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Özaltın GE, Talu B, Bayındır T. The effect of proprioceptive vestibular rehabilitation on sensory-motor symptoms and quality of life. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-10. [PMID: 39317226 DOI: 10.1055/s-0044-1790568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Abstract
BACKGROUND Peripheral vestibular hypofunction (PVH) is characterized by balance and gait disorders and vestibulo-autonomic findings. The vestibular system and proprioceptive system work together to regulate sensorimotor functions. Vestibular exercises are effective in PVH, but their superiority over each other is still unclear. OBJECTIVE This study aims to examine the effect of proprioceptive vestibular exercises on patients with PVH. METHODS 30 individuals with unilateral PVH were assigned to 3 groups. Group 1 received proprioceptive vestibular rehabilitation, group 2 received standard vestibular rehabilitation. Both groups were given standard vestibular exercises as home exercises. No exercise was applied to the group 3. Patients were evaluated in terms of balance, functional mobility, posture, sensory profile, and quality of life. RESULTS Although there was a significant intra-group difference in balance, functional mobility, and quality of life results in all groups (p < 0.05), the difference between groups was generally in favor of group 1 (p < 0.05). There was a significant difference between the groups in the posture analysis results (p < 0.05), while there was a significant difference in the 1st group (p < 0.05). There was a significant difference between the groups in the results of sensory sensitivity, sensory avoidance, and low recording (p < 0.05). There was no significant difference between the groups in sensory-seeking results (p > 0.05). There was a significant difference in quality of life between and within groups (p < 0.05). CONCLUSION Proprioceptive vestibular rehabilitation is an effective method in PVH. We think that our study will guide clinicians and contribute to the literature. TRIAL REGISTRATION NCT04687371.
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Affiliation(s)
- Gülfem Ezgi Özaltın
- Inonu University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Malatya, Türkiye
| | - Burcu Talu
- Inonu University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Malatya, Türkiye
| | - Tuba Bayındır
- Yüksek İhtisas Unıversity, Medicalpark Ankara Hospital, Ear Nose and Throat Clinic, Ankara, Türkiye
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Vlădăreanu L, Iliescu MG, Andronache IT, Danteș E. Incidence and Importance of Peripheral Vestibular Dysfunction in Adolescent Idiopathic Scoliosis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:723. [PMID: 38929302 PMCID: PMC11201755 DOI: 10.3390/children11060723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Adolescent idiopathic scoliosis (AIS) is a common form of scoliosis. As the name suggests, etiopathogenesis is not clearly defined, so treatment is still anchored in the musculoskeletal theory and correction/prevention of high Cobb angle values. This study aimed to determine whether there is any connection between developing scoliotic curvature and a positive history of motion sickness as a symptom of a peripheral vestibular dysfunction/deficit, and if vestibular rehabilitation exercises could be integrated into the treatment plan. The study was conducted over 12 months on a selected population of 159 patients to evaluate or treat scoliotic curvatures in a private clinic. The collected data were analyzed using IBM SPSS Statistics 25 and illustrated using Microsoft Office Excel/Word 2021. Patients with peripheral vestibular dysfunction had significantly higher Cobb angle values when compared to patients with a negative result in an instrumental test for peripheral vestibular dysfunction. Motion sickness was considerably more associated with peripheral vestibular dysfunction, and a positive Fukuda stepping test was associated with a positive history of motion sickness. Adolescent idiopathic scoliosis with higher Cobb angles is related to positive motion sickness history as part of peripheral vestibular dysfunction. Conservative treatment for scoliosis could incorporate sensory integration techniques, and a positive history of motion sickness could be an indicator of a higher risk of progression in adolescent idiopathic scoliosis.
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Affiliation(s)
- Liliana Vlădăreanu
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Pediatric Neurorehabilitation Department, Techirghiol Balneal and Rehabilitation Sanatorium, 34-41 Climescu Blvd., 906100 Techirghiol, Romania
| | - Mădălina Gabriela Iliescu
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Pediatric Neurorehabilitation Department, Techirghiol Balneal and Rehabilitation Sanatorium, 34-41 Climescu Blvd., 906100 Techirghiol, Romania
| | - Iulia Tania Andronache
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Department of Rheumatology, Internal Medicine Clinic, “Alexandru Gafencu” Military Emergency Hospital Constanta, Mamaia Blvd., 900527 Constanța, Romania
| | - Elena Danteș
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Clinical Hospital of Pulmonology, 40 Sentinelei Street, 900002 Constanta, Romania
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Paramento M, Passarotto E, Maccarone MC, Agostini M, Contessa P, Rubega M, Formaggio E, Masiero S. Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review. PLoS One 2024; 19:e0303086. [PMID: 38776317 PMCID: PMC11111046 DOI: 10.1371/journal.pone.0303086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately 4% of the world's population. Several hypotheses regarding the etiology of AIS have been investigated. In the last decades, impaired visual-spatial perception, alterations in spatial body orientation and sensory integration deficits have been documented. OBJECTIVE We aimed to summarize the neurophysiological, balance, and motion evidence related to AIS published in the last fifteen years, between January 2008 and April 2023. Both observational and interventional studies were considered. Only studies using quantitative assessment methods, such as electroencephalography (EEG), electromyography (EMG), magnetic resonance imaging (MRI), somatosensory evoked potentials, force platform, or motion capture, were included. METHODS 1250 eligible records identified from online database searching were filtered by duplicate removal, title and abstract screening, and qualitative analysis. 61 articles met the inclusion criteria (i.e., Cobb range 10°-35°, age range 10-18 years) and were summarized. RESULTS We found significant evidence of impaired standing balance in individuals with AIS who greatly rely on visual and proprioceptive information to stay upright. EMG studies frequently reported an increased activity on the convex side of the intrinsic spinae muscles. EEG data show increased delta and theta power, higher alpha peak frequencies, and significant suppression in the alpha and beta bands in subjects with AIS during standing tasks. MRI studies report changes in white matter structures, differences in the vestibular system, and abnormal cortical activations over motor-related areas in subjects with AIS. Bracing appears to be an effective treatment for AIS, leading to improvements in static balance and gait. Methodological issues prevent reliable conclusions about the effects of other treatment options. CONCLUSIONS This review underscores the importance of quantitative assessment methods to explore the etiology and pathophysiology of AIS. Further research is needed to measure the impact of physical therapy and orthotic treatments on the neurophysiological mechanisms of the disease.
