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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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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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Furman JM, Shirey I, Roxberg J, Kiderman A. The vertical computerized rotational head impulse test. J Vestib Res 2024; 34:29-38. [PMID: 38393869 PMCID: PMC10894580 DOI: 10.3233/ves-230121] [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: 09/26/2023] [Accepted: 11/29/2023] [Indexed: 02/25/2024]
Abstract
The computerized rotational head impulse test (crHIT) uses a computer-controlled rotational chair to deliver whole-body rotational impulses to assess the semicircular canals. The crHIT has only been described for horizontal head plane rotations. The purpose of this study was to describe the crHIT for vertical head plane rotations. In this preliminary study, we assessed four patients with surgically confirmed unilateral peripheral vestibular abnormalities and two control subjects. Results indicated that the crHIT was well-tolerated for both horizontal head plane and vertical head plane stimuli. The crHIT successfully assessed each of the six semicircular canals. This study suggests that the crHIT has the potential to become a new laboratory-based vestibular test for both the horizontal and vertical semicircular canals.
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Affiliation(s)
- Joseph M. Furman
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jillyn Roxberg
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
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Kumari A, Alam N, Kumar S. High-Resolution Computed Tomography of the Temporal Bone in Chronic Otitis Media: An Observational Study at a Tertiary Care Center in Jharkhand, India. Cureus 2023; 15:e42813. [PMID: 37664290 PMCID: PMC10470848 DOI: 10.7759/cureus.42813] [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: 06/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION Chronic otitis media refers to middle ear inflammation. A radiological exam is a crucial step in this diagnostic process, in addition to a clinical evaluation and an evaluation by an audiologist. For the development of innovative surgical treatment plans for middle ear otitis media with the aim of minimally invasive surgery, accurate information regarding the extent of lesions is required. This is made possible by a temporal bone imaging test. MATERIALS AND METHODS The study was conducted at the Rajendra Institute of Medical Sciences (RIMS), a tertiary care facility in Ranchi, Jharkhand, India. The research was conducted between June 1, 2021, and October 31, 2022. In this prospective observational study, 50 patients who visited the otorhinolaryngology clinic at RIMS Ranchi were the participants. RESULTS The median age was 26 years, there was a male-to-female ratio of 1.63 to 1, and the vast majority (84%) were from lower socioeconomic classes. High-resolution computed tomography has been shown to be highly sensitive and specific in identifying conditions including scutum erosion, malleus erosion, pneumatization type, mastoiditis, mastoid abscess, and morphological abnormalities such as low-lying dura. CONCLUSION The semicircular canal, fallopian canal, dural plate, and sigmoid sinus may all be clearly defined by non-contrast computed tomography of the temporal bone in erosion in cases of otitis media.
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Affiliation(s)
- Abha Kumari
- Department of Pharmacology and Therapeutics, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Noman Alam
- Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Sandeep Kumar
- Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, IND
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Curthoys IS, Smith CM, Burgess AM, Dlugaiczyk J. A Review of Neural Data and Modelling to Explain How a Semicircular Canal Dehiscence (SCD) Causes Enhanced VEMPs, Skull Vibration Induced Nystagmus (SVIN), and the Tullio Phenomenon. Audiol Res 2023; 13:418-430. [PMID: 37366683 DOI: 10.3390/audiolres13030037] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
Angular acceleration stimulation of a semicircular canal causes an increased firing rate in primary canal afferent neurons that result in nystagmus in healthy adult animals. However, increased firing rate in canal afferent neurons can also be caused by sound or vibration in patients after a semicircular canal dehiscence, and so these unusual stimuli will also cause nystagmus. The recent data and model by Iversen and Rabbitt show that sound or vibration may increase firing rate either by neural activation locked to the individual cycles of the stimulus or by slow changes in firing rate due to fluid pumping ("acoustic streaming"), which causes cupula deflection. Both mechanisms will act to increase the primary afferent firing rate and so trigger nystagmus. The primary afferent data in guinea pigs indicate that in some situations, these two mechanisms may oppose each other. This review has shown how these three clinical phenomena-skull vibration-induced nystagmus, enhanced vestibular evoked myogenic potentials, and the Tullio phenomenon-have a common tie: they are caused by the new response of semicircular canal afferent neurons to sound and vibration after a semicircular canal dehiscence.
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Affiliation(s)
- Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| | - Christopher M Smith
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, Annenberg Building, Room 12-90, 1468 Madison Ave., New York, NY 10029, USA
| | - Ann M Burgess
- Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| | - Julia Dlugaiczyk
- Department of Otorhinolaryngology, Head and Neck Surgery & Interdisciplinary Center of Vertigo, Balance and Ocular Motor Disorders, University Hospital Zurich (USZ), University of Zurich (UZH), CH-8091 Zürich, Switzerland
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Chen L, Dai Q, Gao X, Hu N, Sun X, Wang H, Wang M. Prognostic changes after sudden deafness in patients with inner ear malformations characterized by LSCC: a retrospective study. Front Neurol 2023; 14:1174412. [PMID: 37332985 PMCID: PMC10272851 DOI: 10.3389/fneur.2023.1174412] [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: 02/26/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction This study aimed to investigate the clinical features and prognosis of sudden sensorineural hearing loss in patients with lateral semicircular canal (LSCC) malformation. Methods This study enrolled patients with LSCC malformation and sudden sensorineural hearing loss (SSNHL) who were admitted to Shandong ENT Hospital between 2020 and 2022. We collected and analyzed data on examinations of audiology, vestibular function, and imaging records of patients and summarized the clinical characteristics and prognosis of these patients. Results Fourteen patients were enrolled. Patients with LSCC malformation was noted in 0.42% of all SSNHL cases during the same period. One patients had bilateral SSNHL and the rest had unilateral SSNHL. Of them, eight and six patients had unilateral and bilateral LSCC malformations, respectively. Flat hearing loss was noted in 12 ears (80.0%) and severe or profound hearing loss was noted in 10 ears (66.7%). After treatment, the total efficacy rate of SSNHL with LSCC malformation was 40.0%. Vestibular function was abnormal in all patients, but only five patients (35.7%) had dizziness. There were statistically significant differences in the vestibular functions between patients with LSCC malformation and matched patients without the malformation hospitalized during the same period (p < 0.05). Conclusion Patients with SSNHL and LSCC malformation had flat-type and severe hearing loss and worse disease prognosis compared to those with SSNHL without LSCC malformation. Vestibular function is more likely to be abnormal; however, there was no significant difference in vestibular symptoms between patients with and without LSCC malformation. LSCC is a risk factor for the prognosis of SSNHL.
