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Liu D, Wang J, Tian E, Chen J, Kong W, Lu Y, Zhang S. mGluR1/IP3/ERK signaling pathway regulates vestibular compensation in ON UBCs of the cerebellar flocculus. CNS Neurosci Ther 2024; 30:e14419. [PMID: 37622292 PMCID: PMC10848063 DOI: 10.1111/cns.14419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/16/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
AIMS To investigate the role of mGluR1α in cerebellar unipolar brush cells (UBC) in mediating vestibular compensation (VC), using mGluR1α agonist and antagonist to modulate ON UBC neurons, and explore the mGluR1/IP3/extracellular signal-regulated kinase (ERK) signaling pathway. METHODS First, AAV virus that knockdown ON UBC (mGluR1α) were injected into cerebellar UBC by stereotactic, and verified by immunofluorescence and western blot. The effect on VC was evaluated after unilateral labyrinthectomy (UL). Second, saline, (RS)-3,5-dihydroxyphenylglycine (DHPG), and LY367385 were injected into tubes implanted in rats at different time points after UL separately. The effect on ON UBC neuron activity was evaluated by immunofluorescence. Then, Phosphoinositide (PI) and p-ERK1/2 levels of mGluR1α were analyzed by ELISA after UL. The protein levels of p-ERK and total ERK were verified by western blot. In addition, the effect of mGluR1α activation or inhibition on VC-related behavior was observed. RESULTS mGluR1α knockdown induced VC phenotypes. DHPG increased ON UBC activity, while LY367385 reduced ON UBC activity. DHPG group showed an increase in PI and p-ERK1/2 levels, while LY367385 group showed a decrease in PI and p-ERK1/2 levels in cerebellar UBC of rats. The western blot results of p-ERK and total ERK confirm and support the observations. DHPG alleviated VC-related behavior phenotypes, while LY367385 exacerbated vestibular decompensation-like behavior induced by UL. CONCLUSION mGluR1α activity in cerebellar ON UBC is crucial for mediating VC through the mGluR1/IP3/ERK signaling pathway, which affects ON UBC neuron activity and contributes to the pathogenesis of VC.
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Affiliation(s)
- Dan Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - E. Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jingyu Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yisheng Lu
- Department of Physiology, School of Basic MedicineHuazhong University of Science and TechnologyWuhanChina
- Institute of Brain Research, Collaborative Innovation Center for Brain ScienceHuazhong University of Science and TechnologyWuhanChina
| | - Sulin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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de Sousa FA, Alves CS, Pinto AN, Meireles L, Rego ÂR. Pharmacological Treatment of Acute Unilateral Vestibulopathy: A Review. J Audiol Otol 2024; 28:18-28. [PMID: 37953517 PMCID: PMC10808386 DOI: 10.7874/jao.2023.00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 11/14/2023] Open
Abstract
There have been few investigations on the epidemiology, etiology, and medical management of acute unilateral vestibulopathy (AUV). Short-term pharmaceutical resolutions include vestibular symptomatic suppressants, anti-emetics, and some cause-based therapies. Anticholinergics, phenothiazines, antihistamines, antidopaminergics, benzodiazepines, and calcium channel antagonists are examples of vestibular suppressants. Some of these medications may show their effects through multiple mechanisms. In contrast, N-acetyl-L-leucine, Ginkgo biloba, and betahistine improve central vestibular compensation. Currently, AUV pathophysiology is poorly understood. Diverse hypotheses have previously been identified which have brought about some causal treatments presently used. According to some publications, acute administration of anti-inflammatory medications may have a deleterious impact on both post-lesional functional recovery and endogenous adaptive plasticity processes. Thus, some authors do not recommend the use of corticosteroids in AUV. Antivirals are even more contentious in the context of AUV treatment. Although vascular theories have been presented, no verified investigations employing anti-clotting or vasodilator medications have been conducted. There are no standardized treatment protocols for AUV to date, and the pharmacological treatment of AUV is still questionable. This review addresses the most current developments and controversies in AUV medical treatment.