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Affiliation(s)
- Matilde Paramento
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Edoardo Passarotto
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Maria Chiara Maccarone
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Michela Agostini
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Paola Contessa
- Orthopedic Rehabilitation Unit, Padova University Hospital, Padova, Italy
| | - Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Ospedale Riabilitativo di Alta Specializzazione di Motta di Livenza, Motta di Livenza, Treviso, Italy
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Li X, Liu W, Tang X, Li C, Zhang Z. Three-dimensional Analysis of the Temporal Bone Morphology in Patients with Craniofacial Microsomia. Cleft Palate Craniofac J 2024; 61:584-591. [PMID: 36628544 DOI: 10.1177/10556656221149250] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To characterise the morphology of temporal bone in patients with craniofacial microsomia (CFM). DESIGN A retrospective study. SETTING A craniofacial centre. PATIENTS Ninety-four patients with unilateral craniofacial microsomia. INTERVENTIONS Mimics 21.0 (Materialise Inc., Belgium) was used to locate temporal bone landmarks on preoperative computed tomography data. The spatial Cartesian coordinate system was established in 3-matic 13.0 (Materialise Inc., Belgium). The coordinates of each landmark and the distances and angles between the landmarks were calculated. A classification system was used to quantify the severity of the zygomatic arch deformity. MAIN OUTCOME MEASURE(S) The bilateral differences in coordinates, linear and angular measurements, and the severity of temporal bone deformity (TTL δ, Psag δ, Paxiδ, and Tsag δ) among the groups were compared using the paired t-test and Kruskal-Wallis test, respectively. RESULTS Compared to those of the unaffected side, the landmarks of the inner ear and petrous part on the affected side showed a decrease in the Z-coordinate or an increase in the X-coordinate. A superolateral rotation tendency of the temporal bone on the affected side was found. There were no significant differences in the linear and angular measurements between the groups. The degree of zygomatic arch deformation was lower in the mild group; however, no significant difference was found between the moderate and severe groups. CONCLUSIONS In patients with CFM, asymmetry of the temporal bone and its inner organs (vestibulocochlear organ, facial nerve, and vessels) exists in multiple dimensions; its severity is not completely consistent with the degree of mandibular involvement.
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Affiliation(s)
- Xiyuan Li
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Wei Liu
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaojun Tang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Chuan Li
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zhiyong Zhang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Xu J, Chen M, Wang X, Luo X. Biomechanical changes in adolescent idiopathic scoliosis during walking: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e36528. [PMID: 38065886 PMCID: PMC10713143 DOI: 10.1097/md.0000000000036528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND To clarify the differences in biomechanical characteristics present in adolescent idiopathic scoliosis (AIS) patients during walking. METHODS Cross-sectional studies related to the biomechanical characteristics of AIS were included by searching 7 major databases and analyzed using RevMan 5.4 software. RESULTS There were a total of 15 trials involving 377 AIS patients. The results showed that during walking, AIS had increased pelvic coronal tilt (effect size [ES] = -1.34, 95% confidence intervals [CI] = -2.41 to -0.27, P = .01), knee and ankle sagittal mobility were reduced (ES = -5.22, 95% CI = -7.51 to -2.94, P < .001; ES = -3.58, 95% CI = -5.93 to -1.22, P = .003). The duration of electromyogram activity was prolonged in the gluteus medius (ES = 7.65, 95% CI = 5.33-9.96, P < .001), lumbar square (ES = 10.73, 95% CI = 6.97-14.49, P < .001), and erector spinae (ES = 14.35, 95% CI = 6.94-21.76, P < .001) muscles. The results of subgroup analysis showed that the step length of the concave side of the spine was reduced (ES = -0.36, 95% CI = -0.71 to -0.01, P = .04). CONCLUSION AIS has characteristic biomechanical changes in spatiotemporal, phase kinematics, motor mechanics, and electromyographic signatures. Further comprehensive studies are required in the future to analyze the biomechanical and electromyographic differences among different degrees and types of scoliosis, as well as the differences between the concave and convex sides of scoliosis during walking.