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Affiliation(s)
- Lei Chen
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Qinglei Dai
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Xin Gao
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Na Hu
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China
| | - Xiao Sun
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Haibo Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Mingming Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Otology Medicine, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
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Meredith FL, Vu TA, Gehrke B, Benke TA, Dondzillo A, Rennie KJ. Expression of hyperpolarization-activated current ( Ih) in zonally defined vestibular calyx terminals of the crista. J Neurophysiol 2023; 129:1468-1481. [PMID: 37198134 PMCID: PMC10259860 DOI: 10.1152/jn.00135.2023] [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: 03/31/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/19/2023] Open
Abstract
Calyx terminals make afferent synapses with type I hair cells in vestibular epithelia and express diverse ionic conductances that influence action potential generation and discharge regularity in vestibular afferent neurons. Here we investigated the expression of hyperpolarization-activated current (Ih) in calyx terminals in central and peripheral zones of mature gerbil crista slices, using whole cell patch-clamp recordings. Slowly activating Ih was present in >80% calyces tested in both zones. Peak Ih and half-activation voltages were not significantly different; however, Ih activated with a faster time course in peripheral compared with central zone calyces. Calyx Ih in both zones was blocked by 4-(N-ethyl-N-phenylamino)-1,2-dimethyl-6-(methylamino) pyrimidinium chloride (ZD7288; 100 µM), and the resting membrane potential became more hyperpolarized. In the presence of dibutyryl-cAMP (dB-cAMP), peak Ih was increased, activation kinetics became faster, and the voltage of half-activation was more depolarized compared with control calyces. In current clamp, calyces from both zones showed three different categories of firing: spontaneous firing, phasic firing where a single action potential was evoked after a hyperpolarizing pulse, or a single evoked action potential followed by membrane potential oscillations. In the absence of Ih, the latency to peak of the action potential increased; Ih produces a small depolarizing current that facilitates firing by driving the membrane potential closer to threshold. Immunostaining showed the expression of HCN2 subunits in calyx terminals. We conclude that Ih is found in calyx terminals across the crista and could influence conventional and novel forms of synaptic transmission at the type I hair cell-calyx synapse.NEW & NOTEWORTHY Calyx afferent terminals make synapses with vestibular hair cells and express diverse conductances that impact action potential firing in vestibular primary afferents. Conventional and nonconventional synaptic transmission modes are influenced by hyperpolarization-activated current (Ih), but regional differences were previously unexplored. We show that Ih is present in both central and peripheral calyces of the mammalian crista. Ih produces a small depolarizing resting current that facilitates firing by driving the membrane potential closer to threshold.
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Affiliation(s)
- Frances L Meredith
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Tiffany A Vu
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Brandon Gehrke
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Timothy A Benke
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, United States
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, United States
- Department of Pharmacology, University of Colorado School of Medicine, Aurora, Colorado, United States
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Anna Dondzillo
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, United States
| | - Katherine J Rennie
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado, United States
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Sumalde AAM, Scholes MA, Kalmanson OA, Terhune EA, Frejo L, Wethey CI, Roman-Naranjo P, Carry PM, Gubbels SP, Lopez-Escamez JA, Hadley-Miller N, Santos-Cortez RLP. Rare Coding Variants in Patients with Non-Syndromic Vestibular Dysfunction. Genes (Basel) 2023; 14:831. [PMID: 37107589 PMCID: PMC10137884 DOI: 10.3390/genes14040831] [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: 03/08/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
Vertigo due to vestibular dysfunction is rare in children. The elucidation of its etiology will improve clinical management and the quality of life of patients. Genes for vestibular dysfunction were previously identified in patients with both hearing loss and vertigo. This study aimed to identify rare, coding variants in children with peripheral vertigo but no hearing loss, and in patients with potentially overlapping phenotypes, namely, Meniere's disease or idiopathic scoliosis. Rare variants were selected from the exome sequence data of 5 American children with vertigo, 226 Spanish patients with Meniere's disease, and 38 European-American probands with scoliosis. In children with vertigo, 17 variants were found in 15 genes involved in migraine, musculoskeletal phenotypes, and vestibular development. Three genes, OTOP1, HMX3, and LAMA2, have knockout mouse models for vestibular dysfunction. Moreover, HMX3 and LAMA2 were expressed in human vestibular tissues. Rare variants within ECM1, OTOP1, and OTOP2 were each identified in three adult patients with Meniere's disease. Additionally, an OTOP1 variant was identified in 11 adolescents with lateral semicircular canal asymmetry, 10 of whom have scoliosis. We hypothesize that peripheral vestibular dysfunction in children may be due to multiple rare variants within genes that are involved in the inner ear structure, migraine, and musculoskeletal disease.
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Affiliation(s)
- Angelo Augusto M. Sumalde
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Department of Otolaryngology-Head and Neck Surgery, University of the Philippines Manila College of Medicine, Philippine General Hospital, Manila 1000, Philippines
| | - Melissa A. Scholes
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Department of Pediatric Otolaryngology, Children’s Hospital Colorado, Aurora, CO 80045, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Olivia A. Kalmanson
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Elizabeth A. Terhune
- Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Lidia Frejo
- Otology and Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer-University of Granada-Junta de Andalucia, PTS, 18016 Granada, Spain
- Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, ibs.GRANADA, Universidad de Granada, 18071 Granada, Spain
| | - Cambria I. Wethey
- Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Pablo Roman-Naranjo
- Otology and Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer-University of Granada-Junta de Andalucia, PTS, 18016 Granada, Spain
- Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, ibs.GRANADA, Universidad de Granada, 18071 Granada, Spain
| | - Patrick M. Carry
- Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Musculoskeletal Research Center, Children’s Hospital Colorado, Aurora, CO 80045, USA
| | - Samuel P. Gubbels
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Jose A. Lopez-Escamez
- Otology and Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer-University of Granada-Junta de Andalucia, PTS, 18016 Granada, Spain
- Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, ibs.GRANADA, Universidad de Granada, 18071 Granada, Spain
- Meniere’s Disease Neuroscience Research Program, Faculty of Medicine & Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, NSW 2006, Australia
| | - Nancy Hadley-Miller
- Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Musculoskeletal Research Center, Children’s Hospital Colorado, Aurora, CO 80045, USA
| | - Regie Lyn P. Santos-Cortez
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Center for Children’s Surgery, Children’s Hospital Colorado, Aurora, CO 80045, USA
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Kinoshita M, Fujimoto C, Iwasaki S, Kondo K, Yamasoba T. Oral Administration of TrkB Agonist, 7, 8-Dihydroxyflavone Regenerates Hair Cells and Restores Function after Gentamicin-Induced Vestibular Injury in Guinea Pig. Pharmaceutics 2023; 15. [PMID: 36839815 DOI: 10.3390/pharmaceutics15020493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
The causes of vestibular dysfunction include the loss of hair cells (HCs), synapses beneath the HCs, and nerve fibers. 7, 8-dihydroxyflavone (DHF) mimics the physiological functions of brain-derived neurotrophic factor. We investigated the effects of the orally-administered DHF in the guinea pig crista ampullaris after gentamicin (GM)-induced injury. Twenty animals treated with GM received daily administration of DHF or saline for 14 or 28 days (DHF (+) or DHF (-) group; N = 5, each). At 14 days after GM treatment, almost all of the HCs had disappeared in both groups. At 28 days, the HCs number in DHF (+) and DHF (-) groups was 74% and 49%, respectively, compared to GM-untreated control. In the ampullary nerves, neurofilament 200 positive rate in the DHF (+) group was 91% at 28 days, which was significantly higher than 42% in DHF (-). On day 28, the synaptic connections observed between C-terminal-binding protein 2-positive and postsynaptic density protein-95-positive puncta were restored, and caloric response was significantly improved in DHF (+) group (canal paresis: 57.4% in DHF (+) and 100% in DHF (-)). Taken together, the oral administration of DHF may be a novel therapeutic approach for treating vestibular dysfunction in humans.
