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Behtani L, Paromov D, Moïn-Darbari K, Houde MS, Bacon BA, Maheu M, Leroux T, Champoux F. Hearing Aid Amplification Improves Postural Control for Older Adults With Hearing Loss When Other Sensory Cues Are Impoverished. Trends Hear 2024; 28:23312165241232219. [PMID: 38356376 PMCID: PMC10868491 DOI: 10.1177/23312165241232219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Abstract
Recent studies suggest that sound amplification via hearing aids can improve postural control in adults with hearing impairments. Unfortunately, only a few studies used well-defined posturography measures to assess balance in adults with hearing loss with and without their hearing aids. Of these, only two examined postural control specifically in the elderly with hearing loss. The present study examined the impact of hearing aid use on postural control during various sensory perturbations in older adults with age-related hearing loss. Thirty individuals with age-related hearing impairments and using hearing aids bilaterally were tested. Participants were asked to perform a modified clinical sensory integration in balance test on a force platform with and without hearing aids. The experiment was conducted in the presence of a broadband noise ranging from 0.1 to 4 kHz presented through a loudspeaker. As expected, hearing aid use had a beneficial impact on postural control, but only when visual and somatosensory inputs were both reduced. Data also suggest that hearing aid use decreases the dependence on somatosensory input for maintaining postural control. This finding can be of particular importance in older adults considering the reduction of tactile and proprioceptive sensitivity and acuity often associated with aging. These results provide an additional argument for encouraging early hearing aid fitting for people with hearing loss.
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Affiliation(s)
- L. Behtani
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - D. Paromov
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - K. Moïn-Darbari
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - MS Houde
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - BA Bacon
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - M. Maheu
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire Sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Pavillon Laurier, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - T. Leroux
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - F. Champoux
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
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Murofushi T, Monobe H, Ushio M. Isolated bilateral posterior semicircular canal hypofunction: comparison with bilateral vestibulopathy. Acta Otolaryngol 2023; 143:687-691. [PMID: 37682576 DOI: 10.1080/00016489.2023.2253270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Chronic unsteadiness is a common complaint at vestibular clinics. Bilateral vestibulopathy (BVP) is a major cause of chronic unsteadiness but is often overlooked. Although diagnostic criteria for BVP have been established by the Barany Society, isolated vertical canal hypofunction can remain undiagnosed. Recently, the video head-impulse test has enabled clinicians to assess vertical semicircular canal function at clinics. OBJECTIVE This study aimed to compare the features of isolated bilateral posterior semicircular canal hypofunction (IBPH) with those of BVP diagnosed based on the Barany criteria. METHODS The clinical data of 8 IBPH patients that had been diagnosed using our diagnostic criteria (sex, age, subjective symptoms, questionnaire, video head-impulse test and stabilometry) were analyzed and compared with those of 6 BVP patients diagnosed using the Barany criteria. RESULTS The IBPH patients were all aged >70 years, while the age range of the BVP patients was wider. While the BVP patients complained of both oscillopsia during body movement and unsteadiness in darkness, the IBPH patients complained of unsteadiness in darkness without oscillopsia during body movement. The IBPH patients exhibited milder clinical findings than the BVP patients. CONCLUSION IBPH can cause mild unsteadiness in the elderly. SIGNIFICANCE Clinicians should be aware that IBPH can cause unsteadiness in the elderly.
