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Gammeri R, Salatino A, Pyasik M, Cirillo E, Zavattaro C, Serra H, Pia L, Roberts DR, Berti A, Ricci R. Modulation of vestibular input by short-term head-down bed rest affects somatosensory perception: implications for space missions. Front Neural Circuits 2023; 17:1197278. [PMID: 37529715 PMCID: PMC10390228 DOI: 10.3389/fncir.2023.1197278] [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: 03/30/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction On Earth, self-produced somatosensory stimuli are typically perceived as less intense than externally generated stimuli of the same intensity, a phenomenon referred to as somatosensory attenuation (SA). Although this phenomenon arises from the integration of multisensory signals, the specific contribution of the vestibular system and the sense of gravity to somatosensory cognition underlying distinction between self-generated and externally generated sensations remains largely unknown. Here, we investigated whether temporary modulation of the gravitational input by head-down tilt bed rest (HDBR)-a well-known Earth-based analog of microgravity-might significantly affect somatosensory perception of self- and externally generated stimuli. Methods In this study, 40 healthy participants were tested using short-term HDBR. Participants received a total of 40 non-painful self- and others generated electrical stimuli (20 self- and 20 other-generated stimuli) in an upright and HDBR position while blindfolded. After each stimulus, they were asked to rate the perceived intensity of the stimulation on a Likert scale. Results Somatosensory stimulations were perceived as significantly less intense during HDBR compared to upright position, regardless of the agent administering the stimulus. In addition, the magnitude of SA in upright position was negatively correlated with the participants' somatosensory threshold. Based on the direction of SA in the upright position, participants were divided in two subgroups. In the subgroup experiencing SA, the intensity rating of stimulations generated by others decreased significantly during HDBR, leading to the disappearance of the phenomenon of SA. In the second subgroup, on the other hand, reversed SA was not affected by HDBR. Conclusion Modulation of the gravitational input by HDBR produced underestimation of somatosensory stimuli. Furthermore, in participants experiencing SA, the reduction of vestibular inputs by HDBR led to the disappearance of the SA phenomenon. These findings provide new insights into the role of the gravitational input in somatosensory perception and have important implications for astronauts who are exposed to weightlessness during space missions.
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Affiliation(s)
- Roberto Gammeri
- Space, Attention and Action (SAN) Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Adriana Salatino
- Space, Attention and Action (SAN) Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Maria Pyasik
- SpAtial, Motor and Bodily Awareness (SAMBA) Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Emanuele Cirillo
- Space, Attention and Action (SAN) Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Claudio Zavattaro
- Space, Attention and Action (SAN) Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Hilary Serra
- Space, Attention and Action (SAN) Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Lorenzo Pia
- SpAtial, Motor and Bodily Awareness (SAMBA) Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Donna R. Roberts
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States
| | - Anna Berti
- Space, Attention and Action (SAN) Lab, Department of Psychology, University of Turin, Turin, Italy
- SpAtial, Motor and Bodily Awareness (SAMBA) Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Raffaella Ricci
- Space, Attention and Action (SAN) Lab, Department of Psychology, University of Turin, Turin, Italy
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Kearney BE, Lanius RA. The brain-body disconnect: A somatic sensory basis for trauma-related disorders. Front Neurosci 2022; 16:1015749. [PMID: 36478879 PMCID: PMC9720153 DOI: 10.3389/fnins.2022.1015749] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/14/2022] [Indexed: 08/16/2023] Open
Abstract
Although the manifestation of trauma in the body is a phenomenon well-endorsed by clinicians and traumatized individuals, the neurobiological underpinnings of this manifestation remain unclear. The notion of somatic sensory processing, which encompasses vestibular and somatosensory processing and relates to the sensory systems concerned with how the physical body exists in and relates to physical space, is introduced as a major contributor to overall regulatory, social-emotional, and self-referential functioning. From a phylogenetically and ontogenetically informed perspective, trauma-related symptomology is conceptualized to be grounded in brainstem-level somatic sensory processing dysfunction and its cascading influences on physiological arousal modulation, affect regulation, and higher-order capacities. Lastly, we introduce a novel hierarchical model bridging somatic sensory processes with limbic and neocortical mechanisms regulating an individual's emotional experience and sense of a relational, agentive self. This model provides a working framework for the neurobiologically informed assessment and treatment of trauma-related conditions from a somatic sensory processing perspective.
