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Zheng J, Xu M, Xu H, Ye F, Liu X, Liu Y, Jin X. Acute effects of ambient air pollution on daily neurology clinic visits for vertigo: a time-series study in Wuhan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:57707-57716. [PMID: 36971932 DOI: 10.1007/s11356-023-26575-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/16/2023] [Indexed: 05/10/2023]
Abstract
This study aimed to disclose the relationship between ambient air pollution and neurology clinic visits (NCVs) for vertigo. A time-series study was conducted to examine relationships between six different criteria air pollutants (SO2, NO2, PM2.5, PM10, CO, and O3) and daily NCVs for vertigo in Wuhan, China, from January 1st, 2017 to November 30th, 2019. Stratified analyses were computed according to gender, age, and season. A total of 14,749 records of NCVs for vertigo were enrolled in this study. Data showed that the increase in daily NCVs for vertigo corresponding to 10 μg/m3 increase of respective pollutants are: SO2 (- 7.60%; 95% CI: - 14.25 to - 0.44%), NO2 (3.14%; 95% CI: 0.23 to 6.13%), PM2.5 (0.53%; 95% CI: - 0.66 to 1.74%), PM10 (1.32%; 95% CI: - 0.36 to 3.06%), CO (0.00%; 95% CI: - 0.12 to 0.13%), and O3 (0.90%; 95% CI: - 0.01% to 1.83%). Males were more susceptible to acute exposure to SO2 and NO2, compared to females (SO2: - 11.91% vs. - 4.16%; NO2: 3.95% vs. 2.92%), whereas the acute effect of O3 exposure was more significantly obvious in females than males (0.94% vs. 0.87%). Moreover, correlations between daily NCVs for vertigo and acute exposure to SO2, NO2, and O3 were all stronger in individuals under 50 years old (SO2: - 12.75% vs. - 4.41%; NO2: 4.55% vs. 2.75%; O3: 1.27% vs. 0.70%). Short-term exposure to PM2.5 was more significantly associated with daily NCVs for vertigo in cool seasons (1.62% vs. - 0.68%), while the correlation between CO exposure and daily NCVs for vertigo was stronger in warm seasons (0.21% vs. - 0.03%). Our study demonstrated acute exposure to ambient NO2 and O3 positively associated with daily NCVs for vertigo. Acute effects of air pollution on daily NCVs for vertigo varied according to gender, age, and season.
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Affiliation(s)
- Jiachen Zheng
- Emergency Center, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
- Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
- The Second Clinical School, Wuhan University, Wuhan, 430071, Hubei, China
| | - Min Xu
- Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Haoyue Xu
- The Second Clinical School, Wuhan University, Wuhan, 430071, Hubei, China
| | - Fei Ye
- Department of Neurology, Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430071, Hubei, China
| | - Xiaozhou Liu
- Department of Neurology, Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430071, Hubei, China
| | - Yumin Liu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Xiaoqing Jin
- Emergency Center, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China.
- Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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Zhou F, Yu B, Luo J, Ma Y, Li J, Zhang T, Yu G. Global trends in the research on benign paroxysmal positional vertigo: A 20-year bibliometric and visualization analysis. Front Neurol 2022; 13:1046257. [PMID: 36324379 PMCID: PMC9618818 DOI: 10.3389/fneur.2022.1046257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vestibular vertigo. Although BPPV is benign, its underlying mechanisms are complicated, and patients diagnosed with BPPV are significantly affected by it in their daily lives. Hence, this study's purpose was to investigate global trends and frontiers in the field of BPPV. Methods We searched the research literature published from 2002 to 2021 on BPPV using two databases from the Web of Science Core Collection, and we conducted a bibliometric and visualization analysis. Bibliometric tools were used to perform co-authorship, co-citation, and co-occurrence analyses of countries or regions, institutions, authors, journals, keywords, and references. Results In all, 1,419 publications from 4,594 authors, 1,542 institutions, and 65 countries or regions with 71 subject categories were included in the study. The number of articles increased gradually from 2002 to 2021. Seoul National University, the University of Munich, and Osaka University were among the leading institutions with the most publications, while United States of America, South Korea, and China were the leading countries. JS Kim was the most prolific author, Otology & Neurotology was the most prolific journal, and Otorhinolaryngology was the most published subject category. The five most frequently occurring keywords were BPPV, vertigo, dizziness, nystagmus, and management and the top research hot spots were osteoporosis and vitamin D. Conclusion This study systematically analyzed trends in global scientific research on BPPV. The academic understanding of BPPV has improved significantly over the last two decades, with osteoporosis and vitamin D the two main research hot spots in the field of BPPV in recent years. These findings provide direction for current research to grasp the trends and research frontiers of current research.
