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Geno O, Critelli K, Arduino C, Crane BT, Anson E. Psychometrics of inertial heading perception. J Vestib Res 2024:VES230077. [PMID: 38640182 DOI: 10.3233/ves-230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
BACKGROUND Inertial self-motion perception is thought to depend primarily on otolith cues. Recent evidence demonstrated that vestibular perceptual thresholds (including inertial heading) are adaptable, suggesting novel clinical approaches for treating perceptual impairments resulting from vestibular disease. OBJECTIVE Little is known about the psychometric properties of perceptual estimates of inertial heading like test-retest reliability. Here we investigate the psychometric properties of a passive inertial heading perceptual test. METHODS Forty-seven healthy subjects participated across two visits, performing in an inertial heading discrimination task. The point of subjective equality (PSE) and thresholds for heading discrimination were identified for the same day and across day tests. Paired t-tests determined if the PSE or thresholds significantly changed and a mixed interclass correlation coefficient (ICC) model examined test-retest reliability. Minimum detectable change (MDC) was calculated for PSE and threshold for heading discrimination. RESULTS Within a testing session, the heading discrimination PSE score test-retest reliability was good (ICC = 0. 80) and did not change (t(1,36) = -1.23, p = 0.23). Heading discrimination thresholds were moderately reliable (ICC = 0.67) and also stable (t(1,36) = 0.10, p = 0.92). Across testing sessions, heading direction PSE scores were moderately correlated (ICC = 0.59) and stable (t(1,46) = -0.44, p = 0.66). Heading direction thresholds had poor reliability (ICC = 0.03) and were significantly smaller at the second visit (t(1,46) = 2.8, p = 0.008). MDC for heading direction PSE ranged from 6-9 degrees across tests. CONCLUSION The current results indicate moderate reliability for heading perception PSE and provide clinical context for interpreting change in inertial vestibular self-motion perception over time or after an intervention.
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Affiliation(s)
- Olivia Geno
- Department of Neuroscience, University of Rochester, Rochester NY, USA
| | - Kyle Critelli
- Department of Otolaryngology, University of Rochester, Rochester NY, USA
| | - Cesar Arduino
- Department of Otolaryngology, University of Rochester, Rochester NY, USA
| | - Benjamin T Crane
- Department of Neuroscience, University of Rochester, Rochester NY, USA
- Department of Otolaryngology, University of Rochester, Rochester NY, USA
| | - Eric Anson
- Department of Neuroscience, University of Rochester, Rochester NY, USA
- Department of Otolaryngology, University of Rochester, Rochester NY, USA
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2
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Miller RM, Dunn JA, O'Beirne GA, Whitney SL, Snell DL. Relationships between vestibular issues, noise sensitivity, anxiety and prolonged recovery from mild traumatic brain injury among adults: a scoping review. Brain Inj 2024:1-13. [PMID: 38597651 DOI: 10.1080/02699052.2024.2337905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND We investigated the extent of literature and findings on relationships between vestibular issues, noise sensitivity (NS), and anxiety. We were interested in how relationships among these factors impacted adults' recovery three months or more after mild traumatic brain injury (mTBI). METHODS We conducted a scoping review to evaluate the extent of evidence linking relationships between vestibular issues, NS and anxiety with recovery after mTBI. Data relating to study characteristics and key findings were extracted and used to inform a critical narrative synthesis of findings. RESULTS After screening and full-text review, we included two studies. Both studies considered the combination of vestibular issues, NS and anxiety and mTBI recovery. Vestibular issues, NS and anxiety were all significantly associated with one another and their presence was the strongest indicator that symptoms would extend beyond three-months after mTBI. CONCLUSION Few studies have focused on the relationships that vestibular issues, NS and anxiety have with one another and recovery after mTBI. Given the apparent strong relationships between these factors and prolonged recovery, we highlight this as an area warranting further investigation.
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Affiliation(s)
- Rebekah M Miller
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Jennifer A Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Greg A O'Beirne
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, Univeristy of Auckland, Auckland, New Zealand
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Deborah L Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
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3
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Ratzan EM, Lee J, Madison MA, Zhu H, Zhou W, Géléoc GSG, Holt JR. TMC function, dysfunction, and restoration in mouse vestibular organs. Front Neurol 2024; 15:1356614. [PMID: 38638308 PMCID: PMC11024474 DOI: 10.3389/fneur.2024.1356614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Tmc1 and Tmc2 are essential pore-forming subunits of mechanosensory transduction channels localized to the tips of stereovilli in auditory and vestibular hair cells of the inner ear. To investigate expression and function of Tmc1 and Tmc2 in vestibular organs, we used quantitative polymerase chain reaction (qPCR), fluorescence in situ hybridization - hairpin chain reaction (FISH-HCR), immunostaining, FM1-43 uptake and we measured vestibular evoked potentials (VsEPs) and vestibular ocular reflexes (VORs). We found that Tmc1 and Tmc2 showed dynamic developmental changes, differences in regional expression patterns, and overall expression levels which differed between the utricle and saccule. These underlying changes contributed to unanticipated phenotypic loss of VsEPs and VORs in Tmc1 KO mice. In contrast, Tmc2 KO mice retained VsEPs despite the loss of the calcium buffering protein calretinin, a characteristic biomarker of mature striolar calyx-only afferents. Lastly, we found that neonatal Tmc1 gene replacement therapy is sufficient to restore VsEP in Tmc1 KO mice for up to six months post-injection.
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Affiliation(s)
- Evan M. Ratzan
- Department of Otolaryngology, F.M. Kirby Neurobiology Center, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
| | - John Lee
- Department of Otolaryngology, F.M. Kirby Neurobiology Center, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Margot A. Madison
- Department of Otolaryngology, F.M. Kirby Neurobiology Center, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Hong Zhu
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, United States
| | - Wu Zhou
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, United States
| | - Gwenaëlle S. G. Géléoc
- Department of Otolaryngology, F.M. Kirby Neurobiology Center, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Jeffrey R. Holt
- Department of Otolaryngology, F.M. Kirby Neurobiology Center, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
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4
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Jáuregui-Renaud K, García-Jacuinde DM, Bárcenas-Olvera SP, Gresty MA, Gutiérrez-Márquez A. Spatial anxiety contributes to the dizziness-related handicap of adults with peripheral vestibular disease. Front Neurol 2024; 15:1365745. [PMID: 38633539 PMCID: PMC11022853 DOI: 10.3389/fneur.2024.1365745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
In subjects with peripheral vestibular disease and controls, we assessed: 1. The relationship between spatial anxiety and perceived stress, and 2. The combined contribution of spatial anxiety, spatial perspective-taking, and individual cofactors to dizziness-related handicap. 309 adults participated in the study (153 with and 156 without peripheral vestibular disease), including patients with bilateral vestibular deficiency, unilateral deficiency (evolution <3 or ≥3 months), Meniere's disease, and Benign Paroxysmal Positional Vertigo. Assessments included: general health, personal habits, spatial anxiety (3-domains), perceived stress, spatial perspective-taking, dizziness-related handicap (3-domains), unsteadiness, sleep quality, motion sickness susceptibility, trait anxiety/depression, state anxiety, depersonalization/derealization. After bivariate analyses, analysis of covariance was performed (p ≤ 0.05). Spatial anxiety was related to unsteadiness and perceived stress, with an inverse relationship with trait anxiety (ANCoVA, adjusted R2 = 0.27-0.30, F = 17.945-20.086, p < 0.00001). Variability on perspective-taking was related to vestibular disease, trait and state anxiety, motion sickness susceptibility, and age (ANCoVA, adjusted R2 = 0.18, F = 5.834, p < 0.00001). All domains of spatial anxiety contributed to the Physical domain of dizziness-related handicap, while the Navigation domain contributed to the Functional domain of handicap. Handicap variability was also related to unsteadiness, spatial perspective-taking, quality of sleep, and trait anxiety/depression (ANCoVA, adjusted R2 = 0.66, F = 39.07, p < 0.00001). Spatial anxiety is related to perceived stress in adults both with and without vestibular disease, subjects with trait anxiety rated lower on spatial anxiety. State anxiety and acute stress could be helpful for recovery after peripheral vestibular lesion. Spatial anxiety and perspective-taking contribute to the Physical and Functional domains of dizziness-related handicap, possibly because it discourages behavior beneficial to adaptation.
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Affiliation(s)
- Kathrine Jáuregui-Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Dulce Maria García-Jacuinde
- Departamento de Audiología y Otoneurología, Hospital General del Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Simón Pedro Bárcenas-Olvera
- Departamento de Audiología y Otoneurología, Hospital General del Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Michael A. Gresty
- Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, United Kingdom
| | - Aralia Gutiérrez-Márquez
- Departamento de Audiología y Otoneurología, Hospital General del Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Ludwig D, Schubert MC. Case Report: Keep your eyes open! Nystagmus guides atypical BPPV. Front Rehabil Sci 2024; 5:1384151. [PMID: 38606004 PMCID: PMC11006958 DOI: 10.3389/fresc.2024.1384151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/14/2024] [Indexed: 04/13/2024]
Abstract
The clinical diagnosis of benign paroxysmal positional vertigo (BPPV) is confirmed from observing the direction, intensity, and duration of nystagmus from unique head positions that advantage gravity to overcome the inertia of otoconia displaced inside the semicircular canals. This case series highlights BPPV with atypical nystagmus presentations relative to the head position. Clinicians should carefully observe symptoms and nystagmus presentations regardless of the testing position and utilize technology and rules of vestibular physiology to enhance their diagnostic acumen.
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Affiliation(s)
- Daniel Ludwig
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
| | - Michael C. Schubert
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
- Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States
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6
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Aedo-Sanchez C, Riquelme-Contreras P, Henríquez F, Aguilar-Vidal E. Vestibular dysfunction and its association with cognitive impairment and dementia. Front Neurosci 2024; 18:1304810. [PMID: 38601091 PMCID: PMC11004345 DOI: 10.3389/fnins.2024.1304810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/09/2024] [Indexed: 04/12/2024] Open
Abstract
The vestibular system plays an important role in maintaining balance and posture. It also contributes to vertical perception, body awareness and spatial navigation. In addition to its sensory function, the vestibular system has direct connections to key areas responsible for higher cognitive functions, such as the prefrontal cortex, insula and hippocampus. Several studies have reported that vestibular dysfunction, in particular bilateral vestibulopathy, is associated with an increased risk of cognitive impairment and the development of dementias such as Alzheimer's disease. However, it is still controversial whether there is a causal relationship between vestibular damage and cognitive dysfunction. In this mini-review, we will explore the relationship between the vestibular system, cognitive dysfunction and dementia, hypotheses about the hypothesis and causes that may explain this phenomenon and also some potential confounders that may also lead to cognitive impairment. We will also review multimodal neuroimaging approaches that have investigated structural and functional effects on the cortico-vestibular network and finally, describe some approaches to the management of patients with vestibular damage who have shown some cognitive impairment.