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Keriven Serpollet D, Hartnagel D, James Y, Buffat S, Vayatis N, Bargiotas I, Vidal P. Tilt perception is different in the pitch and roll planes in human. Physiol Rep 2023; 11:e15374. [PMID: 36780905 PMCID: PMC9925277 DOI: 10.14814/phy2.15374] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/21/2022] [Accepted: 05/27/2022] [Indexed: 02/15/2023] Open
Abstract
Neurophysiological tests probing the vestibulo-ocular, colic and spinal pathways are the gold standard to evaluate the vestibular system in clinics. In contrast, vestibular perception is rarely tested despite its potential usefulness in professional training and for the longitudinal follow-up of professionals dealing with complex man-machine interfaces, such as aircraft pilots. This is explored here using a helicopter flight simulator to probe the vestibular perception of pilots. The vestibular perception of nine professional helicopter pilots was tested using a full flight helicopter simulator. The cabin was tilted six times in roll and six times in pitch (-15°, -10°, -5°, 5°, 10° and 15°) while the pilots had no visual cue. The velocities of the outbound displacement of the cabin were kept below the threshold of the semicircular canal perception. After the completion of each movement, the pilots were asked to put the cabin back in the horizontal plane (still without visual cues). The order of the 12 trials was randomized with two additional control trials where the cabin stayed in the horizontal plane but rotated in yaw (-10° and +10°). Pilots were significantly more precise in roll (average error in roll: 1.15 ± 0.67°) than in pitch (average error in pitch: 2.89 ± 1.06°) (Wilcoxon signed-rank test: p < 0.01). However, we did not find a significant difference either between left and right roll tilts (p = 0.51) or between forward and backward pitch tilts (p = 0.59). Furthermore, we found that the accuracies were significantly biased with respect to the initial tilt. The greater the initial tilt was, the less precise the pilots were, although maintaining the direction of the tilt, meaning that the error can be expressed as a vestibular error gain in the ability to perceive the modification in the orientation. This significant result was found in both roll (Friedman test: p < 0.01) and pitch (p < 0.001). However, the pitch trend error was more prominent (gain = 0.77 vs gain = 0.93) than roll. This study is a first step in the determination of the perceptive-motor profile of pilots, which could be of major use for their training and their longitudinal follow-up. A similar protocol may also be useful in clinics to monitor the aging process of the otolith system with a simplified testing device.
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Affiliation(s)
- Dimitri Keriven Serpollet
- Training & Simulation, Thales AVS France SASOsnyFrance
- Centre Borelli, Université de Paris, ENS Paris‐Saclay, CNRS, SSAParisFrance
| | - David Hartnagel
- Département Neurosciences et Sciences CognitivesInstitut de Recherche Biomédicale des ArméesBrétigny‐sur‐OrgeFrance
| | - Yannick James
- Training & Simulation, Thales AVS France SASOsnyFrance
| | - Stéphane Buffat
- Laboratoire d'Accidentologie de Biomécanique et du comportement des conducteursGIE Renault‐PSA GroupesNanterreFrance
| | - Nicolas Vayatis
- Centre Borelli, Université de Paris, ENS Paris‐Saclay, CNRS, SSAParisFrance
| | - Ioannis Bargiotas
- Centre Borelli, Université de Paris, ENS Paris‐Saclay, CNRS, SSAParisFrance
| | - Pierre‐Paul Vidal
- Centre Borelli, Université de Paris, ENS Paris‐Saclay, CNRS, SSAParisFrance
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11
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Maruta J. Lasting alteration of spatial orientation induced by passive motion in rabbits and its possible relevance to mal de débarquement syndrome. Front Neurol 2023; 14:1110298. [PMID: 36908625 PMCID: PMC9994528 DOI: 10.3389/fneur.2023.1110298] [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: 11/28/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023] Open
Abstract
Background Mal de débarquement syndrome (MdDS) is a chronic disorder of spatial orientation with a persistent false sensation of self-motion, whose onset typically follows prolonged exposure to passive motion of a transport vehicle. Development of similar but transient after-sensations mimicking the exposed motion and associated postural instability, indicative of central vestibular adaptation, are common. The cause of MdDS is thought to be a subsequent failure to readapt to a stationary environment. However, vestibular plasticity pertinent to this illness has not been studied sufficiently. Because the rabbit's eye movement is sensitive to three-dimensional spatial orientation, characterizing maladaptation of the vestibulo-ocular reflex (VOR) induced in the animal may open an approach to understanding MdDS. Methods Three rabbits underwent a series of 2-h conditioning with an unnatural repetitive motion that involved a complex combination of roll, pitch, and yaw movements in a head-based reference frame, consisting of periodic rolling in darkness in a frame of reference that rotated about an earth-vertical axis. Eye movement in three dimensions was sampled during the conditioning stimulus as well as during test stimuli before and up to several days after conditioning. Results During roll-while-rotating conditioning, the roll component of the VOR was compensatory to the oscillation about the corresponding axis, but the pitch component was not, initially prominently phase-leading the head pitch motion but subsequently becoming patently phase-delayed. Unidirectional yaw nystagmus, weak but directionally compensatory to the earth-vertical axis rotation, was seen throughout the period of conditioning. After conditioning, simple side-to-side rolling induced an abnormal yaw ocular drift in the direction that opposed the nystagmus seen during conditioning, indicating a maladaptive change in spatial orientation. The impact of conditioning appeared to be partially retained even after 1 week and could be partially reversed or cumulated depending on the rotation direction in the subsequent conditioning. Conclusion The observed reversible long-term maladaptation of spatial orientation as well as the depth of knowledge available in relation to the vestibular cerebellar circuits in this species support the potential utility of a rabbit model in MdDS research.
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Affiliation(s)
- Jun Maruta
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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12
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Yang J, Liu Y, Duan M. Editorial: Intratympanic and surgical treatment for Meniere's disease. Front Neurol 2022; 13:1072659. [PMID: 36619914 PMCID: PMC9815598 DOI: 10.3389/fneur.2022.1072659] [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: 10/17/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Jun Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China,Jun Yang
| | - Yupeng Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China
| | - Maoli Duan
- Ear Nose and Throat Patient Area, Trauma and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden,Division of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden,*Correspondence: Maoli Duan
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13
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Liu Y, Zhang X, Deng Q, Liu Q, Wen C, Wang W, Chen T. The 3D characteristics of nystagmus in posterior semicircular canal benign paroxysmal positional vertigo. Front Neurosci 2022; 16:988733. [PMID: 36583103 PMCID: PMC9793705 DOI: 10.3389/fnins.2022.988733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/07/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
Objective The aim of this study was to observe the 3-dimensional (3D; horizontal, vertical, and torsional) characteristics of nystagmus in patients with posterior semicircular canal canalithiasis (PSC-can)-related benign paroxysmal positional vertigo (BPPV) and investigate its correlation with Ewald's. Methods In all, 84 patients with PSC-can were enrolled. The latency, duration, direction, and slow-phase velocity induced by the Dix-Hallpike test in the head-hanging and sitting positions were recorded using 3D video nystagmography (3D-VNG). The characteristics of the horizontal, vertical, and torsional components of nystagmus were quantitatively analyzed. Results 3D-VNG showed that the fast phase of the vertical components and torsional components of left and right ear PSC-can as induced by the head-hanging position of the Dix-Hallpike test were upward, clockwise and counterclockwise, and horizontal components were mainly contralateral. The median slow-phase velocity of each of the three components for consecutive 5 s was 26.3°/s (12.3-45.8), 25.0°/s (15.7-38.9), and 9.2°/s (4.9-13.7). When patients were returned to the sitting position, the fast phase of the vertical and torsional components of nystagmus was reversed. Only 54 patients had horizontal components of nystagmus, and 32 of them remained in the same direction. The median slow-phase velocity of the three components for consecutive 5 s was 9.4°/s (6.0-11.7), 6.8°/s (4.5-11.8), and 4.9°/s (2.8-8.0). The ratios of the slow-phase velocity of the horizontal, vertical, and torsional components of the head-hanging position to the sitting position were close to 1.85 (1.0-6.6), 3.7 (1.9-6.6), and 5.1 (2.6-11.3). The ratios of the slow-phase velocity of the vertical to horizontal component, the torsional to horizontal component, and the vertical to torsional component of the head-hanging position were close to 3.3 (1.7-7.6), 3.9 (1.8-7.6), and 1.0 (0.5-1.8). The ratios of the slow-phase velocity of the vertical to horizontal component, the torsional to horizontal component, and the vertical to torsional component of the sitting position were close to 2.1 (1.1-6.8), 1.5 (1.0-3.8), and 1.2 (0.8-2.8). Conclusion There were three components of nystagmus induced by the Dix-Hallpike test in patients with PSC-can. The vertical component was the strongest and the horizontal component was the weakest. The 3D characteristics of nystagmus were consistent with those of physiological nystagmus associated with the same PSC with a single-factor stimulus, in accordance with Ewald's law.