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Affiliation(s)
- Fangwei Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Bingxi Yu
- Department of Otolaryngology, Xingyi People's Hospital, Xingyi, China
| | - Jiali Luo
- Department of Development and Planning, Guizhou Medical University, Guiyang, China
| | - Yifei Ma
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Jianyao Li
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Tian Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- *Correspondence: Tian Zhang
| | - Guodong Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Guodong Yu
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Brittain K, Harvey M, Cisek R, Pillai S, Christie SD, Tokarz D. Second harmonic generation microscopy of otoconia. BIOMEDICAL OPTICS EXPRESS 2022; 13:3593-3600. [PMID: 35781949 PMCID: PMC9208607 DOI: 10.1364/boe.457967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/11/2022] [Accepted: 05/14/2022] [Indexed: 05/30/2023]
Abstract
The origin of second harmonic generation (SHG) signal in otoconia was investigated. SHG signal intensity from otoconia was compared to pure calcite crystals, given calcite is the primary component of otoconia and is known to emit surface SHG. The SHG intensity from calcite was found to be ∼41× weaker than the SHG intensity from otoconia signifying that the SHG signal from otoconia is likely generated from the organic matrix. Furthermore, the SHG intensity from otoconia increased when treated with a chelating agent known to dissolve calcite which confirms that calcite is not the source of SHG. Additionally, polarization-resolved SHG microscopy imaging revealed that the arrangement of the SHG emitters is radial and can form highly ordered domains.
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Affiliation(s)
- Kennedy Brittain
- Department of Chemistry, Saint Mary’s University, 923 Robie Street, Halifax, Nova Scotia, B3H 3C3, Canada
- Department of Medical Neuroscience, Dalhousie University, 5850 College Street, PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
| | - MacAulay Harvey
- Department of Chemistry, Saint Mary’s University, 923 Robie Street, Halifax, Nova Scotia, B3H 3C3, Canada
| | - Richard Cisek
- Department of Chemistry, Saint Mary’s University, 923 Robie Street, Halifax, Nova Scotia, B3H 3C3, Canada
| | - Saranyan Pillai
- Department of Surgery (Neurosurgery), Dalhousie University, #3814-1796 Summer Street, Halifax, Nova Scotia, B3H 3A7, Canada
| | - Sean D Christie
- Department of Surgery (Neurosurgery), Dalhousie University, #3814-1796 Summer Street, Halifax, Nova Scotia, B3H 3A7, Canada
| | - Danielle Tokarz
- Department of Chemistry, Saint Mary’s University, 923 Robie Street, Halifax, Nova Scotia, B3H 3C3, Canada
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ÖZŞİMŞEK A, KARAÇAY E. Serum 25-Hidroksi D Vitamini ve Kalsiyum Seviyeleri ile İdiyopatik Benign Paroksismal Pozisyonel Vertigo Arasındaki İlişki. ACTA MEDICA ALANYA 2022. [DOI: 10.30565/medalanya.1066381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Amaç: Kliniğimize baş dönmesi şikâyeti ile başvurup idiopathic benign paroksismal pozisyonel vertigo (BPPV) tanısı alan hastalar ile baş dönmesi olmayan sağlıklı kontrol grubunun 25-hidroksi vitamin D (25-OH vitamin D) ve Ca2+ düzeylerinin karşılaştırılması Ca2+ ve 25-OH vitamin D’nin BPPV gelişimindeki rolünün araştırılmasıdır.