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Affiliation(s)
- Cristian Aedo-Sanchez
- Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Patricio Riquelme-Contreras
- Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Department of Neurology, Hospital del Salvador and Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Fernando Henríquez
- Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Enzo Aguilar-Vidal
- Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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Stewart C, King WM, Altschuler R, McCaslin D. Editorial: Bilateral vestibulopathy. Front Integr Neurosci 2024; 18:1387066. [PMID: 38571768 PMCID: PMC10989270 DOI: 10.3389/fnint.2024.1387066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Courtney Stewart
- LTC Charles S. Kettles VA Medical Center, Research Service, Ann Arbor, MI, United States
| | - William Michael King
- Department of Otolaryngology/Head-Neck Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Richard Altschuler
- LTC Charles S. Kettles VA Medical Center, Research Service, Ann Arbor, MI, United States
- Department of Otolaryngology/Head-Neck Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Devin McCaslin
- Department of Otolaryngology/Head-Neck Surgery, University of Michigan, Ann Arbor, MI, United States
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8
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Jáuregui EJ, Scheinman KL, Bibriesca Mejia IK, Pruett L, Zaini H, Finkbeiner C, Phillips JA, Gantz JA, Nguyen TB, Phillips JO, Stone JS. Sensorineural correlates of failed functional recovery after natural regeneration of vestibular hair cells in adult mice. Front Neurol 2024; 15:1322647. [PMID: 38523617 PMCID: PMC10960365 DOI: 10.3389/fneur.2024.1322647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Vestibular hair cells (HCs) are mechanoreceptors that sense head motions by modulating the firing rate of vestibular ganglion neurons (VGNs), whose central processes project to vestibular nucleus neurons (VNNs) and cerebellar neurons. We explored vestibular function after HC destruction in adult Pou4f3+/DTR (DTR) mice, in which injections of high-dose (50 ng/g) diphtheria toxin (DT) destroyed most vestibular HCs within 2 weeks. At that time, DTR mice had lost the horizontal vestibulo-ocular reflex (aVORH), and their VNNs failed to upregulate nuclear cFos expression in response to a vestibular stimulus (centrifugation). Five months later, 21 and 14% of HCs were regenerated in utricles and horizontal ampullae, respectively. The vast majority of HCs present were type II. This degree of HC regeneration did not restore the aVORH or centrifugation-evoked cFos expression in VNNs. The failure to regain vestibular pathway function was not due to degeneration of VGNs or VNNs because normal neuron numbers were maintained after HC destruction. Furthermore, sinusoidal galvanic stimulation at the mastoid process evoked cFos protein expression in VNNs, indicating that VGNs were able to regulate VNN activity after HC loss. aVORH and cFos responses in VNNs were robust after low-dose (25 ng/g) DT, which compared to high-dose DT resulted in a similar degree of type II HC death and regeneration but spared more type I HCs in both organs. These findings demonstrate that having more type I HCs is correlated with stronger responses to vestibular stimulation and suggest that regenerating type I HCs may improve vestibular function after HC loss.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jennifer S. Stone
- Department of Otolaryngology-Head and Neck Surgery and the Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle, WA, United States
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Ellmers TJ, Kal EC. Exploring the role of attention towards balance in chronic dizziness: Development of the Balance Vigilance Questionnaire. Eur J Neurol 2024; 31:e16148. [PMID: 38015469 DOI: 10.1111/ene.16148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND PURPOSE Vigilance towards balance has been proposed to underpin various chronic dizziness disorders, including persistent postural-perceptual dizziness (PPPD). The objective of this study was to develop (through patient input) a validated balance-specific measure of vigilance that comprehensively assesses the varied ways in which this construct may manifest. METHODS We developed the Balance Vigilance Questionnaire (Balance-VQ) through patient and clinician feedback, designed to assess vigilance towards balance. We then validated the questionnaire in 497 participants consisting of patients diagnosed with chronic dizziness disorders (including 97 individuals diagnosed with PPPD) and healthy controls. RESULTS The final six-item Balance-VQ was shown to be a valid and reliable way to assess vigilance towards balance. Scores were significantly higher in individuals diagnosed with PPPD compared to controls. Although scores were also higher in the PPPD group compared to individuals with diagnosed vestibular disorders other than PPPD, Balance-VQ scores did not discriminate between the two groups when confounding factors (including dizziness severity) were controlled for. Scores did, however, independently discriminate between the PPPD group and individuals who experience dizziness in daily life, but who have not been diagnosed with a neuro-otological disorder. CONCLUSIONS Our findings confirm that the Balance-VQ is a valid and reliable instrument for assessing vigilance towards balance. As symptom vigilance has been identified as a key risk factor for developing chronic dizziness following acute vestibular symptoms or balance disruption, we recommend using the Balance-VQ as a screening tool in people presenting with such symptoms.
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Affiliation(s)
- Toby J Ellmers
- Centre for Vestibular Neurology, Department of Brain Sciences, Imperial College London, London, UK
| | - Elmar C Kal
- Centre for Cognitive Neuroscience, Department of Health Sciences, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UK
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10
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Lucieer F, van der Lubbe M, van Stiphout L, Janssen M, Van Rompaey V, Devocht E, Perez-Fornos A, Guinand N, van de Berg R. Multi-frequency VEMPs improve detection of present otolith responses in bilateral vestibulopathy. Front Neurol 2024; 15:1336848. [PMID: 38450070 PMCID: PMC10915078 DOI: 10.3389/fneur.2024.1336848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024] Open
Abstract
Objective To investigate whether multi-frequency Vestibular Evoked Myogenic Potential (VEMP) testing at 500, 750, 1,000, and 2,000 Hz, would improve the detection of present dynamic otolith responses in patients with bilateral vestibulopathy (BV). Methods Prospective study in a tertiary referral center. BV patients underwent multi-frequency VEMP testing. Cervical VEMPs and ocular VEMPs were recorded with the Neuro-Audio system (v2010, Neurosoft, Ivanovo, Russia). The stimuli included air-conducted tone bursts of 500, 750, 1,000, and 2,000 Hz, at a stimulation rate of 13 Hz. Outcome measures included the percentage of present and absent VEMP responses, and VEMP thresholds. Outcomes were compared between frequencies and type of VEMPs (cVEMPs, oVEMPs). VEMP outcomes obtained with the 500 Hz stimulus, were also compared to normative values obtained in healthy subjects. Results Forty-nine BV patients completed VEMP testing: 47 patients completed cVEMP testing and 48 patients completed oVEMP testing. Six to 15 % more present VEMP responses were obtained with multifrequency testing, compared to only testing at 500 Hz. The 2,000 Hz stimulus elicited significantly fewer present cVEMP responses (right and left ears) and oVEMP responses (right ears) compared to the other frequencies (p ≤ 0.044). Using multi-frequency testing, 78% of BV patients demonstrated at least one present VEMP response in at least one ear. In 46% a present VEMP response was found bilaterally. BV patients demonstrated a significantly higher percentage of absent VEMP responses and significantly higher VEMP thresholds than healthy subjects, when corrected for age (p ≤ 0.002). Based on these results, a pragmatic VEMP testing paradigm is proposed, taking into account multi-frequency VEMP testing. Conclusion Multi-frequency VEMP testing improves the detection rate of present otolith responses in BV patients. Therefore, multi-frequency VEMPs should be considered when evaluation of (residual) otolith function is indicated.
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Affiliation(s)
- F. Lucieer
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - M. van der Lubbe
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - L. van Stiphout
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - M. Janssen
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - V. Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - E. Devocht
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - A. Perez-Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - N. Guinand
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - R. van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
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Corre J, Cugnot JF, Boutabla A, Cavuscens S, Ranieri M, van de Berg R, Peterka RJ, Guinand N, Fornos AP. Postural impairments in unilateral and bilateral vestibulopathy. Front Neurol 2024; 15:1324868. [PMID: 38450076 PMCID: PMC10915085 DOI: 10.3389/fneur.2024.1324868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Chronic imbalance is a major complaint of patients suffering from bilateral vestibulopathy (BV) and is often reported by patients with chronic unilateral vestibulopathy (UV), leading to increased risk of falling. We used the Central SensoriMotor Integration (CSMI) test, which evaluates sensory integration, time delay, and motor activation contributions to standing balance control, to determine whether CSMI measures could distinguish between healthy control (HC), UV, and BV subjects and to characterize vestibular, proprioceptive, and visual contributions expressed as sensory weights. We also hypothesized that sensory weight values would be associated with the results of vestibular assessments (vestibulo ocular reflex tests and Dizziness Handicap Inventory scores). Twenty HCs, 15 UVs and 17 BVs performed three CSMI conditions evoking sway in response to pseudorandom (1) surface tilts with eyes open or, (2) surface tilts with eyes closed, and (3) visual surround tilts. Proprioceptive weights were identified in surface tilt conditions and visual weights were identified in the visual tilt condition. BVs relied significantly more on proprioception. There was no overlap in proprioceptive weights between BV and HC subjects and minimal overlap between UV and BV subjects in the eyes-closed surface-tilt condition. Additionally, visual sensory weights were greater in BVs and were similarly able to distinguish BV from HC and UV subjects. We found no significant correlations between sensory weights and the results of vestibular assessments. Sensory weights from CSMI testing could provide a useful measure for diagnosing and for objectively evaluating the effectiveness of rehabilitation efforts and future treatments designed to restore vestibular function such as hair cell regeneration and vestibular implants.
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Affiliation(s)
- Julie Corre
- Division of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Jean-François Cugnot
- Division of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Anissa Boutabla
- Division of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Samuel Cavuscens
- Division of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Maurizio Ranieri
- Division of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Raymond van de Berg
- Division of Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Robert J. Peterka
- National Center for Rehabilitative Auditory Research, Veterans Administration Portland Health Care System and Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Nils Guinand
- Division of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Angélica Pérez Fornos
- Division of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
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Calisgan E, Talu B. The effect of vestibular and somatosensory rehabilitation in addition to early rehabilitation on balance after stroke: a randomized controlled trial. Top Stroke Rehabil 2024:1-10. [PMID: 38373015 DOI: 10.1080/10749357.2024.2318096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/04/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The goal of post-stroke early rehabilitation is to regain ambulation, standing and balance. OBJECTIVE The purpose of this study was to investigate the effects of vestibular and somatosensory rehabilitation in addition to early rehabilitation on balance in patients with early subacute stroke. DESIGN AND SETTING A randomized controlled trial was conducted at a university hospital. METHODS The study was included 52 hemiplegic hospitalized early suacute stroke patients. The experimental group (n: 30), was applied with vestibular and somatosensorial rehabilitation together with early rehabilitation. Vestibular exercises, included Cawthorne-Cooksey exercises, stimulate the vestibulo-ocular and vestibulo-spinal reflex. Somatosensory exercises, which included Frenkel exercises, stimulate the sensory proprioception and somatosensory systems. The control group (n: 22) patients with early subacute stroke were treated with the early rehabilitation program only. The balance parameters of the patients were evaluated with the Korebalance System, Functional Reach Test, Postural Assessment Scale for Stroke, and Functional Ambulation Scale. RESULTS The mean age of the patients was 67.32 ± 9.46 years, and the mean number of days that had passed since the stroke occurred was7.90 ± 7.26. In calculating the balance scores, statistically significant differences were observed in the experimental and control groups, with a statistically greater improvement in the rehabilitation group. Statistically significant differences were determined between the groups in respect of the balance scores. CONCLUSIONS Based on these findings, the use of vestibular and somatosensory rehabilitation can be recommended for better functioning of the compensatory mechanism of early subacute-stroke hemiplegic patients in early ambulation, and this can lead to considerably improved standing and dynamic upper and lower body balance.
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Affiliation(s)
- Elisa Calisgan
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Burcu Talu
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Inonu University, Malatya, Turkey
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13
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Simard ML, Novak N, Drolet JP, Joly MC, Nolte H, Wuestenberg E, Gagnon R. Tolerability of sublingual versus vestibular allergy immunotherapy tablet administration: A randomized pilot study. Clin Exp Allergy 2024; 54:120-129. [PMID: 37990117 DOI: 10.1111/cea.14427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Local application site reactions are common with sublingual allergy immunotherapy (AIT)-tablets for the treatment of allergic rhinitis/conjunctivitis (AR/C) and occasionally lead to treatment discontinuation. Because of the lower mast cell density in the vestibular mucosa than the sublingual area, vestibular AIT-tablet administration may result in fewer adverse events (AEs). This pilot study evaluated the tolerability of the vestibular administration route of AIT-tablets compared with the sublingual route in adult subjects with AR/C. METHODS Adults (n = 164) aged 18-65 years with AR/C treated with daily birch pollen, grass pollen, ragweed pollen or house dust mite AIT in tablet form were randomized 1:1 to vestibular or sublingual administration for 28 days, followed by 28 days of sublingual administration only. The primary endpoint was the severity (mild, moderate, severe) of local treatment-related adverse events (TRAEs) during the first 28 days of treatment. RESULTS During the first 28 days, the percentage of subjects in the vestibular and sublingual groups reporting mild TRAEs were 55.6% versus 50.6%, respectively; moderate TRAEs were 27.2% versus 30.1%; and severe TRAEs were 12.3% versus 6.0% (p = .16). In the vestibular group, 95.1% of the subjects experienced at least one TRAE during the first period versus 81.9% in the sublingual group (p = .01) and discontinuation rates due to AEs were higher (12.3% vs. 3.6%). CONCLUSION The frequencies of subjects experiencing severe TRAEs, at least one TRAE, and discontinuations due to AEs at the initiation of AIT-tablets were numerically higher with vestibular administration than sublingual administration. Sublingual administration should remain the standard of care for subjects treated with AIT-tablets for AR/C.
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Affiliation(s)
- Marie-Lee Simard
- Clinique Spécialisée en Allergie de la Capitale, Québec, Québec, Canada
| | - Natalija Novak
- Clinic and Polyclinic for Dermatology and Allergology, University Hospital Bonn, Bonn, Germany
| | | | - Marie-Claude Joly
- Clinique Spécialisée en Allergie de la Capitale, Québec, Québec, Canada
| | | | - Eike Wuestenberg
- ALK-Abelló A/S, Hørsholm, Denmark
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine (and University Hospital) Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rémi Gagnon
- Clinique Spécialisée en Allergie de la Capitale, Québec, Québec, Canada
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Dieterich M, Brandt T. Central vestibular networking for sensorimotor control, cognition, and emotion. Curr Opin Neurol 2024; 37:74-82. [PMID: 38032266 PMCID: PMC10779454 DOI: 10.1097/wco.0000000000001233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW The aim of this study was to illuminate the extent of the bilateral central vestibular network from brainstem and cerebellum to subcortical and cortical areas and its interrelation to higher cortical functions such as spatial cognition and anxiety. RECENT FINDINGS The conventional view that the main function of the vestibular system is the perception of self-motion and body orientation in space and the sensorimotor control of gaze and posture had to be developed further by a hierarchical organisation with bottom-up and top-down interconnections. Even the vestibulo-ocular and vestibulo-spinal reflexes are modified by perceptual cortical processes, assigned to higher vestibulo-cortical functions. A first comparative fMRI meta-analysis of vestibular stimulation and fear-conditioning studies in healthy participants disclosed widely distributed clusters of concordance, including the prefrontal cortex, anterior insula, temporal and inferior parietal lobe, thalamus, brainstem and cerebellum. In contrast, the cortical vestibular core region around the posterior insula was activated during vestibular stimulation but deactivated during fear conditioning. In recent years, there has been increasing evidence from studies in animals and humans that the central vestibular system has numerous connections related to spatial sensorimotor performance, memory, and emotion. The clinical implication of the complex interaction within various networks makes it difficult to assign some higher multisensory disorders to one particular modality, for example in spatial hemineglect or room-tilt illusion. SUMMARY Our understanding of higher cortical vestibular functions is still in its infancy. Different brain imaging techniques in animals and humans are one of the most promising methodological approaches for further structural and functional decoding of the vestibular and other intimately interconnected networks. The multisensory networking including cognition and emotion determines human behaviour in space.