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Affiliation(s)
- Jie Xu
- Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China
| | - Meng Chen
- Department of Emergency Medicine, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, China
| | - Xin Wang
- Health Science Center, Peking University, Beijing, China
| | - Xiaobing Luo
- Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China
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Vestibular Morphological Alterations in Adolescent Idiopathic Scoliosis: A Systematic Review of Observational Studies. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010035. [PMID: 36670586 PMCID: PMC9856763 DOI: 10.3390/children10010035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/23/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is the most frequent pediatric spinal deformity. Its treatment still shows limited results due to the existent lack of knowledge regarding etiopathogenesis. Thus, the purpose of the study is to check the existence of vestibular morphological alterations among idiopathic scoliosis patients. To meet the objective, we performed this systematic review searching studies in PubMed Medline, SCOPUS, Web of Science, CINAHL Complete and SciELO until 15 September 2022. Articles that analyzed the morphology of the vestibular apparatus were selected, comparing subjects with AIS versus healthy subjects. Variables were selected that measured the orientation of the channels as well as the general conformation of the vestibular apparatus. One hundred and eighty-five records were retrieved in the preliminary searches, of which five studies were finally included, providing data from 154 participants (83 cases and 71 healthy controls) with a mean age 16.07 ± 2.48 years old. Two studies conclude that the superior and lateral semicircular canals are longer and thinner in patients with AIS. One study concluded that the measure between centers of superior and lateral canals and the angle whose vertex is placed the center of posterior canal were significantly shorter in subjects with AIS than in healthy controls in the left-side of vestibular apparatus. Two studies found an asymmetry in the verticality of the lateral canals on both sides in subjects with AIS, although it is not clear whether the left canal is in a more horizontal or vertical position. Patients with AIS seem to present morphological asymmetries of the vestibular apparatus, fundamentally on the left side. These anomalies seem to correlate with the location of the curve but not with its laterality or severity.
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Muir B, Boot B, Hamilton M. Can a structural leg length discrepancy contribute to persistent concussion symptoms? A case report. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2022; 66:300-309. [PMID: 36818361 PMCID: PMC9914830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
In the past several years, concussions and post-concussion syndrome (PCS) have become more commonly recognized conditions. However, with limited physiological explanation for post-concussion syndrome, there is also limited evidence supporting effective treatment. The vestibular system plays a role in postural reflexes and coordinated eye and cervical spine movements and is often disrupted in patients with prolonged concussion symptoms. This disruption has contributed to some of the most debilitating symptoms in PCS patients including dizziness, nausea, and balance deficits. Ongoing, post-concussion, vestibulo-ocular/cervical-ocular disruption due to an underlying structural leg length discrepancy as a contributing factor has not been previously described in the literature. A case of PCS with initial conservative treatment of their structural leg length discrepancy and subsequent vestibulo-ocular/cervical-ocular rehabilitation is presented.
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Affiliation(s)
- Brad Muir
- Canadian Memorial Chiropractic College
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Muñoz-Montecinos C, Romero A, Sepúlveda V, Vira MÁ, Fehrmann-Cartes K, Marcellini S, Aguilera F, Caprile T, Fuentes R. Turning the Curve Into Straight: Phenogenetics of the Spine Morphology and Coordinate Maintenance in the Zebrafish. Front Cell Dev Biol 2022; 9:801652. [PMID: 35155449 PMCID: PMC8826430 DOI: 10.3389/fcell.2021.801652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/31/2021] [Indexed: 12/13/2022] Open
Abstract
The vertebral column, or spine, provides mechanical support and determines body axis posture and motion. The most common malformation altering spine morphology and function is adolescent idiopathic scoliosis (AIS), a three-dimensional spinal deformity that affects approximately 4% of the population worldwide. Due to AIS genetic heterogenicity and the lack of suitable animal models for its study, the etiology of this condition remains unclear, thus limiting treatment options. We here review current advances in zebrafish phenogenetics concerning AIS-like models and highlight the recently discovered biological processes leading to spine malformations. First, we focus on gene functions and phenotypes controlling critical aspects of postembryonic aspects that prime in spine architecture development and straightening. Second, we summarize how primary cilia assembly and biomechanical stimulus transduction, cerebrospinal fluid components and flow driven by motile cilia have been implicated in the pathogenesis of AIS-like phenotypes. Third, we highlight the inflammatory responses associated with scoliosis. We finally discuss recent innovations and methodologies for morphometrically characterize and analyze the zebrafish spine. Ongoing phenotyping projects are expected to identify novel and unprecedented postembryonic gene functions controlling spine morphology and mutant models of AIS. Importantly, imaging and gene editing technologies are allowing deep phenotyping studies in the zebrafish, opening new experimental paradigms in the morphometric and three-dimensional assessment of spinal malformations. In the future, fully elucidating the phenogenetic underpinnings of AIS etiology in zebrafish and humans will undoubtedly lead to innovative pharmacological treatments against spinal deformities.
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Affiliation(s)
- Carlos Muñoz-Montecinos
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Adrián Romero
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Vania Sepúlveda
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - María Ángela Vira
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Karen Fehrmann-Cartes
- Núcleo de Investigaciones Aplicadas en Ciencias Veterinarias y Agronómicas, Universidad de las Américas, Concepción, Chile
| | - Sylvain Marcellini
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Felipe Aguilera
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Teresa Caprile
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Ricardo Fuentes
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
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Harada T, Sugawara T, Ito T, Wada Y, Fukunaga M, Sadato N, Larroque SK, Demertzi A, Laureys S, Sakai H. Vestibular Morphological Asymmetry Associated With Motion Sickness Susceptibility. Front Neurosci 2021; 15:763040. [PMID: 34803595 PMCID: PMC8600179 DOI: 10.3389/fnins.2021.763040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/14/2021] [Indexed: 01/24/2023] Open
Abstract
Sensory conflicts leading to motion sickness can occur not only between but also within sensory modalities. The vestibular organs are located in both left and right inner ears, and their misalignment can be a source of self-motion related sensory conflicts. In the current study, using inner ear magnetic resonance imaging, we examined whether morphological asymmetry of the bilateral vestibular organs was associated with motion sickness susceptibility. The results showed a larger position asymmetry of bilateral vestibular organs in individuals with high rather than low susceptibility. In addition, vestibular position asymmetry was associated with reciprocal interaction (negative resting state functional connectivity) between vestibular and visuocortical regions in lowly, but not highly, susceptible individuals. In conclusion, these findings suggest that vestibular morphological asymmetry can be a source of sensory conflicts in individuals with dysfunctional reciprocal visuo-vestibular interactions, a putative neural mechanism for resolving sensory conflicts.