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Affiliation(s)
- Francisco Alves de Sousa
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Clara Serdoura Alves
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Nóbrega Pinto
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Meireles
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ângela Reis Rego
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
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Antons M, Lindner M, Eilles E, Günther L, Delker A, Branner C, Krämer A, Beck R, Oos R, Wuehr M, Ziegler S, Strupp M, Zwergal A. Dose- and application route-dependent effects of betahistine on behavioral recovery and neuroplasticity after acute unilateral labyrinthectomy in rats. Front Neurol 2023; 14:1175481. [PMID: 37538257 PMCID: PMC10395078 DOI: 10.3389/fneur.2023.1175481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/28/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Betahistine is widely used for the treatment of various vestibular disorders. However, the approved oral administration route and maximum daily dose are evidently not effective in clinical trials, possibly due to a major first-pass metabolism by monoamine oxidases (MAOs). The current study aimed to test different application routes (i.v./s.c./p.o.), doses, and concurrent medication (with the MAO-B inhibitor selegiline) for their effects on behavioral recovery and cerebral target engagement following unilateral labyrinthectomy (UL) in rats. Methods Sixty rats were subjected to UL by transtympanic injection of bupivacaine/arsanilic acid and assigned to five treatment groups: i.v. low-dose betahistine (1 mg/kg bid), i.v. high-dose betahistine (10 mg/kg bid), p.o. betahistine (1 mg/kg bid)/selegiline (1 mg/kg once daily), s.c. betahistine (continuous release of 4.8 mg/day), and i.v. normal saline bid (sham treatment; days 1-3 post-UL), respectively. Behavioral testing of postural asymmetry, nystagmus, and mobility in an open field was performed seven times until day 30 post-UL and paralleled by sequential cerebral [18F]-FDG-μPET measurements. Results The therapeutic effects of betahistine after UL differed in extent and time course and were dependent on the dose, application route, and selegiline co-medication: Postural asymmetry was significantly reduced on 2-3 days post-UL by i.v. high-dose and s.c. betahistine only. No changes were observed in the intensity of nystagmus across groups. When compared to sham treatment, movement distance in the open field increased up to 5-fold from 2 to 30 days post-UL in the s.c., i.v. high-dose, and p.o. betahistine/selegiline groups. [18F]-FDG-μPET showed a dose-dependent rCGM increase in the ipsilesional vestibular nucleus until day 3 post-UL for i.v. high- vs. low-dose betahistine and sham treatment, as well as for p.o. betahistine/selegiline and s.c. betahistine vs. sham treatment. From 1 to 30 days post-UL, rCGM increased in the thalamus bilaterally for i.v. high-dose betahistine, s.c. betahistine, and p.o. betahistine/selegiline vs. saline treatment. Discussion Betahistine has the potential to augment the recovery of dynamic deficits after UL if the administration protocol is optimized toward higher effective plasma levels. This may be achieved by higher doses, inhibition of MAO-based metabolism, or a parenteral route. In vivo imaging suggests a drug-target engagement in central vestibular networks.
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Affiliation(s)
- Melissa Antons
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
| | - Magdalena Lindner
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva Eilles
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lisa Günther
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
| | - Astrid Delker
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christina Branner
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anja Krämer
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
| | - Roswitha Beck
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
| | - Rosel Oos
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Max Wuehr
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sibylle Ziegler
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michael Strupp
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Andreas Zwergal
- German Center for Vertigo and Balance Disorders, DSGZ, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
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Liu D, Wang J, Zhou L, Tian E, Chen J, Kong W, Lu Y, Zhang S. Differential Modulation of Cerebellar Flocculus Unipolar Brush Cells during Vestibular Compensation. Biomedicines 2023; 11:biomedicines11051298. [PMID: 37238967 DOI: 10.3390/biomedicines11051298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Vestibular compensation is a natural behavioral recovery process following unilateral vestibular injury. Understanding the mechanism can considerably enhance vestibular disorder therapy and advance the adult central nervous system functional plasticity study after injury. The cerebellum, particularly the flocculonodular lobe, tightly modulates the vestibular nucleus, the center for vestibular compensation; however, it is still unclear if the flocculus on both sides is involved in vestibular compensation. Here we report that the unipolar brush cells (UBCs) in the flocculus are modulated by unilateral labyrinthectomy (UL). UBCs are excitatory interneurons targeting granule cells to provide feedforward innervation to the Purkinje cells, the primary output neurons in the cerebellum. According to the upregulated or downregulated response to the mossy fiber glutamatergic input, UBC can be classified into ON and OFF forms of UBCs. Furthermore, we discovered that the expression of marker genes of ON and OFF UBCs, mGluR1α and calretinin, was increased and decreased, respectively, only in ipsilateral flocculus 4-8 h after UL. According to further immunostaining studies, the number of ON and OFF UBCs was not altered during UL, demonstrating that the shift in marker gene expression level in the flocculus was not caused by the transformation of cell types between UBCs and non-UBCs. These findings imply the importance of ipsilateral flocculus UBCs in the acute response of UL, and ON and OFF UBCs may be involved in vestibular compensation in opposite directions.
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Affiliation(s)
- Dan Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Liuqing Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - E Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jingyu Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yisheng Lu
- Department of Physiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Sulin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Abouzari M, Tawk K, Lee D, Djalilian HR. Migrainous Vertigo, Tinnitus, and Ear Symptoms and Alternatives. Otolaryngol Clin North Am 2022; 55:1017-1033. [PMID: 36150941 PMCID: PMC9580398 DOI: 10.1016/j.otc.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Migraine headaches frequently coexist with vestibular symptoms such as vertigo, motion sickness, and gait instability. Migraine-related vasospasm can also damage the inner ear, which results in symptoms such as sudden sensorineural hearing loss and resultant tinnitus. The pathophysiology of these symptoms is not yet fully understood, and despite their prevalence, there is no universally approved management. This review summarizes the data on complementary and integrative medicine in treating patients with migrainous ear disorders.