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Affiliation(s)
- Marianne Dieterich
- German Center for Vertigo and Balance Disorders
- Department of Neurology, Ludwig-Maximilians University
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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15
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Bronstein AM, Kattah J. Vascular neuro-otology: vestibular transient ischemic attacks and chronic dizziness in the elderly. Curr Opin Neurol 2024; 37:59-65. [PMID: 38032270 PMCID: PMC10779463 DOI: 10.1097/wco.0000000000001229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW To explore the differential diagnosis of posterior fossa transient ischemic attacks (TIA) associated with vertigo and/or imbalance.To review the contribution of cerebral small vessel (SVD) disease to balance dysfunction and dizziness in the elderly. MAIN FINDINGS TIAs involving vestibular structures that mediate the vestibulo-ocular and vestibulospinal reflexes remain a diagnostic challenge because they overlap with causes of benign episodic vertigo. Here, we summarize the results of multidisciplinary specialty efforts to improve timely recognition and intervention of peripheral and central vestibular ischemia. More papers confirm that SVD is a major cause of gait disability, falls and cognitive disorder in the elderly. Recent work shows that early stages of SVD may also be responsible for dizziness in the elderly. The predominant location of the white matter changes, in the frontal deep white matter and genu of the corpus callosum, explains the association between cognitive and balance dysfunction in SVD related symptoms. SUMMARY The evaluation of patients with intermittent vascular vertigo represent a major diagnostic challenge, recent reviews explore the ideal design approach for a multidisciplinary study to increase early recognition and intervention. Hemispheric white matter microvascular ischemia has been the subject of research progress - advanced stages are known to cause gait disorder and dementia but early stages are associated with "idiopathic" dizziness in the elderly.
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Affiliation(s)
- Adolfo M. Bronstein
- Centre for Vestibular Neuroscience, Department of Brain Sciences, Imperial College London, Charing Cross Hospital, London, UK
| | - Jorge Kattah
- University of Illinois at Chicago | UIC Department of Neurology (Peoria), Chicago, Illinois, USA
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Zhang S, Lang Y, Wang W, Wu Y, Yan S, Zhang T, Li D, Liu S, Hao Y, Yang X, Gu P. Analysis of etiology and clinical features of spontaneous downbeat nystagmus: a retrospective study. Front Neurol 2024; 15:1326879. [PMID: 38361644 PMCID: PMC10867136 DOI: 10.3389/fneur.2024.1326879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/18/2024] [Indexed: 02/17/2024] Open
Abstract
Objective To investigate the topical diagnosis, possible etiology and mechanism of spontaneous downbeat nystagmus (sDBN) patients with dizziness/vertigo. Methods The clinical features of dizziness/vertigo patients accompanied with DBN were retrospectively reviewed in the Vertigo Center of our hospital from January 2018 to March 2021. The clinical features of dizziness/vertigo patients accompanied with DBN were reviewed. Comprehensive VNG, bithermal caloric testing, video-head-impulse test (vHIT), vestibular-evoked myogenic potentials (VEMP), head magnetic resonance imaging (MRI), three-dimensional fluid-attenuated incersion recovery magnetic resonance imaging (3D-FLAIR MRI) in the inner ear, serum immunology and other examinations were to determine the lesion site, and analyze its possible etiology and mechanism. Results A total of 54 patients were included. Among them, 70.4% (n = 38) of DBN patients were diagnosed with episodic vestibular syndrome (EVS), 22.2% (n = 12) with chronic vestibular syndrome (CVS), and 7.4% (n = 4) with acute vestibular syndrome (AVS). Among all the patients, 51.9% of DBN patients had clear etiology, with central lesions of 29.6% and peripheral diseases of 22.2%. The most common diseases in DBN patients were cerebellar lesions (13.0%, n = 7) and vestibular migraine (13.0%, n = 7), followed by benign positional paroxysmal vertigo (7.4%, n = 4) and drug-related dizziness/vertigo (5.6%, n = 3). The other 48.1% of the patients had unknown etiology. 53.8% (14/26) of patients with idiopathic DBN had decreased semicircular canal function, with 42.9% (6/14) decreased posterior semicircular canal function. The posterior semicircular canal gain in DBN patients decreased compared to the anterior semicircular canal in the same conjugate plane. Patients with peripheral DBN were more prone to horizontal/torsional nystagmus during positional testing. Conclusion In our study, DBN patients have a relative decrease in posterior semicircular canal gain, which is possibly a particular result found in a subset of downbeat nystagmus patients. The changes in nystagmus during positional testing may be helpful in distinguishing between peripheral and central causes.
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Affiliation(s)
- Sai Zhang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yilin Lang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Wenting Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuexia Wu
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Shuangmei Yan
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ting Zhang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Dong Li
- Vertigo Center of the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Shaona Liu
- Vertigo Center of the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yongci Hao
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xu Yang
- Department of Neurology, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Ping Gu
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Zwergal A, Grabova D, Schöberl F. Vestibular contribution to spatial orientation and navigation. Curr Opin Neurol 2024; 37:52-58. [PMID: 38010039 PMCID: PMC10779452 DOI: 10.1097/wco.0000000000001230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
PURPOSE OF REVIEW The vestibular system provides three-dimensional idiothetic cues for updating of one's position in space during head and body movement. Ascending vestibular signals reach entorhinal and hippocampal networks via head-direction pathways, where they converge with multisensory information to tune the place and grid cell code. RECENT FINDINGS Animal models have provided insight to neurobiological consequences of vestibular lesions for cerebral networks controlling spatial cognition. Multimodal cerebral imaging combined with behavioural testing of spatial orientation and navigation performance as well as strategy in the last years helped to decipher vestibular-cognitive interactions also in humans. SUMMARY This review will update the current knowledge on the anatomical and cellular basis of vestibular contributions to spatial orientation and navigation from a translational perspective (animal and human studies), delineate the behavioural and functional consequences of different vestibular pathologies on these cognitive domains, and will lastly speculate on a potential role of vestibular dysfunction for cognitive aging and impeding cognitive impairment in analogy to the well known effects of hearing loss.
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Affiliation(s)
- Andreas Zwergal
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Denis Grabova
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich
| | - Florian Schöberl
- German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
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18
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Hoppes CW, Lambert KH, Whitney SL, Erbele ID, Esquivel CR, Yuan TT. Leveraging Technology for Vestibular Assessment and Rehabilitation in the Operational Environment: A Scoping Review. Bioengineering (Basel) 2024; 11:117. [PMID: 38391603 PMCID: PMC10886105 DOI: 10.3390/bioengineering11020117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION The vestibular system, essential for gaze and postural stability, can be damaged by threats on the battlefield. Technology can aid in vestibular assessment and rehabilitation; however, not all devices are conducive to the delivery of healthcare in an austere setting. This scoping review aimed to examine the literature for technologies that can be utilized for vestibular assessment and rehabilitation in operational environments. MATERIALS AND METHODS A comprehensive search of PubMed was performed. Articles were included if they related to central or peripheral vestibular disorders, addressed assessment or rehabilitation, leveraged technology, and were written in English. Articles were excluded if they discussed health conditions other than vestibular disorders, focused on devices or techniques not conducive to the operational environment, or were written in a language other than English. RESULTS Our search strategy yielded 32 articles: 8 articles met our inclusion and exclusion criteria whereas the other 24 articles were rejected. DISCUSSION There is untapped potential for leveraging technology for vestibular assessment and rehabilitation in the operational environment. Few studies were found in the peer-reviewed literature that described the application of technology to improve the identification of central and/or peripheral vestibular system impairments; triage of acutely injured patients; diagnosis; delivery and monitoring of rehabilitation; and determination of readiness for return to duty. CONCLUSIONS This scoping review highlighted technology for vestibular assessment and rehabilitation feasible for use in an austere setting. Such technology may be leveraged for prevention; monitoring exposure to mechanisms of injury; vestibular-ocular motor evaluation; assessment, treatment, and monitoring of rehabilitation progress; and return-to-duty determination after vestibular injury. FUTURE DIRECTIONS The future of vestibular assessment and rehabilitation may be shaped by austere manufacturing and 3D printing; artificial intelligence; drug delivery in combination with vestibular implantation; organ-on-chip and organoids; cell and gene therapy; and bioprinting.
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Affiliation(s)
- Carrie W Hoppes
- Army-Baylor University Doctoral Program in Physical Therapy, 3630 Stanley Road, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
| | - Karen H Lambert
- Hearing Center of Excellence, 2200 Bergquist Drive, Lackland Air Force Base, TX 78236, USA
| | - Susan L Whitney
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Pittsburgh, PA 15219, USA
| | - Isaac D Erbele
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Brooke Army Medical Center, 3551 Roger Brooke Drive, Joint Base San Antonio-Fort Sam Houston, TX 78234, USA
- Department of Surgery, School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Carlos R Esquivel
- Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Drive, Lackland Air Force Base, TX 78236, USA
| | - Tony T Yuan
- Department of Radiology and Radiological Sciences, School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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DiLiberto FE, Kamath HER, Olson ML, Cherchi M, Helminski JO, Schubert MC. When, where, and why should we look for vestibular dysfunction in people with diabetes mellitus? Front Rehabil Sci 2024; 4:1306010. [PMID: 38273862 PMCID: PMC10808374 DOI: 10.3389/fresc.2023.1306010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
The biochemistry of diabetes mellitus results in multi-system tissue compromise that reduces functional mobility and interferes with disease management. Sensory system compromise, such as peripheral neuropathy and retinopathy, are specific examples of tissue compromise detrimental to functional mobility. There is lack of clarity regarding if, when, and where parallel changes in the peripheral vestibular system, an additional essential sensory system for functional mobility, occur as a result of diabetes. Given the systemic nature of diabetes and the plasticity of the vestibular system, there is even less clarity regarding if potential vestibular system changes impact functional mobility in a meaningful fashion. This commentary will provide insight as to when we should employ diagnostic vestibular function tests in people with diabetes, where in the periphery we should look, and why testing may or may not matter. The commentary concludes with recommendations for future research and clinical care.
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Affiliation(s)
- Frank E. DiLiberto
- Department of Audiology and Speech Pathology, Captain James A. Lovell Federal Health Care Center, North Chicago, IL, United States
- Department of Physical Therapy, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Heather E. R. Kamath
- Department of Audiology and Speech Pathology, Captain James A. Lovell Federal Health Care Center, North Chicago, IL, United States
| | - Maxine L. Olson
- Department of Audiology and Speech Pathology, Captain James A. Lovell Federal Health Care Center, North Chicago, IL, United States
- Department of Physical Therapy, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Marcello Cherchi
- Neurology, University of Chicago Medicine, Chicago, IL, United States
| | - Janet O. Helminski
- Department of Physical Therapy, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Michael C. Schubert
- Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States
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Arvaniti CK, Brotis AG, Paschalis T, Kapsalaki EZ, Fountas KN. Localization of Vestibular Cortex Using Electrical Cortical Stimulation: A Systematic Literature Review. Brain Sci 2024; 14:75. [PMID: 38248290 PMCID: PMC10813901 DOI: 10.3390/brainsci14010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
The vestibular system plays a fundamental role in body orientation, posture control, and spatial and body motion perception, as well as in gaze and eye movements. We aimed to review the current knowledge regarding the location of the cortical and subcortical areas, implicated in the processing of vestibular stimuli. The search was performed in PubMed and Scopus. We focused on studies reporting on vestibular manifestations after electrical cortical stimulation. A total of 16 studies were finally included. Two main types of vestibular responses were elicited, including vertigo and perception of body movement. The latter could be either rotatory or translational. Electrical stimulation of the temporal structures elicited mainly vertigo, while stimulation of the parietal lobe was associated with perceptions of body movement. Stimulation of the occipital lobe produced vertigo with visual manifestations. There was evidence that the vestibular responses became more robust with increasing current intensity. Low-frequency stimulation proved to be more effective than high-frequency in eliciting vestibular responses. Numerous non-vestibular responses were recorded after stimulation of the vestibular cortex, including somatosensory, viscero-sensory, and emotional manifestations. Newer imaging modalities such as functional MRI (fMRI), Positron Emission Tomography (PET), SPECT, and near infra-red spectroscopy (NIRS) can provide useful information regarding localization of the vestibular cortex.
