Resting-State Electroencephalography and P300 Evidence: Age-Related Vestibular Loss as a Risk Factor Contributes to Cognitive Decline

Executive functions in patients with bilateral and unilateral peripheral vestibular dysfunction

Previous research suggests that patients with peripheral vestibular dysfunction (PVD) suffer from nonspatial cognitive problems, including executive impairments. However, previous studies that assessed executive functions are conflicting, limited to single executive components, and assessments are confounded by other cognitive functions. We compared performance in a comprehensive executive test battery in a large sample of 83 patients with several conditions of PVD (34 bilateral, 29 chronic unilateral, 20 acute unilateral) to healthy controls who were pairwise matched to patients regarding age, sex, and education. We assessed basic and complex executive functions with validated neuropsychological tests. Patients with bilateral PVD performed worse than controls in verbal initiation and working memory span, while other executive functions were preserved. Patients with chronic unilateral PVD had equal executive performance as controls. Patients with acute unilateral PVD performed worse than controls in the exact same tests as patients with bilateral PVD (verbal initiation, working memory span); however, this effect in patients with acute PVD diminished after correcting for multiple comparisons. Hearing loss and affective disorders did not influence our results. Vestibular related variables (disease duration, symptoms, dizziness handicap, deafferentation degree, and compensation) did not predict verbal initiation or working memory span in patients with bilateral PVD. The results suggest that bilateral PVD not only manifests in difficulties when solving spatial tasks but leads to more general neurocognitive deficits. This understanding is important for multidisciplinary workgroups (e.g., neurotologists, neurologists, audiologists) that are involved in diagnosing and treating patients with PVD. We recommend screening patients with PVD for executive impairments and if indicated providing them with cognitive training or psychoeducational support.

The Current Status and Trends of Research Related to Vestibular Disorders, Vertigo, and Cognitive Impairment in the Elderly Population: A Bibliometric Analysis

Background: The vestibular system not only supports reflex function at the brainstem level, but is also associated with higher levels of cognitive function. Vertigo due to vestibular disorders may lead to or be associated with cognitive dysfunction. Patients with deficits of both vestibular as well as cognitive function may be at particularly high risk for events like falls or certain diseases, such as Alzheimer's. Objective: To analyze the current state of research and trends in the global research literature regarding the correlation between vestibular disorders, vertigo, and cognitive impairment. Methods: We utilized Bibliometrix package to search databases including PubMed, Web of Science, etc for search terms. Results: Databases were searched up to December 15, 2022, and a total of 2222 publications were retrieved. Ultimately, 53 studies were included. A total of 261 authors published in 38 journals and conferences with an overall increasing annual growth rate of 6.94%. The most-published journal was Frontiers in Neurology. The most-published country was the United States, followed by Italy and Brazil. The most-published institution was Johns Hopkins University with a total of 13 articles. On performing trend analysis, we found that the most frequent focus of research in this field include the testing of vestibular perception, activation of the brain-related cortex, and the influence of stimulus-triggered vestibular snail reflex on visual space. The potential focal points are the risk of falling and the ability to extract spatial memory information, and the focus of research in recent decades has revolved around balance, falling, and Alzheimer's disease. Conclusions: Vestibular impairment in older adults affects cognitive function, particularly immediate memory, visuospatial cognition, and attention, with spatial cognition being the most significantly affected. In the future, virtual reality-based vestibular rehabilitation techniques and caloric stimulation could be potential interventions for the treatment of cognitive impairment.

Dynamics of Cerebral Function in Patients with Acute Cerebellar Infarction

Few studies were devoted to investigating cerebral functional changes after acute cerebellar infarction (CI). The purpose of this study was to examine the brain functional dynamics of CI using electroencephalographic (EEG) microstate analysis. And the possible heterogenicity in neural dynamics between CI with vertigo and CI with dizziness was explored. Thirty-four CI patients and 37 age- and gender-matched healthy controls(HC) were included in the study. Each included subject underwent a 19-channel video EEG examination. Five 10-s resting-state EEG epochs were extracted after data preprocessing. Then, microstate analysis and source localization were performed using the LORETA-KEY tool. Microstate parameters such as duration, coverage, occurrence, and transition probability are all extracted. The current study showed that the duration, coverage, and occurrence of microstate(Ms) B significantly increased in CI patients, but the duration and coverage of MsA and MsD decreased. Compared CI with vertigo to dizziness, finding a decreased trend in the coverage of MsD and the transition from MsA and MsB to MsD. Taken together, our study sheds new light on the dynamics of cerebral function after CI, mainly reflecting increased activity in functional networks involved in MsB and decreased activity in functional networks involved in MsA and MsD. Vertigo and dizziness post-CI may be suggested by cerebral functional dynamics. Further longitudinal studies are needed to validate and explore the alterations in brain dynamics to what extent depict the clinical traits and their potential applications in the recovery of CI.