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Affiliation(s)
- Toshihisa Murofushi
- Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, Kasasaki, Japan
| | - Hiroko Monobe
- Department of Otolaryngology, Japan Red Cross Medical Center, Tokyo, Japan
| | - Munetaka Ushio
- Department of Otolaryngology, Toho University School of Medicine Sakura Medical Center, Sakura, Japan
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Gabriel GA, Harris LR, Gnanasegaram JJ, Cushing SL, Gordon KA, Haycock BC, Campos JL. Age-related changes to vestibular heave and pitch perception and associations with postural control. Sci Rep 2022; 12:6426. [PMID: 35440744 PMCID: PMC9018785 DOI: 10.1038/s41598-022-09807-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
Falls are a common cause of injury in older adults (OAs), and age-related declines across the sensory systems are associated with increased falls risk. The vestibular system is particularly important for maintaining balance and supporting safe mobility, and aging has been associated with declines in vestibular end-organ functioning. However, few studies have examined potential age-related differences in vestibular perceptual sensitivities or their association with postural stability. Here we used an adaptive-staircase procedure to measure detection and discrimination thresholds in 19 healthy OAs and 18 healthy younger adults (YAs), by presenting participants with passive heave (linear up-and-down translations) and pitch (forward-backward tilt rotations) movements on a motion-platform in the dark. We also examined participants' postural stability under various standing-balance conditions. Associations among these postural measures and vestibular perceptual thresholds were further examined. Ultimately, OAs showed larger heave and pitch detection thresholds compared to YAs, and larger perceptual thresholds were associated with greater postural sway, but only in OAs. Overall, these results suggest that vestibular perceptual sensitivity declines with older age and that such declines are associated with poorer postural stability. Future studies could consider the potential applicability of these results in the development of screening tools for falls prevention in OAs.
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Affiliation(s)
- Grace A Gabriel
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Psychology, University of Toronto, 500 University Avenue, Toronto, ON, M5G 2A2, Canada
| | - Laurence R Harris
- Department of Psychology and Centre for Vision Research, York University, Toronto, ON, Canada
| | - Joshua J Gnanasegaram
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Sharon L Cushing
- Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, Toronto, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.,Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, ON, Canada
| | - Karen A Gordon
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.,Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, ON, Canada
| | - Bruce C Haycock
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,University of Toronto Institute for Aerospace Studies, Toronto, ON, Canada
| | - Jennifer L Campos
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. .,Department of Psychology, University of Toronto, 500 University Avenue, Toronto, ON, M5G 2A2, Canada.
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Fabre C, Tan H, Dumas G, Giraud L, Perrin P, Schmerber S. Skull Vibration Induced Nystagmus Test: Correlations with Semicircular Canal and Otolith Asymmetries. Audiol Res 2021; 11:618-628. [PMID: 34842617 PMCID: PMC8628575 DOI: 10.3390/audiolres11040056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background: To establish in patients with peripheral vestibular disorders relations between skull vibration-induced nystagmus (SVIN) different components (horizontal, vertical, torsional) and the results of different structurally related vestibular tests. Methods: SVIN test, canal vestibular test (CVT: caloric test + video head impulse test: VHIT), otolithic vestibular test (OVT: ocular vestibular evoked myogenic potential oVEMP + cervical vestibular evoked myogenic potential cVEMP) performed on the same day in 52 patients with peripheral vestibular diseases (age < 65 years), and 11 control patients were analyzed. Mixed effects logistic regression analysis was performed to assert whether the presence of nystagmus in SVIN (3D analysis) have an association with the presence of peripheral vestibular dysfunction measured by vestibular explorations (CVT or OVT). Results: We obtained different groups: Group-Co (control group), Group-VNT (dizzy patients with no vestibular tests alterations), Group-O (OVT alterations only), Group-C (CVT alterations only), Group-M (mixed alterations). SVIN-SPV horizontal component was significantly higher in Group-M than in the other groups (p = 0.005) and correlated with alterations of lateral-VHIT (p < 0.001), caloric test (p = 0.002) and oVEMP (p = 0.006). SVIN-SPV vertical component was correlated with the anterior-VHIT and oVEMP alterations (p = 0.007; p = 0.017, respectively). SVIN-SPV torsional component was correlated with the anterior-VHIT positivity (p = 0.017). SVIN was the only positive test for 10% of patients (83% of Group-VNT). Conclusion: SVIN-SPV analysis in dizzy patients shows significant correlation to both CVT and OVT. SVIN horizontal component is mainly relevant to both vestibular tests exploring lateral canal and utricle responses. SVIN-SPV is significantly higher in patients with combined canal and otolith lesions. In some patients with dizziness, SVIN may be the only positive test.
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Affiliation(s)
- Christol Fabre
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, 801321 Grenoble, France; (G.D.); (L.G.); (S.S.)