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Affiliation(s)
- Christina K. Arvaniti
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (C.K.A.); (A.G.B.)
| | - Alexandros G. Brotis
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (C.K.A.); (A.G.B.)
| | - Thanasis Paschalis
- Department of Neuro-Oncology, Cambridge University Hospital, Cambridge CB4 1GN, UK;
| | - Eftychia Z. Kapsalaki
- Department of Diagnostic Radiology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larisa, Greece;
- Advanced Diagnostic Institute Euromedica-Encephalos, 15233 Athens, Greece
| | - Kostas N. Fountas
- Department of Neurosurgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (C.K.A.); (A.G.B.)
- Faculty of Medicine, University of Thessaly, Biopolis, 41110 Larissa, Greece
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Voros J, Kravets V, Smith K, Clark TK. Humans gradually integrate sudden gain or loss of visual information into spatial orientation perception. Front Neurosci 2024; 17:1274949. [PMID: 38260024 PMCID: PMC10800753 DOI: 10.3389/fnins.2023.1274949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/01/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Vestibular and visual information is used in determining spatial orientation. Existing computational models of orientation perception focus on the integration of visual and vestibular orientation information when both are available. It is well-known, and computational models capture, differences in spatial orientation perception with visual information or without (i.e., in the dark). For example, during earth vertical yaw rotation at constant angular velocity without visual information, humans perceive their rate of rotation to decay. However, during the same sustained rotation with visual information, humans can continue to more accurately perceive self-rotation. Prior to this study, there was no existing literature on human motion perception where visual information suddenly become available or unavailable during self-motion. Methods Via a well verified psychophysical task, we obtained perceptual reports of self-rotation during various profiles of Earth-vertical yaw rotation. The task involved transitions in the availability of visual information (and control conditions with visual information available throughout the motion or unavailable throughout). Results We found that when visual orientation information suddenly became available, subjects gradually integrated the new visual information over ~10 seconds. In the opposite scenario (visual information suddenly removed), past visual information continued to impact subject perception of self-rotation for ~30 seconds. We present a novel computational model of orientation perception that is consistent with the experimental results presented in this study. Discussion The gradual integration of sudden loss or gain of visual information is achieved via low pass filtering in the visual angular velocity sensory conflict pathway. In conclusion, humans gradually integrate sudden gain or loss of visual information into their existing perception of self-motion.
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Affiliation(s)
- Jamie Voros
- Ann and H.J. Smead Department of Aerospace Engineering Sciences, Boulder, CO, United States
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22
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Li Q, Xu H, Chen W, Su A, Fu MJ, Walker MF. Short-term learning of the vestibulo-ocular reflex induced by a custom interactive computer game. J Neurophysiol 2024; 131:16-27. [PMID: 37964728 DOI: 10.1152/jn.00130.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 10/24/2023] [Accepted: 11/09/2023] [Indexed: 11/16/2023] Open
Abstract
Retinal image slip during head rotation drives motor learning in the rotational vestibulo-ocular reflex (VOR) and forms the basis of gaze-stability exercises that treat vestibular dysfunction. Clinical exercises, however, are unengaging, cannot easily be titrated to the level of impairment, and provide neither direct feedback nor tracking of the patient's adherence, performance, and progress. To address this, we have developed a custom application for VOR training based on an interactive computer game. In this study, we tested the ability of this game to induce VOR learning in individuals with normal vestibular function, and we compared the efficacy of single-step and incremental learning protocols. Eighteen participants played the game twice on different days. All participants tolerated the game and were able to complete both sessions. The game scenario incorporated a series of brief head rotations, similar to active head impulses, that were paired with a dynamic acuity task and with a visual-vestibular mismatch (VVM) intended to increase VOR gain (single-step: 300 successful trials at ×1.5 viewing; incremental: 100 trials each of ×1.13, ×1.33, and ×1.5 viewing). Overall, VOR gain increased by 15 ± 4.7% (mean ± 95% CI, P < 0.001). Gains increased similarly for active and passive head rotations, and, contrary to our hypothesis, there was little effect of the learning strategy. This study shows that an interactive computer game provides robust VOR training and has the potential to deliver effective, engaging, and trackable gaze-stability exercises to patients with a range of vestibular dysfunctions.NEW & NOTEWORTHY This study demonstrates the feasibility and efficacy of a customized computer game to induce motor learning in the high-frequency rotational vestibulo-ocular reflex. It provides a physiological basis for the deployment of this technology to clinical vestibular rehabilitation.
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Affiliation(s)
- Qi Li
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Honglu Xu
- Department of Computer and Data Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Weicong Chen
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Andrew Su
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, Ohio, United States
| | - Michael J Fu
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, Ohio, United States
- Functional Electrical Stimulation Center, VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
- MetroHealth Rehabilitation Institute, The MetroHealth System, Cleveland, Ohio, United States
| | - Mark F Walker
- Neurology Service, VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
- Department of Neurology, Case Western Reserve University, Cleveland, Ohio, United States
- Advanced Platform Technology Center, VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
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Rahman SM, Luebke AE. Calcitonin gene-related peptide receptor antagonism reduces motion sickness indicators in mouse migraine models. Cephalalgia 2024; 44:3331024231223971. [PMID: 38215227 DOI: 10.1177/03331024231223971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
BACKGROUND Migraine and vestibular migraine are disorders associated with a heightened motion sensitivity that provoke symptoms of motion-induced nausea and motion sickness. VM affects ∼3% of adults in the USA and affects three-fold more women than men. Triptans (selective serotonin receptor agonists) relieve migraine pain but lack efficacy for vertigo. Murine models of photophobia and allodynia have used injections of calcitonin gene-related peptide (CGRP) or other migraine triggers, such as sodium nitroprusside (SNP), to induce migraine sensitivities in mice to touch and light. Yet, there is limited research on whether these triggers affect motion-induced nausea in mice, and whether migraine blockers can reduce these migraine symptoms. We hypothesized that systemic delivery of CGRP or SNP will increase motion sickness susceptibility and motion-induced nausea in mouse models, and that migraine blockers can block these changes induced by systemically delivered CGRP or SNP. METHODS We investigated two measures of motion sickness assessment [motion sickness index (MSI) scoring and motion-induced thermoregulation] after intraperitoneal injections of either CGRP or SNP in C57BL/6J mice. The drugs olcegepant, sumatriptan and rizatriptan were used to assess the efficacy of migraine blockers. RESULTS MSI measures were confounded by CGRP's effect on gastric distress. However, analysis of tail vasodilatations as a surrogate for motion-induced nausea was robust for both migraine triggers. Only olcegepant treatment rescued tail vasodilatations. CONCLUSIONS These preclinical findings support the use of small molecule CGRP receptor antagonists for the treatment of motion-induced nausea of migraine, and show that triptan therapeutics are ineffective against motion-induced nausea of migraine.Trial Registration: Not Applicable.
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Affiliation(s)
- Shafaqat M Rahman
- University of Rochester, Department of Biomedical Engineering, Rochester, NY, USA
| | - Anne E Luebke
- University of Rochester, Department of Biomedical Engineering, Rochester, NY, USA
- University of Rochester Medical Center, Department of Neuroscience, Del Monte Institute of Neuroscience, Rochester, NY, USA
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24
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Barnhart M, McLeod TV, Bay RC. The Ability of Vestibular and Oculomotor Screenings to Predict Recovery in Patients After Concussion: A Systematic Review of the Literature. J Athl Train 2024; 59:49-65. [PMID: 36913634 PMCID: PMC10783467 DOI: 10.4085/1062-6050-0429.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
OBJECTIVE The objective of this systematic review was to investigate if a positive vestibular or oculomotor screening is predictive of recovery in patients after concussion. DATA SOURCES Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search through PubMed, Ovid MEDLINE, SPORTDiscus, and the Cochrane Central Register of Controlled Trials (CENTRAL) and hand searches of included articles. STUDY SELECTION Two authors evaluated all articles for inclusion and assessed their quality using the Mixed Methods Assessment Tool. DATA EXTRACTION After quality assessment was completed, the authors extracted recovery time, vestibular or ocular assessment results, study population demographics, number of participants, inclusion and exclusion criteria, symptom scores, and any other outcomes of assessments reported in the included studies. DATA SYNTHESIS Data were critically analyzed by 2 of the authors and categorized into tables regarding the ability of researchers of each article to answer the research question. Many patients who have vision, vestibular, or oculomotor dysfunction appear to have longer recovery times than patients who do not. CONCLUSIONS Researchers routinely reported that vestibular and oculomotor screenings are prognostic of time to recovery. Specifically, a positive Vestibular Ocular Motor Screening test appears to consistently predict longer recovery.
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Affiliation(s)
- Mitchell Barnhart
- Athletic Training Programs, A.T. Still University, Mesa, AZ; Phoenix Country Day School, Paradise Valley, AZ
| | - Tamara Valovich McLeod
- Department of Athletic Training, Athletic Training Programs and School of Osteopathic Medicine, A.T. Still University, Mesa, AZ
| | - R. Curtis Bay
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
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25
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Lunsford ET, Bobkov YV, Ray BC, Liao JC, Strother JA. Anion efflux mediates transduction in the hair cells of the zebrafish lateral line. Proc Natl Acad Sci U S A 2023; 120:e2315515120. [PMID: 38117855 PMCID: PMC10756195 DOI: 10.1073/pnas.2315515120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/01/2023] [Indexed: 12/22/2023] Open
Abstract
Hair cells are the principal sensory receptors of the vertebrate auditory system, where they transduce sounds through mechanically gated ion channels that permit cations to flow from the surrounding endolymph into the cells. The lateral line of zebrafish has served as a key model system for understanding hair cell physiology and development, often with the belief that these hair cells employ a similar transduction mechanism. In this study, we demonstrate that these hair cells are exposed to an unregulated external environment with cation concentrations that are too low to support transduction. Our results indicate that hair cell excitation is instead mediated by a substantially different mechanism involving the outward flow of anions. Further investigation of hair cell transduction in a diversity of sensory systems and species will likely yield deep insights into the physiology of these unique cells.
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Affiliation(s)
- Elias T. Lunsford
- Department of Biology, The Whitney Laboratory for Marine Bioscience, University of Florida, Saint Augustine, FL32080
- Institut du Cerveau (Paris Brain Institute), Hôpital Pitié-Salpêtrière, Paris75013, France
| | - Yuriy V. Bobkov
- Department of Biology, The Whitney Laboratory for Marine Bioscience, University of Florida, Saint Augustine, FL32080
| | - Brandon C. Ray
- Department of Biology, The Whitney Laboratory for Marine Bioscience, University of Florida, Saint Augustine, FL32080
| | - James C. Liao
- Department of Biology, The Whitney Laboratory for Marine Bioscience, University of Florida, Saint Augustine, FL32080
| | - James A. Strother
- Department of Biology, The Whitney Laboratory for Marine Bioscience, University of Florida, Saint Augustine, FL32080
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26
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Campbell KR, Wilhelm JL, Antonellis P, Scanlan KT, Pettigrew NC, Martini DN, Chesnutt JC, King LA. Assessing the Effects of Mild Traumatic Brain Injury on Vestibular Home Exercise Performance with Wearable Sensors. Sensors (Basel) 2023; 23:9860. [PMID: 38139706 PMCID: PMC10748190 DOI: 10.3390/s23249860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
After a mild traumatic brain injury (mTBI), dizziness and balance problems are frequently reported, affecting individuals' daily lives and functioning. Vestibular rehabilitation is a standard treatment approach for addressing these issues, but its efficacy in this population remains inconclusive. A potential reason for suboptimal outcomes is the lack of objective monitoring of exercise performance, which is crucial for therapeutic success. This study utilized wearable inertial measurement units (IMUs) to quantify exercise performance in individuals with mTBI during home-based vestibular rehabilitation exercises. Seventy-three people with mTBI and fifty healthy controls were enrolled. Vestibular exercises were performed, and IMUs measured forehead and sternum velocities and range of motions. The mTBI group demonstrated a slower forehead peak angular velocity in all exercises, which may be a compensatory strategy to manage balance issues or symptom exacerbation. Additionally, the mTBI group exhibited a larger forehead range of motion during specific exercises, potentially linked to proprioceptive deficits. These findings emphasize the usefulness of utilizing IMUs to monitor the quality of home-based vestibular exercises for individuals with mTBI and the potential for IMUs improving rehabilitation outcomes.