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Affiliation(s)
- Yao Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China,Institute of Otolaryngology of Tianjin, Tianjin, China,Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China,Key Medical Discipline of Tianjin (Otolaryngology), Tianjin, China,Quality Control Centre of Otolaryngology, Tianjin, China
| | - Xueqing Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China,Institute of Otolaryngology of Tianjin, Tianjin, China,Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China,Key Medical Discipline of Tianjin (Otolaryngology), Tianjin, China,Quality Control Centre of Otolaryngology, Tianjin, China
| | - Qiaomei Deng
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China,Institute of Otolaryngology of Tianjin, Tianjin, China,Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China,Key Medical Discipline of Tianjin (Otolaryngology), Tianjin, China,Quality Control Centre of Otolaryngology, Tianjin, China
| | - Qiang Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China,Institute of Otolaryngology of Tianjin, Tianjin, China,Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China,Key Medical Discipline of Tianjin (Otolaryngology), Tianjin, China,Quality Control Centre of Otolaryngology, Tianjin, China
| | - Chao Wen
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China,Institute of Otolaryngology of Tianjin, Tianjin, China,Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China,Key Medical Discipline of Tianjin (Otolaryngology), Tianjin, China,Quality Control Centre of Otolaryngology, Tianjin, China
| | - Wei Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China,Institute of Otolaryngology of Tianjin, Tianjin, China,Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China,Key Medical Discipline of Tianjin (Otolaryngology), Tianjin, China,Quality Control Centre of Otolaryngology, Tianjin, China,*Correspondence: Wei Wang,
| | - Taisheng Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China,Institute of Otolaryngology of Tianjin, Tianjin, China,Key Laboratory of Auditory Speech and Balance Medicine, Tianjin, China,Key Medical Discipline of Tianjin (Otolaryngology), Tianjin, China,Quality Control Centre of Otolaryngology, Tianjin, China,Taisheng Chen,
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14
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Psillas G, Petrou I, Printza A, Sfakianaki I, Binos P, Anastasiadou S, Constantinidis J. Video Head Impulse Test (vHIT): Value of Gain and Refixation Saccades in Unilateral Vestibular Neuritis. J Clin Med 2022; 11:jcm11123467. [PMID: 35743536 PMCID: PMC9224852 DOI: 10.3390/jcm11123467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate gain and refixation saccades (covert and overt) using a video head impulse test (vHIT) in the horizontal and vertical planes in patients after the onset of unilateral acute vestibular neuritis (AVN). Thirty-five patients were examined in the acute stage of AVN and at follow-up (range, 6–30 months); a control group of 32 healthy subjects also participated. At onset, the mean gain was significantly lower on the affected side in all of the semi-circular canal planes, mainly in the horizontal canal plane, and saccades (covert and overt) were more prevalent in the horizontal compared to the vertical canal planes. Multi-canal affection occurred more frequently (80% for gain, 71% for saccades) than isolated canal affection. At follow-up, which ranged from 6 to 30 months, the gain was recovered in all of the canals (anterior in 50%, horizontal in 42.8%, and posterior canal in 41.1% of cases), while covert and overt saccades were reduced in the horizontal and vertical planes. However, covert saccades were still recorded in a greater proportion (69%) than overt saccades (57%) in the horizontal plane and at a lower rate in the vertical planes. The compensatory mechanisms after AVN mainly involve the horizontal canal, as the refixation saccades—especially covert ones—were more frequently recorded in the horizontal than vertical canals.
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Affiliation(s)
- George Psillas
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, Stilponos Kyriakidi St., 546 36 Thessaloniki, Greece; (I.P.); (A.P.); (I.S.); (S.A.); (J.C.)
- Correspondence: ; Tel.: +30-2310-994-762; Fax: +30-2310-994-916
| | - Ioanna Petrou
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, Stilponos Kyriakidi St., 546 36 Thessaloniki, Greece; (I.P.); (A.P.); (I.S.); (S.A.); (J.C.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, Stilponos Kyriakidi St., 546 36 Thessaloniki, Greece; (I.P.); (A.P.); (I.S.); (S.A.); (J.C.)
| | - Ioanna Sfakianaki
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, Stilponos Kyriakidi St., 546 36 Thessaloniki, Greece; (I.P.); (A.P.); (I.S.); (S.A.); (J.C.)
| | - Paris Binos
- Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol 3036, Cyprus;
| | - Sofia Anastasiadou
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, Stilponos Kyriakidi St., 546 36 Thessaloniki, Greece; (I.P.); (A.P.); (I.S.); (S.A.); (J.C.)
| | - Jiannis Constantinidis
- 1st Otolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA Hospital, Stilponos Kyriakidi St., 546 36 Thessaloniki, Greece; (I.P.); (A.P.); (I.S.); (S.A.); (J.C.)
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15
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Ogawa Y, Inagaki T, Kondo T, Takeda A, Nagai N, Itani S, Otsuka K. The clinical outcome of the patients with horizontal semicircular canal variants of benign paroxysmal positional vertigo. Acta Otolaryngol 2022; 142:381-387. [PMID: 35491854 DOI: 10.1080/00016489.2022.2049363] [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: 12/16/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Gufoni maneuver is known to be effective for horizontal canal benign positional vertigo (HC-BPPV), but there are some intractable patients that the treatment procedure does not work. OBJECTIVE The clinical outcomes of patients with HC-BPPV were investigated. We also investigated the characteristics of intractable patients which needed long time to the remission. METHODS Sixty-six patients with HC-BPPV receiving Gufoni maneuver at Tokyo Medical University Hachioji Medical Center were investigated. The patients were classified into geotropic DCPN group and apogeotropic DCPN group. The clinical outcomes in 2 groups were examined. RESULTS There were 48 patients with geotropic DCPN and 18 patients with apogeotropic DCPN. There were significant differences between the geotropic HC-BPPV and apogeotropic HC BPPV in the period to remission. There were 7 intractable patients and the average ages of these intractable patients were higher than other patients. CONCLUSION The patients with geotropic DCPN and the patients with the nystagmus conversion from apogeotropic to geotropic DCPN have tendency to easy to resolve, but in patients with apogeotropic type without nystagmus transformation have long time to resolve. The elderly patients whose nystagmus remains apogeotropic without nystagmus conversion have tendencies to become intractable.