- Correspondence: ; Tel.: +33-0476765656
| | - Haoyue Tan
- Department of Otolaryngology H & N Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China;
| | - Georges Dumas
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, 801321 Grenoble, France; (G.D.); (L.G.); (S.S.)
- EA 3450 DevAH, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, 54578 Villers-lès-Nancy, France;
| | - Ludovic Giraud
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, 801321 Grenoble, France; (G.D.); (L.G.); (S.S.)
| | - Philippe Perrin
- EA 3450 DevAH, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, 54578 Villers-lès-Nancy, France;
- Department of Paediatric Oto-Rhino-Laryngology, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
| | - Sébastien Schmerber
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, 801321 Grenoble, France; (G.D.); (L.G.); (S.S.)
- BrainTech Lab., INSERM UMR 1205, 38000 Grenoble, France
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Abstract
OBJECTIVES Older adults with age-related hearing loss (ARHL) are at greater risk of falling and have greater mobility problems than older adults with normal hearing (NH). The underlying cause of these associations remains unclear. One possible reason is that age-related declines in the vestibular system could parallel those observed in the auditory system within the same individuals. Here, we compare the sensitivity of vestibular perceptual abilities (psychophysics), vestibular end-organ functioning (vestibular evoked myogenic potentials and video head impulse tests), and standing balance (posturography) in healthy older adults with and without ARHL. DESIGN A total of 46 community-dwelling older adults, 23 with ARHL and 23 with NH, were passively translated in heave (up and down) and rotated in pitch (tilted forward and backward) in the dark using a motion platform. Using an adaptive staircase psychophysical procedure, participants' heave and pitch detection and discrimination thresholds were determined. In a posturography task, participants' center of pressure (COP) path length was measured as they stood on a forceplate with eyes open and closed, on firm and compliant surfaces, with and without sound suppression. Baseline motor, cognitive, and sensory functioning, including vestibular end-organ function, were measured. RESULTS Individuals with ARHL were less sensitive at discriminating pitch movements compared to older adults with NH. Poorer self-reported hearing abilities were also associated with poorer pitch discrimination. In addition to pitch discrimination thresholds, lower pitch detection thresholds were significantly associated with hearing loss in the low-frequency range. Less stable standing balance was significantly associated with poorer vestibular perceptual sensitivity. DISCUSSION These findings provide evidence for an association between ARHL and reduced vestibular perceptual sensitivity.
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Jiang X, He L, Gai Y, Jia C, Li W, Hu S, Tang J, Cao L. Risk factors for residual dizziness in patients successfully treated for unilateral benign posterior semicircular canal paroxysmal positional vertigo. J Int Med Res 2021; 48:300060520973093. [PMID: 33296610 PMCID: PMC7731704 DOI: 10.1177/0300060520973093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective The risk factors for residual dizziness (RD) after successful treatment of benign paroxysmal positional vertigo (BPPV) are poorly characterized. We determined the risk factors for RD in patients with benign unilateral posterior semicircular canal paroxysmal positional vertigo (pc-BPPV) after successful treatment. Methods We conducted a prospective study of patients diagnosed with unilateral pc-BPPV between March 2015 and January 2017. Bone mineral density (BMD) was measured by dual-energy X-ray bone mineral densitometry. Participants underwent bithermal caloric testing (C-test) using videonystagmography and a canalith repositioning procedure (CRP). The occurrence of RD was the primary outcome. The participants underwent follow-up 1 week, 1 month, and 1 year after successful CRP, consisting of outpatient visits, questionnaires, and telephone interviews. Results We assessed 115 participants with unilateral pc-BPPV (31 men and 84 women) who were 53.2 ± 8.8 years old. RD occurred in 60 (52.2%) participants. The participants who experienced RD were older, had vertigo for longer before treatment, and were more likely to show a positive C-test and significant BMD loss. Conclusions We found that a significant reduction in BMD (T-score < −1 standard deviation), a positive C-test, and older age are independently associated with RD in patients with pc-BPPV after successful CRP.