Gereç ve Yöntem: Çalışmamız geriye dönük vaka kontrol çalışması olup, 01.01.2018-01.08.2021 arası Alanya Egitim ve Araştırma Hastanesi Nöroloji polikliniğine başvuran İdiopatik BPPV tanısı alan 409 hasta ile kontrol grubu olarak kliniğimize başvuru öncesi son 1 yıl içerisinde vertigo, dizziness ya da dengesizlik nedeniyle hekim başvurusu olmayan serum D vitamini düzeyi ölçümü yapılmış 338 hasta seçilerek oluşturuldu. İstatiksel değerlendirmeler için ki-kare ve T testi testi kullanıldı.
Bulgular: Ortalama serum 25-OH vitamin D düzeyleri BPPV ve kontrol grubunda sırasıyla 15,74 ng/mL ve 17,91 ng/mL idi. Serum 25-OH vitamin D düzeyleri BPPV grubunda kontrol grubuna göre anlamlı derecede düşük bulundu ((p=0,01, p
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Boyle R, Varelas J. Otoconia Structure After Short- and Long-Duration Exposure to Altered Gravity. J Assoc Res Otolaryngol 2021; 22:509-525. [PMID: 34008038 PMCID: PMC8476704 DOI: 10.1007/s10162-021-00791-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 02/09/2021] [Indexed: 10/21/2022] Open
Abstract
Vertebrates use weight-lending otoconia in the inner ear otolith organs to enable detection of their translation during self or imposed movements and a change in their orientation with respect to gravity. In spaceflight, otoconia are near weightless. It has been hypothesized that otoconia undergo structural remodeling after exposure to weightlessness to restore normal sensation. A structural remodeling is reasoned to occur for hypergravity but in the opposite sense. We explored these hypotheses in several strains of mice within a Biospecimen Sharing Program in separate space- and ground-based projects. Mice were housed 90 days on the International Space Station, 13 days on two Shuttle Orbiter missions, or exposed to 90 days of hindlimb unloading or net 2.38 g via centrifugation. Corresponding flight habitat and standard cage vivarium controls were used. Utricular otoliths were visually analyzed using scanning electron microscopy and in selected samples before and after focused ion beam (FIB) milling. Results suggest a possible mass addition to the otoconia outer shell might occur after exposure to longer-duration spaceflight, but not short ones or hindlimb unloading. A destructive process is clearly seen after centrifugation: an ablation or thinning of the outer shell and cavitation of the inner core. This study provides a purely descriptive account of otoconia remodeling after exposures to altered gravity. The mechanism(s) underlying these processes must be identified and quantitatively validated to develop countermeasures to altered gravity levels during exploration missions.
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Affiliation(s)
- Richard Boyle
- National Aeronautics and Space Administration, Ames Research Center, Moffett Field, CA, 94035, USA.
| | - Joseph Varelas
- National Aeronautics and Space Administration, Ames Research Center, Moffett Field, CA, 94035, USA
- Science & Technology Innovation Labs, Universities Space Research Association, Ames Research Center, Moffett Field, CA, 94035, USA
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Hołubowicz R, Ożyhar A, Dobryszycki P. Natural Mutations Affect Structure and Function of gC1q Domain of Otolin-1. Int J Mol Sci 2021; 22:ijms22169085. [PMID: 34445792 PMCID: PMC8396674 DOI: 10.3390/ijms22169085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 12/29/2022] Open
Abstract
Otolin-1 is a scaffold protein of otoliths and otoconia, calcium carbonate biominerals from the inner ear. It contains a gC1q domain responsible for trimerization and binding of Ca2+. Knowledge of a structure-function relationship of gC1q domain of otolin-1 is crucial for understanding the biology of balance sensing. Here, we show how natural variants alter the structure of gC1q otolin-1 and how Ca2+ are able to revert some effects of the mutations. We discovered that natural substitutions: R339S, R342W and R402P negatively affect the stability of apo-gC1q otolin-1, and that Q426R has a stabilizing effect. In the presence of Ca2+, R342W and Q426R were stabilized at higher Ca2+ concentrations than the wild-type form, and R402P was completely insensitive to Ca2+. The mutations affected the self-association of gC1q otolin-1 by inducing detrimental aggregation (R342W) or disabling the trimerization (R402P) of the protein. Our results indicate that the natural variants of gC1q otolin-1 may have a potential to cause pathological changes in otoconia and otoconial membrane, which could affect sensing of balance and increase the probability of occurrence of benign paroxysmal positional vertigo (BPPV).