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Affiliation(s)
| | | | - Taeko Ito
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Yoshiro Wada
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, Department of System Neuroscience, National Institute for Physiological Sciences, Okazaki, Japan
| | - Norihiro Sadato
- Division of Cerebral Integration, Department of System Neuroscience, National Institute for Physiological Sciences, Okazaki, Japan
| | - Stephen K. Larroque
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liege, Belgium
| | - Athena Demertzi
- Physiology of Cognition Research Lab, GIGA-Consciousness, GIGA Institute, University of Liège, Liege, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liege, Belgium
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Idiopathic scoliosis: general characteristics and analysis of etiological theories (literature review). ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.3.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Idiopathic scoliosis is a severe pathology of the musculoskeletal system that affects children and adolescents all over the world. The disease occurs in approximately 0.2-0.6% of the general population, and is the largest subgroup of spinal curvature in humans (70-90% of all known scoliosis cases). In idiopathic scoliosis, a threedimensional deformation of the vertebral column is formed, leading to the formation of a rib hump, curvature of the ribs and chest, asymmetry of the pelvis and impaired development of internal organs. The main feature of the disease is the spontaneous development of deformity during the growth of the child and the tendency to progress. Scoliosis is not only an orthopedic disease, but also a ignificant cosmetic, and, consequently, a psychological and social problem. The standard of treatment for scoliotic disease remains unchanged for a long time: observation, corset treatment and surgical correction. The prognosis for the development of pathology varies depending on the degree of deformation. The corset-therapy, hospitalization, surgery and treatment of chronic back pain have a negative impact on the psychoemotional state of children and adolescents. Despite significant advances in the methods of diagnosis of deformity, improvement of surgical treatment methods and in the study of pathogenesis, the etiological factor of pathology is still unknown. The search for the causes of idiopathic scoliosis covers almost all aspects of its possible origin: genetic, environmental, hormonal, metabolic, biochemical, neurological, and others. In recent decades, relevant theories of the development of scoliosis have been formulated, but none of the theories reveals the essence of the pathological process and has no clear justification. The greatest number of supporters is the genetic theory: genetic factors play a key role in the occurrence and development of idiopathic scoliosis. Understanding the underlying factors of the disease will enable prevention, early diagnosis, and identification of the risk groups of the patients in question.
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Severity of Idiopathic Scoliosis Is Associated with Differential Methylation: An Epigenome-Wide Association Study of Monozygotic Twins with Idiopathic Scoliosis. Genes (Basel) 2021; 12:genes12081191. [PMID: 34440365 PMCID: PMC8391702 DOI: 10.3390/genes12081191] [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: 07/16/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 12/27/2022] Open
Abstract
Epigenetic mechanisms may contribute to idiopathic scoliosis (IS). We identified 8 monozygotic twin pairs with IS, 6 discordant (Cobb angle difference > 10°) and 2 concordant (Cobb angle difference ≤ 2°). Genome-wide methylation in blood was measured with the Infinium HumanMethylation EPIC Beadchip. We tested for differences in methylation and methylation variability between discordant twins and tested the association between methylation and curve severity in all twins. Differentially methylated region (DMR) analyses identified gene promoter regions. Methylation at cg12959265 (chr. 7 DPY19L1) was less variable in cases (false discovery rate (FDR) = 0.0791). We identified four probes (false discovery rate, FDR < 0.10); cg02477677 (chr. 17, RARA gene), cg12922161 (chr. 2 LOC150622 gene), cg08826461 (chr. 2), and cg16382077 (chr. 7) associated with curve severity. We identified 57 DMRs where hyper- or hypo-methylation was consistent across the region and 28 DMRs with a consistent association with curve severity. Among DMRs, 21 were correlated with bone methylation. Prioritization of regions based on methylation concordance in bone identified promoter regions for WNT10A (WNT signaling), NPY (regulator of bone and energy homeostasis), and others predicted to be relevant for bone formation/remodeling. These regions may aid in understanding the complex interplay between genetics, environment, and IS.
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Marie-Hardy L, Cantaut-Belarif Y, Pietton R, Slimani L, Pascal-Moussellard H. The orthopedic characterization of cfap298 tm304 mutants validate zebrafish to faithfully model human AIS. Sci Rep 2021; 11:7392. [PMID: 33795825 PMCID: PMC8016992 DOI: 10.1038/s41598-021-86856-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023] Open
Abstract
Cerebrospinal fluid (CSF) circulation relies on the beating of motile cilia projecting in the lumen of the brain and spinal cord cavities Mutations in genes involved in cilia motility disturb cerebrospinal fluid circulation and result in scoliosis-like deformities of the spine in juvenile zebrafish. However, these defects in spine alignment have not been validated with clinical criteria used to diagnose adolescent idiopathic scoliosis (AIS). The aim of this study was to describe, using orthopaedic criteria the spinal deformities of a zebrafish mutant model of AIS targeting a gene involved in cilia polarity and motility, cfap298tm304. The zebrafish mutant line cfap298tm304, exhibiting alteration of CSF flow due to defective cilia motility, was raised to the juvenile stage. The analysis of mutant animals was based on micro-computed tomography (micro-CT), which was conducted in a QUANTUM FX CALIPER, with a 59 µm-30 mm protocol. 63% of the cfap298tm304 zebrafish analyzed presented a three-dimensional deformity of the spine, that was evolutive during the juvenile phase, more frequent in females, with a right convexity, a rotational component and involving at least one dislocation. We confirm here that cfap298tm304 scoliotic individuals display a typical AIS phenotype, with orthopedic criteria mirroring patient's diagnosis.