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Affiliation(s)
- Xiuwen Jiang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sir Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Lina He
- Department of Otorhinolaryngology-Head and Neck Surgery, Sir Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Yinzhe Gai
- Department of Otorhinolaryngology-Head and Neck Surgery, Sir Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Chengfang Jia
- Department of Endocrinology, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Wenya Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Sir Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Sunhong Hu
- Department of Otorhinolaryngology-Head and Neck Surgery, Sir Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Jianguo Tang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sir Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
| | - Liping Cao
- Department of General Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China
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Sombric CJ, Torres-Oviedo G. Cognitive and Motor Perseveration Are Associated in Older Adults. Front Aging Neurosci 2021; 13:610359. [PMID: 33986654 PMCID: PMC8110726 DOI: 10.3389/fnagi.2021.610359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Aging causes perseveration (difficulty to switch between actions) in motor and cognitive tasks, suggesting that the same neural processes could govern these abilities in older adults. To test this, we evaluated the relation between independently measured motor and cognitive perseveration in young (21.4 ± 3.7 y/o) and older participants (76.5 ± 2.9 y/o). Motor perseveration was measured with a locomotor task in which participants had to transition between distinct walking patterns. Cognitive perseveration was measured with a card matching task in which participants had to switch between distinct matching rules. We found that perseveration in the cognitive and motor domains were positively related in older, but not younger individuals, such that participants exhibiting greater perseveration in the motor task also perseverated more in the cognitive task. Additionally, exposure reduces motor perseveration: older adults who had practiced the motor task could transition between walking patterns as proficiently as naïve, young individuals. Our results suggest an overlap in neural processes governing cognitive and motor perseveration with aging and that exposure can counteract the age-related motor perseveration.
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Affiliation(s)
| | - Gelsy Torres-Oviedo
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
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Maheu M, Nooristani M, Kaci B, Moïn-Darbari K, Bacon BA, Champoux F. The aging-related decrease in cVEMP amplitude cannot be accounted for by normalization. J Vestib Res 2021; 31:375-380. [PMID: 33720864 DOI: 10.3233/ves-201515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cervical Vestibular Evoked Myogenic Potentials (cVEMP) is an electromyogenic measure commonly used in clinic to assess saccule function. The main parameters are peak-peak amplitude and interaural asymmetry ratio (IAR). Several non-vestibular factors may influence these parameters. Notably, a greater EMG contraction level prior to stimulation leads to an increased amplitude. As aging impacts both vestibular structures and muscle propreties, it is still a matter of debate whether the decrease in cVEMP amplitude observed in normal aging is due to EMG differences prior to stimulation or to the effect of aging on the sacculo-collic reflex pathway. At the clinical level, understanding the effect of aging on the relationship between EMG activity and cVEMP response (amplitude, asymmetry ratio) and the effect of normalization is crucial to improving the categorization of healthy versus pathological responses. OBJECTIVE To investigate whether normalization modifies cVEMP amplitude and asymmetry ratios differently in younger and older heatlhy adults. METHOD cVEMP recordings were conducted in 42 normal healthy participants divided in two age groups: younger (n = 29): mean = 22.79 years old SD = 1.66; and older (n = 13): mean = 69.00 years old SD = 3.61. Air-conducted cVEMP were recorded using Eclipse (Interacoustics, Denmark). The stimulus was a 95 dBnHL tone burst (500 Hz) with rise, plateau and fall time of 1 ms. cVEMP were recorded only when EMG levels were between 50μV and 150μV, using the Eclipse (Interacoustic, Denmark) monitoring system. RESULTS No significant differences were observed for prestimulus EMG levels between younger and older participants (F(1,83) = 1.13, p = 0.291). However, significant differences between groups were observed for raw cVEMP amplitude (F(1,83) = 14.78; p < 0.001) and corrected cVEMP amplitude (F(1,83) = 21.85; p < 0.0001). A significant positive linear relationship between prestimulus EMG contraction level (RMS) and raw cVEMP amplitude was observed in younger participants (r2 = 0.234; p < 0.001), but not in older adults (r2 = -0.0144; p = 0.056). Finally, no significant differences between younger and older participants were observed for raw amplitude asymmetry ratios (F(1,41) = 0.124, p = 0.726) or normalized asymmetry ratios (F(1,41) = 0.726, p = 0.508). CONCLUSION Our results suggest that when EMG is monitored and activation of the SCM is sufficient, the observed decline in cVEMP amplitude with normal aging does not seem to be caused by EMG differences and is therefore likely due to the known histopathological modifications of the vestibular system that occurs with normal aging.
