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Schöne CG, Vibert D, Mast FW. Executive functions in patients with bilateral and unilateral peripheral vestibular dysfunction. J Neurol 2024; 271:3291-3308. [PMID: 38466421 PMCID: PMC11136862 DOI: 10.1007/s00415-024-12267-7] [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: 10/31/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 03/13/2024]
Abstract
Previous research suggests that patients with peripheral vestibular dysfunction (PVD) suffer from nonspatial cognitive problems, including executive impairments. However, previous studies that assessed executive functions are conflicting, limited to single executive components, and assessments are confounded by other cognitive functions. We compared performance in a comprehensive executive test battery in a large sample of 83 patients with several conditions of PVD (34 bilateral, 29 chronic unilateral, 20 acute unilateral) to healthy controls who were pairwise matched to patients regarding age, sex, and education. We assessed basic and complex executive functions with validated neuropsychological tests. Patients with bilateral PVD performed worse than controls in verbal initiation and working memory span, while other executive functions were preserved. Patients with chronic unilateral PVD had equal executive performance as controls. Patients with acute unilateral PVD performed worse than controls in the exact same tests as patients with bilateral PVD (verbal initiation, working memory span); however, this effect in patients with acute PVD diminished after correcting for multiple comparisons. Hearing loss and affective disorders did not influence our results. Vestibular related variables (disease duration, symptoms, dizziness handicap, deafferentation degree, and compensation) did not predict verbal initiation or working memory span in patients with bilateral PVD. The results suggest that bilateral PVD not only manifests in difficulties when solving spatial tasks but leads to more general neurocognitive deficits. This understanding is important for multidisciplinary workgroups (e.g., neurotologists, neurologists, audiologists) that are involved in diagnosing and treating patients with PVD. We recommend screening patients with PVD for executive impairments and if indicated providing them with cognitive training or psychoeducational support.
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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.
| | - 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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2
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Reyhani Y, Taheri A, Tavanai E, Rahimi V, Hasanalifard M, Jalaie S. Comparison of the Degree of Handicap Between Different Types of Vestibular Disorders. Indian J Otolaryngol Head Neck Surg 2024; 76:2635-2645. [PMID: 38883464 PMCID: PMC11169380 DOI: 10.1007/s12070-023-04315-x] [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: 06/20/2023] [Accepted: 10/21/2023] [Indexed: 06/18/2024] Open
Abstract
Vestibular disorders have had a disabling effect because of the symptoms they cause. The aim of this study was to evaluate the degree of disability associated with vertigo in patients with different vestibular disorders using a handicap questionnaire and to investigate the possible relationship between some factors with different types of vestibular disorders and vertigo-related handicap scores. 462 subjects aged 12-90 years old with symptoms of vertigo, dizziness, or imbalance were recruited from several public and private centers. After taking the medical history, the patients fillled out the Vertigo Handicap Questionnaire (VHQ). There was a significant difference between the VHQ mean scores of vestibular disorders (p = 0.002). There was also a significant relationship between the male sex and BPPV and blood supply problems, between women with endolymphatic hydrops, vestibular neuritis, VM, CNS disorders, concomitant BPPV, and hydrops, between vestibular disorders and various ranges of hearing. BPPV, neuritis, VM, were also significantly correlated with blood pressure, concomitant BPPV and hydrops, with diabetes and hydrops, and concomitant BPPV and hydrops were significantly correlated with cholesterol. The coexistence of various vestibular disorders may cause additional handicaps and should be considered. Some comorbidities may also affect the degree of handicap, although their effects may not be the same. Various factors in addition to the type of vestibular disorder, such as personality, culture, education level, income, and strategies for coping with the disease, may also determine the level of patient-reported vertigo handicap.
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Affiliation(s)
- Yousef Reyhani
- New Hearing Technologies Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abolfazl Taheri
- New Hearing Technologies Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Elham Tavanai
- Department of Audiology, Faculty of Rehabilitation, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Vida Rahimi
- Department of Audiology, Faculty of Rehabilitation, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahdieh Hasanalifard
- New Hearing Technologies Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shohreh Jalaie
- School of Rehabilitation Sciences, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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3
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Smith LJ, Wilkinson D, Bodani M, Surenthiran SS. Cognition in vestibular disorders: state of the field, challenges, and priorities for the future. Front Neurol 2024; 15:1159174. [PMID: 38304077 PMCID: PMC10830645 DOI: 10.3389/fneur.2024.1159174] [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: 02/05/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Vestibular disorders are prevalent and debilitating conditions of the inner ear and brain which affect balance, coordination, and the integration of multisensory inputs. A growing body of research has linked vestibular disorders to cognitive problems, most notably attention, visuospatial perception, spatial memory, and executive function. However, the mechanistic bases of these cognitive sequelae remain poorly defined, and there is a gap between our theoretical understanding of vestibular cognitive dysfunction, and how best to identify and manage this within clinical practice. This article takes stock of these shortcomings and provides recommendations and priorities for healthcare professionals who assess and treat vestibular disorders, and for researchers developing cognitive models and rehabilitation interventions. We highlight the importance of multidisciplinary collaboration for developing and evaluating clinically relevant theoretical models of vestibular cognition, to advance research and treatment.