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Affiliation(s)
- Laura Marie-Hardy
- Orthopedic Surgery and Trauma Center, Pitié-Salpêtrière Teaching Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Yasmine Cantaut-Belarif
- Paris Brain Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, 75013, Paris, France
| | - Raphaël Pietton
- Orthopedic Surgery and Trauma Center, Pitié-Salpêtrière Teaching Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France
| | - Lotfi Slimani
- EA 2496 Laboratory Orofacial Pathologies, Imaging and Biotherapies, Dental School University Paris Descartes Sorbonne Paris Cité, and Life Imaging Platform (PIV), Montrouge, France
| | - Hugues Pascal-Moussellard
- Orthopedic Surgery and Trauma Center, Pitié-Salpêtrière Teaching Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France
- Paris Brain Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, 75013, Paris, France
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13
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Zaydman AM, Strokova EL, Pahomova NY, Gusev AF, Mikhaylovskiy MV, Shevchenko AI, Zaidman MN, Shilo AR, Subbotin VM. Etiopathogenesis of adolescent idiopathic scoliosis: Review of the literature and new epigenetic hypothesis on altered neural crest cells migration in early embryogenesis as the key event. Med Hypotheses 2021; 151:110585. [PMID: 33932710 DOI: 10.1016/j.mehy.2021.110585] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/28/2021] [Accepted: 03/24/2021] [Indexed: 12/17/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) affects 2-3% of children. Numerous hypotheses on etiologic/causal factors of AIS were investigated, but all failed to identify therapeutic targets and hence failed to offer a cure. Therefore, currently there are only two options to minimize morbidity of the patients suffering AIS: bracing and spinal surgery. From the beginning of 1960th, spinal surgery, both fusion and rod placement, became the standard of management for progressive adolescent idiopathic spine deformity. However, spinal surgery is often associated with complications. These circumstances motivate AIS scientific community to continue the search for new etiologic and causal factors of AIS. While the role of the genetic factors in AIS pathogenesis was investigated intensively and universally recognized, these studies failed to nominate mutation of a particular gene or genes combination responsible for AIS development. More recently epigenetic factors were suggested to play causal role in AIS pathogenesis. Sharing this new approach, we investigated scoliotic vertebral growth plates removed during vertebral fusion (anterior surgery) for AIS correction. In recent publications we showed that cells from the convex side of human scoliotic deformities undergo normal chondrogenic/osteogenic differentiation, while cells from the concave side acquire a neuronal phenotype. Based on these facts we hypothesized that altered neural crest cell migration in early embryogenesis can be the etiological factor of AIS. In particular, we suggested that neural crest cells failed to migrate through the anterior half of somites and became deposited in sclerotome, which in turn produced chondrogenic/osteogenic-insufficient vertebral growth plates. To test this hypothesis we conducted experiments on chicken embryos with arrest neural crest cell migration by inhibiting expression of Paired-box 3 (Pax3) gene, a known enhancer and promoter of neural crest cells migration and differentiation. The results showed that chicken embryos treated with Pax3 siRNA (microinjection into the neural tube, 44 h post-fertilization) progressively developed scoliotic deformity during maturation. Therefore, this analysis suggests that although adolescent idiopathic scoliosis manifests in children around puberty, the real onset of the disease is of epigenetic nature and takes place in early embryogenesis and involves altered neural crest cells migration. If these results confirmed and further elaborated, the hypothesis may shed new light on the etiology and pathogenesis of AIS.
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Affiliation(s)
- Alla M Zaydman
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Elena L Strokova
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Nataliya Y Pahomova
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Arkady F Gusev
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Mikhail V Mikhaylovskiy
- Novosibirsk Research Institute of Traumatology and Orthopaedics named after Ya.L. Tsivyan, Novosibirsk, Russia
| | - Alexander I Shevchenko
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences", Novosibirsk, Russia
| | | | - Andrey R Shilo
- Novosibirsk Zoo named after R.A. Shilo, Novosibirsk, Russia
| | - Vladimir M Subbotin
- Arrowhead Pharmaceuticals Inc., Madison WI, USA; University of Pittsburgh, Pittsburgh PA, USA; University of Wisconsin, Madison WI, USA.
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14
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Abstract
Etiology of adolescent idiopathic scoliosis (AIS), a complicated three-dimensional spinal deformity with early-onset, receives continuous attention but remains unclear. To gain an insight into AIS pathogenesis, this review searched PubMed database up to June 2019, using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis," "etiology," "genetics," "mesenchymal stem cells," and their combinations, summarized existing literatures and categorized the theories or hypothesis into nine aspects. These aspects include bone marrow mesenchymal stem cell studies, genetic studies, tissue analysis, spine biomechanics measurements, neurologic analysis, hormone studies, biochemical analysis, environmental factor analysis, and lifestyle explorations. These categories could be a guidance for further etiology or treatment researches to gain inspiration.