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Affiliation(s)
- Rafał Hołubowicz
- Correspondence: (R.H.); (P.D.); Tel.: +48-71-320-63-34 (R.H.); +48-71-320-63-32 (P.D.)
| | | | - Piotr Dobryszycki
- Correspondence: (R.H.); (P.D.); Tel.: +48-71-320-63-34 (R.H.); +48-71-320-63-32 (P.D.)
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Mun SK, Oh SR, Yang BR, Oh SH, Chang M. Impact of air pollution on benign paroxysmal positional vertigo incidence: a retrospective study of the citizens of Seoul, South Korea. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10.1007/s11356-021-13105-3. [PMID: 33638780 DOI: 10.1007/s11356-021-13105-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Benign paroxysmal positional vertigo (BPPV) is among the most common inner ear diseases. Although BPPV is one of the most common causes of dizziness, its pathogenesis remains unknown. Air pollutants might reach the middle ear through the eustachian tube and be absorbed into the inner ear through the round window membrane, increasing the risk of BPPV. We investigated the relationship between air pollution and BPPV risk. Data were extracted from the Korean Health Insurance Review and Assessment Service database, which contains health claims information of the entire South Korean population. Variables of interest included the number of patients diagnosed with BPPV in Seoul, South Korea, patients' clinical and demographic characteristics, and osteopenia status. Seoul's daily air pollution indicators, including SO2, CO, O3, NO2, PM10, and PM2.5, were obtained from the Korea Environment Corporation website. Overdispersed Poisson regression analysis was performed. In the multivariable analysis, NO2 air concentration (ppb) was associated with increased incidence of BPPV. In analysis stratified by gender, levels of NO2 were associated with increased incidence of BPPV in both men and women. In the analysis stratified by age, NO2 air concentration was associated with increased incidence of BPPV among all adults over the age of 19 years. In the analysis stratified by osteopenia status, NO2 was associated with increased incidence of BPPV in patients with and without osteopenia. Air levels of NO2 were associated with increased incidence of BPPV in the present study. This finding contributes toward a better understanding of BPPV pathogenesis and improved prevention and management of this condition.
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Affiliation(s)
- Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Seung Ri Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Bo Ram Yang
- College of Pharmacy, Chungnam National University, 99, Daehak-ro, Yuseong-gu, Daejeon, 34134, South Korea
| | - Seung-Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea.
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Inan HC, Mertoğlu C, Erdur ZB. Investigation of Serum Calcium and 25-Hydroxy Vitamin D Levels in Benign Paroxysmal Positional Vertigo Patients. EAR, NOSE & THROAT JOURNAL 2021; 100:643-646. [PMID: 33491490 DOI: 10.1177/0145561321989451] [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: 11/16/2022] Open
Abstract
OBJECTIVE Benign paroxysmal positional vertigo (BPPV) is characterized by recurrent attacks of vertigo caused by head movements. It occurs as a result of otoconia falling into the semicircular canal. Calcium and 25 hydroxyvitamin D [25(OH)D] metabolism in the inner ear play an important role in otoconia formation and degeneration. Our aim in this study was to investigate the relationship between 25(OH)D levels and BPPV. METHODS This retrospective, case-controlled study included 52 patients with posterior canal BPPV and 52 controls aged 18 to 80 years. Age, sex, serum calcium, corrected calcium, and 25(OH)D levels of the BPPV and control group were compared. RESULTS Twenty-three of the patients were male (44.2%) and 29 were female (55.8%). The average age was 55.6 years. The 25(OH)D level was 15.3 ng/mL in the BPPV group and 20.2 ng/mL in controls. There was no significant difference in 25(OH)D and albumin-corrected calcium values (P = .394; P = .084, respectively). In 80.7% of the BPPV group and 61.5% of the controls, 25(OH)D levels were 20 ng/mL and below. 25 hydroxyvitamin D deficiency was found statistically significantly more frequently in patients with BPPV (P = .030). CONCLUSION In our study, serum 25(OH)D levels were found to be lower in patients with BPPV, and the rate of vitamin D deficiency was higher in these patients. Based on these results, it is recommended to examine the 25(OH)D levels of patients with BPPV at the time of diagnosis.