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Affiliation(s)
- Mehdi Abouzari
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, 19182 Jamboree Road, Otolaryngology-5386, Irvine, CA 92697, USA
| | - Karen Tawk
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, 19182 Jamboree Road, Otolaryngology-5386, Irvine, CA 92697, USA
| | - Darlene Lee
- Susan Samueli Integrative Health Institute, University of California, 5141 California Avenue, Suite 200B, Irvine, CA 92617, USA
| | - Hamid R Djalilian
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, 19182 Jamboree Road, Otolaryngology-5386, Irvine, CA 92697, USA; Department of Biomedical Engineering, University of California, Irvine, USA.
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姜 梦, 席 恺. [Advances in vestibular rehabilitation in the treatment of peripheral vestibular vertigo]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:566-570. [PMID: 35822389 PMCID: PMC10128387 DOI: 10.13201/j.issn.2096-7993.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Indexed: 04/30/2023]
Abstract
The attack of vertigo and balance disorder affects individual quality of life among all age, while brings high medical burden. Vestibular rehabilitation plays an important role in the treatment for balance disorder. Early active and systematic rehabilitation treatment will be more conducive to symptom relief, functional recovery, and prevent the occurrence of chronic vestibular syndrome. There were no criteria for the methods, influencing factors and evaluation of vestibular rehabilitation in the treatment of peripheral vestibular vertigo yet, and the clinical application is diversified. This paper reviewed and summarized the related studies of vestibular rehabilitation in peripheral vestibular vertigo in recent years.
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Affiliation(s)
- 梦莎 姜
- 河南科技大学临床医学院 河南科技大学第一附属医院耳鼻咽喉头颈外科(河南洛阳,471003)Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
| | - 恺 席
- 河南科技大学临床医学院 河南科技大学第一附属医院耳鼻咽喉头颈外科(河南洛阳,471003)Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China
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Zwergal A, Lindner M, Grosch M, Dieterich M. In vivo neuroplasticity in vestibular animal models. Mol Cell Neurosci 2022; 120:103721. [PMID: 35338004 DOI: 10.1016/j.mcn.2022.103721] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 12/21/2022] Open
Abstract
An acute unilateral vestibulopathy leads to symptoms of vestibular tone imbalance, which gradually decrease over days to weeks due to central vestibular compensation. Animal models of acute peripheral vestibular lesions are optimally suited to investigate the mechanisms underlying this lesion-induced adaptive neuroplasticity. Previous studies applied ex vivo histochemical techniques or local in vivo electrophysiological recordings mostly in the vestibular nucleus complex to delineate the mechanisms involved. Recently, the use of imaging methods, such as positron emission tomography (PET) or magnetic resonance imaging (MRI), in vestibular animal models have opened a complementary perspective by depicting whole-brain structure and network changes of neuronal activity over time and in correlation to behaviour. Here, we review recent multimodal imaging studies in vestibular animal models with a focus on PET-based measurements of glucose metabolism, glial activation and synaptic plasticity. [18F]-FDG-PET studies indicate dynamic alterations of regional glucose metabolism in brainstem-cerebellar, thalamic, cortical sensory and motor, as well as limbic areas starting early after unilateral labyrinthectomy (UL) in the rat. Sequential whole-brain analysis of the metabolic connectome during vestibular compensation shows a significant increase of connections mostly in the contralesional hemisphere after UL, which reaches a maximum at day 3 and thereby parallels the course of vestibular recovery. Glial activation in the ipsilesional vestibular nerve and nucleus peak between days 7 and 15 after UL. Synaptic density in brainstem-cerebellar circuits decreases until 8 weeks after UL, while it increases in frontal, motor and sensory cortical areas. We finally report how pharmacological compounds modulate the functional and structural plasticity mechanisms during vestibular compensation.
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Affiliation(s)
- Andreas Zwergal
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders, DSGZ, LMU Munich, Germany.
