hippocampal approaches using volumetric and surface-based measures yielded no significant differences when comparing BV to controls. Binary support vector machines were unable to classify inner ear health status above chance level. Otolith parameters were not associated with hippocampal volume in preserved semicircular canal function. CONCLUSIONS No significant differences in whole-brain or hippocampal volume were found when comparing BV participants with healthy controls. Saccular parameters in subjects with preserved semicircular canal function were not associated with hippocampal volume changes.
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Affiliation(s)
- Joyce Bosmans
- Faculty of Medicine and Health Sciences, Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, University of Antwerp, Belgium
| | - Hanne Gommeren
- Faculty of Medicine and Health Sciences, Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, University of Antwerp, Belgium
- University Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Peter Zu Eulenburg
- German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Munich, Germany
- Institute for Neuroradiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Annick Gilles
- Faculty of Medicine and Health Sciences, Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, University of Antwerp, Belgium
- University Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Griet Mertens
- Faculty of Medicine and Health Sciences, Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, University of Antwerp, Belgium
- University Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Angelique Van Ombergen
- Faculty of Medicine and Health Sciences, Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, University of Antwerp, Belgium
- Discipline Lead for Life Sciences, SciSpacE Team, Directorate for Human Spaceflight and Robotic Exploration Programmes, European Space Agency
| | - Patrick Cras
- Faculty of Medicine and Health Sciences, Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, University of Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital and Born-Bunge Institute, University of Antwerp, Antwerp, Belgium
| | - Sebastiaan Engelborghs
- Department of Neurology, Universitair Ziekenhuis Brussel and Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, University of Antwerp, Belgium
- University Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
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Ferreira MM, Lopes KDC, Grigol TADAES, Ganança MM, Caovilla HH. Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease. Braz J Otorhinolaryngol 2022; 89:485-493. [PMID: 36670010 PMCID: PMC10165191 DOI: 10.1016/j.bjorl.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/11/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To evaluate otolith function by comparing the findings of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential tests in patients in the inter-crisis period of unilateral definite Meniere's disease. METHODS The sample consisted of an experimental group (n=22; 10 men and 12 women, mean age 47.32±12.82 years) with definite unilateral Meniere's disease and a control group (n=14; 5 men and 9 women, with a mean age of 41.64±13.45 years). They all underwent vestibular evaluation by means of Subjective Visual Vertical with the bucket method and, cervical and ocular Vestibular Evoked Myogenic Potential tests. The data were collected and subjected to statistical analysis. RESULTS The results of the comparison of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential, the ocular Vestibular Evoked Myogenic Potential and, the association of cervical Vestibular Evoked Myogenic Potential with the ocular Vestibular Evoked Myogenic Potential showed no significant difference, indicating concordance among the tests. CONCLUSION The identified abnormalities and the concordance between the combined proportion of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential findings indicate that the association of these three tests contributes to the identification of sustained and transient otolith dysfunction in the inter-crisis of unilateral definite Meniere's disease. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Maristela Mian Ferreira
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Discipline of Otology and Neurotology, São Paulo, SP, Brazil.
| | - Karen de Carvalho Lopes
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Discipline of Otology and Neurotology, São Paulo, SP, Brazil
| | | | - Maurício Malavasi Ganança
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Discipline of Otology and Neurotology, São Paulo, SP, Brazil
| | - Heloisa Helena Caovilla
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Discipline of Otology and Neurotology, São Paulo, SP, Brazil
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Zhang Y, Chen Z, Zhao H, Shen J, Zhong B, Wu Q, Yang J, Jin Y, Zhang Q, Ren P. B81 Bone Vibrator-Induced Vestibular-Evoked Myogenic Potentials: Normal Values and the Effect of Age. Front Neurol 2022; 13:881682. [PMID: 35645948 PMCID: PMC9131004 DOI: 10.3389/fneur.2022.881682] [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: 02/22/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo define the normal values and examine the influence of aging on B81 bone vibrator-induced cervical vestibular-evoked myogenic potentials (B81-cVEMPs) and ocular vestibular-evoked myogenic potentials (B81-oVEMPs).MethodsSeventy healthy subjects, divided into seven groups according to their ages, were enrolled in this study. The 4–9-, 10–19-, 20–29-, 30–39-, 40–49-, 50–59-, and 60–70-year-old participants were divided into groups I–VII, respectively. B81-cVEMP and B81-oVEMP were recorded in each group.ResultsThe B81-cVEMP response rates for groups I–VII were 100, 100, 100, 100, 95, 95, and 75%, respectively, with significant differences only between groups I–VI and group VII (p = 0.047, p < 0.05). The B81-oVEMP response rates for groups I–VII were 100, 100, 100, 100, 70, 65, and 40%, respectively, with significant differences only between groups I–IV and groups V–VII (p = 0.020, p = 0.008, p = 0.000; p < 0.05). The threshold, P13, and N23 latencies of B81-cVEMP positively correlated with age (r = 0.756, p = 0.000; r = 0.357, p = 0.003; r = 0.316, p = 0.009; p < 0.05). The raw amplitudes and corrected amplitudes negatively correlated with age (r = −0.641, p = 0.000; r = −0.609, p = 0.000, p < 0.05). For B81-oVEMP, the corrected amplitudes negatively correlated with age (r = −0.638, p = 0.000, p<0.05), but the threshold and N10 latency positively correlated with age (r = 0.768, p = 0.000; r = 0.334, p = 0.009, p < 0.05). Moreover, the interaural asymmetry ratio did not significantly correlate with age for B81-cVEMP and B81-oVEMP.ConclusionAs age increased, the B81-cVEMP response rate decreased, the thresholds increased, P13 and N23 latencies were prolonged, and the raw amplitude and corrected amplitude decreased. The B81-oVEMP response rate and corrected amplitude decreased, the thresholds increased, and N10 latency was prolonged with age. These changes are probably due to the occurrence of morphological and functional changes in the vestibular system with aging. Therefore, we suggest establishing different reference values according to different age groups when evaluating the VEMP results in patients with vestibular diseases.