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Affiliation(s)
- Hakkı Caner Inan
- Department of Otorhinolaryngology, Erzincan University Medical Faculty, Erzincan, Turkey
| | - Cuma Mertoğlu
- Department of Medical Biochemistry, Erzincan University Medical Faculty, Erzincan, Turkey
| | - Zülküf Burak Erdur
- Department of Otorhinolaryngology, Kırklareli Training and Research Hospital, Kırklareli, Turkey
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Impaired Calcium Metabolism in Benign Paroxysmal Positional Vertigo: A Topical Review. J Neurol Phys Ther 2020; 43 Suppl 2:S37-S41. [PMID: 30883492 DOI: 10.1097/npt.0000000000000273] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Although acute attacks of benign paroxysmal positional vertigo (BPPV) may be treated with canalith repositioning maneuvers, there have been no well-designed prospective trials to prevent this highly prevalent and recurrent disorder. This topical review explores the evidence related to the association between deficient calcium metabolism and BPPV. We also describe the development of therapeutic options to prevent recurrences of BPPV and introduce results from a recent randomized controlled trial on the effect of vitamin D and calcium supplementation in preventing BPPV recurrences. SUMMARY OF KEY POINTS The literature describes 3 lines of evidence on association of impaired calcium metabolism and development of BPPV: (1) decreased bone mineral density was more frequently observed in persons with BPPV than in healthy controls; (2) estrogen plays a vital role in maintenance of otoconia, and estrogen deficiency appears to precipitate degeneration of otoconia and development of BPPV; and (3) lower serum vitamin D level is associated with development of BPPV, and supplementation of vitamin D and calcium carbonate may reduce further attacks of BPPV in persons with BPPV and subnormal serum vitamin D level. RECOMMENDATIONS FOR CLINICAL PRACTICE Restoration of impaired calcium metabolism with supplementation of vitamin D or estrogen should be considered in the treatment of individuals with frequent recurrences of BPPV. Future randomized controlled trials are mandatory to validate these supplementation therapies in individuals with recurrent BPPV.
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Guerra J, Devesa J. Causes and treatment of idiopathic benign paroxysmal positional vertigo based on endocrinological and other metabolic factors. J Otol 2020; 15:155-160. [PMID: 33293917 PMCID: PMC7691829 DOI: 10.1016/j.joto.2020.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/07/2020] [Accepted: 04/12/2020] [Indexed: 12/21/2022] Open
Abstract
The genesis of the Benign Paroxysmal Positional Vertigo (BPPV) seems to be related to some metabolic factors. These factors, such as vitamin D, glucocorticoids, and even thyroid and growth hormones, can affect bone metabolism and the mineralization of otoconia. It also seems to link to factors related to aging or nutritional habits. Besides, since the incidence of BPPV is quantitatively higher in women than in men, female sex steroids could be associated with this process. It could be useful to understand how these factors act in otoconial mineralization if we want to develop treatments aimed at preventing or delaying BPPV recurrences. In this review, we will analyze the role of these metabolic and hormonal factors in otoconial mineralization and in the treatment of BPPV.
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Affiliation(s)
- Joaquín Guerra
- Otolaryngology, Medical Center Foltra, Travesía de Montouto 24, 15886, Teo, Spain
- Corresponding author. Medical Center Foltra, Travesía de Montouto 24, 15886, Teo, Spain.
| | - Jesús Devesa
- Scientific Direction, Medical Center Foltra, Travesía de Montouto 24, 15886, Teo, Spain
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Abstract
Vertigo and dizziness in advanced age are common complaints in daily clinical practice. The otorhinolaryngologist holds a central position in the differential diagnostic clarification. Age-related disorders (e.g. benign positional vertigo, presbyvestibulopathy, otholith functional disorders) arise due to a physiological, individually distinct and objectively detectable reduction in the sensitivity of sensory and extrasensory elements of the vestibular system. They may reach pathological significance if these dysfunctions affect the physical and emotional well-being (e.g. gait disturbances and falls with subsequent morbidity). Disorders accompanying aging (e.g. neurological, cardiovascular or psychiatric) can occur simultaneously with age-related changes in sensory function. The identification, especially with respect to the risk of falling in older people and the development of individual therapeutic strategies is an interdisciplinary task. Besides a causative therapy, strength, coordination and balance training contribute to the treatment of equilibrium disorders and falls from the perspective of evidence-based medicine.