| | - Magdalena Lindner
- German Center for Vertigo and Balance Disorders, DSGZ, LMU Munich, Germany; Department of Nuclear Medicine, LMU Munich, Germany
| | - Maximilian Grosch
- German Center for Vertigo and Balance Disorders, DSGZ, LMU Munich, Germany
| | - Marianne Dieterich
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders, DSGZ, LMU Munich, Germany; Munich Cluster of Systems Neurology, SyNergy, Munich, Germany
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Decker L, Basta D, Burkart M, Ernst A. Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo. Front Neurol 2021; 12:691917. [PMID: 34917009 PMCID: PMC8669892 DOI: 10.3389/fneur.2021.691917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 11/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Balance training with vibrotactile neurofeedback (VNF) can improve balance and subjective impairment in age-related vertigo and dizziness. Ginkgo biloba dry extract EGb 761 has been shown to improve subjective impairment in chronic vertigo and the efficacy of conventional balance training. The combination was expected to work synergistically in this difficult-to-treat population.Objectives: To demonstrate the efficacy of VNF added to EGb 761 for age-related vertigo and dizziness.Design: Multicenter, prospective, controlled, randomized, single-blind, two-arm trial (German Clinical Trials Register https://www.drks.de No. DRKS00007633).Setting: Specialist offices and tertiary care outpatient department.Participants: One hundred and twenty subjects aged 60+ years with chronic dizziness for over 3 months, a Dizziness Handicap Inventory (DHI) Sum Score >25 and fall risk in balance-related situations as measured by the geriatric Standard Balance Deficit Test Composite Score (gSBDT-CS)>40. Patients with other distinct vestibular pathology (e.g., Meniére's disease, stroke, BPPV) were excluded.Intervention: EGb 761 (80 mg twice daily for 12 weeks) plus 10 days of individually adapted balance training with VNF, randomized 1:1 to sensitive (active) or non-sensitive (sham) neurofeedback.Measurements: The change in gSBDT-CS after 6 weeks (primary), other gSBDT outcomes, DHI, cognition, hearing, and safety.Results: One hundred nine of 120 enrolled subjects received both treatments at least once. Over 12 weeks, the gSBDT-CS improved by 6.7 (active) vs. 4.5 (sham). There was a difference in favor of the active treatment of −2.4 (95% CI −5.4; 0.6) after 6 weeks. Under active treatment, more pronounced effects occurred in all secondary analyses and in nearly all secondary endpoints. The DHI sum score decreased from 44.1 to 31.1 in the total sample with a treatment group difference after 6 weeks of −3.1, 95% CI (−7.1; 0.9). No safety issues were reported.Conclusion: Over 12 weeks, the combination of balance training with VNF and Ginkgo biloba dry extract EGb 761 reached a clinically relevant improvement of age-related vertigo and dizziness with a good pharmacological safety profile.
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Affiliation(s)
- Lars Decker
- Department of Otolaryngology, Unfallkrankenhaus Berlin, Hospital of the University of Berlin, Charité Medical School, Berlin, Germany
| | - Dietmar Basta
- Department of Otolaryngology, Unfallkrankenhaus Berlin, Hospital of the University of Berlin, Charité Medical School, Berlin, Germany
| | | | - Arne Ernst
- Department of Otolaryngology, Unfallkrankenhaus Berlin, Hospital of the University of Berlin, Charité Medical School, Berlin, Germany
- *Correspondence: Arne Ernst
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Nowak A, Kojder K, Zielonka-Brzezicka J, Wróbel J, Bosiacki M, Fabiańska M, Wróbel M, Sołek-Pastuszka J, Klimowicz A. The Use of Ginkgo Biloba L. as a Neuroprotective Agent in the Alzheimer's Disease. Front Pharmacol 2021; 12:775034. [PMID: 34803717 PMCID: PMC8599153 DOI: 10.3389/fphar.2021.775034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/22/2021] [Indexed: 12/19/2022] Open
Abstract
Alzheimer's disease, a neurodegenerative disease, is one of the most common causes of dementia if elderly people worldwide. Alzheimer's disease leads to the alienation of individuals and their exclusion from social and professional life. It is characterized mainly by the degradation of memory and disorientation, which occurs as a result of the loss of neuronal structure and function in different brain areas. In recent years, more and more attention has been paid to use in the treatment of natural bioactive compounds that will be effective in neurodegenerative diseases, including Alzheimer's disease. G. biloba L. and its most frequently used standardized extract (EGb 761), have been used for many years in supportive therapy and in the prevention of cognitive disorders. The paper presents an overview of reports on the pathogenesis of Alzheimer's disease, as well as a summary of the properties of G. biloba extract and its effects on the possible pathogenesis of the disease. By exploring more about the pathogenesis of the disease and the benefits of G. biloba extract for patients with Alzheimer's disease, it will be possible to create an individualized therapeutic protocol to optimize the treatment.
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Affiliation(s)
- Anna Nowak
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Klaudyna Kojder
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Joanna Zielonka-Brzezicka
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jacek Wróbel
- Department of Bioengineering, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Mateusz Bosiacki
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marta Fabiańska
- Institute of Philosophy and Cognitive Science, University of Szczecin, Szczecin, Poland
| | - Mariola Wróbel
- Department of Landscape Architecture, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Joanna Sołek-Pastuszka
- Department of Anesthesiology and Intensive Care, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Adam Klimowicz
- Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Abstract
Medical therapies for dizziness are aimed at vertigo reduction, secondary symptom management, or the root cause of the pathologic process. Acute peripheral vertigo pharmacotherapies include antihistamines, calcium channel blockers, and benzodiazepines. Prophylactic pharmacotherapies vary between causes. For Meniere disease, betahistine and diuretics remain initial first-line oral options, whereas intratympanic steroids and intratympanic gentamicin are reserved for uncontrolled symptoms. For cerebellar dizziness and oculomotor disorders, 4-aminopyridine may provide benefit. For vestibular migraine, persistent postural perceptual dizziness and mal de débarquement, treatment options overlap and include selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants and calcium channel blockers.