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Affiliation(s)
- Yasuo Ogawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo
| | - Taro Inagaki
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Nishi-Shinjyu, Tokyo
| | - Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo
| | - Atsuo Takeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo
| | - Noriko Nagai
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Nishi-Shinjyu, Tokyo
| | - Shigeto Itani
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Nishi-Shinjyu, Tokyo
| | - Koji Otsuka
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Nishi-Shinjyu, Tokyo
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16
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Xu XD, Chen BJ, Sun AR, Zhang Q, Cheng Y, Ren DD, Yu J, Luo HP. Uneven Effects of Sleep Apnea on Semicircular Canals and Otolithic Organs. Front Neurol 2022; 13:819721. [PMID: 35250822 PMCID: PMC8888406 DOI: 10.3389/fneur.2022.819721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/12/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE This study aimed to explore how obstructive sleep apnea (OSA) affects the function of each vestibular organ and to identify the correlations among them. METHODS A prospective study was conducted involving 32 healthy controls and 64 patients with OSA. The objective detection methods of the utricle and saccule are vestibular-evoked myogenic potentials (VEMPs). A combination of the caloric test and video head impulse test (vHIT) was used to comprehensively evaluate the objective function of semicircular canals. RESULTS Elevated thresholds (p < 0.001), decreased waveform amplitudes (p < 0.001), prolonged first wave latencies (p < 0.001), and shortened first interpeak latencies (p < 0.001) were observed in both ocular VEMP (oVEMP) and cervical VEMP (cVEMP). A significant difference was found in the caloric test comparison (χ2 = 4.030, p = 0.045) but not in the vHIT. The intergroup comparison of normal rates among the VEMPs, caloric test, and vHIT groups showed a significant difference (p < 0.001). CONCLUSION The impairment of vestibular function in patients with OSA was uneven and biased. More attention should be given to vestibular dysfunction in the diagnosis and treatment of OSA.
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Affiliation(s)
- Xin-Da Xu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine Research (Fudan University), Shanghai, China
| | - Bin-Jun Chen
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine Research (Fudan University), Shanghai, China
| | - An-Rong Sun
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Qing Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Cheng
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiao Tong University School of Medicine, Xi'an, China
| | - Dong-Dong Ren
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine Research (Fudan University), Shanghai, China
| | - Jing Yu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine Research (Fudan University), Shanghai, China
| | - Hui-Ping Luo
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.,The Therapy Center of Sleep-Disordered Breathing, Eye & ENT Hospital, Fudan University Shanghai, Shanghai, China
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17
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Liu W, Chen G, Xie J, Liang T, Zhang C, Liao X, Liao W, Song L, Zhang X. A New Coordinate System for Magnetic Resonance Imaging of the Vestibular System. Front Neurol 2022; 12:789887. [PMID: 35069419 PMCID: PMC8766740 DOI: 10.3389/fneur.2021.789887] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To develop and evaluate a new coordinate system for MRI of the vestibular system. Methods: In this study, 53 internal auditory canal MRI and 78 temporal bone CT datasets were analyzed. Mimics Medical software version 21.0 was used to visualize and three-dimensionally reconstruct the image data. We established a new coordinate system, named W–X, based on the center of the bilateral eyeballs and vertex of the bilateral superior semicircular canals. Using the W–X coordinate system and Reid's coordinate system, we measured the orientations of the planes of the anterior semicircular canal (ASCC), the lateral semicircular canal (LSCC), and the posterior semicircular canal (PSCC). Results: No significant differences between the angles measured using CT and MRI were found for any of the semicircular canal planes (p > 0.05). No statistical differences were found between the angles measured using Reid's coordinate system (CT) and the W–X coordinate system (MRI). The mean values of ∠ASCC & LSCC, ∠ASCC & PSCC, and ∠LSCC & PSCC were 84.67 ± 5.76, 94.21 ± 3.81, and 91.79 ± 5.22 degrees, respectively. The angle between the LSCC plane and the horizontal imaging plane was 15.64 ± 3.92 degrees, and the angle between the PSCC plane and the sagittal imaging plane was 48.79 ± 4.46 degrees. Conclusion: A new W–X coordinate system was developed for MRI studies of the vestibular system and can be used to measure the orientations of the semicircular canals.
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Affiliation(s)
- Weixing Liu
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gui Chen
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Junyang Xie
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tianhao Liang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunyi Zhang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiao Liao
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenjing Liao
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijuan Song
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaowen Zhang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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18
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Abstract
Roll tilt vestibular perceptual thresholds, an assay of vestibular noise, have recently been shown to be associated with suboptimal balance performance in healthy older adults. However, despite the strength of this correlation, the use of a categorical (i.e., pass/fail) balance assessment limits insight into the impacts of vestibular noise on postural sway. As a result, an explanation for this correlation has yet to be determined. We hypothesized that the correlation between roll tilt vestibular thresholds and postural control reflects a shared influence of sensory noise. To address this hypothesis, we measured roll tilt perceptual thresholds at multiple frequencies (0.2 Hz, 0.5 Hz, 1 Hz) and compared each threshold to quantitative measures of quiet stance postural control in 33 healthy young adults (mean = 24.9 years, SD = 3.67). Our data showed a significant linear association between 0.5 Hz roll tilt thresholds and the root mean square distance (RMSD) of the center of pressure in the mediolateral (ML; β = 5.31, p = 0.002, 95% CI = 2.1-8.5) but not anteroposterior (AP; β = 5.13, p = 0.016, 95% CI = 1.03-9.23) direction (Bonferroni corrected α of 0.006). In contrast, vestibular thresholds measured at 0.2 Hz and 1 Hz did not show a significant correlation with ML or AP RMSD. In a multivariable regression model, controlling for both 0.2 Hz and 1 Hz thresholds, the significant effect of 0.5 Hz roll tilt thresholds persisted (β = 5.44, p = 0.029, CI = 0.60-10.28), suggesting that the effect cannot be explained by elements shared by vestibular thresholds measured at the three frequencies. These data suggest that vestibular noise is significantly associated with the temporospatial control of quiet stance in the mediolateral plane when visual and proprioceptive cues are degraded (i.e., eyes closed, standing on foam). Furthermore, the selective association of quiet-stance sway with 0.5 Hz roll tilt thresholds, but not thresholds measured at lower (0.2 Hz) or higher (1.0 Hz) frequencies, may reflect the influence of noise that results from the temporal integration of noisy canal and otolith cues.
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Affiliation(s)
- Andrew R Wagner
- Department of Otolaryngology-Head & 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
| | - Megan J Kobel
- Department of Otolaryngology-Head & Neck Surgery, Ohio State University Wexner Medical Center, Columbus, OH, United States.,Department of Speech and Hearing Science, Ohio State University, Columbus, OH, United States
| | - Daniel M Merfeld
- Department of Otolaryngology-Head & 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.,Department of Speech and Hearing Science, Ohio State University, Columbus, OH, United States.,Department of Biomedical Engineering, Ohio State University, Columbus, OH, United States
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19
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Abstract
I list a summary of the major clinical observations of SVIN in patients with total unilateral vestibular loss (TUVL) and show how basic results from neurophysiology can explain these clinical observations. The account integrates results from single neuron recordings of identified semicircular canal and otolith afferent neurons in guinea pigs in response to low frequency skull vibration with evidence of the eye movement response in cats to selective semicircular canal stimulation (both individual and combined) and a simple model of nystagmus generation to show how these results explain most of the major characteristics of SVIN.