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Affiliation(s)
- Maxime Maheu
- Vestibulab, Université de Montréal, School of Speech Language Pathology and Audiology, Montreal, Quebec, Canada.,School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Quebec, Canada
| | - Mujda Nooristani
- School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Quebec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Brahim Kaci
- Vestibulab, Université de Montréal, School of Speech Language Pathology and Audiology, Montreal, Quebec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Karina Moïn-Darbari
- School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Quebec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | | | - François Champoux
- School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, Quebec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
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Grove CR, Whitney SL, Hetzel SJ, Heiderscheit BC, Pyle GM. Validation of a next-generation sensory organization test in adults with and without vestibular dysfunction. J Vestib Res 2021; 31:33-45. [PMID: 33325418 DOI: 10.3233/ves-200040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The traditional Sensory Organization Test (T-SOT) is a gold standard balance test; however, the psychometric properties of assessing sensory organization with a virtual-reality-based posturography device have not been established. OBJECTIVE Our overall aims were to assess the criterion, concurrent, and convergent validity of a next-generation Sensory Organization Test (NG-SOT). METHODS Thirty-four adults (17 vestibular-impaired) participated. We compared the area under the curve (AUC) for receiver operator characteristic (ROC) analysis for the T-SOT and NG-SOT composite scores. Between-group and between-test differences for the composite and sensory analysis scores from each SOT were assessed using Wilcoxon Rank Sum tests. Additionally, we ran Spearman correlations between the NG-SOT composite score and outcomes of interest. RESULTS The AUCs for the NG-SOT and T-SOT were 0.950 (0.883, 1) and 0.990 (0.969, 1) respectively (p = 0.168). The median composite, vision, and visual preference scores were lower on the NG-SOT compared to the T-SOT; whereas, the median somatosensory score was higher on the NG-SOT compared to the T-SOT. Associations between the composite score and patient-reported or performance-based outcomes ranged from poor to strong. CONCLUSIONS The NG-SOT is a valid measure of balance in adults. However, the results of the NG-SOT and T-SOT should not be used interchangeably.
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Affiliation(s)
| | | | | | | | - G Mark Pyle
- University of Wisconsin-Madison, Madison, WI, USA
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10
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Kocak E, Bozdemir K, Çallıoğlu EE, Dikicier BS. The evaluation of the use of isotretinoin on vestibular system by using vHIT. Am J Otolaryngol 2020; 41:102579. [PMID: 32531621 DOI: 10.1016/j.amjoto.2020.102579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/25/2020] [Indexed: 11/25/2022]
Abstract
AIM The aim of the present study was to evaluate the effect of isotretinoin (ISO) on peripheral vestibular system using vHIT. MATERIAL AND METHOD This is a prospective study in which 30 patients administered ISO treatment with the diagnosis of acne vulgaris was evaluated. Following ear nose and throat, examination, audiological and vestibular evaluations were carried out. vHIT tests were conducted before and three months after the use of ISO (0.5-0.75 mg/kg/day). In addition, all participants underwent perceptual vertigo and dizziness tests before and three months after the use of ISO. RESULTS In vHIT evaluation of all patients, no overt saccade, covert saccade and spontaneous nystagmus finding was observed. Gain and asymmetry were compared before and after the use of ISO: No significant difference was found between lateral semicircular canal, anterior, and posterior semi-circular and symmetry measurements made before ISO use and those made three months after it (p = 1.00; p = 0.99; p = 0.66). Similarly, there was no significant difference in asymmetry values of vertical semicircular canals measured before ISO and three months after it (p = 0.90; p = 0.76). No statistically significant difference was found in vertigo, nausea and dizziness in terms of responses before and 3 months after ISO use (p = 0.063; p = 0.031; p = 0.063). CONCLUSION Although the studies demonstrating the effect of ISO on cochlea and symptoms occurring during treatment such as nausea, vomiting and vertigo suggest that it may exert effects on peripheral vestibular system, the present study indicates that it has no short terms effects on structures in peripheral vestibular system and vestibuloocular reflex pathways.