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Affiliation(s)
- Mallory J Raymond
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue MSC 550, 11th Floor, Charleston, SC 29425, USA
| | - Esther X Vivas
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, 550 Peachtree Street Northeast, 11th Floor, Atlanta, GA 30308, USA.
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11
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El Mahmoudi N, Rastoldo G, Marouane E, Péricat D, Watabe I, Tonetto A, Hautefort C, Chabbert C, Sargolini F, Tighilet B. Breaking a dogma: acute anti-inflammatory treatment alters both post-lesional functional recovery and endogenous adaptive plasticity mechanisms in a rodent model of acute peripheral vestibulopathy. J Neuroinflammation 2021; 18:183. [PMID: 34419105 PMCID: PMC8380392 DOI: 10.1186/s12974-021-02222-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Due to their anti-inflammatory action, corticosteroids are the reference treatment for brain injuries and many inflammatory diseases. However, the benefits of acute corticotherapy are now being questioned, particularly in the case of acute peripheral vestibulopathies (APV), characterized by a vestibular syndrome composed of sustained spinning vertigo, spontaneous ocular nystagmus and oscillopsia, perceptual-cognitive, posturo-locomotor, and vegetative disorders. We assessed the effectiveness of acute corticotherapy, and the functional role of acute inflammation observed after sudden unilateral vestibular loss. METHODS We used the rodent model of unilateral vestibular neurectomy, mimicking the syndrome observed in patients with APV. We treated the animals during the acute phase of the vestibular syndrome, either with placebo or methylprednisolone, an anti-inflammatory corticosteroid. At the cellular level, impacts of methylprednisolone on endogenous plasticity mechanisms were assessed through analysis of cell proliferation and survival, glial reactions, neuron's membrane excitability, and stress marker. At the behavioral level, vestibular and posturo-locomotor functions' recovery were assessed with appropriate qualitative and quantitative evaluations. RESULTS We observed that acute treatment with methylprednisolone significantly decreases glial reactions, cell proliferation and survival. In addition, stress and excitability markers were significantly impacted by the treatment. Besides, vestibular syndrome's intensity was enhanced, and vestibular compensation delayed under acute methylprednisolone treatment. CONCLUSIONS We show here, for the first time, that acute anti-inflammatory treatment alters the expression of the adaptive plasticity mechanisms in the deafferented vestibular nuclei and generates enhanced and prolonged vestibular and postural deficits. These results strongly suggest a beneficial role for acute endogenous neuroinflammation in vestibular compensation. They open the way to a change in dogma for the treatment and therapeutic management of vestibular patients.
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Affiliation(s)
- Nada El Mahmoudi
- Aix-Marseille Université-CNRS, Laboratoire de Neurosciences Cognitives, LNC UMR 7291, Centre Saint Charles, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
- Centre Saint-Charles, Aix-Marseille Université CNRS, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
| | - Guillaume Rastoldo
- Aix-Marseille Université-CNRS, Laboratoire de Neurosciences Cognitives, LNC UMR 7291, Centre Saint Charles, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
- Centre Saint-Charles, Aix-Marseille Université CNRS, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
| | - Emna Marouane
- Aix-Marseille Université-CNRS, Laboratoire de Neurosciences Cognitives, LNC UMR 7291, Centre Saint Charles, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
- Centre Saint-Charles, Aix-Marseille Université CNRS, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
| | - David Péricat
- Institut de Pharmacologie Et de Biologie Structurale, Université de Toulouse Paul Sabatier-CNRS, Toulouse, France
| | - Isabelle Watabe
- Aix-Marseille Université-CNRS, Laboratoire de Neurosciences Cognitives, LNC UMR 7291, Centre Saint Charles, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
- Centre Saint-Charles, Aix-Marseille Université CNRS, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
| | - Alain Tonetto
- Centrale Marseille, FSCM (FR 1739), PRATIM, Aix Marseille Université-CNRS, 13397, Marseille, France
| | - Charlotte Hautefort
- Department of Head and Neck Surgery, Lariboisière University Hospital, Paris, France
| | - Christian Chabbert
- Aix-Marseille Université-CNRS, Laboratoire de Neurosciences Cognitives, LNC UMR 7291, Centre Saint Charles, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
- Centre Saint-Charles, Aix-Marseille Université CNRS, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
- GDR Physiopathologie Vestibulaire-Unité GDR2074 CNRS, Marseille, France
| | - Francesca Sargolini
- Aix-Marseille Université-CNRS, Laboratoire de Neurosciences Cognitives, LNC UMR 7291, Centre Saint Charles, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France
| | - Brahim Tighilet
- Aix-Marseille Université-CNRS, Laboratoire de Neurosciences Cognitives, LNC UMR 7291, Centre Saint Charles, Case C; 3 Place Victor Hugo, 13331, Marseille Cedex 03, France.