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Affiliation(s)
- Breanne E. Kearney
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Ruth A. Lanius
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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3
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Black RD, Chaparro E. Time-varying caloric vestibular stimulation for the treatment of neurodegenerative disease. Front Aging Neurosci 2022; 14:1049637. [DOI: 10.3389/fnagi.2022.1049637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Time-varying caloric vestibular stimulation (tvCVS) is a new form of non-invasive neuromodulation similar to, but different from, diagnostic caloric vestibular stimulation (CVS). Using a non-invasive, solid-state delivery device, tvCVS has been successfully used in a human clinical trial with Parkinson’s disease (PD) subjects. Additionally, the effects of tvCVS on brain activation have been studied in healthy human subjects using transcranial Doppler sonography (TCD) and functional magnetic resonance imaging (BOLD fMRI). A novel finding in the TCD and fMRI studies was the induction of cerebral blood flow velocity (CBFv) oscillations. How such oscillations might lead to the observed clinical effects seen in PD subjects will be discussed. Enabling studies of tvCVS with rodents is an attractive goal in support of explorations of the mechanism of action. Male Wistar rats were used in a proof-of-concept study described herein. Rats were anesthetized (isoflurane) and ventilated for the duration of the tvCVS runs. Time-varying thermal stimuli were administered using a digital temperature controller to modulate Peltier-type heater/cooler devices. Blunt ear bars conveyed the thermal stimulus to the external ear canals of the rats. Different thermal waveform combinations were evaluated for evidence of successful induction of the CVS effect. It was found that bilateral triangular thermal waveforms could induce oscillations in CBFv both during and after the application of tvCVS. These oscillations were similar to, but different from those observed in awake human subjects. The establishment of a viable animal model for the study of tvCVS will augment ongoing clinical investigations of this new form of neuromodulation in patients with neurodegenerative disease.
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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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Hagiwara K, Perchet C, Frot M, Bastuji H, Garcia-Larrea L. Cortical modulation of nociception by galvanic vestibular stimulation: A potential clinical tool? Brain Stimul 2019; 13:60-68. [PMID: 31636023 DOI: 10.1016/j.brs.2019.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 09/27/2019] [Accepted: 10/09/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Vestibular afferents converge with nociceptive ones within the posterior insula, and can therefore modulate nociception. Consistent with this hypothesis, caloric vestibular stimulation (CVS) has been shown to reduce experimental and clinical pain. Since CVS can induce undesirable effects in a proportion of patients, here we explored an alternative means to activate non-invasively the vestibular pathways using innocuous bi-mastoid galvanic stimulation (GVS), and assessed its effects on experimental pain. METHODS Sixteen healthy volunteers participated in this study. Experimental pain was induced by noxious laser-heat stimuli to the left hand while recording pain ratings and related brain potentials (LEPs). We evaluated changes of these indices during left- or right-anodal GVS (cathode on contralateral mastoid), and contrasted them with those during sham GVS, optokinetic vestibular stimulation (OKS) using virtual reality, and attentional distraction to ascertain the vestibular-specific analgesic effects of GVS. RESULTS GVS elicited brief sensations of head/trunk deviation, inoffensive to all participants. Both active GVS conditions showed analgesic effects, greater for the right anodal stimulation. OKS was helpful to attain significant LEP reductions during the left-anodal stimulation. Neither sham-GVS nor the distraction task were able to modulate significantly pain ratings or LEPs. CONCLUSIONS GVS appeared as a well-tolerated and powerful procedure for the relief of experimental pain, probably through physiological interaction within insular nociceptive networks. Either isolated or in combination with other types of vestibular activation (e.g., optokinetic stimuli), GVS deserves being tested in clinical settings.