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15
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Scheyerer MJ, Rohde A, Stuermer KJ, Kluenter HD, Bredow J, Oikonomidis S, Klußmann JP, Eysel P, Eysel-Gosepath K. Impact of the Vestibular System on the Formation and Progression to Idiopathic Scoliosis: A Review of Literature. Asian Spine J 2020; 15:701-707. [PMID: 33189104 PMCID: PMC8561148 DOI: 10.31616/asj.2020.0308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022] Open
Abstract
The physiopathogenesis of adolescent idiopathic scoliosis remains unknown. However, a multifactorial pathogenesis is being assumed. Besides biomechanical, biochemical, and genetic factors, some studies have focused on congenital or acquired abnormalities in the vestibular organ with consecutive development of scoliosis. This study aims to analyze a possible correlation between any vestibular organ congenital or acquired pathologies and scoliosis based on the current literature. Therefore, we conducted a literature search in three databases, with search terms such as “scoliosis,” “organ of balance,” “idiopathic scoliosis,” “vestibular organ,” “spine,” and “balance.” Fifteen studies were selected and used for research. The relationship between scoliosis and vestibular organ abnormalities was recorded from all included works. Seven studies demonstrated a direct correlation between vestibular organ anatomical abnormalities and the form of the scoliotic spine. Another study confirmed the influence of the pathology of the vestibular organ on scoliosis but questioned whether it had an impact on the formation or the progression of the curvature. Others demonstrated a temporal overlap of the embryonic development of the vestibular organ and the beginning of pre-scoliotic characteristics, but their relationship remained questionable. In three studies, the correlation remained unclear, and any context has been denied. It seems unlikely that an isolated vestibular disorder can trigger structural scoliosis. However, the vestibular system pathologies may certainly occur in the multifactorial genesis of idiopathic scoliosis. Whether the correlation refers to the expression or the progression of scoliosis or may even have an influence on both remains unclear. New treatment options could be derived from these findings with a positive influence on the course of the deformity.
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Affiliation(s)
- Max Joseph Scheyerer
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Axel Rohde
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Konrad Johannes Stuermer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Heinz-Dieter Kluenter
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jan Bredow
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Stavros Oikonomidis
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Peer Eysel
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kathrin Eysel-Gosepath
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, Duesseldorf University Hospital, Duesseldorf, Germany
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16
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Tang H, Chen Y, Cen Z, Ouyang Z, Lou D, Tan Y, Luo W. The link between lateral trunk flexion in Parkinson's disease and vestibular dysfunction: a clinical study. Int J Neurosci 2020; 131:521-526. [PMID: 32942935 DOI: 10.1080/00207454.2020.1825419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Lateral trunk flexion (LTF) is a common postural deformity in Parkinson's disease (PD). Postural control is known to depend on visual, vestibular, and somatosensory information. OBJECTIVES This study aimed to investigate the relationship between vestibular dysfunction and postural abnormalities in PD patients with LTF. METHODS We enrolled a total of 19 PD patients with LTF (PD-LTF+) and 19 age- and sex-matched PD patients without LTF (PD-LTF-). All patients underwent vestibular tests, including spontaneous nystagmus, gaze-evoked nystagmus, ocular movements, optokinetic eye test, fast positioning maneuvers, and the bithermal caloric test. RESULTS Most of the PD-LTF + patients had abnormal vestibular function (11/19), while there were fewer vestibular function injuries in the control group (3/19). In PD-LTF + group, there were 5 patients (5/11, 45.5%) of peripheral vestibular dysfunction, 2 patients (2/11, 18.2%) of central vestibular damage, and 4 patients (4/11, 36.4%) of mixed injuries. The peripheral vestibular deficiencies could be either bilateral (4/9, 44.4%) or unilateral (5/9, 55.6%). The unilateral vestibular dysfunction was ipsilateral to the leaning side in 2 patients and contralateral to the leaning side in the other 3 patients. CONCLUSION Vestibular dysfunction may be an independent risk factor for LTF in PD patients.
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Affiliation(s)
- Haiyan Tang
- Department of Neurology, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang, China.,Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - You Chen
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhidong Cen
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhiyuan Ouyang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Danning Lou
- Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ying Tan
- Department of Neurology, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang, China
| | - Wei Luo
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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17
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Carry PM, Duke VR, Brazell CJ, Stence N, Scholes M, Rousie DL, Hadley Miller N. Lateral semi-circular canal asymmetry in females with idiopathic scoliosis. PLoS One 2020; 15:e0232417. [PMID: 32349123 PMCID: PMC7190182 DOI: 10.1371/journal.pone.0232417] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/14/2020] [Indexed: 01/09/2023] Open
Abstract
Purpose Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal structural deformity that occurs in otherwise normal individuals. Although curve progression and severity vary amongst individuals, AIS can lead to significant cosmetic and functional deformity. AIS etiology has been determined to be genetic, however, exact genetic and biological processes underlying this disorder remain unknown. Vestibular structure and function have potentially been related to the etiopathogenesis of AIS. Here, we aimed to characterize the anatomy of the semicircular canals (SCC) within the vestibular system through a novel approach utilizing T2-weighted magnetic resonance images (MRI). Methods Three dimensional, MRI-based models of the SCCs were generated from AIS subjects (n = 20) and healthy control subjects (n = 19). Linear mixed models were used to compare SCC morphological measurements in the two groups. We compared side-to-side differences in the SCC measurements between groups (group*side interaction). Results Side-to-side differences in the lateral SCC were different between the two groups [false discovery rate adjusted p-value: 0.0107]. Orientation of right versus left lateral SCC was significantly different in the AIS group compared to the control group [mean side-to-side difference: -4.1°, 95% CI: -6.4° to -1.7°]. Overall, among subjects in the AIS group, the left lateral SCC tended to be oriented in a more horizontal position than subjects in the control group. Significance Asymmetry within the SCCs of the vestibular system of individuals with AIS potentially results in abnormal efferent activity to postural muscles. Consequences of this muscular activity during periods of rapid growth, which often coincides with AIS onset and progression, warrant consideration.
