1
|
de Sousa FA, Alves CS, Pinto AN, Meireles L, Rego ÂR. Pharmacological Treatment of Acute Unilateral Vestibulopathy: A Review. J Audiol Otol 2024; 28:18-28. [PMID: 37953517 PMCID: PMC10808386 DOI: 10.7874/jao.2023.00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 11/14/2023] Open
Abstract
There have been few investigations on the epidemiology, etiology, and medical management of acute unilateral vestibulopathy (AUV). Short-term pharmaceutical resolutions include vestibular symptomatic suppressants, anti-emetics, and some cause-based therapies. Anticholinergics, phenothiazines, antihistamines, antidopaminergics, benzodiazepines, and calcium channel antagonists are examples of vestibular suppressants. Some of these medications may show their effects through multiple mechanisms. In contrast, N-acetyl-L-leucine, Ginkgo biloba, and betahistine improve central vestibular compensation. Currently, AUV pathophysiology is poorly understood. Diverse hypotheses have previously been identified which have brought about some causal treatments presently used. According to some publications, acute administration of anti-inflammatory medications may have a deleterious impact on both post-lesional functional recovery and endogenous adaptive plasticity processes. Thus, some authors do not recommend the use of corticosteroids in AUV. Antivirals are even more contentious in the context of AUV treatment. Although vascular theories have been presented, no verified investigations employing anti-clotting or vasodilator medications have been conducted. There are no standardized treatment protocols for AUV to date, and the pharmacological treatment of AUV is still questionable. This review addresses the most current developments and controversies in AUV medical treatment.
Collapse
Affiliation(s)
- Francisco Alves de Sousa
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Clara Serdoura Alves
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Nóbrega Pinto
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Meireles
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ângela Reis Rego
- Otorhinolaryngology and Head & Neck Surgery Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| |
Collapse
|
2
|
|
3
|
Abstract
Methods to control neural activity by light have been introduced to the field of neuroscience. During the last decade, several techniques have been established, including optogenetics, thermogenetics, and infrared neural stimulation. The techniques allow investigators to turn-on or turn-off neural activity. This review is an attempt to show the importance of the techniques for the auditory field and provide insight in the similarities, overlap, and differences of the techniques. Discussing the mechanism of each of the techniques will shed light on the abilities and challenges for each of the techniques. The field has been grown tremendously and a review cannot be complete. However, efforts are made to summarize the important points and to refer the reader to excellent papers and reviews to specific topics. This article is part of a Special Issue entitled .
Collapse
Affiliation(s)
- Claus-Peter Richter
- Northwestern University Feinberg School of Medicine, Department of Otolaryngology, 303 E. Chicago Ave, Searle 12-561, Chicago, IL 60611, USA; Dept. of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Tech E310, Evanston, IL 60208, USA; The Hugh Knowles Center, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA.
| | - Xiaodong Tan
- Northwestern University Feinberg School of Medicine, Department of Otolaryngology, 303 E. Chicago Ave, Searle 12-561, Chicago, IL 60611, USA
| |
Collapse
|
4
|
Chagnaud BP, Zee MC, Baker R, Bass AH. Innovations in motoneuron synchrony drive rapid temporal modulations in vertebrate acoustic signaling. J Neurophysiol 2012; 107:3528-42. [PMID: 22423004 DOI: 10.1152/jn.00030.2012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Rapid temporal modulation of acoustic signals among several vertebrate lineages has recently been shown to depend on the actions of superfast muscles. We hypothesized that such fast events, known to require synchronous activation of muscle fibers, would rely on motoneuronal properties adapted to generating a highly synchronous output to sonic muscles. Using intracellular in vivo recordings, we identified a suite of premotor network inputs and intrinsic motoneuronal properties synchronizing the oscillatory-like, simultaneous activation of superfast muscles at high gamma frequencies in fish. Motoneurons lacked spontaneous activity, firing synchronously only at the frequency of premotor excitatory input. Population-level motoneuronal output generated a spike-like, vocal nerve volley that directly determines muscle contraction rate and, in turn, natural call frequency. In the absence of vocal