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Affiliation(s)
- Koichi Hagiwara
- Central Integration of Pain (NeuroPain), Lab-Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France.
| | - Caroline Perchet
- Central Integration of Pain (NeuroPain), Lab-Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Maud Frot
- Central Integration of Pain (NeuroPain), Lab-Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France
| | - Hélène Bastuji
- Central Integration of Pain (NeuroPain), Lab-Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France; Service de Neurologie Fonctionnelle et D'Épileptologie et Centre Du Sommeil, Hospices Civils de Lyon, Bron, F-69677, France
| | - Luis Garcia-Larrea
- Central Integration of Pain (NeuroPain), Lab-Lyon Neuroscience Research Center, INSERM U1028, CNRS, UMR5292, Université Claude Bernard, Bron, F-69677, France; Centre D'évaluation et de Traitement de La Douleur, Hôpital Neurologique, Lyon, F-69000, France
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Whitsel BL, Vierck CJ, Waters RS, Tommerdahl M, Favorov OV. Contributions of Nociresponsive Area 3a to Normal and Abnormal Somatosensory Perception. THE JOURNAL OF PAIN 2019; 20:405-419. [PMID: 30227224 PMCID: PMC6420406 DOI: 10.1016/j.jpain.2018.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/12/2018] [Accepted: 08/11/2018] [Indexed: 12/29/2022]
Abstract
Traditionally, cytoarchitectonic area 3a of primary somatosensory cortex (SI) has been regarded as a proprioceptive relay to motor cortex. However, neuronal spike-train recordings and optical intrinsic signal imaging, obtained from nonhuman sensorimotor cortex, show that neuronal activity in some of the cortical columns in area 3a can be readily triggered by a C-nociceptor afferent drive. These findings indicate that area 3a is a critical link in cerebral cortical encoding of secondary/slow pain. Also, area 3a contributes to abnormal pain processing in the presence of activity-dependent reversal of gamma-aminobutyric acid A receptor-mediated inhibition. Accordingly, abnormal processing within area 3a may contribute mechanistically to generation of clinical pain conditions. PERSPECTIVE: Optical imaging and neurophysiological mapping of area 3a of SI has revealed substantial driving from unmyelinated cutaneous nociceptors, complementing input to areas 3b and 1 of SI from myelinated nociceptors and non-nociceptors. These and related findings force a reconsideration of mechanisms for SI processing of pain.
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Affiliation(s)
- Barry L Whitsel
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
| | - Charles J Vierck
- Department of Neuroscience, University of Florida College of Medicine, Gainesville, Florida
| | - Robert S Waters
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee
| | - Mark Tommerdahl
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, North Carolina
| | - Oleg V Favorov
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, North Carolina.
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De Cicco V, Tramonti Fantozzi MP, Cataldo E, Barresi M, Bruschini L, Faraguna U, Manzoni D. Trigeminal, Visceral and Vestibular Inputs May Improve Cognitive Functions by Acting through the Locus Coeruleus and the Ascending Reticular Activating System: A New Hypothesis. Front Neuroanat 2018; 11:130. [PMID: 29358907 PMCID: PMC5766640 DOI: 10.3389/fnana.2017.00130] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 12/15/2017] [Indexed: 12/25/2022] Open
Abstract
It is known that sensory signals sustain the background discharge of the ascending reticular activating system (ARAS) which includes the noradrenergic locus coeruleus (LC) neurons and controls the level of attention and alertness. Moreover, LC neurons influence brain metabolic activity, gene expression and brain inflammatory processes. As a consequence of the sensory control of ARAS/LC, stimulation of a sensory channel may potential influence neuronal activity and trophic state all over the brain, supporting cognitive functions and exerting a neuroprotective action. On the other hand, an imbalance of the same input on the two sides may lead to an asymmetric hemispheric excitability, leading to an impairment in cognitive functions. Among the inputs that may drive LC neurons and ARAS, those arising from the trigeminal region, from visceral organs and, possibly, from the vestibular system seem to be particularly relevant in regulating their activity. The trigeminal, visceral and vestibular control of ARAS/LC activity may explain why these input signals: (1) affect sensorimotor and cognitive functions which are not directly related to their specific informational content; and (2) are effective in relieving the symptoms of some brain pathologies, thus prompting peripheral activation of these input systems as a complementary approach for the treatment of cognitive impairments and neurodegenerative disorders.