Parameters of Auditory Evoked Related Potentials P300 in Disorders of Different Cognitive Function Domains (Visuospatial/Executive and Memory) in Elderly Hypertensive Persons

The neurophysiological correlates of certain types of cognitive impairment in relation to the spatial pattern of auditory cognitive evoked-related potentials (ERPs) in hypertensive persons remain unclear. The aim of this study was to determine the parameters of ERPs (N200, P300) in impaired different domains (visuospatial/executive and memory) of cognitive function in arterial hypertension, including cardiovascular ischemic events. A total of 46 patients (65-84 years) were observed. The clinical diagnosis of vascular dementia, the Montreal Cognitive Assessment Scale (MoCA test) and the spatial pattern of ERPs (N200, P300) were the parameters used to identify three groups: the Control Group without cognitive impairment (n = 13), the group with a leading memory disturbance (Memory Group, n = 20) and the group with a leading visuospatial/executive disturbance (VS/E Group, n = 13). In persons belonging to the Memory Group, N2 latency was prolonged in the central (C3 C4) and right parietal (P4) brain parts; latency of the motor component (P300) may remain similar to that of the ControlGroup. In persons belonging to theVS/E Group, maximal prolonged recognition time (N2), especially in the left central (C3), frontal-midline (Fz), right parietal (P3) and temporal (P4) brain parts, was observed; P300 latency in the central-midline (Cz) and left anterior-temporal (F7) brain parts among all the groups was revealed.

Assessing vestibular function using electroencephalogram rhythms evoked during the caloric test

Introduction

The vestibular system is responsible for motion perception and balance preservation in the body. The vestibular function examination is useful for determining the cause of associated symptoms, diagnosis, and therapy of the patients. The associated cerebral cortex processes and integrates information and is the ultimate perceptual site for vestibular-related symptoms. In recent clinical examinations, less consideration has been given to the cortex associated with the vestibular system. As a result, it is crucial to increase focus on the expression of the cortical level while evaluating vestibular function. From the viewpoint of neuroelectrophysiology, electroencephalograms (EEG) can enhance the assessments of vestibular function at the cortex level.

Methods

This study recorded nystagmus and EEG data throughout the caloric test. Four phases were considered according to the vestibular activation status: before activation, activation, fixation suppression, and recovery. In different phases, the distribution and changes of the relative power of the EEG rhythms (delta, theta, alpha, and beta) were analyzed, and the correlation between EEG characteristics and nystagmus was also investigated.

Results

The results showed that, when the vestibule was activated, the alpha power of the occipital region increased, and the beta power of the central and top regions and the occipital region on the left decreased. The changes in the alpha and beta rhythms significantly correlate with nystagmus values in left warm stimulation.

Discussion

Our findings offer a fresh perspective on cortical electrophysiology for the assessment of vestibular function by demonstrating that the relative power change in EEG rhythms can be used to assess vestibular function.

Neurometabolic correlates of posturography in normal aging and older adults with mild cognitive impairment: Evidence from a 1H-MRS study

Proton magnetic resonance spectroscopy (¹H-MRS) holds promise for revealing and understanding neurodegenerative processes associated with cognitive and functional impairments in aging. In the present study, we examined the neurometabolic correlates of balance performance in 42 cognitively intact older adults (healthy controls - HC) and 26 older individuals that were diagnosed with mild cognitive impairment (MCI). Neurometabolite ratios of total N-acetyl aspartate (tNAA), glutamate-glutamine complex (Glx), total choline (tCho) and myo-inositol (mIns) relative to total creatine (tCr) were assessed using single voxel ¹H-MRS in four different brain regions. Regions of interest were the left hippocampus (HPC), dorsal posterior cingulate cortex (dPCC), left sensorimotor cortex (SM1), and right dorsolateral prefrontal cortex (dlPFC). Center-of-pressure velocity (Vcop) and dual task effect (DTE) were used as measures of balance performance. Results indicated no significant group differences in neurometabolite ratios and balance performance measures. However, our observations revealed that higher tCho/tCr and mIns/tCr in hippocampus and dPCC were generic predictors of worse balance performance, suggesting that neuroinflammatory processes in these regions might be a driving factor for impaired balance performance in aging. Further, we found that higher tNAA/tCr and mIns/tCr and lower Glx/tCr in left SM1 were predictors of better balance performance in MCI but not in HC. The latter observation hints at the possibility that individuals with MCI may upregulate balance control through recruitment of sensorimotor pathways.

Recent developments in the understanding of the interactions between the vestibular system, memory, the hippocampus, and the striatum

Over the last two decades, evidence has accumulated to demonstrate that the vestibular system has extensive connections with areas of the brain related to spatial memory, such as the hippocampus, and also that it has significant interactions with areas associated with voluntary motor control, such as the striatum in the basal ganglia. In fact, these functions are far from separate and it is believed that interactions between the striatum and hippocampus are important for memory processing. The data relating to vestibular-hippocampal-striatal interactions have considerable implications for the understanding and treatment of Alzheimer's Disease and Parkinson's Disease, in addition to other neurological disorders. However, evidence is accumulating rapidly, and it is difficult to keep up with the latest developments in these and related areas. The aim of this review is to summarize and critically evaluate the relevant evidence that has been published over the last 2 years (i.e., since 2021), in order to identify emerging themes in this research area.