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Affiliation(s)
- Patrick M. Carry
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | - Victoria R. Duke
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | - Christopher J. Brazell
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | - Nicholas Stence
- Department of Radiology, Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | - Melissa Scholes
- Department of Otolaryngology, Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | | | - Nancy Hadley Miller
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Children’s Hospital Colorado, Aurora, Colorado, United States of America
- * E-mail:
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18
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Shupak A, Faranesh N. Bone Mineral Density in Patients Suffering from Ménière's Disease. Audiol Neurootol 2020; 25:158-163. [PMID: 32088708 DOI: 10.1159/000506039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Previous studies have reported an association between reduced bone mineral density and the occurrence of benign paroxysmal positional vertigo, balance impairment, and saccular dysfunction. Furthermore, the results of recent animal studies have raised the possibility that vestibular dysfunction could affect bone remodeling and bone mass. The goal of the study was to compare bone mineral density of patients suffering from definite Ménière's disease to that of a matched control group. METHODS We conducted a case-control cross-sectional study in a tertiary referral center. The study group included 23 patients suffering from definite Ménière's disease, and the control group was comprised of 23 patients matched in their race, gender, and age parameters in whom no vestibular pathology could be found. Dual energy X-ray absorptiometry of the femoral head was used for the assessment of bone mineral density. The T and Z scores of the femoral heads' bone mineral density were compared. RESULTS The average T scores were -1.53 ± 1.08 in the study and -0.39 ± 0.72 (p = 0.016) in the control groups, and the Z scores were -0.4 ± 0.63 and 0.33 ± 0.31 (p = 0.018), respectively. Seventeen patients (74%) of the study group and 9 (39%) of the control group had T scores less than -1.0, indicating osteopenia/osteoporosis (p = 0.036). CONCLUSIONS The results showed a significant association between Ménière's disease and reduced bone mineral density of the femoral head. Bone mineral density studies of the weight-bearing bones are warranted in Ménière's disease for the early diagnosis and treatment of osteopenia/osteoporosis on the one hand and possible benefit of this treatment for the evolution of Ménière's disease on the other hand.
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Affiliation(s)
- Avi Shupak
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel, .,Department of Otolaryngology Head and Neck Surgery, Carmel Medical Center, Haifa, Israel, .,The Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel,
| | - Nabil Faranesh
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel.,Department of Otolaryngology, Head and Neck Surgery, French Hospital, Nazareth, Israel
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19
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Woo EJ, Siegmund GP, Reilly CW, Blouin JS. Asymmetric Unilateral Vestibular Perception in Adolescents With Idiopathic Scoliosis. Front Neurol 2019; 10:1270. [PMID: 31849828 PMCID: PMC6903771 DOI: 10.3389/fneur.2019.01270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/18/2019] [Indexed: 11/13/2022] Open
Abstract
The cause of Adolescent Idiopathic Scoliosis (AIS) remains unclear, but one proposed cause of AIS is asymmetric vestibular function and the related descending drive to the spine musculature. The objective of this study was to determine if asymmetric vestibular function is present in individuals with AIS. Ten individuals with AIS (8F, 2M) and 10 healthy age- and sex-matched controls were exposed to 10s-long virtual rotations induced by monaural or binaural electrical vestibular stimulation (EVS), and 10s-long real rotations delivered by a rotating chair. Using a forced-choice paradigm, participants indicated their perceived rotation direction (right or left) to stimuli of varying intensity. A Bayesian adaptive algorithm adjusted the stimulus intensity and direction to identify a stimulus level, which we called the direction recognition threshold, at which participants correctly identified the rotation direction 69% of the time. For unilateral vestibular stimuli (monaural EVS), the direction recognition thresholds were more asymmetric in all participants with AIS compared to control participants [(0.22-1.00 mA) vs. (0.01-0.21 mA); p < 0.001]. For bilateral vestibular stimuli, however, the direction recognition thresholds did not differ between groups for either the real or virtual rotations (multiple p > 0.05). Previous reports of semicircular canal orientation asymmetry in individuals with AIS could not explain the magnitude of the vestibular function asymmetry we observed, suggesting a functional cause to the observed vestibular asymmetry. Thus, the present results suggest that a unilateral vestibular dysfunction is linked to AIS, potentially revealing a new path for the screening and monitoring of scoliosis in adolescents.