output, motoneurons showed low excitability and a weak afterhyperpolarization, leading to rapid accommodation in firing rate. By contrast, vocal activity was accompanied by a prominent afterhyperpolarization, indicating a dependency on network activity. Local injection of a GABA(A) receptor antagonist demonstrated the necessity of electrophysiologically and immunohistochemically confirmed inhibitory GABAergic input for motoneuronal synchrony and vocalization. Numerous transneuronally labeled motoneurons following single-cell neurobiotin injection together with electrophysiological collision experiments confirmed gap junctional coupling, known to contribute to synchronous activity in other neural networks. Motoneuronal synchrony at the premotor input frequency was maintained during differential recruitment of variably sized motoneurons. Differential motoneuron recruitment led, however, to amplitude modulation (AM) of vocal output and, hence, natural call AM. In summary, motoneuronal intrinsic properties, in particular low excitability, predisposed vocal motoneurons to the synchronizing influences of premotor inputs to translate a temporal input code into a coincident and extremely synchronous, but variable-amplitude, output code. We propose an analogous suite of neuronal properties as a key innovation underlying similarly rapid acoustic events observed among amphibians, reptiles, birds, and mammals.
Collapse
Affiliation(s)
- Boris P Chagnaud
- Dept. of Neurobiology and Behavior, Cornell Univ., Ithaca, NY 14853, USA
| | | | | | | |
Collapse
|
5
|
Rajguru SM, Richter CP, Matic AI, Holstein GR, Highstein SM, Dittami GM, Rabbitt RD. Infrared photostimulation of the crista ampullaris. J Physiol 2011; 589:1283-94. [PMID: 21242259 DOI: 10.1113/jphysiol.2010.198333] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The present results show that the semicircular canal crista ampullaris of the toadfish, Opsanus tau, is sensitive to infrared radiation (IR) applied in vivo. IR pulse trains (∼1862 nm, ∼200 μs pulse⁻¹) delivered to the sensory epithelium by an optical fibre evoked profound changes in phasic and tonic discharge rates of postsynaptic afferent neurons. Phasic afferent responses to pulsed IR occurred with a latency of <8 ms while tonic responses developed with a time constant (τ) of 7 ms to 10 s following the onset or cessation of the radiation. Afferents responded to direct optical radiation of the sensory epithelium but did not respond to thermal stimuli that generated nearly equivalent temperature increases of the whole organ. A subset of afferent neurons fired an action potential in response to each IR pulse delivered to the sensory epithelium, at phase-locked rates up to 96 pulses per second. The latency between IR pulses and afferent nerve action potentials was much greater than synaptic delay and spike generation, demonstrating the presence of a signalling delay interposed between the IR pulse and the action potential. The same IR stimulus applied to afferent nerve axons failed to evoke responses of similar magnitude and failed to phase-lock afferent nerve action potentials. The present data support the hypothesis that pulsed IR activates sensory hair cells, thus leading to modulation of synaptic transmission and afferent nerve discharge reported here.
Collapse
Affiliation(s)
- Suhrud M Rajguru
- Department of Otolaryngology, Northwestern University, Chicago, IL 60611, USA.
| | | | | | | | | | | | | |
Collapse
|
6
|
Richter CP, Matic AI, Wells JD, Jansen ED, Walsh JT. Neural stimulation with optical radiation. LASER & PHOTONICS REVIEWS 2011; 5:68-80. [PMID: 23082105 PMCID: PMC3472451 DOI: 10.1002/lpor.200900044] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 04/08/2010] [Indexed: 05/18/2023]
Abstract
This paper reviews the existing research on infrared neural stimulation, a means of artificially stimulating neurons that has been proposed as an alternative to electrical stimulation. Infrared neural stimulation (INS) is defined as the direct induction of an evoked potential in response to a transient targeted deposition of optical energy. The foremost advantage of using optical radiation for neural stimulation is its spatial resolution. Exogenously applied or trans-genetically synthesized fluorophores are not used to achieve stimulation. Here, current work on INS is presented for motor nerves, sensory nerves, central nervous system, and in vitro preparations. A discussion follows addressing the mechanism of INS and its potential use in neuroprostheses. A brief review of neural depolarization involving other optical methods is also presented. Topics covered include optical stimulation concurrent with electrical stimulation, optical stimulation using exogenous fluorophores, and optical stimulation by transgenic induction of light-gated ion channels.