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Affiliation(s)
- Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, The University of Sydney, Sydney, NSW 2006, Australia
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20
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Abstract
Located deep in the temporal bone, the semicircular canal is a subtle structure that requires a spatial coordinate system for measurement and observation. In this study, 55 semicircular canal and eyeball models were obtained by segmentation of MRI data. The spatial coordinate system was established by taking the top of the common crus and the bottom of the eyeball as the horizontal plane. First, the plane equation was established according to the centerline of the semicircular canals. Then, according to the parameters of the plane equation, the plane normal vectors were obtained. Finally, the average unit normal vector of each semicircular canal plane was obtained by calculating the average value of the vectors. The standard normal vectors of the and left posterior semicircular canal, superior semicircular canal and lateral semicircular canal were [−0.651, 0.702, 0.287], [0.749, 0.577, 0.324], [−0.017, −0.299, 0.954], [0.660, 0.702, 0.266], [−0.739, 0.588, 0.329], [0.025, −0.279, 0.960]. The different angles for the different ways of calculating the standard normal vectors of the right and left posterior semicircular canal, superior semicircular canal and lateral semicircular canal were 0.011, 0.028, 0.008, 0.011, 0.024, and 0.006 degrees. The technology for measuring the semicircular canal spatial attitudes in this study are reliable, and the measurement results can guide vestibular function examinations and help with guiding the diagnosis and treatment of BPPV.
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Affiliation(s)
- Shuzhi Wu
- Neurology Department, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Ping Lin
- Neurology Department, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Yanyan Zheng
- Neurology Department, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Yifei Zhou
- ENT Department, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Zhaobang Liu
- Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
| | - Xiaokai Yang
- Neurology Department, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
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21
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Abstract
Inner ear hair cells form synapses with afferent terminals and afferent neurons carry signals as action potentials to the central nervous system. Efferent neurons have their origins in the brainstem and some make synaptic contact with afferent dendrites beneath hair cells. Several neurotransmitters have been identified that may be released from efferent terminals to modulate afferent activity. Dopamine is a candidate efferent neurotransmitter in both the vestibular and auditory systems. Within the cochlea, activation of dopamine receptors may reduce excitotoxicity at the inner hair cell synapse via a direct effect of dopamine on afferent terminals. Here we investigated the effect of dopamine on sodium currents in acutely dissociated vestibular afferent calyces to determine if dopaminergic signaling could also modulate vestibular responses. Calyx terminals were isolated along with their accompanying type I hair cells from the cristae of gerbils (P15-33) and whole cell patch clamp recordings performed. Large transient sodium currents were present in all isolated calyces; compared to data from crista slices, resurgent Na+ currents were rare. Perfusion of dopamine (100 μM) in the extracellular solution significantly reduced peak transient Na+ currents by approximately 20% of control. A decrease in Na+ current amplitude was also seen with extracellular application of the D2 dopamine receptor agonist quinpirole, whereas the D2 receptor antagonist eticlopride largely abolished the response to dopamine. Inclusion of the phosphatase inhibitor okadaic acid in the patch electrode solution occluded the response to dopamine. The reduction in calyx sodium current in response to dopamine suggests efferent signaling through D2 dopaminergic receptors may occur via common mechanisms to decrease excitability in inner ear afferents.
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Affiliation(s)
- Frances L Meredith
- Department of Otolaryngology - Head & Neck Surgery, School of Medicine, University of Colorado, Aurora, CO, United States
| | - Katherine J Rennie
- Department of Otolaryngology - Head & Neck Surgery, School of Medicine, University of Colorado, Aurora, CO, United States.,Department of Physiology & Biophysics, School of Medicine, University of Colorado, Aurora, CO, United States
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22
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Curthoys IS, Grant JW, Pastras CJ, Fröhlich L, Brown DJ. Similarities and Differences Between Vestibular and Cochlear Systems - A Review of Clinical and Physiological Evidence. Front Neurosci 2021; 15:695179. [PMID: 34456671 PMCID: PMC8397526 DOI: 10.3389/fnins.2021.695179] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/12/2021] [Indexed: 12/04/2022] Open
Abstract
The evoked response to repeated brief stimuli, such as clicks or short tone bursts, is used for clinical evaluation of the function of both the auditory and vestibular systems. One auditory response is a neural potential - the Auditory Brainstem Response (ABR) - recorded by surface electrodes on the head. The clinical analogue for testing the otolithic response to abrupt sounds and vibration is the myogenic potential recorded from tensed muscles - the vestibular evoked myogenic potential (VEMP). VEMPs have provided clinicians with a long sought-after tool - a simple, clinically realistic indicator of the function of each of the 4 otolithic sensory regions. We review the basic neural evidence for VEMPs and discuss the similarities and differences between otolithic and cochlear receptors and afferents. VEMPs are probably initiated by sound or vibration selectively activating afferent neurons with irregular resting discharge originating from the unique type I receptors at a specialized region of the otolithic maculae (the striola). We review how changes in VEMP responses indicate the functional state of peripheral vestibular function and the likely transduction mechanisms allowing otolithic receptors and afferents to trigger such very short latency responses. In section "ELECTROPHYSIOLOGY" we show how cochlear and vestibular receptors and afferents have many similar electrophysiological characteristics [e.g., both generate microphonics, summating potentials, and compound action potentials (the vestibular evoked potential, VsEP)]. Recent electrophysiological evidence shows that the hydrodynamic changes in the labyrinth caused by increased fluid volume (endolymphatic hydrops), change the responses of utricular receptors and afferents in a way which mimics the changes in vestibular function attributed to endolymphatic hydrops in human patients. In section "MECHANICS OF OTOLITHS IN VEMPS TESTING" we show how the major VEMP results (latency and frequency response) follow from modeling the physical characteristics of the macula (dimensions, stiffness etc.). In particular, the structure and mechanical operation of the utricular macula explains the very fast response of the type I receptors and irregular afferents which is the very basis of VEMPs and these structural changes of the macula in Menière's Disease (MD) predict the upward shift of VEMP tuning in these patients.
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Affiliation(s)
- Ian S. Curthoys
- Vestibular Research Laboratory, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - John Wally Grant
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, United States
| | - Christopher J. Pastras
- The Menière’s Research Laboratory, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Laura Fröhlich
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Daniel J. Brown
- School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, WA, Australia
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23
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Emekci T, Erbek HS. The relationship between functional head impulse test and age in healthy individuals. J Vestib Res 2021; 32:123-134. [PMID: 34120922 DOI: 10.3233/ves-210040] [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: 11/15/2022]
Abstract
BACKGROUND fHIT is an easily applicable test battery that indirectly evaluates the vestibulo-ocular reflex (VOR) from a functional perspective. AIMS/OBJECTIVES The aim of this study was to Individuals determine the correlation between age and the percentage of correct answers (% CA) obtained in the functional head impulse test (fHIT) in healthy individuals. MATERIAL AND METHODS A total of 105 volunteers, 50 males and 55 females, between the ages of 18 and 70 years, participated in the study. A Beon Solution fHIT system (Zero Branco (TV), Italy) was used in the study. RESULTS In our study, a decrease in the mean % CA was observed in all semicircular canals (SCCs) with increasing age. Between age and mean % CA, a significant negative moderate (-0.311) correlation was observed in lateral SCCs, and a significant negative low (-0.257) correlation was observed in posterior SCCs (p < 0.05). In anterior SCCs, there was no statistically significant relationship between age and mean % CA (p > 0.05). CONCLUSIONS The present study performed in a healthy population will be helpful in terms of making comparisons in studies to be conducted in various vestibular diseases. It will also be a guide for identifying pathological consequences in vestibular diseases.