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Affiliation(s)
- Kody R. Campbell
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (J.L.W.); (P.A.); (L.A.K.)
| | - Jennifer L. Wilhelm
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (J.L.W.); (P.A.); (L.A.K.)
| | - Prokopios Antonellis
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (J.L.W.); (P.A.); (L.A.K.)
| | - Kathleen T. Scanlan
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (J.L.W.); (P.A.); (L.A.K.)
| | - Natalie C. Pettigrew
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (J.L.W.); (P.A.); (L.A.K.)
| | - Douglas N. Martini
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA 01060, USA
| | - James C. Chesnutt
- Department of Family Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Laurie A. King
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA; (J.L.W.); (P.A.); (L.A.K.)
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Chen CC, Bery AK, Chang TP. Weak nystagmus in the dark persists for months after acute unilateral vestibular loss. Front Neurol 2023; 14:1327735. [PMID: 38162452 PMCID: PMC10754966 DOI: 10.3389/fneur.2023.1327735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Background Weak nystagmus with fixation removed can be seen both in normal individuals and in recovery from a unilateral vestibular insult, thus its clinical significance is unclear in patients with dizziness. We thus sought to compare features of nystagmus at various stages following unilateral vestibular loss (UVL). Methods We enrolled thirty consecutive patients after acute UVL with impaired vestibulo-ocular reflex (VOR) gain. The patients were allocated into three groups according to time from onset of symptoms: acute (1-7 days), subacute (8-30 days), and chronic (>30 days). Patients underwent video-oculography (with and without fixation) and video head impulse testing (vHIT) to determine VOR gain. We examined the relationships amongst SPV, VOR gain, and time from symptom onset across groups. Results There were 11, 10, and 9 patients in the acute, subacute, and chronic stages of UVL, respectively. With visual fixation, only 8 patients (26.7%) demonstrated nystagmus, all from the acute group. With fixation removed, 26 patients (86.7%) exhibited spontaneous nystagmus, including 90.9%, 90%, and 77.8% of the patients from the acute, subacute, and chronic groups, respectively. Horizontal nystagmus was paralytic (i.e., fast phase contralesional) in 25 (96.7%) cases. Horizontal SPV was negatively correlated with logarithm of time from onset to examination (r = -0.48, p = 0.007) and weakly negatively correlated with ipsilesional VOR gain (r = -0.325, p = 0.08). Conclusion In the subacute or chronic stages of UVL, paralytic nystagmus with fixation removed persisted at a low intensity. Therefore, weak nystagmus in the dark may have diagnostic value in chronic dizziness.
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Affiliation(s)
- Chih-Chung Chen
- Dizziness and Balance Disorder Center, Taipei Medical University–Shuang Ho Hospital, New Taipei City, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Anand K. Bery
- Division of Neuro-Visual and Vestibular Disorders, Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, United States
| | - Tzu-Pu Chang
- Department of Neurology/Neuro-medical Scientific Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- Department of Neurology, School of Medicine, Tzu Chi University, Hualien, Taiwan
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28
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Zhao Y, Wei Y, Wang Y, So RHY, Chan CCH, Cheung RTF, Wilkins A. Identification of the human cerebral cortical hemodynamic response to passive whole-body movements using near-infrared spectroscopy. Front Neurol 2023; 14:1280015. [PMID: 38152645 PMCID: PMC10751349 DOI: 10.3389/fneur.2023.1280015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/08/2023] [Indexed: 12/29/2023] Open
Abstract
The human vestibular system is crucial for motion perception, balance control, and various higher cognitive functions. Exploring how the cerebral cortex responds to vestibular signals is not only valuable for a better understanding of how the vestibular system participates in cognitive and motor functions but also clinically significant in diagnosing central vestibular disorders. Near-infrared spectroscopy (NIRS) provides a portable and non-invasive brain imaging technology to monitor cortical hemodynamics under physical motion. Objective This study aimed to investigate the cerebral cortical response to naturalistic vestibular stimulation induced by real physical motion and to validate the vestibular cerebral cortex previously identified using alternative vestibular stimulation. Approach Functional NIRS data were collected from 12 right-handed subjects when they were sitting in a motion platform that generated three types of whole-body passive translational motion (circular, lateral, and fore-and-aft). Main results The study found that different cortical regions were activated by the three types of motion. The cortical response was more widespread under circular motion in two dimensions compared to lateral and fore-and-aft motions in one dimensions. Overall, the identified regions were consistent with the cortical areas found to be activated in previous brain imaging studies. Significance The results provide new evidence of brain selectivity to different types of motion and validate previous findings on the vestibular cerebral cortex.
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Affiliation(s)
- Yue Zhao
- HKUST-Shenzhen Research Institute, Shenzhen, China
- Department of Industrial Engineering and Decision Analytics, Hong Kong University of Science and Technology, Kowloon, Hong Kong SAR, China
| | - Yue Wei
- HKUST-Shenzhen Research Institute, Shenzhen, China
- Department of Basic Psychology, School of Psychology, Shenzhen University, Shenzhen, China
| | - Yixuan Wang
- HKUST-Shenzhen Research Institute, Shenzhen, China
- Bio-Engineering Graduate Program, School of Engineering, Hong Kong University of Science and Technology, Kowloon, Hong Kong SAR, China
| | - Richard H. Y. So
- HKUST-Shenzhen Research Institute, Shenzhen, China
- Department of Industrial Engineering and Decision Analytics, Hong Kong University of Science and Technology, Kowloon, Hong Kong SAR, China
| | - Chetwyn C. H. Chan
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
| | - Raymond T. F. Cheung
- Department of Medicine, School of Clinical Medicine, University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Arnold Wilkins
- Centre for Brain Studies, University of Essex, Colchester, United Kingdom
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29
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Chari DA, Ahmad M, King S, Boutabla A, Fattahi C, Panic AS, Karmali F, Lewis RF. Vestibular damage affects the precision and accuracy of navigation in a virtual visual environment. Brain Commun 2023; 5:fcad345. [PMID: 38116141 PMCID: PMC10729862 DOI: 10.1093/braincomms/fcad345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/17/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Abstract
Vestibular information is available to the brain during navigation, as are the other self-generated (idiothetic) and external (allothetic) sensorimotor cues that contribute to central estimates of position and motion. Rodent studies provide strong evidence that vestibular information contributes to navigation but human studies have been less conclusive. Furthermore, sex-based differences have been described in human navigation studies performed with the head stationary, a situation where dynamic vestibular (and other idiothetic) information is absent, but sex differences in the utilization of vestibular information have not been described. Here, we studied men and women with severe bilateral vestibular damage as they navigated through a visually barren virtual reality environment and compared their performance to normal men and women. Two navigation protocols were employed, which either activated dynamic idiothetic cues ('dynamic task', navigate by turning, walking in place) or eliminated them ('static task', navigate with key presses, head stationary). For both protocols, we employed a standard 'triangle completion task' in which subjects moved to two visual targets in series and then were required to return to their perceived starting position without localizing visual information. The angular and linear 'accuracy' (derived from response error) and 'precision' (derived from response variability) were calculated. Comparing performance 'within tasks', navigation on the dynamic paradigm was worse in male vestibular-deficient patients than in normal men but vestibular-deficient and normal women were equivalent; on the static paradigm, vestibular-deficient men (but not women) performed better than normal subjects. Comparing performance 'between tasks', normal men performed better on the dynamic than the static paradigm while vestibular-deficient men and both normal and vestibular-deficient women were equivalent on both tasks. Statistical analysis demonstrated that for the angular precision metric, sex had a significant effect on the interaction between vestibular status and the test paradigm. These results provide evidence that humans use vestibular information when they navigate in a virtual visual environment and that men and women may utilize vestibular (and visual) information differently. On our navigation paradigm, men used vestibular information to improve navigation performance, and in the presence of severe vestibular damage, they utilized visual information more effectively. In contrast, we did not find evidence that women used vestibular information while navigating on our virtual task, nor did we find evidence that they improved their utilization of visual information in the presence of severe vestibular damage.
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Affiliation(s)
- Divya A Chari
- Department of Otolaryngolgy-Head and Neck Surgery, Massachusetts Eye and Ear, Boston MA 02114, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Massachusetts Medical School, Worcester MA 01655, USA
| | - Maimuna Ahmad
- Department of Otolaryngolgy-Head and Neck Surgery, Massachusetts Eye and Ear, Boston MA 02114, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Massachusetts Medical School, Worcester MA 01655, USA
| | - Susan King
- Department of Otolaryngolgy-Head and Neck Surgery, Massachusetts Eye and Ear, Boston MA 02114, USA
| | - Anissa Boutabla
- Department of Otolaryngolgy-Head and Neck Surgery, Massachusetts Eye and Ear, Boston MA 02114, USA
- Division of Otorhinolaryngology Head and Neck Surgery, Geneva University Hospitals and University of Geneva, Geneva 1205, Switzerland
| | - Cameron Fattahi
- Department of Otolaryngolgy-Head and Neck Surgery, Massachusetts Eye and Ear, Boston MA 02114, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Massachusetts Medical School, Worcester MA 01655, USA
| | - Alexander S Panic
- Ashton Graybiel Spatial Orientation Lab, Brandeis University, Waltham, MA 02454, USA
| | - Faisal Karmali
- Department of Otolaryngolgy-Head and Neck Surgery, Massachusetts Eye and Ear, Boston MA 02114, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA 02114, USA
| | - Richard F Lewis
- Department of Otolaryngolgy-Head and Neck Surgery, Massachusetts Eye and Ear, Boston MA 02114, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02114, USA
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Halow SJ, Hamilton A, Folmer E, MacNeilage PR. Impaired stationarity perception is associated with increased virtual reality sickness. J Vis 2023; 23:7. [PMID: 38127329 PMCID: PMC10750839 DOI: 10.1167/jov.23.14.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/05/2023] [Indexed: 12/23/2023] Open
Abstract
Stationarity perception refers to the ability to accurately perceive the surrounding visual environment as world-fixed during self-motion. Perception of stationarity depends on mechanisms that evaluate the congruence between retinal/oculomotor signals and head movement signals. In a series of psychophysical experiments, we systematically varied the congruence between retinal/oculomotor and head movement signals to find the range of visual gains that is compatible with perception of a stationary environment. On each trial, human subjects wearing a head-mounted display execute a yaw head movement and report whether the visual gain was perceived to be too slow or fast. A psychometric fit to the data across trials reveals the visual gain most compatible with stationarity (a measure of accuracy) and the sensitivity to visual gain manipulation (a measure of precision). Across experiments, we varied 1) the spatial frequency of the visual stimulus, 2) the retinal location of the visual stimulus (central vs. peripheral), and 3) fixation behavior (scene-fixed vs. head-fixed). Stationarity perception is most precise and accurate during scene-fixed fixation. Effects of spatial frequency and retinal stimulus location become evident during head-fixed fixation, when retinal image motion is increased. Virtual Reality sickness assessed using the Simulator Sickness Questionnaire covaries with perceptual performance. Decreased accuracy is associated with an increase in the nausea subscore, while decreased precision is associated with an increase in the oculomotor and disorientation subscores.
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Affiliation(s)
| | - Allie Hamilton
- University of Nevada, Reno, Psychology, Reno, Nevada, USA
| | - Eelke Folmer
- University of Nevada, Reno, Computer Science, Reno, Nevada, USA
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Broberg MA, Boyd BS. Similarities between explaining dizziness and explaining pain? Exploring common patient experiences, theoretical models, treatment approaches and potential therapeutic narratives for persistent dizziness or pain. Physiother Theory Pract 2023; 39:2502-2519. [PMID: 35751384 DOI: 10.1080/09593985.2022.2091497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 10/17/2022]
Abstract
Pain and dizziness are common experiences throughout the lifespan. However, nearly a quarter of those with acute pain or dizziness experience persistence, which is associated with disability, social isolation, psychological distress, decreased independence, and poorer quality of life. Thus, persistent pain or dizziness impacts peoples' lives in similarly negative ways. Conceptual models of pain and dizziness also have many similarities. Many of these models are more expansive than explaining mere symptoms; rather they describe pain or dizziness as holistic experiences that are influenced by biopsychosocial and contextual factors. These experiences also appear to be associated with multi-modal bodily responses related to evaluation of safety, threat detection and anticipation, as influenced by expectations, and predictions anticipation, not simply a reflection of tissue injury or pathology. Conceptual models also characterize the body as adaptable and therefore capable of recovery. These concepts may provide useful therapeutic narratives to facilitate understanding, dethreaten the experience, and provide hope for patients. In addition, therapeutic alliance, promoting an active movement-based approach, building self-efficacy, and condition-specific approaches can help optimize outcomes. In conclusion, there are significant overlaps in the patient experience, theoretical models and potential therapeutic narratives that guide care for people suffering with persistent pain or dizziness.