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11
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Magnani RM, Bruijn SM, van Dieën JH, Vieira MF. Head orientation and gait stability in young adults, dancers and older adults. Gait Posture 2020; 80:68-73. [PMID: 32492622 DOI: 10.1016/j.gaitpost.2020.05.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 04/07/2020] [Accepted: 05/20/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Control of body orientation requires head motion detection by the vestibular system and small changes with respect to the gravitational acceleration vector could cause destabilization. RESEARCH QUESTION We aimed to compare the effects of different head orientations on gait stability in young adults, dancers and older adults. METHODS Three groups of 10 subjects were evaluated, the first composed of young adults (aged 18-30 years), the second composed of young healthy dancers under high performance dance training (aged 18-30 years), and the third group composed of community-dwelling older adults (aged 65-80 years). Participants walked on a treadmill at their preferred speed in four distinct head orientation conditions for four minutes each: control (neutral orientation); dynamic yaw (following a target over 45° bilaterally); up (15° neck extension), and down (40° neck flexion). Foot and trunk kinematic data were acquired using a 3D motion capture system and the gait pattern was assessed by basic gait parameters (step length, stride width and corresponding variability) and gait stability (local divergence exponents and margins of stability). Main effects of conditions and groups, as well as their interaction effects, were evaluated by repeated-measures analysis of variance. RESULTS Interactions of group and head orientation were found for both step length and stride width variability; main effects of head orientation were found for all evaluated parameters and main effects of group were found for step length and its variability and local divergence exponents in all directions. SIGNIFICANCE As expected, the older adults group showed less stable gait (higher local divergence exponent), the shortest step length and greater step length variability. However, contrary to expectation, the dancers were not more stable. The yaw condition was the most challenging for all groups and the down condition seemed to be least challenging.
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Affiliation(s)
- Rina M Magnani
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Brazil.
| | - Sjoerd M Bruijn
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Science, Amsterdam, The Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Science, Amsterdam, The Netherlands
| | - Marcus F Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Brazil
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Vestibular Aging Process from 3D Physiological Imaging of the Membranous Labyrinth. Sci Rep 2020; 10:9618. [PMID: 32541659 PMCID: PMC7295805 DOI: 10.1038/s41598-020-66520-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/23/2020] [Indexed: 12/15/2022] Open
Abstract
There is no three-dimensional (3D) technique to study the microanatomical structures of the in vivo 3D vestibular membranous labyrinth. Recent two MRI methods using a contrast agent can only depict the low-resolution imaging of endolymphatic hydrops. Therefore, we provide the new precise volume rendering algorithms to create the in vivo 3D vestibular membranous labyrinth images from high-resolution temporal bone low-dose CT data. We also ascertain whether the created 3D microstructure images are reliable in anatomical findings. Secondary, we will analyze the age-related changes of the vestibular membranous labyrinth. These created 3D membranous vestibular images were almost consistent with the appearance, dimensions, areas, and angles from those acquired in previous histological works. The age-related image changes showed the enlarged saccule in females, the enlarged utricle in males, and the dilated tendency of the lateral semicircular duct. These results may correlate to the findings of the previous physiological works on cervical and ocular vestibular evoked myogenic potentials, and gait studies. The age-related balance disorders may be associated with the enlargement of each membranous organ in the vestibule. This new imaging technique now enables visualizing microanatomical changes in the in vivo membranous vestibulum, and these created 3D images may suggest physiological information.