Collapse
Affiliation(s)
- Claus-Peter Richter
- Department of Otolaryngology, Feinberg Medical School, Northwestern University, Searle Building 12-470, 303 E. Chicago Avenue, Chicago, IL 60611-3008, USA
- The Hugh Knowles Center, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Agnella Izzo Matic
- Department of Otolaryngology, Feinberg Medical School, Northwestern University, Searle Building 12-470, 303 E. Chicago Avenue, Chicago, IL 60611-3008, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | | | - E. Duco Jansen
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Joseph T. Walsh
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| |
Collapse
|
7
|
Soto E, Vega R. Neuropharmacology of vestibular system disorders. Curr Neuropharmacol 2010; 8:26-40. [PMID: 20808544 PMCID: PMC2866460 DOI: 10.2174/157015910790909511] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 12/17/2009] [Accepted: 01/08/2010] [Indexed: 11/22/2022] Open
Abstract
This work reviews the neuropharmacology of the vestibular system, with an emphasis on the mechanism of action of drugs used in the treatment of vestibular disorders. Otolaryngologists are confronted with a rapidly changing field in which advances in the knowledge of ionic channel function and synaptic transmission mechanisms have led to the development of new scientific models for the understanding of vestibular dysfunction and its management. In particular, there have been recent advances in our knowledge of the fundamental mechanisms of vestibular system function and drug mechanisms of action. In this work, drugs acting on vestibular system have been grouped into two main categories according to their primary mechanisms of action: those with effects on neurotransmitters and neuromodulator receptors and those that act on voltage-gated ion channels. Particular attention is given in this review to drugs that may provide additional insight into the pathophysiology of vestibular diseases. A critical review of the pharmacology and highlights of the major advances are discussed in each case.
Collapse
Affiliation(s)
- Enrique Soto
- Institute of Physiology, Autonomous University of Puebla, México.
| | | |
Collapse
|
8
|
Evangelista C, Mills M, Siebeck UE, Collin SP. A comparison of the external morphology of the membranous inner ear in elasmobranchs. J Morphol 2010; 271:483-95. [DOI: 10.1002/jmor.10812] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
9
|
Diverse synaptic terminals on rat stapedius motoneurons. J Assoc Res Otolaryngol 2008; 9:321-33. [PMID: 18563488 DOI: 10.1007/s10162-008-0125-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 04/21/2008] [Indexed: 12/20/2022] Open
Abstract
Stapedius motoneurons (SMN) mediate the contraction of the stapedius muscle, which protects the inner ear from injury and reduces the masking effects of background noise. A variety of inputs to SMNs are known to exist, but their terminal ultrastructure has not been investigated. We characterized the synaptic terminals on retrogradely labeled SMNs found just ventromedial to the facial motor nucleus. About 80% of the terminals contained round synaptic vesicles. One type (Sm Rnd) had small, round vesicles filling the terminal with occasional dense core vesicles and formed an asymmetric synapse. Sm Rnd terminals were small with lengths of apposition to the SMN less than 3 microm. Partial reconstructions from serial sections demonstrated that these terminals formed up to three synapses per terminal. Another terminal type (Lg Rnd) had large, round vesicles and asymmetric synapses. Most Lg Rnd terminals were small but some were extensive, e.g., abutting the SMN for up to 10 microm. One of these terminals formed at least seven synapses. Another terminal type (Pleo) had pleomorphic vesicles and symmetric active zones that, in some cases, were invaginated by spines from the SMN. A fourth uncommon terminal type (Het Rnd) had round vesicles of heterogeneous sizes and asymmetric synapses. A fifth rare terminal type (Cist) had large, round vesicles and an accompanying subsurface cistern in the SMN. These were generally the same kinds of terminals found on other motoneurons, but the high proportion of round vesicle synapses indicate that SMNs receive mostly excitatory inputs.