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Affiliation(s)
- Marc A Broberg
- Department of Physical Therapy, Two Trees Physical Therapy and Wellness, Ventura, CA, USA
| | - Benjamin S Boyd
- Department of Physical Therapy, Samuel Merritt University, Oakland, CA, USA
- Physical and Sports Medicine, Stanford ValleyCare, Livermore, CA, USA
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Liu B, Cao J, Lu W, Yao H. Toothbrushing-induced vestibular ulcerations with severe gingival defects. Gerodontology 2023; 40:523-525. [PMID: 37971287 DOI: 10.1111/ger.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Daily toothbrushing is a routine approach for helping to keep the oral cavity healthy. However, using a toothbrush as an ordinary oral hygiene habit can also lead to adverse events. CASE PRESENTATION A 75-year-old man was referred by a periodontist for vestibular ulcerations with gingival defects. The patient reported no significant medical or social history, which might be associated with his symptoms. On examination, wide labio-buccal gingival defects, white attached gingiva and linear vestibular ulcerations were observed. With the help of the periodontist, a diagnosis of inappropriate toothbrushing-induced traumatic ulcerations was reasoned via an approach of aetiological elimination. The patient was put on a trial course of topical dexamethasone powder with lincomycin. The resolution of vestibular ulcerations was apparent after two weeks. He reported no similar oral ulcerations during the following nine years. CONCLUSION To our knowledge, this is the first case reported in the literature of vestibular ulcerations with severe gingival defects caused by inappropriate toothbrushing. The establishment of a correct diagnosis needs a close collaboration between periodontists and oral medicine specialists. Instruction on correct toothbrushing, especially for older people can be beneficial.
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Affiliation(s)
- Beili Liu
- Department of Prosthodontics, Dental & Ophthalmic Clinic of Putuo District, Shanghai, China
| | - Jie Cao
- Department of Prosthodontics, Dental & Ophthalmic Clinic of Putuo District, Shanghai, China
| | - Weiqing Lu
- Department of Periodontics, Dental & Ophthalmic Clinic of Putuo District, Shanghai, China
| | - Hui Yao
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Jiao Tong University, Shanghai, China
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Quimby AE, Wen CZ, Ruckenstein MJ, Brant JA, Bigelow DC. Caloric function as a predictor of cochlear implant performance. Cochlear Implants Int 2023:1-8. [PMID: 38032414 DOI: 10.1080/14670100.2023.2286165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
OBJECTIVES Changes in vestibular function have been demonstrated following cochlear implantation (CI). The functional impact of these changes on CI performance has not been well-studied. We sought to assess whether caloric changes postimplantation could predict CI performance. METHODS Retrospective review of a prospectively collected database at a tertiary care hospital. Patients who underwent CI over a 22-year period (1999-2021) and had videonystagmography (VNG) testing pre- and postimplantation were included. Caloric responses were compared pre- versus post-implantation, and assessed for their ability to predict CI performance as evaluated using AzBio +10 decibels signal-to-noise ratio (dB S/N) scores. RESULTS 43 CI recipients were included. There was a significant difference in the average maximal slow-phase velocity in response to caloric irrigation in the implanted ear pre- versus post-operatively (21.2 vs. 18.5 deg/s; p = 0.02). Controlling for age and pre-implantation speech recognition performance, pre- and post-implantation caloric responses in the implanted ear significantly predicted CI performance at 0-6 months and >6 months post-implantation. Caloric changes following implantation were not significantly correlated with CI performance. CONCLUSION CI impacts vestibular function as evidenced by changes in caloric responses. Vestibular function pre- and possibly post-CI may be clinically useful metrics for predicting some proportion of CI performance variability.
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Affiliation(s)
- Alexandra E Quimby
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Z Wen
- Department of Otorhinolaryngology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Michael J Ruckenstein
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jason A Brant
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Douglas C Bigelow
- Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Martin HR, Lysakowski A, Eatock RA. The potassium channel subunit K V1.8 ( Kcna10) is essential for the distinctive outwardly rectifying conductances of type I and II vestibular hair cells. bioRxiv 2023:2023.11.21.563853. [PMID: 38045305 PMCID: PMC10690164 DOI: 10.1101/2023.11.21.563853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
In amniotes, head motions and tilt are detected by two types of vestibular hair cells (HCs) with strikingly different morphology and physiology. Mature type I HCs express a large and very unusual potassium conductance, gK,L, which activates negative to resting potential, confers very negative resting potentials and low input resistances, and enhances an unusual non-quantal transmission from type I cells onto their calyceal afferent terminals. Following clues pointing to KV1.8 (KCNA10) in the Shaker K channel family as a candidate gK,L subunit, we compared whole-cell voltage-dependent currents from utricular hair cells of KV1.8-null mice and littermate controls. We found that KV1.8 is necessary not just for gK,L but also for fast-inactivating and delayed rectifier currents in type II HCs, which activate positive to resting potential. The distinct properties of the three KV1.8-dependent conductances may reflect different mixing with other KV1 subunits, such as KV1.4 (KCNA4). In KV1.8-null HCs of both types, residual outwardly rectifying conductances include KV7 (KCNQ) channels. Current clamp records show that in both HC types, KV1.8-dependent conductances increase the speed and damping of voltage responses. Features that speed up vestibular receptor potentials and non-quantal afferent transmission may have helped stabilize locomotion as tetrapods moved from water to land.
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Affiliation(s)
| | - Anna Lysakowski
- University of Illinois at Chicago, Department of Anatomy and Cell Biology
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35
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Lin A, Álvarez-Salvado E, Milicic N, Pujara N, Ehrlich DE. Multisensory navigational strategies of hatchling fish for dispersal. Curr Biol 2023; 33:4917-4925.e4. [PMID: 37865093 PMCID: PMC10842570 DOI: 10.1016/j.cub.2023.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/23/2023]
Abstract
Animals influence how they disperse in the environment by sensing local cues and adapting how they move. However, controlling dispersal can present a particular challenge early in life when animals tend to be more limited in their capacities to sense and move. To what extent and by what mechanisms can newly hatched fish control how they disperse? Here, we reveal hatchling sensorimotor mechanisms for controlling dispersal by combining swim tracking and precise sensory manipulations of a model species, zebrafish. In controlled laboratory experiments, if we physically constrained hatchlings or blocked sensations of motion through vision and the lateral line, hatchlings responded by elevating their buoyancy and passively moving with faster surface currents. Complementarily, in stagnant water, hatchlings covered more ground using hyperstable swimming, strongly orienting based on graviception. Using experimentally calibrated hydrodynamic simulations, we show that these hatchling behaviors nearly tripled diffusivity and made dispersal robust to local conditions, suggesting this multisensory strategy may provide important advantages for early life in a variable environment.
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Affiliation(s)
- Allia Lin
- Department of Integrative Biology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Efrén Álvarez-Salvado
- Department of Integrative Biology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Nikola Milicic
- Department of Integrative Biology, University of Wisconsin-Madison, Madison, WI 53706, USA; Integrative Biology Graduate Program, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Nimish Pujara
- Department of Civil and Environmental Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - David E Ehrlich
- Department of Integrative Biology, University of Wisconsin-Madison, Madison, WI 53706, USA; Integrative Biology Graduate Program, University of Wisconsin-Madison, Madison, WI 53706, USA.
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Vimal VP, Panic AS, Lackner JR, DiZio P. Vibrotactile feedback as a countermeasure for spatial disorientation. Front Physiol 2023; 14:1249962. [PMID: 38028769 PMCID: PMC10657135 DOI: 10.3389/fphys.2023.1249962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Spaceflight can make astronauts susceptible to spatial disorientation which is one of the leading causes of fatal aircraft accidents. In our experiment, blindfolded participants used a joystick to balance themselves while inside a multi-axis rotation device (MARS) in either the vertical or horizontal roll plane. On Day 1, in the vertical roll plane (Earth analog condition) participants could use gravitational cues and therefore had a good sense of their orientation. On Day 2, in the horizontal roll plane (spaceflight analog condition) participants could not use gravitational cues and rapidly became disoriented and showed minimal learning and poor performance. One potential countermeasure for spatial disorientation is vibrotactile feedback that conveys body orientation provided by small vibrating devices applied to the skin. Orientation-dependent vibrotactile feedback provided to one group enhanced performance in the spaceflight condition but the participants reported a conflict between the accurate vibrotactile cues and their erroneous perception of their orientation. Specialized vibrotactile training on Day 1 provided to another group resulted in significantly better learning and performance in the spaceflight analog task with vibrotactile cueing. In this training, participants in the Earth analog condition on Day 1 were required to disengage from the task of aligning with the gravitational vertical encoded by natural vestibular/somatosensory afference and had to align with randomized non-vertical directions of balance signaled by vibrotactile feedback. At the end of Day 2, we deactivated the vibrotactile feedback after both vibration-cued groups had practiced with it in the spaceflight analog condition. They performed as well as the group who did not have any vibrotactile feedback. We conclude that after appropriate training, vibrotactile orientation feedback augments dynamic spatial orientation and does not lead to any negative dependence.
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Affiliation(s)
- Vivekanand Pandey Vimal
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, MA, United States
- Volen Center for Complex Systems, Brandeis University, Waltham, MA, United States
| | - Alexander Sacha Panic
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, MA, United States
| | - James R. Lackner
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, MA, United States
- Volen Center for Complex Systems, Brandeis University, Waltham, MA, United States
- Psychology Department, Brandeis University, Waltham, MA, United States
| | - Paul DiZio
- Ashton Graybiel Spatial Orientation Laboratory, Brandeis University, Waltham, MA, United States
- Volen Center for Complex Systems, Brandeis University, Waltham, MA, United States
- Psychology Department, Brandeis University, Waltham, MA, United States
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Parabakan Polat A, Demir S, Kale Ö, Kuntman BD, Erbek HS. Evaluation of Mental Rotation Ability in Patients with Unilateral Benign Paroxysmal Positional Vertigo. J Int Adv Otol 2023; 19:529-534. [PMID: 38088328 PMCID: PMC10765187 DOI: 10.5152/iao.2023.22964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 07/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Our study aims to determine whether there are differences in mental rotation abilities between unilateral benign paroxysmal positional vertigo patients and healthy controls using object-based mental rotation tasks. METHODS Our study included 17 unilateral posterior canal benign paroxysmal positional vertigo patients and 20 healthy adults. Spontaneous nystagmus test, saccade test, and dynamic positional tests with videonystagmography and object-based mental rotation test with 2-dimensional images of cubes rotated at certain angles in 3-dimensional space were performed on the participants. The mental rotation test response time and the number of correct answers were compared between patients and controls. We also evaluated whether there was a relationship between saccade test parameters and mental rotation test parameters in our study. RESULTS No significant relationship was found between benign paroxysmal positional vertigo patients and controls on any of the dependent measures (P -gt; .05). When we evaluated the relationship between saccadic latency and accuracy and mental rotation test response time and number of correct answers in benign paroxysmal positional vertigo patients, no significant relationship was found (P -gt; .05). CONCLUSION Our findings show that unilateral, posterior canal benign paroxysmal positional vertigo does not affect object-based mental rotation performance. In our study, no correlation was found between saccadic function and mental rotation ability in unilateral benign paroxysmal positional vertigo patients.
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Affiliation(s)
- Anı Parabakan Polat
- Department of Audiology, University of Health Sciences, Gülhane Faculty of Health Sciences, Ankara, Turkey
| | - Serpil Demir
- Department of Otorhinolaryngology, Başkent University, School of Medicine, Ankara, Turkey
| | - Özge Kale
- Department of Otorhinolaryngology, Başkent University, School of Medicine, Ankara, Turkey
| | - Berna Deniz Kuntman
- Department of Audiology, University of Health Sciences, Gülhane Faculty of Health Sciences, Ankara, Turkey
| | - Hatice Seyra Erbek
- Department of Otolaryngology Head and Neck Surgery, Başkent University, Faculty of Medicine, Ankara, Turkey
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Machuca-Márquez P, Sánchez-Benito L, Menardy F, Urpi A, Girona M, Puighermanal E, Appiah I, Palmiter RD, Sanz E, Quintana A. Vestibular CCK signaling drives motion sickness-like behavior in mice. Proc Natl Acad Sci U S A 2023; 120:e2304933120. [PMID: 37847729 PMCID: PMC10622874 DOI: 10.1073/pnas.2304933120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/23/2023] [Indexed: 10/19/2023] Open
Abstract
Travel can induce motion sickness (MS) in susceptible individuals. MS is an evolutionary conserved mechanism caused by mismatches between motion-related sensory information and past visual and motion memory, triggering a malaise accompanied by hypolocomotion, hypothermia, hypophagia, and nausea. Vestibular nuclei (VN) are critical for the processing of movement input from the inner ear. Motion-induced activation of VN neurons recapitulates MS-related signs. However, the genetic identity of VN neurons mediating MS-related autonomic and aversive responses remains unknown. Here, we identify a central role of cholecystokinin (CCK)-expressing VN neurons in motion-induced malaise. Moreover, we show that CCK VN inputs onto the parabrachial nucleus activate Calca-expressing neurons and are sufficient to establish avoidance to novel food, which is prevented by CCK-A receptor antagonism. These observations provide greater insight into the neurobiological regulation of MS by identifying the neural substrates of MS and providing potential targets for treatment.