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Strupp M, Grimberg J, Teufel J, Laurell G, Kingma H, Grill E. Worldwide survey on laboratory testing of vestibular function. Neurol Clin Pract 2019; 10:379-387. [PMID: 33299665 DOI: 10.1212/cpj.0000000000000744] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/26/2019] [Indexed: 11/15/2022]
Abstract
Background The function of the peripheral vestibular system can nowadays be quantified. The video head impulse test (vHIT) and caloric irrigation are used for the semicircular canals, cervical vestibular evoked myogenic potentials (cVEMP) for the sacculus, and ocular vestibular evoked myogenic potentials (oVEMP) for the utriculus. Because there is no agreement on normal and pathologic values, we performed a worldwide survey. Methods A web-based standardized survey questionnaire was used to collect data on "reference values" and "cutoff" values. Thirty-eight centers from all continents (except Africa) replied. Results "Reference values": vHIT: mean for the vestibulo-ocular reflex gain of the left horizontal canal 0.91 (range: 0.7-1.01) and of the left horizontal canal 0.92 (0.7-1.05); side difference 0.15 (0.25-0.3). Caloric irrigation: mean peak slow phase velocity of caloric-induced nystagmus for warm (44°C) water 18.65°/s (12-30°/s); cold (30°C) water 18.21°/s (10-25°/s). cVEMP: P13-N23 amplitude mean for the lower limit 28.67 μV (16-50 μV); upper limit 200 μV (50-350 μV). "Cutoff values": vHIT: side difference 0.26 (0.1-0.4), bilateral vestibulopathy <0.61 (0.3-0.8); unilateral vestibulopathy (UVP) <0.68 (0.4-0.8). Caloric irrigation pathologic side difference mean 25.93% (17.7%-40%) or 12°/sec (5-30°/s); side difference UVP 26.73% (20%-40%) or 29.8°/s (5-100°/s). cVEMP: P13/N23 amplitude mean lower cutoff 32.5 μV (15-50 μV), mean upper cutoff 125 μV (50-200 μV), asymmetry 36.08 μV (20-50 μV). Conclusion This worldwide survey showed a large variability in terms of reference and pathologic cutoff values in the 38 centers included. Therefore, standardization of how to achieve these values and agreement on which values should be used is highly warranted to guarantee a high quality of vestibular testing and interpretation of clinical and scientific results.
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Affiliation(s)
- Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands
| | - Joy Grimberg
- Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands
| | - Julian Teufel
- Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands
| | - Göran Laurell
- Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands
| | - Herman Kingma
- Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands
| | - Eva Grill
- Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands
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Abstract
OBJECTIVE Over the last decade, ocular vestibular evoked myogenic potentials (oVEMPs) have evolved as a new clinical test for dynamic otolith (predominantly utricular) function. The aim of this review is to give an update on the neurophysiological foundations of oVEMPs and their implications for recording and interpreting oVEMP responses in clinical practice. CONCLUSION Different lines of anatomical, neurophysiological, and clinical evidence support the notion that oVEMPs measure predominantly contralateral utricular function, while cervical cVEMPs are an indicator of ipsilateral saccular function. Bone-conducted vibration (BCV) in the midline of the forehead at the hairline (Fz) or unilateral air-conducted sound (ACS) are commonly used as stimuli for oVEMPs. It is recommended to apply short stimuli with short rise times for obtaining optimal oVEMP responses. Finally, this review summarizes the clinical application and interpretation of oVEMPs, particularly for vestibular neuritis, Ménière's disease, superior canal dehiscence and "challenging" patients.