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Affiliation(s)
- Yuzhong Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zichen Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huandi Zhao
- Department of Otorhinolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiali Shen
- Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Ear Science, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Otolaryngology and Translational Medicine, Shanghai, China
| | - Bo Zhong
- Division of Mechanics and Acoustics, National Institute of Metrology, Beijing, China
| | - Qiong Wu
- Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Ear Science, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Otolaryngology and Translational Medicine, Shanghai, China
| | - Jun Yang
- Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Ear Science, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Otolaryngology and Translational Medicine, Shanghai, China
| | - Yulian Jin
- Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Ear Science, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Otolaryngology and Translational Medicine, Shanghai, China
- Yulian Jin
| | - Qing Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Ear Science, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Otolaryngology and Translational Medicine, Shanghai, China
- Qing Zhang
| | - Pengyu Ren
- Department of Otorhinolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- *Correspondence: Pengyu Ren
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Gao T, Zhang Q, Hou J, Zhu K, Sun B, Chen J, Xia C, Ren X, Cheng Y, Wang Z. Vestibular-evoked myogenic potentials in patients with severe obstructive sleep apnea. J Int Med Res 2020; 48:300060520909717. [PMID: 32216492 PMCID: PMC7133081 DOI: 10.1177/0300060520909717] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective Previous studies have shown that patients with obstructive sleep apnea syndrome (OSAS) may have various vestibular abnormalities, and these mainly present as subclinical lesions. In this study, we attempted to combine ocular vestibular-evoked myogenic potentials (VEMPs) and cervical (VEMPs) to investigate vestibular dysfunction in patients with OSAS. Methods Thirty-eight patients with severe OSAS and 42 healthy controls were enrolled and divided into two groups according to results of polysomnography. All parameters of VEMP graphs were analyzed. Results The response rate of ocular VEMPs was significantly lower in patients with severe OSAS (85.5%) than in controls (96.4%). The mean n1 latency of patients with severe OSAS (10.6 ± 1.0 months) was significantly longer than that of controls (10.2 ± 1.1 months). With regard to cervical VEMP, p1-n1 amplitudes were significantly different between the groups. Other VEMP parameters were not significantly different between the groups. Conclusions VEMPs can potentially be used to evaluate vestibular system lesions at the early stage of OSAS, including not only the vestibular nerve, but also the otolith organs involved.
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Affiliation(s)
- Tianxi Gao
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Qing Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jin Hou
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Kang Zhu
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bin Sun
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jingguo Chen
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Cui Xia
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyong Ren
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Cheng
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology and Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China.,*These authors contributed equally to this work
| | - Zhenghui Wang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,*These authors contributed equally to this work
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Abstract
The world's population is ageing due to increased hygiene and improved medical care. Dizziness and imbalance frequently affect the elderly and is most common among individuals over the age of 60. In this age group approximately 30% of the population experience these debilitating symptoms at some point. They contribute to falls and frailty, which often result in hospitalization causing tremendous cost for the health care systems, and increased mortality. To make the matters worse balance disorders are often complex. Physicians face the difficulty of diagnosing the patient with the exact disorder especially since each disorder may manifest differently in each patient. In addition, several treatment options exist, however, with a low level of evidence. This chapter summarizes the underlying degenerative processes of the peripheral as well as the central vestibular system, diagnostic tools, the most common balance disorders in the elderly, and possible treatment options of these disorders.
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