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Affiliation(s)
- Vincenzo De Cicco
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Maria P Tramonti Fantozzi
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | | | - Massimo Barresi
- Institut des Maladie Neurodégénératives, University of Bordeaux, Bordeaux, France
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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8
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Chen CC, Chuang YF, Huang ACW, Chen CK, Chang YJ. The antalgic effects of non-invasive physical modalities on central post-stroke pain: a systematic review. J Phys Ther Sci 2016; 28:1368-73. [PMID: 27190485 PMCID: PMC4868245 DOI: 10.1589/jpts.28.1368] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/18/2015] [Indexed: 12/14/2022] Open
Abstract
[Purpose] This study systematically reviewed the antalgic effects of non-invasive
physical modalities (NIPMs) on central post-stroke pain (CPSP). [Subjects and Methods]
Clinical studies were sought on September 2015 in 10 electronic databases, including
Medline and Scopus. The searching strings were “central pain and stroke” and “treatment,
and physical or non-pharmacological”. The inclusion and exclusion criteria were set for
screening the clinical articles by two reviewers. Pain scores on visual analog scale in an
article were used as the outcome measure for resulting judgment. The NIPMs intervention
summarized from the eligible articles was rated from Levels A to C according to Evidence
Classification Scheme for Therapeutic Interventions. [Results] Over 1200 articles were
identified in the initial searches and 85 studies were retrieved. Sixteen studies were
eligible and judged. Caloric vestibular stimulation (n=3), heterotopic noxious
conditioning stimulation (n=1), and transcutaneous electrical stimulation (n=1) were rated
below Level C. Transcranial direct current stimulation (TDCS; n=2) and transcranial
magnetic stimulation (TMS; n=9) were rated as Level B. [Conclusion] The findings suggest
that TMS and TDCS were better than other treatments for CPSP relief but the studies were
of insufficient quality.
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Affiliation(s)
- Chih-Chung Chen
- Department of Physical Therapy, Chang Gung University, Taiwan; Healthy Aging Center Chang Gung University, Taiwan
| | - Yu-Fen Chuang
- Department of Physical Therapy, Chang Gung University, Taiwan; Healthy Aging Center Chang Gung University, Taiwan
| | | | - Chih-Kuang Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taiwan; School of Medicine, Chang Gung University, Taiwan
| | - Ya-Ju Chang
- Department of Physical Therapy, Chang Gung University, Taiwan; Healthy Aging Center Chang Gung University, Taiwan
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Grabherr L, Macauda G, Lenggenhager B. The Moving History of Vestibular Stimulation as a Therapeutic Intervention. Multisens Res 2016; 28:653-87. [PMID: 26595961 DOI: 10.1163/22134808-00002495] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although the discovery and understanding of the function of the vestibular system date back only to the 19th century, strategies that involve vestibular stimulation were used long before to calm, soothe and even cure people. While such stimulation was classically achieved with various motion devices, like Cox's chair or Hallaran's swing, the development of caloric and galvanic vestibular stimulation has opened up new possibilities in the 20th century. With the increasing knowledge and recognition of vestibular contributions to various perceptual, motor, cognitive, and emotional processes, vestibular stimulation has been suggested as a powerful and non-invasive treatment for a range of psychiatric, neurological and neurodevelopmental conditions. Yet, the therapeutic interventions were, and still are, often not hypothesis-driven as broader theories remain scarce and underlying neurophysiological mechanisms are often vague. We aim to critically review the literature on vestibular stimulation as a form of therapy in various selected disorders and present its successes, expectations, and drawbacks from a historical perspective.
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Macrea LM, Macauda G, Bertolini G, Straumann D, Brugger P, Maurer K, Palla A, Lenggenhager B. Reducing pain by moving? A commentary on Ferrè et al. 2013. Cortex 2016; 78:167-169. [PMID: 26897724 DOI: 10.1016/j.cortex.2016.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/18/2016] [Accepted: 01/18/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Lucian M Macrea
- Department of Anesthesiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Gianluca Macauda
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland.