- GDR Physiopathologie Vestibulaire-Unité GDR2074 CNRS, Marseille, France.
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12
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Ding CR, Gao YQ, Zhou YJ, Gu J, Wang J. Advantages of Short-term Personalized Vestibular Rehabilitation at Home Guided by Professional Therapist for Treatment of Decompensated Vestibular Vertigo. Curr Med Sci 2021; 41:687-694. [PMID: 34403093 DOI: 10.1007/s11596-021-2420-4] [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] [Received: 05/14/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Patients suffered a lot from decompensated vestibular vertigo. Pharmacotherapy and vestibular rehabilitation training have been proven to be effective in prompting vestibular compensation. Routine rehabilitation training is faced with the challenges of patients' compliance, completion, the average recuperation time and so on. This study is aimed to investigate advantages of short-term personalized vestibular rehabihitation at home guided by professional therapist. METHODS A short-term personalized vestibular rehabilitation program (ST-PVR) was designed for patients with decompensated vestibular vertigo in this study. RESULTS Patients experiencing the ST-PVR program showed significant improvement of Self-Rating Anxiety Scale (SAS), Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence Scale (ABC) scores by the second follow-up (at 2nd week after treatment, P<0.05). However-improvement in the medication group occurred slightly later, DHI for 1 month and SAS for 2 months after treatment (P<0.05). Also, the improvement in the onset time of unilateral weakness (UW) at 2nd week after treatment in the personalized vestibular rehabilitation (PVR) group was faster than that in the medication group. CONCLUSION In general, the short-term PVR program showed great advantages by prompting vestibular compensation quickly and putting forward future direction for clinical treatment on decompensated vestibular vertigo.
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Affiliation(s)
- Chen-Ru Ding
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Ying-Qi Gao
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Yu-Juan Zhou
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Jun Gu
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Jing Wang
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China. .,Shanghai Auditory Medical Center, Shanghai, 200031, China. .,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China.
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13
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Abstract
The number of older people has been increasing over recent decades in Western populations. Dizziness, imbalance, and vertigo constitute some of the most common complaints in older patients, and risk of falling is the most frequent and worrying consequence. It has been reported that 15–20% of the adult population experiences these debilitating symptoms. Among the diseases that may be associated with vertigo, the three classes of otological, central, and functional (psychological) dizziness may be distinguished. Overall, vestibular disorders account for 48% of vertiginous complaints in the older population. The main focus of this article is to review the forms of pharmacotherapy for vertigo, especially with regard to older patients, who may be treated simultaneously with other drugs for different comorbidities. Interactions with other drugs should be considered in the choice of a particular course of treatment. Moreover, overuse of pharmacotherapy for the management of vertigo in the elderly may prevent the development of the central compensatory mechanism that sustains both static and dynamic imbalance after a vertiginous crisis. In the majority of patients, vestibular and physical rehabilitation are strongly advised and rarely contraindicated.
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14
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Xie L, Zhang T, Zheng L, Xie D, Jin J, Wang X, Jin Q. Chemical Compositions and Oxidative Stabilities of
Ginkgo biloba
Kernel Oils from Four Cultivated Regions in China. J AM OIL CHEM SOC 2021. [DOI: 10.1002/aocs.12474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Liangliang Xie
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, National Engineering Research Center for Functional Food, School of Food Science and Technology Jiangnan University Wuxi Jiangsu 214122 China
- College of Biological and Chemical Engineering Anhui Polytechnic University Wuhu 241000 China
| | - Tao Zhang
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, National Engineering Research Center for Functional Food, School of Food Science and Technology Jiangnan University Wuxi Jiangsu 214122 China
| | - Liyou Zheng
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, National Engineering Research Center for Functional Food, School of Food Science and Technology Jiangnan University Wuxi Jiangsu 214122 China
| | - Dan Xie
- College of Biological and Chemical Engineering Anhui Polytechnic University Wuhu 241000 China
| | - Jun Jin
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, National Engineering Research Center for Functional Food, School of Food Science and Technology Jiangnan University Wuxi Jiangsu 214122 China
| | - Xingguo Wang
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, National Engineering Research Center for Functional Food, School of Food Science and Technology Jiangnan University Wuxi Jiangsu 214122 China
| | - Qingzhe Jin
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, National Engineering Research Center for Functional Food, School of Food Science and Technology Jiangnan University Wuxi Jiangsu 214122 China
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15
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Grosch M, Beyer L, Lindner M, Kaiser L, Ahmadi SA, Stockbauer A, Bartenstein P, Dieterich M, Brendel M, Zwergal A, Ziegler S. Metabolic connectivity-based single subject classification by multi-regional linear approximation in the rat. Neuroimage 2021; 235:118007. [PMID: 33831550 DOI: 10.1016/j.neuroimage.2021.118007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022] Open
Abstract
Metabolic connectivity patterns on the basis of [18F]-FDG positron emission tomography (PET) are used to depict complex cerebral network alterations in different neurological disorders and therefore may have the potential to support diagnostic decisions. In this study, we established a novel statistical classification method taking advantage of differential time-dependent states of whole-brain metabolic connectivity following unilateral labyrinthectomy (UL) in the rat and explored its classification accuracy. The dataset consisted of repeated [18F]-FDG PET measurements at baseline and 1, 3, 7, and 15 days (= maximum of 5 classes) after UL with 17 rats per measurement day. Classification in different stages after UL was performed by determining connectivity patterns for the different classes by Pearson's correlation between uptake values in atlas-based segmented brain regions. Connections were fitted with a linear function, with which different thresholds on the correlation coefficient (r = [0.5, 0.85]) were investigated. Rats were classified by determining the congruence of their PET uptake pattern with the fitted connectivity patterns in the classes. Overall, the classification accuracy with this method was 84.3% for 3 classes, 75.0% for 4 classes, and 54.1% for 5 classes and outperformed random classification as well as machine learning classification on the same dataset. The optimal classification thresholds of the correlation coefficient and distance-to-fit were found to be |r| > 0.65 and d = 4 when using Siegel's slope estimator for fitting. This connectivity-based classification method can compete with machine learning classification and may have methodological advantages when applied to support PET-based diagnostic decisions in neurological network disorders (such as neurodegenerative syndromes).