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Affiliation(s)
| | - Laura Sánchez-Benito
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Fabien Menardy
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Andrea Urpi
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Mònica Girona
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Emma Puighermanal
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Isabella Appiah
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Richard D. Palmiter
- HHMI, University of Washington, Seattle, WA98195
- Department of Biochemistry, University of Washington, Seattle, WA98195
| | - Elisenda Sanz
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Albert Quintana
- Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona08193, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona08193, Spain
- Focus Area for Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom2520, South Africa
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Pastras CJ, Curthoys IS, Asadnia M, McAlpine D, Rabbitt RD, Brown DJ. Evidence That Ultrafast Nonquantal Transmission Underlies Synchronized Vestibular Action Potential Generation. J Neurosci 2023; 43:7149-7157. [PMID: 37775302 PMCID: PMC10601366 DOI: 10.1523/jneurosci.1417-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/10/2023] [Accepted: 09/13/2023] [Indexed: 10/01/2023] Open
Abstract
Amniotes evolved a unique postsynaptic terminal in the inner ear vestibular organs called the calyx that receives both quantal and nonquantal (NQ) synaptic inputs from Type I sensory hair cells. The nonquantal synaptic current includes an ultrafast component that has been hypothesized to underlie the exceptionally high synchronization index (vector strength) of vestibular afferent neurons in response to sound and vibration. Here, we present three lines of evidence supporting the hypothesis that nonquantal transmission is responsible for synchronized vestibular action potentials of short latency in the guinea pig utricle of either sex. First, synchronized vestibular nerve responses are unchanged after administration of the AMPA receptor antagonist CNQX, while auditory nerve responses are completely abolished. Second, stimulus evoked vestibular nerve compound action potentials (vCAP) are shown to occur without measurable synaptic delay and three times shorter than the latency of auditory nerve compound action potentials (cCAP), relative to the generation of extracellular receptor potentials. Third, paired-pulse stimuli designed to deplete the readily releasable pool (RRP) of synaptic vesicles in hair cells reveal forward masking in guinea pig auditory cCAPs, but a complete lack of forward masking in vestibular vCAPs. Results support the conclusion that the fast component of nonquantal transmission at calyceal synapses is indefatigable and responsible for ultrafast responses of vestibular organs evoked by transient stimuli.SIGNIFICANCE STATEMENT The mammalian vestibular system drives some of the fastest reflex pathways in the nervous system, ensuring stable gaze and postural control for locomotion on land. To achieve this, terrestrial amniotes evolved a large, unique calyx afferent terminal which completely envelopes one or more presynaptic vestibular hair cells, which transmits mechanosensory signals mediated by quantal and nonquantal (NQ) synaptic transmission. We present several lines of evidence in the guinea pig which reveals the most sensitive vestibular afferents are remarkably fast, much faster than their auditory nerve counterparts. Here, we present neurophysiological and pharmacological evidence that demonstrates this vestibular speed advantage arises from ultrafast NQ electrical synaptic transmission from Type I hair cells to their calyx partners.
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Affiliation(s)
- Christopher J Pastras
- Faculty of Science and Engineering, School of Engineering, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Ian S Curthoys
- School of Psychology, Vestibular Research Laboratory, The University of Sydney, Sydney, New South Wales 2050, Australia
- Department of Linguistics, The Australian Hearing Hub, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Mohsen Asadnia
- Faculty of Science and Engineering, School of Engineering, Macquarie University, Sydney, New South Wales 2109, Australia
| | - David McAlpine
- Department of Linguistics, The Australian Hearing Hub, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Richard D Rabbitt
- Departments of Biomedical Engineering, Otolaryngology, and Neuroscience Program, University of Utah, Salt Lake City, Utah 84112
| | - Daniel J Brown
- School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, Western Australia 6102, Australia
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Lin R, Zeng F, Wang Q, Chen A. Cross-Modal Plasticity during Self-Motion Perception. Brain Sci 2023; 13:1504. [PMID: 38002465 PMCID: PMC10669852 DOI: 10.3390/brainsci13111504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
To maintain stable and coherent perception in an ever-changing environment, the brain needs to continuously and dynamically calibrate information from multiple sensory sources, using sensory and non-sensory information in a flexible manner. Here, we review how the vestibular and visual signals are recalibrated during self-motion perception. We illustrate two different types of recalibration: one long-term cross-modal (visual-vestibular) recalibration concerning how multisensory cues recalibrate over time in response to a constant cue discrepancy, and one rapid-term cross-modal (visual-vestibular) recalibration concerning how recent prior stimuli and choices differentially affect subsequent self-motion decisions. In addition, we highlight the neural substrates of long-term visual-vestibular recalibration, with profound differences observed in neuronal recalibration across multisensory cortical areas. We suggest that multisensory recalibration is a complex process in the brain, is modulated by many factors, and requires the coordination of many distinct cortical areas. We hope this review will shed some light on research into the neural circuits of visual-vestibular recalibration and help develop a more generalized theory for cross-modal plasticity.
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Affiliation(s)
- Rushi Lin
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, 3663 Zhongshan Road N., Shanghai 200062, China; (R.L.); (F.Z.); (Q.W.)
| | - Fu Zeng
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, 3663 Zhongshan Road N., Shanghai 200062, China; (R.L.); (F.Z.); (Q.W.)
| | - Qingjun Wang
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, 3663 Zhongshan Road N., Shanghai 200062, China; (R.L.); (F.Z.); (Q.W.)
| | - Aihua Chen
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, 3663 Zhongshan Road N., Shanghai 200062, China; (R.L.); (F.Z.); (Q.W.)
- NYU-ECNU Institute of Brain and Cognitive Science, New York University Shanghai, Shanghai 200122, China
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Mowery TM, Wackym PA, Nacipucha J, Dangcil E, Stadler RD, Tucker A, Carayannopoulos NL, Beshy MA, Hong SS, Yao JD. Superior semicircular canal dehiscence and subsequent closure induces reversible impaired decision-making. Front Neurol 2023; 14:1259030. [PMID: 37905188 PMCID: PMC10613502 DOI: 10.3389/fneur.2023.1259030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/14/2023] [Indexed: 11/02/2023] Open
Abstract
Background Vestibular loss and dysfunction has been associated with cognitive deficits, decreased spatial navigation, spatial memory, visuospatial ability, attention, executive function, and processing speed among others. Superior semicircular canal dehiscence (SSCD) is a vestibular-cochlear disorder in humans in which a pathological third mobile window of the otic capsule creates changes to the flow of sound pressure energy through the perilymph/endolymph. The primary symptoms include sound-induced dizziness/vertigo, inner ear conductive hearing loss, autophony, headaches, and visual problems; however, individuals also experience measurable deficits in basic decision-making, short-term memory, concentration, spatial cognition, and depression. These suggest central mechanisms of impairment are associated with vestibular disorders; therefore, we directly tested this hypothesis using both an auditory and visual decision-making task of varying difficulty levels in our model of SSCD. Methods Adult Mongolian gerbils (n = 33) were trained on one of four versions of a Go-NoGo stimulus presentation rate discrimination task that included standard ("easy") or more difficult ("hard") auditory and visual stimuli. After 10 days of training, preoperative ABR and c+VEMP testing was followed by a surgical fenestration of the left superior semicircular canal. Animals with persistent circling or head tilt were excluded to minimize effects from acute vestibular injury. Testing recommenced at postoperative day 5 and continued through postoperative day 15 at which point final ABR and c+VEMP testing was carried out. Results Behavioral data (d-primes) were compared between preoperative performance (training day 8-10) and postoperative days 6-8 and 13-15. Behavioral performance was measured during the peak of SSCD induced ABR and c + VEMP impairment and the return towards baseline as the dehiscence began to resurface by osteoneogenesis. There were significant differences in behavioral performance (d-prime) and its behavioral components (Hits, Misses, False Alarms, and Correct Rejections). These changes were highly correlated with persistent deficits in c + VEMPs at the end of training (postoperative day 15). The controls demonstrated additional learning post procedure that was absent in the SSCD group. Conclusion These results suggest that aberrant asymmetric vestibular output results in decision-making impairments in these discrimination tasks and could be associated with the other cognitive impairments resulting from vestibular dysfunction.
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Affiliation(s)
- Todd M. Mowery
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
- Rutgers Brain Health Institute, New Brunswick, NJ, United States
| | - P. Ashley Wackym
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
- Rutgers Brain Health Institute, New Brunswick, NJ, United States
| | - Jacqueline Nacipucha
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Evelynne Dangcil
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Ryan D. Stadler
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Aaron Tucker
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Nicolas L. Carayannopoulos
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Mina A. Beshy
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Sean S. Hong
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Justin D. Yao
- Department of Otolaryngology – Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
- Rutgers Brain Health Institute, New Brunswick, NJ, United States
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Grove CR, Klatt BN, Wagner AR, Anson ER. Vestibular perceptual testing from lab to clinic: a review. Front Neurol 2023; 14:1265889. [PMID: 37859653 PMCID: PMC10583719 DOI: 10.3389/fneur.2023.1265889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Not all dizziness presents as vertigo, suggesting other perceptual symptoms for individuals with vestibular disease. These non-specific perceptual complaints of dizziness have led to a recent resurgence in literature examining vestibular perceptual testing with the aim to enhance clinical diagnostics and therapeutics. Recent evidence supports incorporating rehabilitation methods to retrain vestibular perception. This review describes the current field of vestibular perceptual testing from scientific laboratory techniques that may not be clinic friendly to some low-tech options that may be more clinic friendly. Limitations are highlighted suggesting directions for additional research.
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Affiliation(s)
- Colin R. Grove
- Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Division of Physical Therapy, Department of Physical Medicine and Rehabilitation School of Medicine, Emory University, Atlanta, GA, United States
| | - Brooke N. Klatt
- Physical Therapy Department, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrew R. Wagner
- Department of Otolaryngology—Head and Neck Surgery, Ohio State University Wexner Medical Center, Columbus, OH, United States
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH, United States
| | - Eric R. Anson
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States
- Physical Therapy Department, University of Rochester, Rochester, NY, United States
- Department of Neuroscience, University of Rochester, Rochester, NY, United States
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Preszler J, Manderino L, Fazio-Sumrok V, Eagle SR, Holland C, Collins MW, Kontos AP. Multidomain concussion symptoms in adolescents: A network analysis. Appl Neuropsychol Child 2023; 12:294-303. [PMID: 35853233 DOI: 10.1080/21622965.2022.2099742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Concussion is a heterogeneous injury involving symptoms and impairment that represent multiple domains (e.g., anxiety, cognitive, vestibular). Network analysis, a modeling technique that estimates relationships among symptoms, provides a statistically sound and clinically practical method for evaluating these interrelationships. The purpose of this study was to examine, using network analysis, relationships among clinical assessments and multidomain symptom report within a sample of adolescent patients following a concussion. Participants included 326 patients (49.7% female) aged 10-21 years presenting to a concussion specialty clinic within 28 days of a diagnosed concussion. Participants completed the Post-Concussion Symptom Scale (PCSS) and Vestibular-Ocular Motor Screening (VOMS) tool at initial visit. Network models were applied to PCSS symptoms initially, and then applied to VOMS and PCSS symptom data together. Dizziness (Expected influence (EI) = 1.10) and sadness (EI = 1.91) were most central (i.e., highest cumulative partial correlations) to the symptom network. Numerous interdomain relationships were supported, including irritability with mental fogginess (edgeweight = 0.12), dizziness with headache (edgeweight = 0.16), and dizziness with vision problems (edgeweight = 0.13). Community analyses resulted in VOMS groupings by domain (e.g., vestibular) and symptom (e.g., dizziness). The findings suggest a more direct focus on symptom interrelationships, such as how dizziness contributes to emotional symptoms, may help guide and better target treatments. Also, results suggest grouping VOMS assessment by symptom (e.g., dizziness) and item (e.g., vestibular-ocular reflex) may better reflect underlying impairments reflected by these symptom-item combinations.
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Affiliation(s)
- Jonathan Preszler
- UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA
| | - Lisa Manderino
- UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA
| | - Vanessa Fazio-Sumrok
- UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shawn R Eagle
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cynthia Holland
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael W Collins
- UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anthony P Kontos
- UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Lambert FM, Beraneck M, Straka H, Simmers J. Locomotor efference copy signaling and gaze control: An evolutionary perspective. Curr Opin Neurobiol 2023; 82:102761. [PMID: 37604066 DOI: 10.1016/j.conb.2023.102761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/08/2023] [Accepted: 07/22/2023] [Indexed: 08/23/2023]
Abstract
Neural replicas of the spinal motor commands that drive locomotion have become increasingly recognized as an intrinsic neural mechanism for producing gaze-stabilizing eye movements that counteract the perturbing effects of self-generated head/body motion. By pre-empting reactive signaling by motion-detecting vestibular sensors, such locomotor efference copies (ECs) provide estimates of the sensory consequences of behavioral action. Initially demonstrated in amphibian larvae during spontaneous fictive swimming in deafferented in vitro preparations, direct evidence for a contribution of locomotor ECs to gaze stabilization now extends to the ancestral lamprey and to tetrapod adult frogs and mice. Supporting behavioral evidence also exists for other mammals, including humans, therefore further indicating the mechanism's conservation during vertebrate evolution. The relationship between feedforward ECs and vestibular sensory feedback in ocular movement control is variable, ranging from additive to the former supplanting the latter, depending on vestibular sensing ability, and the intensity and regularity of rhythmic locomotor movements.