| | - Giovanni Bertolini
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland
| | - Dominik Straumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland
| | - Peter Brugger
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland; Institute of Physiology and Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Switzerland
| | - Konrad Maurer
- Department of Anesthesiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Antonella Palla
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland
| | - Bigna Lenggenhager
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland; Institute of Physiology and Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Switzerland
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11
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Age-related decline in functional connectivity of the vestibular cortical network. Brain Struct Funct 2015; 221:1443-63. [PMID: 25567421 DOI: 10.1007/s00429-014-0983-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 12/28/2014] [Indexed: 12/11/2022]
Abstract
In the elderly, major complaints include dizziness and an increasing number of falls, possibly related to an altered processing of vestibular sensory input. In this study, we therefore investigate age-related changes induced by processing of vestibular sensory stimulation. While previous functional imaging studies of healthy aging have investigated brain function during task performance or at rest, we used galvanic vestibular stimulation during functional MRI in a task-free sensory stimulation paradigm to study the effect of healthy aging on central vestibular processing, which might only become apparent during stimulation processing. Since aging may affect signatures of brain function beyond the BOLD-signal amplitude-such as functional connectivity or temporal signal variability--we employed independent component analysis and partial least squares analysis of temporal signal variability. We tested for age-associated changes unrelated to vestibular processing, using a motor paradigm, voxel-based morphometry and diffusion tensor imaging. This allows us to control for general age-related modifications, possibly originating from vascular, atrophic or structural connectivity changes. Age-correlated decreases of functional connectivity and increases of BOLD--signal variability were associated with multisensory vestibular networks. In contrast, no age-related functional connectivity changes were detected in somatosensory networks or during the motor paradigm. The functional connectivity decrease was not due to structural changes but to a decrease in response amplitude. In synopsis, our data suggest that both the age-dependent functional connectivity decrease and the variability increase may be due to deteriorating reciprocal cortico-cortical inhibition with age and related to multimodal vestibular integration of sensory inputs.
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Bottini G, Gandola M. Beyond the Non-Specific Attentional Effect of Caloric Vestibular Stimulation: Evidence from Healthy Subjects and Patients. Multisens Res 2015; 28:591-612. [DOI: 10.1163/22134808-00002504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Caloric vestibular stimulation (CVS) is a simple physiological manipulation that has been used for a long time in different clinical fields due to its rapid and relevant effects on behaviour. One of the most debated issues in this research field concerns the degree of specificity of such stimulation, namely whether the effects of CVS can be, and to what extent are, independent of the mere influence of non-specific factors such as general arousal, ocular movements or attentional shift towards the stimulated side. The hypothesis that CVS might cause a shift of attention towards the side of the stimulation has been largely supported; moreover, a large amount of evidence is available nowadays to corroborate the specific effect of CVS, providing behavioural and neurophysiological data in both patients and normal subjects. These data converge in indicating that the effects of CVS can be independent of eye deviation and general arousal, can modulate different symptoms in different directions, and do not merely depend on a general shift of attention. The present article is divided into three main sections. In the first section, we describe classical studies that investigate the effects of CVS on neglect and related symptoms. In the second and third parts, we provide an overview of the modulatory effects of CVS on somatosensory processes and body representation in both brain-damaged patients and healthy subjects. Finally, we conclude by discussing the relevance of these new findings for the understanding of the neural mechanisms underlying the modulatory effects of CVS.