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Affiliation(s)
- Laura J. Smith
- Centre for Preventative Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
| | - David Wilkinson
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
| | - Mayur Bodani
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
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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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Van Hecke R, Danneels M, Deconinck FJA, Dhooge I, Leyssens L, Van Acker E, Van Waelvelde H, Wiersema JR, Maes L. A cross-sectional study on the neurocognitive outcomes in vestibular impaired school-aged children: are they at higher risk for cognitive deficits? J Neurol 2023; 270:4326-4341. [PMID: 37209128 DOI: 10.1007/s00415-023-11774-3] [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: 02/20/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
This study aimed to assess if children with a vestibular impairment (VI) are more prone to have neurocognitive deficits compared to typically developing (TD) peers, taking into account important confounding factors with hearing loss being the most important. The neurocognitive performance of fifteen VI children (6-13 years old) was compared to that of an age-, handedness- and sex-weighted group of TD peers (n = 60). Secondly, their performance was also compared to matched groups of TD and hearing impaired (HI) children to evaluate the involvement of HI. The protocol comprises cognitive tests assessing response inhibition, emotion recognition, visuospatial memory, selective and sustained attention, visual memory and visual-motor integration.Based on the results, the VI group had significantly reduced scores on 'social cognition' (p = 0.018), 'executive functions' (p < 0.01), and 'perceptual-motor functioning' (p = 0.020) compared to their TD and HI peers. For the categories 'complex attention' and 'learning and memory' no differences could be observed. Analogous to the findings of previous literature, the symptoms of a VI are often not limited to the primary functions of the system, but also comprise an impact on emotional and cognitive performance. Therefore, more holistic rehabilitation approaches should be encouraged, with a screening and attention for cognitive, emotional and behavioral dysfunctions in the vestibular population. Since this is one of the first studies to investigate the involvement of a VI in a child's cognitive development, these findings support the need for studies further characterizing the impact of a VI, the underlying pathophysiology and the effect of different rehabilitation procedures.
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Affiliation(s)
- Ruth Van Hecke
- Department of Rehabilitation Sciences-Corneel, Ghent University, Heymanslaan 10, 9000, Ghent, Belgium.
| | - Maya Danneels
- Department of Rehabilitation Sciences-Corneel, Ghent University, Heymanslaan 10, 9000, Ghent, Belgium
| | - Frederik J A Deconinck
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Ingeborg Dhooge
- Department of Otorhinolaryngology-Corneel, Ghent University Hospital, Heymanslaan 10, 9000, Ghent, Belgium
- Department of Head and Skin-Corneel, Ghent University, Heymanslaan 10, 9000, Ghent, Belgium
| | - Laura Leyssens
- Department of Rehabilitation Sciences-Corneel, Ghent University, Heymanslaan 10, 9000, Ghent, Belgium
| | - Emmely Van Acker
- Department of Rehabilitation Sciences-Corneel, Ghent University, Heymanslaan 10, 9000, Ghent, Belgium
| | - Hilde Van Waelvelde
- Department of Rehabilitation Sciences-Corneel, Ghent University, Heymanslaan 10, 9000, Ghent, Belgium
| | - Jan R Wiersema
- Department of Experimental Clinical and Health Psychology-Henri, Ghent University, Dunantlaan 2, 9000, Ghent, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences-Corneel, Ghent University, Heymanslaan 10, 9000, Ghent, Belgium
- Department of Otorhinolaryngology-Corneel, Ghent University Hospital, Heymanslaan 10, 9000, Ghent, Belgium
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Qiu Y, Dou H, Dai Y, Li H, Lei Y. The influence of being left behind on fear acquisition and academic performance—a study of left-behind children. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hearing loss versus vestibular loss as contributors to cognitive dysfunction. J Neurol 2022; 269:87-99. [PMID: 33387012 DOI: 10.1007/s00415-020-10343-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/23/2020] [Accepted: 12/04/2020] [Indexed: 02/02/2023]
Abstract
In the last 5 years, there has been a surge in evidence that hearing loss (HL) may be a risk factor for cognitive dysfunction, including dementia. At the same time, there has been an increase in the number of studies implicating vestibular loss in cognitive dysfunction. Due to the fact that vestibular disorders often present with HL and other auditory disorders such as tinnitus, it has been suggested that, in many cases, what appears to be vestibular-related cognitive dysfunction may be due to HL (e.g., Dobbels et al. Front Neurol 11:710, 2020). This review analyses the studies of vestibular-related cognitive dysfunction which have controlled HL. It is suggested that despite the fact that many studies in the area have not controlled HL, many other studies have (~ 19/44 studies or 43%). Therefore, although there is certainly a need for further studies controlling HL, there is evidence to suggest that vestibular loss is associated with cognitive dysfunction, especially related to spatial memory. This is consistent with the overwhelming evidence from animal studies that the vestibular system transmits specific types of information about self-motion to structures such as the hippocampus.