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Affiliation(s)
- Tuğba Emekci
- Necmettin Erbakan University, Faculty of Medicine ENT Clinic, Konya, Turkey
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24
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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25
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Gan Z, Zhou S, Yang H, He F, Wei D, Bai Y, Wang Y, Wang Y, Fu W, Han J. Self-Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo: A Preliminary Study. Front Med (Lausanne) 2021; 8:654637. [PMID: 33996859 PMCID: PMC8116577 DOI: 10.3389/fmed.2021.654637] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/15/2021] [Indexed: 12/04/2022] Open
Abstract
Objectives: The purpose of this study is to investigate a modified Epley maneuver for self-treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV). Methods: The study recruited 155 patients with PC-BPPV. All patients were randomized into the Epley maneuver group (n = 77) and modified Epley maneuver group (n = 78). We analyzed the resolution rate (1 day and 1 week), residual symptoms after the maneuver, and adverse effects. Results: It was found that the modified Epley maneuver group had a higher resolution rate than that of the Epley maneuver group in the treatment of PC-BPPV after 1 day of the initial maneuver (p < 0.05). However, there was no difference in resolution rate between the Epley maneuver group and the modified Epley maneuver group in resolution rate after 1 week of the initial maneuver (p > 0.05). The modified Epley maneuver group had fewer residual symptoms than that of the Epley maneuver group 1 week after treatment of PC-BPPV (p < 0.05). Significant improvements were also observed in average DHI scores in patients who underwent the modified Epley maneuver compared to the Epley maneuver (p < 0.05). There was no significant difference in adverse effects between the two groups (p > 0.05). Conclusions: The modified Epley maneuver has a satisfactory therapeutic efficacy with less residual symptoms and could be recommended as a self-treatment for patients with PC-BPPV.
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Affiliation(s)
- Zhuangqin Gan
- Department of Neurology, Qionghai People's Hospital, Qionghai, China
| | - Shiling Zhou
- Department of Neurology, Qionghai People's Hospital, Qionghai, China
| | - Hui Yang
- Department of Neurology, Qionghai People's Hospital, Qionghai, China
| | - Feng He
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Dong Wei
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ya Bai
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yuanyuan Wang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yingxia Wang
- Department of Neurology, Qionghai People's Hospital, Qionghai, China
| | - Wei Fu
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Junliang Han
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Satar B, Karaçaylı C, Çoban VK, Özdemir S. Do otosclerosis and stapedotomy affect semicircular canal functions? Preliminary results of video head impulse test. Acta Otolaryngol 2021; 141:348-353. [PMID: 33522866 DOI: 10.1080/00016489.2021.1873416] [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: 10/22/2022]
Abstract
BACKGROUND Otosclerosis and stapedotomy have some effects on the vestibular system, but there are very limited data on their effects on semicircular canals (SCCs). OBJECTIVE The aim of the study is to investigate if otosclerosis and stapedotomy have an effect on SCCs and video head impulse test (vHIT). MATERIAL AND METHODS This retrospective study included 11 otosclerosis patients who had undergone stapedotomy and 30 healthy participants. Twenty-two ears of 11 patients with otosclerosis were divided into two groups based on whether the ear had been operated (12 ears) or not (10 ears). All participants underwent vHIT. We compared gains of all SCCs, presence of saccades among the operated ears, unoperated ears and control ears. RESULTS Significant difference (p<.05) was noted in comparisons of gain of lateral SCCs among all groups. Control group had the highest gain, followed by unoperated and operated groups, respectively. Comparison of incidence of covert saccade showed significant difference (p<.05) for lateral and posterior SCCs. CONCLUSIONS AND SIGNIFICANCE Otosclerosis and otosclerosis surgery may have some effects on SCC functions and thereby vHIT. Lateral SCC is the most affected SCC in terms of gain. These findings appear to add important contributions to our knowledge.
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Affiliation(s)
- Bülent Satar
- Department of Otorhinolaryngology, Gulhane Faculty of Medicine, University of Health Science Turkey, Ankara, Turkey
| | - Ceren Karaçaylı
- Department of Audiology, Gulhane Faculty of Health Science, University of Health Science Turkey, Ankara, Turkey
| | - Volkan Kenan Çoban
- Department of Otorhinolaryngology, Gülhane Training and Research Hospital, University of Health Science Turkey, Ankara, Turkey
| | - Songül Özdemir
- Department of Otorhinolaryngology, Gülhane Training and Research Hospital, University of Health Science Turkey, Ankara, Turkey
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27
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Abstract
Vestibular and optokinetic space is represented in three-dimensions in vermal lobules IX-X (uvula, nodulus) and hemisphere lobule X (flocculus) of the cerebellum. Vermal lobules IX-X encodes gravity and head movement using the utricular otolith and the two vertical semicircular canals. Hemispheric lobule X encodes self-motion using optokinetic feedback about the three axes of the semicircular canals. Vestibular and visual adaptation of this circuitry is needed to maintain balance during perturbations of self-induced motion. Vestibular and optokinetic (self-motion detection) stimulation is encoded by cerebellar climbing and mossy fibers. These two afferent pathways excite the discharge of Purkinje cells directly. Climbing fibers preferentially decrease the discharge of Purkinje cells by exciting stellate cell inhibitory interneurons. We describe instances adaptive balance at a behavioral level in which prolonged vestibular or optokinetic stimulation evokes reflexive eye movements that persist when the stimulation that initially evoked them stops. Adaptation to prolonged optokinetic stimulation also can be detected at cellular and subcellular levels. The transcription and expression of a neuropeptide, corticotropin releasing factor (CRF), is influenced by optokinetically-evoked olivary discharge and may contribute to optokinetic adaptation. The transcription and expression of microRNAs in floccular Purkinje cells evoked by long-term optokinetic stimulation may provide one of the subcellular mechanisms by which the membrane insertion of the GABAA receptors is regulated. The neurosteroids, estradiol (E2) and dihydrotestosterone (DHT), influence adaptation of vestibular nuclear neurons to electrically-induced potentiation and depression. In each section of this review, we discuss how adaptive changes in the vestibular and optokinetic subsystems of lobule X, inferior olivary nuclei and vestibular nuclei may contribute to the control of balance.