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Affiliation(s)
- François M Lambert
- Institut des Neurosciences Cognitives et Intégratives d'Aquitaine, CNRS Unité Mixte de Recherche 5287, Université de Bordeaux, 33706 Bordeaux, France
| | - Mathieu Beraneck
- Integrative Neuroscience and Cognition Center, CNRS UMR 8002, Université Paris Cité, 75006 Paris, France
| | - Hans Straka
- Department Biology II, Ludwig-Maximilians-University Munich, 82152 Planegg, Germany
| | - John Simmers
- Institut des Neurosciences Cognitives et Intégratives d'Aquitaine, CNRS Unité Mixte de Recherche 5287, Université de Bordeaux, 33706 Bordeaux, France.
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Zeng Z, Zhang C, Gu Y. Visuo- vestibular heading perception: a model system to study multi-sensory decision making. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220334. [PMID: 37545303 PMCID: PMC10404926 DOI: 10.1098/rstb.2022.0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/15/2023] [Indexed: 08/08/2023] Open
Abstract
Integrating noisy signals across time as well as sensory modalities, a process named multi-sensory decision making (MSDM), is an essential strategy for making more accurate and sensitive decisions in complex environments. Although this field is just emerging, recent extraordinary works from different perspectives, including computational theory, psychophysical behaviour and neurophysiology, begin to shed new light onto MSDM. In the current review, we focus on MSDM by using a model system of visuo-vestibular heading. Combining well-controlled behavioural paradigms on virtual-reality systems, single-unit recordings, causal manipulations and computational theory based on spiking activity, recent progress reveals that vestibular signals contain complex temporal dynamics in many brain regions, including unisensory, multi-sensory and sensory-motor association areas. This challenges the brain for cue integration across time and sensory modality such as optic flow which mainly contains a motion velocity signal. In addition, new evidence from the higher-level decision-related areas, mostly in the posterior and frontal/prefrontal regions, helps revise our conventional thought on how signals from different sensory modalities may be processed, converged, and moment-by-moment accumulated through neural circuits for forming a unified, optimal perceptual decision. This article is part of the theme issue 'Decision and control processes in multisensory perception'.
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Affiliation(s)
- Zhao Zeng
- CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, 200031 Shanghai, People's Republic of China
- University of Chinese Academy of Sciences, 100049 Beijing, People's Republic of China
| | - Ce Zhang
- CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, 200031 Shanghai, People's Republic of China
- University of Chinese Academy of Sciences, 100049 Beijing, People's Republic of China
| | - Yong Gu
- CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, 200031 Shanghai, People's Republic of China
- University of Chinese Academy of Sciences, 100049 Beijing, People's Republic of China
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Jerjian SJ, Harsch DR, Fetsch CR. Self-motion perception and sequential decision-making: where are we heading? Philos Trans R Soc Lond B Biol Sci 2023; 378:20220333. [PMID: 37545301 PMCID: PMC10404932 DOI: 10.1098/rstb.2022.0333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/18/2023] [Indexed: 08/08/2023] Open
Abstract
To navigate and guide adaptive behaviour in a dynamic environment, animals must accurately estimate their own motion relative to the external world. This is a fundamentally multisensory process involving integration of visual, vestibular and kinesthetic inputs. Ideal observer models, paired with careful neurophysiological investigation, helped to reveal how visual and vestibular signals are combined to support perception of linear self-motion direction, or heading. Recent work has extended these findings by emphasizing the dimension of time, both with regard to stimulus dynamics and the trade-off between speed and accuracy. Both time and certainty-i.e. the degree of confidence in a multisensory decision-are essential to the ecological goals of the system: terminating a decision process is necessary for timely action, and predicting one's accuracy is critical for making multiple decisions in a sequence, as in navigation. Here, we summarize a leading model for multisensory decision-making, then show how the model can be extended to study confidence in heading discrimination. Lastly, we preview ongoing efforts to bridge self-motion perception and navigation per se, including closed-loop virtual reality and active self-motion. The design of unconstrained, ethologically inspired tasks, accompanied by large-scale neural recordings, raise promise for a deeper understanding of spatial perception and decision-making in the behaving animal. This article is part of the theme issue 'Decision and control processes in multisensory perception'.
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Affiliation(s)
- Steven J. Jerjian
- Solomon H. Snyder Department of Neuroscience, Zanvyl Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Devin R. Harsch
- Solomon H. Snyder Department of Neuroscience, Zanvyl Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD 21218, USA
- Center for Neuroscience and Department of Neurobiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Christopher R. Fetsch
- Solomon H. Snyder Department of Neuroscience, Zanvyl Krieger Mind/Brain Institute, Johns Hopkins University, Baltimore, MD 21218, USA
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Paplou VG, Schubert NMA, van Tuinen M, Vijayakumar S, Pyott SJ. Functional, Morphological and Molecular Changes Reveal the Mechanisms Associated with Age-Related Vestibular Loss. Biomolecules 2023; 13:1429. [PMID: 37759828 PMCID: PMC10526133 DOI: 10.3390/biom13091429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Age-related loss of vestibular function and hearing are common disorders that arise from the loss of function of the inner ear and significantly decrease quality of life. The underlying pathophysiological mechanisms are poorly understood and difficult to investigate in humans. Therefore, our study examined young (1.5-month-old) and old (24-month-old) C57BL/6 mice, utilizing physiological, histological, and transcriptomic methods. Vestibular sensory-evoked potentials revealed that older mice had reduced wave I amplitudes and delayed wave I latencies, indicating reduced vestibular function. Immunofluorescence and image analysis revealed that older mice exhibited a significant decline in type I sensory hair cell density, particularly in hair cells connected to dimorphic vestibular afferents. An analysis of gene expression in the isolated vestibule revealed the upregulation of immune-related genes and the downregulation of genes associated with ossification and nervous system development. A comparison with the isolated cochlear sensorineural structures showed similar changes in genes related to immune response, chondrocyte differentiation, and myelin formation. These findings suggest that age-related vestibular hypofunction is linked to diminished peripheral vestibular responses, likely due to the loss of a specific subpopulation of hair cells and calyceal afferents. The upregulation of immune- and inflammation-related genes implies that inflammation contributes to these functional and structural changes. Furthermore, the comparison of gene expression between the vestibule and cochlea indicates both shared and distinct mechanisms contributing to age-related vestibular and hearing impairments. Further research is necessary to understand the mechanistic connection between inflammation and age-related balance and hearing disorders and to translate these findings into clinical treatment strategies.
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Affiliation(s)
- Vasiliki Georgia Paplou
- Department of Otorhinolaryngology and Head/Neck Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (V.G.P.); (N.M.A.S.); (M.v.T.)
| | - Nick M. A. Schubert
- Department of Otorhinolaryngology and Head/Neck Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (V.G.P.); (N.M.A.S.); (M.v.T.)
- Graduate School of Medical Sciences Research, School of Behavioural and Cognitive Neurosciences, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Marcel van Tuinen
- Department of Otorhinolaryngology and Head/Neck Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (V.G.P.); (N.M.A.S.); (M.v.T.)
| | - Sarath Vijayakumar
- Department of Biomedical Sciences, School of Medicine, Creighton University, Omaha, NE 68178, USA;
| | - Sonja J. Pyott
- Department of Otorhinolaryngology and Head/Neck Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (V.G.P.); (N.M.A.S.); (M.v.T.)
- Graduate School of Medical Sciences Research, School of Behavioural and Cognitive Neurosciences, University of Groningen, 9713 AV Groningen, The Netherlands
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Chang TP, Kheradmand A, Kim JS, Kojima Y, Manto MU. Editorial: Nystagmus in vestibular and cerebellar disorders. Front Neurol 2023; 14:1289354. [PMID: 37799286 PMCID: PMC10548371 DOI: 10.3389/fneur.2023.1289354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- Tzu-Pu Chang
- Department of Neurology/Neuro-medical Scientific Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- Department of Neurology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Amir Kheradmand
- Department of Neurology, Johns Hopkins, Baltimore, MD, United States
| | - Ji-Soo Kim
- Department of Neurolgy, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yoshiko Kojima
- Department of Otolaryngology – Head and Neck Surgery, Washington National Primate Research Center, University of Washington, Seattle, WA, United States
| | - Mario U. Manto
- Service des Neurosciences, Université de Mons, Mons, Belgium
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Kojima Y, Ling L, Phillips JO. Compensatory saccade in the vestibular impaired monkey. Front Neurol 2023; 14:1198274. [PMID: 37780695 PMCID: PMC10538121 DOI: 10.3389/fneur.2023.1198274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/11/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Loss of the vestibulo-ocular reflex (VOR) affects visual acuity during head movements. Patients with unilateral and bilateral vestibular deficits often use saccadic eye movements to compensate for an inadequate VOR. Two types of compensatory saccades have been distinguished, covert saccades and overt saccades. Covert saccades occur during head rotation, whereas overt saccades occur after the head has stopped moving. The generation of covert saccades is part of a central vestibular compensation process that improves visual acuity and suppresses oscillopsia. Understanding the covert saccade mechanism may facilitate vestibular rehabilitation strategies that can improve the patient's quality of life. To understand the brain mechanisms underlying covert saccades at the neural level, studies in an animal model are necessary. In this study, we employed non-human primates whose vestibular end organs are injured. Methods We examined eye movement during the head-impulse test, which is a clinical test to evaluate the vestibulo-ocular reflex. During this test, the monkeys are required to fixate on a target and the head is rapidly and unexpectedly rotated to stimulate the horizontal semi-circular canals. Results Similar to human subjects, monkeys made compensatory saccades. We compared these saccades with catch-up saccades following a moving target that simulates the visual conditions during the head impulse test. The shortest latency of the catch-up saccades was 250 ms, which indicates that it requires at least 250 ms to induce saccades by a visual signal. The latency of some compensatory saccades is shorter than 250 ms during the head impulse test, suggesting that such short latency compensatory saccades were not induced visually. The peak velocity of the short latency saccades was significantly lower than that of longer latency saccades. The peak velocity of these longer latency saccades was closer to that of visually guided saccades induced by a stepping target. Conclusion These results are consistent with studies in human patients. Thus, this study demonstrates, for the first time, compensatory covert saccades in vestibular impaired monkeys.
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Affiliation(s)
- Yoshiko Kojima
- Department of Otolaryngology-HNS, University of Washington, Seattle, WA, United States
- National Primate Research Center, Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle, WA, United States
| | - Leo Ling
- National Primate Research Center, Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle, WA, United States
| | - James O. Phillips
- Department of Otolaryngology-HNS, University of Washington, Seattle, WA, United States
- National Primate Research Center, Virginia Merrill Bloedel Hearing Research Center, University of Washington, Seattle, WA, United States
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Liu B, Shan J, Gu Y. Temporal and spatial properties of vestibular signals for perception of self-motion. Front Neurol 2023; 14:1266513. [PMID: 37780704 PMCID: PMC10534010 DOI: 10.3389/fneur.2023.1266513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
It is well recognized that the vestibular system is involved in numerous important cognitive functions, including self-motion perception, spatial orientation, locomotion, and vector-based navigation, in addition to basic reflexes, such as oculomotor or body postural control. Consistent with this rationale, vestibular signals exist broadly in the brain, including several regions of the cerebral cortex, potentially allowing tight coordination with other sensory systems to improve the accuracy and precision of perception or action during self-motion. Recent neurophysiological studies in animal models based on single-cell resolution indicate that vestibular signals exhibit complex spatiotemporal dynamics, producing challenges in identifying their exact functions and how they are integrated with other modality signals. For example, vestibular and optic flow could provide congruent and incongruent signals regarding spatial tuning functions, reference frames, and temporal dynamics. Comprehensive studies, including behavioral tasks, neural recording across sensory and sensory-motor association areas, and causal link manipulations, have provided some insights into the neural mechanisms underlying multisensory self-motion perception.
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Affiliation(s)
- Bingyu Liu
- Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, International Center for Primate Brain Research, Chinese Academy of Sciences, Shanghai, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jiayu Shan
- Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, International Center for Primate Brain Research, Chinese Academy of Sciences, Shanghai, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yong Gu
- Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, International Center for Primate Brain Research, Chinese Academy of Sciences, Shanghai, China
- University of Chinese Academy of Sciences, Beijing, China
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