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Calcium phosphate and calcium carbonate mineralization of bioinspired hydrogels based on β-chitin isolated from biomineral of the common cuttlefish (Sepia officinalis, L.). JOURNAL OF POLYMER RESEARCH 2018. [DOI: 10.1007/s10965-018-1626-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Walther LE, Wulfes J, Blödow A, Kniep R. Magnesium as an intrinsic component of human otoconia. Acta Otolaryngol 2018; 138:775-778. [PMID: 29764268 DOI: 10.1080/00016489.2018.1467572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES To investigate morphology changes of artificial otoconia (CGC) in the presence of magnesium during growth under in vitro conditions. METHODS Investigating human otoconia by environmental scanning electron microscope and determining their magnesium content by energy-dispersive X-ray microanalysis (EDX). Comparing structural and morphological data of human and artificial otoconia (CGC, Ca1Mg0) without and with magnesium substitution (Ca1-xMgx). RESULTS EDX- and X-ray data reveals that the inorganic component in human otoconia consists of calcite containing a minor amount of magnesium substitution (Ca1-xMgx). CGC containing magnesium (length 397.0 ± 146.4 µm, diameter 325.6 ± 100.1 µm) are slimmer and significantly smaller (p < .01) than pure CGC (length 548.6 ± 160 µm, diameter 373.0 ± 110.4 µm) and reveal a significant influence on the final morphology. The length/diameter ratio is significantly higher by incorporation of magnesium into CGC (1.84 ± 0.25 µm versus 1.48 ± 0.11 µm in pure CGC, p < .01), which brings the overall shape to a close relationship with human otoconia (1.98 ± 0.08 µm). CONCLUSIONS Magnesium is an intrinsic component of human otoconia by partial substitution of calcium in the calcite crystal structure (Ca1-xMgx) and affects the development of the shape of artificial otoconia (calcite gelatin composites, CGC).
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Affiliation(s)
- Leif Erik Walther
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Mannheim, University of Heidelberg, Germany
| | - Jana Wulfes
- Chemical Physics of Solids, Max Planck Institute, Dresden, Germany
| | - Alexander Blödow
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin-Luther-University Halle-Wittenberg Medizinische Fakultät, Halle, Germany
| | - Rüdiger Kniep
- Chemical Physics of Solids, Max Planck Institute, Dresden, Germany
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Hołubowicz R, Wojtas M, Taube M, Kozak M, Ożyhar A, Dobryszycki P. Effect of calcium ions on structure and stability of the C1q-like domain of otolin-1 from human and zebrafish. FEBS J 2017; 284:4278-4297. [DOI: 10.1111/febs.14308] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/17/2017] [Accepted: 10/24/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Rafał Hołubowicz
- Department of Biochemistry; Faculty of Chemistry; Wroclaw University of Science and Technology; Poland
| | - Magdalena Wojtas
- Department of Biochemistry; Faculty of Chemistry; Wroclaw University of Science and Technology; Poland
| | - Michał Taube
- Department of Macromolecular Physics; Faculty of Physics; A. Mickiewicz University; Poznan Poland
| | - Maciej Kozak
- Department of Macromolecular Physics; Faculty of Physics; A. Mickiewicz University; Poznan Poland
| | - Andrzej Ożyhar
- Department of Biochemistry; Faculty of Chemistry; Wroclaw University of Science and Technology; Poland
| | - Piotr Dobryszycki
- Department of Biochemistry; Faculty of Chemistry; Wroclaw University of Science and Technology; Poland
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Kniep R, Zahn D, Wulfes J, Walther LE. The sense of balance in humans: Structural features of otoconia and their response to linear acceleration. PLoS One 2017; 12:e0175769. [PMID: 28406968 PMCID: PMC5391102 DOI: 10.1371/journal.pone.0175769] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/30/2017] [Indexed: 11/18/2022] Open
Abstract
We explored the functional role of individual otoconia within the otolith system of mammalians responsible for the detection of linear accelerations and head tilts in relation to the gravity vector. Details of the inner structure and the shape of intact human and artificial otoconia were studied using environmental scanning electron microscopy (ESEM), including decalcification by ethylenediaminetetraacetic acid (EDTA) to discriminate local calcium carbonate density. Considerable differences between the rhombohedral faces of human and artificial otoconia already indicate that the inner architecture of otoconia is not consistent with the point group -3m. This is clearly confirmed by decalcified otoconia specimen which are characterized by a non-centrosymmetric volume distribution of the compact 3+3 branches. This structural evidence for asymmetric mass distribution was further supported by light microscopy in combination with a high speed camera showing the movement of single otoconia specimen (artificial specimen) under gravitational influence within a viscous medium (artificial endolymph). Moreover, the response of otoconia to linear acceleration forces was investigated by particle dynamics simulations. Both, time-resolved microscopy and computer simulations of otoconia acceleration show that the dislocation of otoconia include significant rotational movement stemming from density asymmetry. Based on these findings, we suggest an otolith membrane expansion/stiffening mechanism for enhanced response to linear acceleration transmitted to the vestibular hair cells.