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Lacroix E, Deggouj N, Edwards MG, Van Cutsem J, Van Puyvelde M, Pattyn N. The Cognitive-Vestibular Compensation Hypothesis: How Cognitive Impairments Might Be the Cost of Coping With Compensation. Front Hum Neurosci 2021; 15:732974. [PMID: 34658819 PMCID: PMC8517512 DOI: 10.3389/fnhum.2021.732974] [Citation(s) in RCA: 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: 06/29/2021] [Accepted: 09/10/2021] [Indexed: 11/13/2022] Open
Abstract
Previous research in vestibular cognition has clearly demonstrated a link between the vestibular system and several cognitive and emotional functions. However, the most coherent results supporting this link come from rodent models and healthy human participants artificial stimulation models. Human research with vestibular-damaged patients shows much more variability in the observed results, mostly because of the heterogeneity of vestibular loss (VL), and the interindividual differences in the natural vestibular compensation process. The link between the physiological consequences of VL (such as postural difficulties), and specific cognitive or emotional dysfunction is not clear yet. We suggest that a neuropsychological model, based on Kahneman's Capacity Model of Attention, could contribute to the understanding of the vestibular compensation process, and partially explain the variability of results observed in vestibular-damaged patients. Several findings in the literature support the idea of a limited quantity of cognitive resources that can be allocated to cognitive tasks during the compensation stages. This basic mechanism of attentional limitations may lead to different compensation profiles in patients, with or without cognitive dysfunction, depending on the compensation stage. We suggest several objective and subjective measures to evaluate this cognitive-vestibular compensation hypothesis.
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Affiliation(s)
- Emilie Lacroix
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Institute for Research in Psychological Science (IPSY), Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Naïma Deggouj
- Institute for Research in Psychological Science (IPSY), Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Institute of Neuroscience (IONS), Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Otorhinolaryngology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Martin Gareth Edwards
- Institute for Research in Psychological Science (IPSY), Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Institute of Neuroscience (IONS), Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Jeroen Van Cutsem
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Martine Van Puyvelde
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Brain Body and Cognition Research Group, Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.,Clinical and Lifespan Psychology, Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nathalie Pattyn
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium.,Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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Papadatou-Pastou M, Panagiotidou DA, Abbondanza F, Fischer U, Paracchini S, Karagiannakis G. Hand preference and Mathematical Learning Difficulties: New data from Greece, the United Kingdom, and Germany and two meta-analyses of the literature. Laterality 2021; 26:485-538. [PMID: 33823756 DOI: 10.1080/1357650x.2021.1906693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Increased rates of atypical handedness are observed in neurotypical individuals who are low-performing in mathematical tasks as well as in individuals with special educational needs, such as dyslexia. This is the first investigation of handedness in individuals with Mathematical Learning Difficulties (MLD). We report three new studies (N = 134; N = 1,893; N = 153) and two sets of meta-analyses (22 studies; N = 3,667). No difference in atypical hand preference between MLD and Typically Achieving (TA) individuals was found when handedness was assessed with self-report questionnaires, but weak evidence of a difference was found when writing hand was the handedness criterion in Study 1 (p = .049). Similarly, when combining data meta-analytically, no hand preference differences were detected. We suggest that: (i) potential handedness effects require larger samples, (ii) direction of hand preference is not a sensitive enough measure of handedness in this context, or that (iii) increased rates of atypical hand preference are not associated with MLD. The latter scenario would suggest that handedness is specifically linked to language-related conditions rather than conditions related to cognitive abilities at large. Future studies need to consider hand skill and degree of hand preference in MLD.
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Affiliation(s)
- Marietta Papadatou-Pastou
- School of Education, National and Kapodistrian University of Athens, Athens, Greece.,Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | - Filippo Abbondanza
- School of Medicine, North Haugh, University of St Andrews, St Andrews, UK
| | - Ursula Fischer
- Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Silvia Paracchini
- School of Medicine, North Haugh, University of St Andrews, St Andrews, UK
| | - Giannis Karagiannakis
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
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Van Hecke R, Danneels M, Dhooge I, Van Waelvelde H, Wiersema JR, Deconinck FJA, Maes L. Vestibular Function in Children with Neurodevelopmental Disorders: A Systematic Review. J Autism Dev Disord 2019; 49:3328-3350. [DOI: 10.1007/s10803-019-04059-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Hitier M, Sato G, Zhang YF, Zheng Y, Besnard S, Smith PF. Vestibular-related eye movements in the rat following selective electrical stimulation of the vestibular sensors. J Comp Physiol A Neuroethol Sens Neural Behav Physiol 2018; 204:835-847. [DOI: 10.1007/s00359-018-1286-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/29/2018] [Accepted: 09/04/2018] [Indexed: 01/26/2023]
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