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Affiliation(s)
- Gabriella Bottini
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy
- Cognitive Neuropsychology Centre, Niguarda Ca’ Granda Hospital, Milano, Italy
- NeuroMi — Milan Center for Neuroscience, Milano, Italy
| | - Martina Gandola
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy
- NeuroMi — Milan Center for Neuroscience, Milano, Italy
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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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Mast FW, Preuss N, Hartmann M, Grabherr L. Spatial cognition, body representation and affective processes: the role of vestibular information beyond ocular reflexes and control of posture. Front Integr Neurosci 2014; 8:44. [PMID: 24904327 PMCID: PMC4035009 DOI: 10.3389/fnint.2014.00044] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/13/2014] [Indexed: 01/23/2023] Open
Abstract
A growing number of studies in humans demonstrate the involvement of vestibular information in tasks that are seemingly remote from well-known functions such as space constancy or postural control. In this review article we point out three emerging streams of research highlighting the importance of vestibular input: (1) Spatial Cognition: Modulation of vestibular signals can induce specific changes in spatial cognitive tasks like mental imagery and the processing of numbers. This has been shown in studies manipulating body orientation (changing the input from the otoliths), body rotation (changing the input from the semicircular canals), in clinical findings with vestibular patients, and in studies carried out in microgravity. There is also an effect in the reverse direction; top-down processes can affect perception of vestibular stimuli. (2) Body Representation: Numerous studies demonstrate that vestibular stimulation changes the representation of body parts, and sensitivity to tactile input or pain. Thus, the vestibular system plays an integral role in multisensory coordination of body representation. (3) Affective Processes and Disorders: Studies in psychiatric patients and patients with a vestibular disorder report a high comorbidity of vestibular dysfunctions and psychiatric symptoms. Recent studies investigated the beneficial effect of vestibular stimulation on psychiatric disorders, and how vestibular input can change mood and affect. These three emerging streams of research in vestibular science are-at least in part-associated with different neuronal core mechanisms. Spatial transformations draw on parietal areas, body representation is associated with somatosensory areas, and affective processes involve insular and cingulate cortices, all of which receive vestibular input. Even though a wide range of different vestibular cortical projection areas has been ascertained, their functionality still is scarcely understood.
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Affiliation(s)
- Fred W Mast
- Department of Psychology, University of Bern Bern, Switzerland ; Center for Cognition, Learning and Memory, University of Bern Bern, Switzerland
| | - Nora Preuss
- Department of Psychology, University of Bern Bern, Switzerland ; Center for Cognition, Learning and Memory, University of Bern Bern, Switzerland
| | - Matthias Hartmann
- Department of Psychology, University of Bern Bern, Switzerland ; Center for Cognition, Learning and Memory, University of Bern Bern, Switzerland
| | - Luzia Grabherr
- Sansom Institute for Health Research, University of South Australia Adelaide, SA, Australia
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Baier B, Zu Eulenburg P, Best C, Geber C, Müller-Forell W, Birklein F, Dieterich M. Posterior insular cortex - a site of vestibular-somatosensory interaction? Brain Behav 2013; 3:519-24. [PMID: 24392273 PMCID: PMC3869980 DOI: 10.1002/brb3.155] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 05/08/2013] [Accepted: 05/20/2013] [Indexed: 11/06/2022] Open
Abstract
Background In previous imaging studies the insular cortex (IC) has been identified as an essential part of the processing of a wide spectrum of perception and sensorimotor integration. Yet, there are no systematic lesion studies in a sufficient number of patients examining whether processing of vestibular and the interaction of somatosensory and vestibular signals take place in the IC. Methods We investigated acute stroke patients with lesions affecting the IC in order to fill this gap. In detail, we explored signs of a vestibular tone imbalance such as the deviation of the subjective visual vertical (SVV). We applied voxel-lesion behaviour mapping analysis in 27 patients with acute unilateral stroke. Results Our data demonstrate that patients with lesions of the posterior IC have an abnormal tilt of SVV. Furthermore, re-analysing data of 20 patients from a previous study, we found a positive correlation between thermal perception contralateral to the stroke and the severity of the SVV tilt. Conclusions We conclude that the IC is a sensory brain region where different modalities might interact.