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Affiliation(s)
- Rüdiger Kniep
- Max Planck Institute for Chemical Physics of Solids, Dresden, Germany
| | - Dirk Zahn
- Computer Chemistry Center, Department of Chemistry and Pharmacy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Jana Wulfes
- Max Planck Institute for Chemical Physics of Solids, Dresden, Germany
| | - Leif Erik Walther
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Mannheim, University of Heidelberg, Mannheim, Germany
- * E-mail:
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16
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Obrist D, Nienhaus A, Zamaro E, Kalla R, Mantokoudis G, Strupp M. Determinants for a Successful Sémont Maneuver: An In vitro Study with a Semicircular Canal Model. Front Neurol 2016; 7:150. [PMID: 27695437 PMCID: PMC5025435 DOI: 10.3389/fneur.2016.00150] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/02/2016] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate the effect of time between the movements/steps, angle of body movements as well as the angular velocity of the maneuvers in an in vitro model of a semicircular canal (SCC) to improve the efficacy of the Sémont maneuver (SM) in benign paroxysmal positional vertigo. Materials and Methods Sémont maneuvers were performed on an in vitro SCC model. Otoconia trajectories were captured by a video camera. The effects of time between the movements, angles of motion (0°, 10°, 20°, and 30° below the horizontal line), different angular velocities (90, 135, 180°/s), and otoconia size (36 and 50 μm) on the final position of the otoconia in the SCC were tested. Results Without extension of the movements beyond the horizontal, the in vitro experiments (with particles corresponding to 50 μm diameter) did not yield successful canalith repositioning. If the movements were extended by 20° beyond the horizontal position, SM were successful with resting times of at least 16 s. For larger extension angles, the required time decreased. However, for smaller particles (36 μm), the required time doubled. The angular maneuver velocity (tested between 90 and 180°/s) did not have a major impact on the final position of the otoconia. Interpretation The two primary determinants for success of the SM are the time between the movements and the extension of the movements beyond the horizontal. The time between the movements should be at least 45 s. Angles of 20° or more below horizontal line (so-called Sémont+) should increase the success rate of SM.