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Affiliation(s)
- Maximilian Grosch
- German Center for Vertigo and Balance Disorders, DSGZ, University Hospital, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, Germany; Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany.
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany
| | - Magdalena Lindner
- German Center for Vertigo and Balance Disorders, DSGZ, University Hospital, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, Germany; Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany
| | - Lena Kaiser
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany
| | - Seyed-Ahmad Ahmadi
- German Center for Vertigo and Balance Disorders, DSGZ, University Hospital, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, Germany
| | - Anna Stockbauer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany; Munich Cluster of Systems Neurology, SyNergy, Munich, Germany
| | - Marianne Dieterich
- German Center for Vertigo and Balance Disorders, DSGZ, University Hospital, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, Germany; Department of Neurology, University Hospital, LMU Munich, Munich, Germany; Munich Cluster of Systems Neurology, SyNergy, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany; Munich Cluster of Systems Neurology, SyNergy, Munich, Germany
| | - Andreas Zwergal
- German Center for Vertigo and Balance Disorders, DSGZ, University Hospital, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, D-81377 Munich, Germany; Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Sibylle Ziegler
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich Germany
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16
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Dynamic whole-brain metabolic connectivity during vestibular compensation in the rat. Neuroimage 2020; 226:117588. [PMID: 33249212 DOI: 10.1016/j.neuroimage.2020.117588] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/05/2020] [Accepted: 11/19/2020] [Indexed: 12/16/2022] Open
Abstract
Unilateral damage to the inner ear results in an acute vestibular syndrome, which is compensated within days to weeks due to adaptive cerebral plasticity. This process, called central vestibular compensation (VC), involves a wide range of functional and structural mechanisms at the cellular and network level. The short-term dynamics of whole-brain functional network recruitment and recalibration during VC has not been depicted in vivo. The purpose of this study was to investigate the interplay of separate and distinct brain regions and in vivo networks in the course of VC by sequential [18F]-FDG-PET-based statistical and graph theoretical analysis with the aim of revealing the metabolic connectome before and 1, 3, 7, and 15 days post unilateral labyrinthectomy (UL) in the rat. Temporal changes in metabolic brain connectivity were determined by Pearson's correlation (|r| > 0.5, p < 0.001) of regional cerebral glucose metabolism (rCGM) in 57 segmented brain regions. Metabolic connectivity analysis was compared to univariate voxel-wise statistical analysis of rCGM over time and to behavioral scores of static and dynamic sensorimotor recovery. Univariate statistical analysis revealed an ipsilesional relative rCGM decrease (compared to baseline) and a contralesional rCGM increase in vestibular and limbic networks and an increase in bilateral cerebellar and sensorimotor networks. Quantitative analysis of the metabolic connections showed a maximal increase from baseline to day 3 post UL (interhemispheric: 2-fold, ipsilesional: 3-fold, contralesional: 12-fold) and a gradual decline until day 15 post UL, which paralleled the dynamics of vestibular symptoms. In graph theoretical analysis, an increase in connectivity occurred especially within brain regions associated with brainstem-cerebellar and thalamocortical vestibular networks and cortical sensorimotor networks. At the symptom peak (day 3 post UL), brain networks were found to be organized in large ensembles of distinct and highly connected hubs of brain regions, which separated again with progressing VC. Thus, we found rapid changes in network organization at the subcortical and cortical level and in both hemispheres, which may indicate an initial functional substitution of vestibular loss and subsequent recalibration and reorganization of sensorimotor networks during VC.