Collapse
|
10
|
Highstein SM, Rabbitt RD, Holstein GR, Boyle RD. Determinants of spatial and temporal coding by semicircular canal afferents. J Neurophysiol 2005; 93:2359-70. [PMID: 15845995 PMCID: PMC3000935 DOI: 10.1152/jn.00533.2004] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The vestibular semicircular canals are internal sensors that signal the magnitude, direction, and temporal properties of angular head motion. Fluid mechanics within the 3-canal labyrinth code the direction of movement and integrate angular acceleration stimuli over time. Directional coding is accomplished by decomposition of complex angular accelerations into 3 biomechanical components-one component exciting each of the 3 ampullary organs and associated afferent nerve bundles separately. For low-frequency angular motion stimuli, fluid displacement within each canal is proportional to angular acceleration. At higher frequencies, above the lower corner frequency, real-time integration is accomplished by viscous forces arising from the movement of fluid within the slender lumen of each canal. This results in angular velocity sensitive fluid displacements. Reflecting this, a subset of afferent fibers indeed report angular acceleration to the brain for low frequencies of head movement and report angular velocity for higher frequencies. However, a substantial number of afferent fibers also report angular acceleration, or a signal between acceleration and velocity, even at frequencies where the endolymph displacement is known to follow angular head velocity. These non-velocity-sensitive afferent signals cannot be attributed to canal biomechanics alone. The responses of non-velocity-sensitive cells include a mathematical differentiation (first-order or fractional) imparted by hair-cell and/or afferent complexes. This mathematical differentiation from velocity to acceleration cannot be attributed to hair cell ionic currents, but occurs as a result of the dynamics of synaptic transmission between hair cells and their primary afferent fibers. The evidence for this conclusion is reviewed below.
Collapse
Affiliation(s)
- Stephen M Highstein
- Washington University School of Medicine, Department of Otolaryngology, St. Louis, MO 63110, USA
| | | | | | | |
Collapse
|
11
|
Holstein GR, Martinelli GP, Nicolae RA, Rosenthal TM, Friedrich VL. Synapsin-like immunoreactivity is present in hair cells and efferent terminals of the toadfish crista ampullaris. Exp Brain Res 2004; 162:287-92. [PMID: 15599720 DOI: 10.1007/s00221-004-2194-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2004] [Accepted: 11/09/2004] [Indexed: 12/20/2022]
Abstract
The synapsins are presynaptic membrane-associated proteins involved in neurotransmitter release. They are differentially expressed in tissues and cells of the central and peripheral nervous system. In vestibular end organs of mammals, synapsin I-like immunoreactivity has been reported in efferent and afferent terminals and in afferent nerve calyces surrounding type I hair cells. In addition, synapsin I has recently been described in several non-neural cell lines. The present study was conducted to locate synapsin-like immunoreactivity in the neuronal and non-neuronal cells of the fish crista ampullaris, to examine the possibility that the non-neuronal sensory receptor cells express synapsins in vivo. Synapsin-like immunostaining was visualized by immunofluorescence detection in wholemounts of the toadfish crista ampullaris using multiphoton laser scanning microscopy and by electron microscopic visualization of post-embedding immunogold labeling. The results demonstrate that synapsin-like immunoreactivity is present in vestibular hair cells and efferent boutons of the toadfish crista ampullaris. Afferent endings are not labeled. Staining in hair cells is not associated with the synaptic ribbons, suggesting that there is an additional, non-synaptic role for the synapsins in some non-neuronal cells of vertebrates. Moreover, while the cristae of amniote and anamniote species share many functional attributes, differences in their synaptic vesicle-associated protein profiles appear to reflect their disparate hair cell populations.
Collapse
Affiliation(s)
- G R Holstein
- Department of Neurology, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1140, New York, NY 10029, USA.
| | | | | | | | | |
Collapse
|