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Affiliation(s)
- Emma J Woo
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Gunter P Siegmund
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.,MEA Forensic Engineers & Scientists, Richmond, BC, Canada
| | - Christopher W Reilly
- British Columbia Children's Hospital, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jean-Sébastien Blouin
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Institute for Computing, Information, and Cognitive System, University of British Columbia, Vancouver, BC, Canada
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20
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Hatzilazaridis I, Hatzitaki V, Antoniadou N, Samoladas E. Postural and muscle responses to galvanic vestibular stimulation reveal a vestibular deficit in adolescents with idiopathic scoliosis. Eur J Neurosci 2019; 50:3614-3626. [PMID: 31336391 DOI: 10.1111/ejn.14525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 05/14/2019] [Accepted: 06/10/2019] [Indexed: 11/27/2022]
Abstract
One of the most appealing hypotheses around the aetiopathogenesis of adolescent idiopathic scoliosis attributes the development of the spine deformity to an imbalance in the descending vestibulospinal drive to the muscles resulting in a differential mechanical pull on the spine during the early life stages. In this study, we explored this hypothesis by examining postural and muscle responses to binaural bipolar galvanic vestibular stimulation (GVS) of randomly alternating polarity. Adolescents diagnosed with idiopathic scoliosis (n = 12) and healthy age-matched controls (n = 12) stood quietly with feet together (stance duration 66-102 s), eyes closed and facing forward, while 10 short (2s), transmastoidal, bipolar square wave GVS pulses (0.3-2.0 mA) of randomly alternating polarity were delivered at varying time intervals. Responses depicted in the electromyographic (EMG) activity of bilateral axial and appendicular muscles, vertical reaction forces and segment kinematics were recorded and analysed. Scoliotic patients demonstrated smaller ankle muscle responses and a delayed postural shift to the right relative to controls during anode right/cathode left GVS. When GVS polarity was reversed, patients had a greater soleus short-latency response on the left anodal side, while the rest of the muscle and postural responses were similar between groups. Vestibular stimulation also evoked greater head and upper trunk sway in scoliotic compared with healthy adolescents irrespective of stimulus polarity. Results provide new preliminary evidence for a vestibular imbalance in adolescents with idiopathic scoliosis that is compensated by somatosensory, load-related afferent feedback from the lower limbs during the latter part of the response.
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Affiliation(s)
- Ioannis Hatzilazaridis
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilia Hatzitaki
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikoleta Antoniadou
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Samoladas
- Orthopeadics Division of Genimatas Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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21
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Christy JB. Considerations for Testing and Treating Children with Central Vestibular Impairments. Semin Hear 2018; 39:321-333. [PMID: 30038458 DOI: 10.1055/s-0038-1666821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
This perspective explores common pediatric diagnoses that could present with central vestibular pathway dysfunction, leading to delays in motor development and postural control, and gaze instability. Specifically, the following diagnoses are considered: cerebral palsy, myelomeningocele, vestibular migraine, attention-deficit hyperactivity disorder, developmental coordination disorder, concussion, childhood cancer, congenital muscular torticollis, adolescent idiopathic scoliosis, and autism. Suggestions for clinical screening, vestibular function testing, and vestibular rehabilitation for children with these diagnoses are based on evidence for the efficacy of testing and interventions for children with peripheral vestibular hypofunction. More research is needed to explore peripheral and central vestibular function in children with these diagnoses. Testing and intervention methods may need to be modified to accommodate for the specific behavior and motor challenges that some children might present. Researchers should develop technology so that gaze stabilization exercises can be delivered in a fun, functional, and effective way.
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Affiliation(s)
- Jennifer B Christy
- Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama
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22
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Verticality perception reveals a vestibular deficit in adolescents with idiopathic scoliosis. Exp Brain Res 2018; 236:1725-1734. [DOI: 10.1007/s00221-018-5256-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/07/2018] [Indexed: 10/17/2022]
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23
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Latalski M, Danielewicz-Bromberek A, Fatyga M, Latalska M, Kröber M, Zwolak P. Current insights into the aetiology of adolescent idiopathic scoliosis. Arch Orthop Trauma Surg 2017; 137:1327-1333. [PMID: 28710669 PMCID: PMC5602042 DOI: 10.1007/s00402-017-2756-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Indexed: 02/02/2023]
Abstract
Scoliosis occurs in about 0.2-0.6% of the general population. In the majority of cases the cause of this entity remains mostly unidentified. The search for the causes covers almost all aspects of its possible origin. We collected and systematised the contemporary theories and concepts concerning the aetiology of adolescent idiopathic scoliosis. Genetic and hereditary factors are commonly accepted as possible causes; however, the identification of the single gene responsible for the development of this condition seems impossible, which suggests multifactorial mechanism of its formation. Dysfunctions of the nervous system are recognised risks related to the development of scoliosis, but they are classified as belonging to a separate aetiological category. Scoliosis develops at the quickest rate during the child's growth spurt, which prompted the research on the role of the growth hormone in scoliosis aetiology. Melatonin is another hormone that is studied as a possible factor involved in development of this entity. In cases of progressive scoliosis, increased activity of calmodulin-a protein that regulates the levels of calcium ions-has been observed. The scientists have characterised numerous qualitative and quantitative changes in the composition of the tissue of intervertebral discs, spinal ligaments and paraspinal muscles. Some of the theories, explaining the nature of this entity, presented in this review seem to have only a purely theoretical value; their proliferation only confirms the fact that the actual nature of this condition has not been unveiled yet, and suggests its multifactorial aetiology.
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Affiliation(s)
- Michal Latalski
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland.
| | - A Danielewicz-Bromberek
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
| | - M Fatyga
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
| | - M Latalska
- Department of Vitreoretinal Surgery, Medical University of Lublin, ul. Chmielna 1, 20-079, Lublin, Poland
| | - M Kröber
- Department of Orthopaedics, Trauma und Spine Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany
| | - P Zwolak
- Department of Paediatric Orthopaedics, Medical University of Lublin, ul. Gebali 6, 20-093, Lublin, Poland
- Department of Orthopaedics, Trauma und Spine Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany
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