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17
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Rastoldo G, Marouane E, El Mahmoudi N, Péricat D, Bourdet A, Timon-David E, Dumas O, Chabbert C, Tighilet B. Quantitative Evaluation of a New Posturo-Locomotor Phenotype in a Rodent Model of Acute Unilateral Vestibulopathy. Front Neurol 2020; 11:505. [PMID: 32582016 PMCID: PMC7291375 DOI: 10.3389/fneur.2020.00505] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022] Open
Abstract
Vestibular pathologies are difficult to diagnose. Existing devices make it possible to quantify and follow the evolution of posturo-locomotor symptoms following vestibular loss in static conditions. However, today, there are no diagnostic tools allowing the quantitative and spontaneous analysis of these symptoms in dynamic situations. With this in mind, we used an open-field video tracking test aiming at identifying specific posturo-locomotor markers in a rodent model of vestibular pathology. Using Ethovision XT 14 software (Noldus), we identified and quantified several behavioral parameters typical of unilateral vestibular lesions in a rat model of vestibular pathology. The unilateral vestibular neurectomy (UVN) rat model reproduces the symptoms of acute unilateral peripheral vestibulopathy in humans. Our data show deficits in locomotion velocity, distance traveled and animal mobility in the first day after the injury. We also highlighted alterations in several parameters, such as head and body acceleration, locomotor pattern, and position of the body, as well as “circling” behavior after vestibular loss. Here, we provide an enriched posturo-locomotor phenotype specific to full and irreversible unilateral vestibular loss. This test helps to strengthen the quantitative evaluation of vestibular disorders in unilateral vestibular lesion rat model. It may also be useful for testing pharmacological compounds promoting the restoration of balance. Transfer of these novel evaluation parameters to human pathology may improve the diagnosis of acute unilateral vestibulopathies and could better follow the evolution of the symptoms upon pharmacological and physical rehabilitation.
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Affiliation(s)
- Guillaume Rastoldo
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
| | - Emna Marouane
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
| | - Nada El Mahmoudi
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
| | - David Péricat
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
| | - Audrey Bourdet
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
| | - Elise Timon-David
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
| | - Olivier Dumas
- Société Française de Kinésithérapie Vestibulaire, Lyon, France
| | - Christian Chabbert
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
| | - Brahim Tighilet
- Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Groupe de Recherche Vertige (GDR#2074), Marseille, France
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18
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Guajardo‐Vergara C, Perez‐Fernandez N. A New and Faster Method to Assess Vestibular Compensation: A Cross‐Sectional Study. Laryngoscope 2020; 130:E911-E917. [DOI: 10.1002/lary.28505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Carlos Guajardo‐Vergara
- Department of Otorhinolaryngology Clínica Universidad de Navarra Pamplona Spain
- Escuela de Fonoaudiología, Universidad Austral de Chile Sede Puerto Montt Chile
| | - Nicolas Perez‐Fernandez
- Department of Otorhinolaryngology Clínica Universidad de Navarra Madrid Spain
- Research Group Interdisciplinar Theragnosis and Radiosomics, University of Navarra Madrid Spain
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Zwergal A, Strupp M, Brandt T. Advances in pharmacotherapy of vestibular and ocular motor disorders. Expert Opin Pharmacother 2019; 20:1267-1276. [PMID: 31030580 DOI: 10.1080/14656566.2019.1610386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Vertigo and dizziness are common chief complaints of vestibular and ocular motor disorders (lifetime prevalence 30%). Treatment relies on physical, pharmacological, psychological and rarely surgical approaches. Eight groups of drugs are currently used in vestibular and ocular motor disorders, namely anti-vertiginous, anti-inflammatory, anti-menière's, anti-migrainous medications, anti-depressants, anti-convulsants, aminopyridines and agents that enhance vestibular plasticity. AREAS COVERED The purpose of this review is to summarize the pharmacological characteristics and clinical applications of medications that are used for peripheral, central and functional vestibular and ocular motor disorders. The level of evidence for the respective drugs is described alongside the pathophysiological premises supporting their use. The authors place particular focus on translation and back-translation in vestibular pharmacological research and the repurposing of known drugs for new indications and rare disorders. EXPERT OPINION The use of drugs in vestibular and ocular motor disorders is often based on open-label, non-controlled studies and expert opinion. In the future, strong evidence derived from RCTs is needed to support the effectiveness and tolerability of these therapies in well-defined vestibular and ocular motor disorders. Vestibular pharmacological research must be guided by a better understanding of the molecular targets relevant in the pathophysiology of vestibular and ocular motor disorders.
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Affiliation(s)
- Andreas Zwergal
- a Department of Neurology , University Hospital LMU , Munich , Germany.,b German Center for Vertigo and Balance Disorders , DSGZ, LMU Munich , Munich , Germany
| | - Michael Strupp
- a Department of Neurology , University Hospital LMU , Munich , Germany.,b German Center for Vertigo and Balance Disorders , DSGZ, LMU Munich , Munich , Germany
| | - Thomas Brandt
- b German Center for Vertigo and Balance Disorders , DSGZ, LMU Munich , Munich , Germany.,c Clinical Neurosciences , LMU Munich , Munich , Germany
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