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Negahban H, Bavarsad Cheshmeh Ali M, Nassadj G. Effect of hearing aids on static balance function in elderly with hearing loss. Gait Posture 2017; 58:126-129. [PMID: 28772132 DOI: 10.1016/j.gaitpost.2017.07.112] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 07/20/2017] [Accepted: 07/23/2017] [Indexed: 02/02/2023]
Abstract
While a few studies have investigated the relationship between hearing acuity and postural control, little is known about the effect of hearing aids on postural stability in elderly with hearing loss. The aim was to compare static balance function between elderly with hearing loss who used hearing aids and those who did not use. The subjects asked to stand with (A) open eyes on rigid surface (force platform), (B) closed eyes on rigid surface, (C) open eyes on a foam pad, and (D) closed eyes on a foam pad. Subjects in the aided group (n=22) were tested with their hearing aids turned on and hearing aids turned off in each experimental condition. Subjects in the unaided group (n=25) were tested under the same experimental conditions as the aided group. Indicators for postural stability were center of pressure (COP) parameters including; mean velocity, standard deviation (SD) velocity in anteroposterior (AP) and mediolateral (ML) directions, and sway area (95% confidence ellipse). The results showed that within open eyes-foam surface condition, there was greater SD velocity in the off-aided than the on-aided and the unaided than the on-aided (p<0.0001 for SD velocity in AP and ML). Also, no significant differences were found between the off-aided and unaided group (p=0.56 and p=0.77 for SD velocity in AP and ML, respectively). Hearing aids improve static balance function by reducing the SD velocity. Clinical implications may include improving hearing inputs in order to increase postural stability in older adults with hearing loss.
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Affiliation(s)
- Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Gholamhossein Nassadj
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Maheu M, Pagé S, Sharp A, Delcenserie A, Champoux F. The impact of vestibular status prior to cochlear implantation on postural control: A multiple case study. Cochlear Implants Int 2017; 18:250-255. [DOI: 10.1080/14670100.2017.1341362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Maxime Maheu
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
- CIUSSS Centre-Sud-de-l’île-de-Montréal/Institut Raymond-Dewar, Montréal, Canada
| | - Sara Pagé
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
- CIUSSS Centre-Sud-de-l’île-de-Montréal/Institut Raymond-Dewar, Montréal, Canada
| | - Andréanne Sharp
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
- CIUSSS Centre-Sud-de-l’île-de-Montréal/Institut Raymond-Dewar, Montréal, Canada
| | - Audrey Delcenserie
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
- Département de psychologie, Université de Montréal, Montréal, Canada
| | - François Champoux
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
- CIUSSS Centre-Sud-de-l’île-de-Montréal/Institut Raymond-Dewar, Montréal, Canada
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Sombric CJ, Harker HM, Sparto PJ, Torres-Oviedo G. Explicit Action Switching Interferes with the Context-Specificity of Motor Memories in Older Adults. Front Aging Neurosci 2017; 9:40. [PMID: 28321188 PMCID: PMC5337495 DOI: 10.3389/fnagi.2017.00040] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/14/2017] [Indexed: 12/17/2022] Open
Abstract
Healthy aging impairs the ability to adapt movements to novel situations and to switch choices according to the context in cognitive tasks, indicating resistance to changes in motor and cognitive behaviors. Here we examined if this lack of “flexibility” in old subjects observed in motor and cognitive domains were related. To this end, we evaluated subjects' performance in a motor task that required switching walking patterns and its relation to performance in a cognitive switching task. Specifically, a group of old (>73 years old) and young subjects learned a new locomotor pattern on a split-belt treadmill, which drives the legs at different speeds. In both groups, we assessed the ability to disengage the walking pattern learned on the treadmill when walking overground. Then, we determined if this motor context-specificity was related to subjects' cognitive ability to switch actions in a set-shift task. Motor and cognitive behaviors were tested twice on separate visits to determine if age-related differences were maintained with exposure. Consistent with previous studies, we found that old adults adapted slower and had deficits in retention. Most importantly, we found that older subjects could not switch locomotor patterns when transitioning across walking contexts. Interestingly, cognitive switching performance was inversely related to subjects' ability to switch walking patterns. Thus, cognitive mediated switching interfered with locomotor switching. These findings were maintained across testing sessions. Our results suggest that distinct neural substrates mediate motor and cognitive action selection, and that these processes interfere with each other as we age.
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Affiliation(s)
- Carly J Sombric
- Department of Bioengineering, University of Pittsburgh Pittsburgh, PA, USA
| | - Harrison M Harker
- Department of Bioengineering, University of Pittsburgh Pittsburgh, PA, USA
| | - Patrick J Sparto
- Department of Physical Therapy, University of Pittsburgh Pittsburgh, PA, USA
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