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Affiliation(s)
- Dominik Obrist
- ARTORG Center for Biomedical Engineering Research, University of Bern , Bern , Switzerland
| | - Andrea Nienhaus
- ARTORG Center for Biomedical Engineering Research, University of Bern , Bern , Switzerland
| | - Ewa Zamaro
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bern, Inselspital , Bern , Switzerland
| | - Roger Kalla
- Department of Neurology, Division of Cognitive and Restorative Neurology, University Hospital Bern, Inselspital , Bern , Switzerland
| | - Georgios Mantokoudis
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bern, Inselspital , Bern , Switzerland
| | - Michael Strupp
- Department of Neurology, German Center for Vertigo and Balance Disorders, University Hospital Munich , Munich , Germany
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17
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Walther LE. [Otoconia : Current aspects of research]. HNO 2016; 64:767-76. [PMID: 27590488 DOI: 10.1007/s00106-016-0234-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Otoconia are calcite-based nanocomposites containing >90 % calcite and <10 % organic material. The mean size is approximately 10 µm. The external structure of all otoconia in the utricle and saccule is similar, with a cylindrical bulbous body with a slightly hexagonal contour. The internal structure consists of a composite with varying volume thickness, dense branching structures (branches) and less dense surrounding areas (bellies). Intact otoconia can be clearly identified only by scanning electron microscopy. In the case of morphological changes (e.g. due to "degeneration") the origin of even very small particles of otoconia can be assigned using physical and chemical analytical methods. The inorganic component of otoconia (calcite) is extremely sensitive to chemical influences, which leads to morphological alterations. A "degeneration" of otoconia can be objectively accomplished in vitro by alterations in pH, electrolyte imbalance and by the influence of complex formation. These three main processes then lead to irreversible morphological alterations. Artificial (biomimetic) otoconia serve as a suitable model system for detailed investigation of growth and degenerative processes.
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Affiliation(s)
- L E Walther
- HNO-Gemeinschaftspraxis, Main-Taunus-Zentrum, 65843, Sulzbach (Taunus), Deutschland.
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18
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Walther LE, Hülse R, Lauer K, Wenzel A. [Current aspects of ototoxicity. Ototoxic substances and their effects]. HNO 2015; 63:315-24; quiz 325-6. [PMID: 25616875 DOI: 10.1007/s00106-014-2966-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ototoxicity describes reversible or irreversible disorders of inner ear functions due to the influence of chemical, biological, or physical substances. Ototoxicity should be kept in mind during differential diagnosis of hearing loss, tinnitus, dizziness, and vertigo. In clinical practice, drug-induced ototoxic effects play a major role. The otorhinolaryngologist should also be involved in interdisciplinary cooperation, e.g., during treatment with antineoplastic chemotherapeutic agents with potential ototoxic side effects. In clinical practice, multimedication and interactions between different agents can complicate precise correlation in individual cases. Recent studies also show that noncellular components, such as otoconia, are extremely sensitive to chemical attacks.
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Affiliation(s)
- L E Walther
- HNO-Gemeinschaftspraxis, Main-Taunus-Zentrum, 65843, Sulzbach (Taunus), Deutschland,
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19
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Kniep R. Otoconia: Mimicking a calcite-based functional material of the human body. From basic research to medical aspects. PURE APPL CHEM 2015. [DOI: 10.1515/pac-2015-0201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractOtoconia (calcite-based biominerals) are part of the sensory system in the inner ear of vertebrates, acting as gravity receptors responding to linear accelerations. Biomimetic otoconia are grown by double-diffusion into gelatine-gel matrices, and represent the first example of successful imitation of a biomineral, not only in outer shape but also in composite structure and hierarchical inner architecture. Biomimetic and biogenic (human) otoconia are investigated by X-ray methods, chemical analytics, ESEM, and TEM. Shape development (morphogenesis) as well as (partial) dissolution of the calcite component of the composite underline the hierarchical inner architecture built of more dense rhombohedral branches (with plane end-faces) and a rounded, more porous belly area. Atomistic simulations are performed in order to get insight into very first nucleation steps. Based on the detailed observations made up to now, first assumptions for the function of otoconia are developed, including the questions of density distribution within the volume of the specimen, the surrounding endolymph, as well as anchoring and interconnections of otoconia. A final point concerns the degeneration of otoconia which is caused by complexing agents and/or changes in ion concentrations (and pH) of the endolymph.
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Affiliation(s)
- Rüdiger Kniep
- 1Max-Planck-Institute for Chemical Physics of Solids, Nöthnitzer Straße 40, 01187 Dresden, Germany
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20
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Rose-Martel M, Smiley S, Hincke MT. Novel identification of matrix proteins involved in calcitic biomineralization. J Proteomics 2015; 116:81-96. [DOI: 10.1016/j.jprot.2015.01.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/01/2015] [Accepted: 01/03/2015] [Indexed: 02/06/2023]
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21
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Kniep R, Buder J, Blödow A, Walther LE. Destructive properties of formalin on human otoconia. Histol Histopathol 2015. [DOI: 10.7243/2055-091x-2-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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