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Affiliation(s)
- Bernhard Baier
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
| | - Peter Zu Eulenburg
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
| | - Christoph Best
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
| | - Christian Geber
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
| | - Wibke Müller-Forell
- Department of Neuroradiology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
| | - Frank Birklein
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
| | - Marianne Dieterich
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany ; Department of Neurology and German Vertigo/Dizziness Center IFB, Ludwig-Maximilians-University Munich, Germany
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Ferrè ER, Bottini G, Iannetti GD, Haggard P. The balance of feelings: Vestibular modulation of bodily sensations. Cortex 2013; 49:748-58. [DOI: 10.1016/j.cortex.2012.01.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 12/14/2011] [Accepted: 01/26/2012] [Indexed: 11/28/2022]
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Oshinsky ML, Sanghvi MM, Maxwell CR, Gonzalez D, Spangenberg RJ, Cooper M, Silberstein SD. Spontaneous trigeminal allodynia in rats: a model of primary headache. Headache 2012; 52:1336-49. [PMID: 22963523 DOI: 10.1111/j.1526-4610.2012.02247.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Animal models are essential for studying the pathophysiology of headache disorders and as a screening tool for new therapies. Most animal models modify a normal animal in an attempt to mimic migraine symptoms. They require manipulation to activate the trigeminal nerve or dural nociceptors. At best, they are models of secondary headache. No existing model can address the fundamental question: How is a primary headache spontaneously initiated? In the process of obtaining baseline periorbital von Frey thresholds in a wild-type Sprague-Dawley rat, we discovered a rat with spontaneous episodic trigeminal allodynia (manifested by episodically changing periorbital pain threshold). Subsequent mating showed that the trait is inherited. Animals with spontaneous trigeminal allodynia allow us to study the pathophysiology of primary recurrent headache disorders. To validate this as a model for migraine, we tested the effects of clinically proven acute and preventive migraine treatments on spontaneous changes in rat periorbital sensitivity. Sumatriptan, ketorolac, and dihydroergotamine temporarily reversed the low periorbital pain thresholds. Thirty days of chronic valproic acid treatment prevented spontaneous changes in trigeminal allodynia. After discontinuation, the rats returned to their baseline of spontaneous episodic threshold changes. We also tested the effects of known chemical human migraine triggers. On days when the rats did not have allodynia and showed normal periorbital von Frey thresholds, glycerol trinitrate and calcitonin gene related peptide induced significant decreases in the periorbital pain threshold. This model can be used as a predictive model for drug development and for studies of putative biomarkers for headache diagnosis and treatment.
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Affiliation(s)
- Michael L Oshinsky
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107-6799, USA.
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Rinalduzzi S, Cipriani AM, Capozza M, Accornero N. Postural responses to low-intensity, short-duration, galvanic vestibular stimulation as a possible differential diagnostic procedure. Acta Neurol Scand 2011; 123:111-6. [PMID: 20456247 DOI: 10.1111/j.1600-0404.2010.01349.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES In this study we investigated the effect of polarity-related differences in short-duration very low-intensity galvanic vestibular stimulation (GVS), not perceived by the subject, by evaluating the minimal postural sway responses in healthy people. We also verified its possible usefulness as a differential diagnostic tool in patients with postural instability disturbances related to polyneuropathy or peripheral vertigo. METHODS We applied bimastoid opposite polarity direct current GVS (0.7 mA for 1 s) and recorded the induced postural response with an electromagnetic head position tracker. Latency, amplitude, velocity and an asymmetry index were measured between two reverse polarity sessions. RESULTS The postural response was easily recorded and was statistically wider in amplitude and velocity in the polyneuropathy group than in the other groups. Postural responses were asymmetric only in the group with mild peripheral vertigo. CONCLUSION These findings suggest that even weak GVS affects vestibular excitability: cathodal polarization increases whereas anodal GVS decreases excitability. Symmetry and amplitude or velocity of the postural responses, particularly in the eyes closed condition, can differentiate the three groups of subjects tested.
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Smith PF, Geddes LH, Baek JH, Darlington CL, Zheng Y. Modulation of memory by vestibular lesions and galvanic vestibular stimulation. Front Neurol 2010; 1:141. [PMID: 21173897 PMCID: PMC2995955 DOI: 10.3389/fneur.2010.00141] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 10/13/2010] [Indexed: 11/26/2022] Open
Abstract
For decades it has been speculated that there is a close association between the vestibular system and spatial memories constructed by areas of the brain such as the hippocampus. While many animal studies have been conducted which support this relationship, only in the last 10 years have detailed quantitative studies been carried out in patients with vestibular disorders. The majority of these studies suggest that complete bilateral vestibular loss results in spatial memory deficits that are not simply due to vestibular reflex dysfunction, while the effects of unilateral vestibular damage are more complex and subtle. Very recently, reports have emerged that sub-threshold, noisy galvanic vestibular stimulation can enhance memory in humans, although this has not been investigated for spatial memory as yet. These studies add to the increasing evidence that suggests a connection between vestibular sensory information and memory in humans.
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Affiliation(s)
- Paul F Smith
- Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School Dunedin, New Zealand.
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