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Affiliation(s)
- Neal H. Barmack
- Department of Physiology & Pharmacology, Oregon Health & Science University, Portland, OR, United States
| | - Vito Enrico Pettorossi
- Section of Human Physiology and Biochemistry, Department of Experimental Medicine, University of Perugia, Perugia, Italy
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28
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Yadav H, Irugu D, Ramakrishanan L, Singh A, Abraham R, Sikka K, Thakar A, Verma H. An evaluation of serum Otolin-1 & Vitamin-D in benign paroxysmal positional vertigo. J Vestib Res 2021; 31:433-440. [PMID: 33720865 DOI: 10.3233/ves-201601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/03/2023]
Abstract
BACKGROUND Serum otolin-1 is an inner ear protein exclusively expressed in otoconia and cells of vestibule and cochlea. Serum otolin-1 is found to be quantifiable in patients with BPPV. Low Vitamin-D is associated with pathogenesis of BPPV. Since otoconia degeneration contributes to BPPV, lack of Vitamin-D may impact otoconia structure and integrity. OBJECTIVE We aimed at studying the s.otolin-1 as biomarker and significance of vit-D in BPPV. MATERIAL AND METHOD 23 patients in test and control groups respectively were chosen within the age of 20 to 65 years. All the patients were diagnosed using Dix Hallpike menouver and head roll test, patients were treated with appropriate Canal Reposition Menouver (CRM). RESULTS Serum Otolin-1 levels among the test ranged from 366 to 882 pg/mL with mean of 585.17 pg/mL whereas in control group ranged from 223 to 462 pg/mL with mean of 335.26 pg/mL. Mean Vitamin-D levels among the test group was 22.67 ng/mL (Range = 6.3-68.4) and that of control 15.43 pg/mL (Range = 5.4-27.7) respectively. The relationship between the serum Otolin-1 and Vitamin-D was not statistically significant. CONCLUSION Otolin-1 levels is increased in BPPV patients and is sensitive in BPPV, specificity needs to be validated. Role of vitamin-D with respect to inner ear proteins needs further investigation.
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Affiliation(s)
- Harsha Yadav
- Junior Resident, Department of Otorhinolaryngology-Head & Neck surgery, AIIMS, New Delhi, India
| | - Dvk Irugu
- Associate Professor, Department of Otorhinolaryngology-Head & Neck surgery, AIIMS, New Delhi, India
| | | | - Archana Singh
- Associate Professor, Department of Biochemistry, AIIMS, New Delhi, India
| | - Ransi Abraham
- Senior Research Officer, Department of Cardiac Biochemistry, AIIMS, New Delhi, India
| | - Kapil Sikka
- Additional Professor, Department of Otorhinolaryngology-Head & Neck surgery, AIIMS, New Delhi, India
| | - Alok Thakar
- Professor & Head, Department of Otorhinolaryngology-Head & Neck surgery, AIIMS, New Delhi, India
| | - Hitesh Verma
- Associate Professor, Department of Otorhinolaryngology-Head & Neck surgery, AIIMS, New Delhi, India
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29
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Gebhart I, Götting C, Hool SL, Morrison M, Korda A, Caversaccio M, Obrist D, Mantokoudis G. Sémont Maneuver for Benign Paroxysmal Positional Vertigo Treatment: Moving in the Correct Plane Matters. Otol Neurotol 2021; 42:e341-e347. [PMID: 33165161 PMCID: PMC7880166 DOI: 10.1097/mao.0000000000002992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS We aimed to investigate the effect of the head excursion angle on the success of the Sémont Maneuver (SM). BACKGROUND SM is performed with the head turned by 45 degrees toward the unaffected ear. In clinical routine, it is unlikely that physicians can turn the head to a position of exactly 45 degrees. Moreover, it is unclear how possible deviations from 45 degrees would affect the outcome with SM. METHODS We used an in vitro model (upscaled by ×5) of a posterior semicircular canal with canalithiasis to study head excursion angles (0-75 degrees) and minimum waiting times in SM. Additionally, we measured actual head excursion angles performed by trained physicians during SM on a healthy subject. RESULTS Successful canalith repositioning to the utricle was possible at head excursion angles between 21 and 67 degrees. Waiting time increased from 16 to 30 seconds with increasing deviation from 45 degrees. Angles larger than 67 degrees or smaller than 21 degrees did not lead to successful repositioning even after a waiting period of 5 minutes. Physicians set head excursion angles of 50 degrees ±SD 4.8 degrees while performing the SM. CONCLUSION Angular deviations up to ±20 degrees from the ideal SCC plane (45 degrees) still allows for successful SM. Although the tested physicians tended to underestimate the actual head excursion angle by 5 degrees (and more), the success of SM will not be affected provided that the waiting time is sufficiently long. Further, the results suggest that the Brandt-Daroff maneuver is a form of habituation training rather than a liberatory maneuver.
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Affiliation(s)
- Isabel Gebhart
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern
| | - Carina Götting
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern
| | - Sara-Lynn Hool
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern
| | - Miranda Morrison
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern
| | - Athanasia Korda
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern
| | - Marco Caversaccio
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern
| | - Dominik Obrist
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Georgios Mantokoudis
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern
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30
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Emekci T, Uğur KŞ, Cengiz DU, Men Kılınç F. Normative values for semicircular canal function with the video head impulse test (vHIT) in healthy adolescents. Acta Otolaryngol 2021; 141:141-146. [PMID: 33151099 DOI: 10.1080/00016489.2020.1836396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/23/2022]
Abstract
BACKGROUND The vHIT device, which has a mechanism based on measuring the VOR gain, helps us to quickly evaluate six semicircular canals. AIMS/OBJECTIVES The aim of this study was to establish normative values for semicircular canal function with the video head impulse test (vHIT) battery in normal adolescents. MATERIAL AND METHODS 100 (50 females, 50 males) individuals aged 11-18 years, with a mean age of 14.99 years, were included in the study. RESULTS As a result of the vHIT evaluations performed with vHIT Otometrics ICS Impulse A/S Taastrup, Denmark, the mean lateral canal vestibulo-ocular reflex (VOR) gain value was 0.96, the mean anterior canal VOR gain value was 0.89, and the mean posterior canal VOR gain value was 0.87, all of which were within the normal value range. CONCLUSION AND SIGNIFICANCE While the VOR gain values and asymmetry values are within the normal value range and are similar to the literature, no statistically significant correlation was observed between these values and age. As a result, the vHIT battery is an easy, fast, and practical test method that can be used in adolescents.
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Affiliation(s)
- Tuğba Emekci
- Faculty of Medicine ENT Clinic, Necmettin Erbakan University, Konya, Turkey
| | | | - Deniz Uğur Cengiz
- Faculty of Health Science, Department of Audiology, İnönü University, Malatya, Turkey
| | - Fatma Men Kılınç
- Faculty of Medicine ENT Clinic, Department of Audiology, Başkent University, Ankara, Turkey
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Molnár D, Mező M, Vaska Z, Sevecsek Z, Helfferich F. Report of an Otic Capsule Disrupting Fracture of the Temporal Bone: Visualization of Pneumolabyrinth and Functional Assessment. Cureus 2021; 13:e12425. [PMID: 33542872 PMCID: PMC7849929 DOI: 10.7759/cureus.12425] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Blunt trauma of the head can result in temporal bone fracture. Different classifications exist, but from a functional perspective, to distinguish otic capsule sparing and otic capsule disrupting fractures is superior to the classic nomenclature. Disruption of the otic capsule is often associated with sensorineural hearing loss, vestibular dysfunction, cerebrospinal leakage, or even intracranial consequences. Pneumolabyrinth describes the condition when air is enclosed within the inner ear. It is a result of a pathological communication between the labyrinth and the middle ear spaces that often occurs due to trauma. It is not a ubiquitous but obvious radiographic hallmark of otic capsule violation. The present case is about a young woman who suffered a temporal bone fracture that involved the right lateral semicircular canal. Multiplanar and segmentation images were generated to depict the pneumolabyrinth developed in the lateral semicircular canal. Despite the preserved hearing, vestibular dysfunction was registered during the video head impulse test and videonystagmography. Treatment of pneumolabyrinth after temporal bone fracture can be a matter of surgery or conservative therapy. In the present case, we preferred conservative therapy because of the absence of serious consequences. Nevertheless, timing and the type of therapeutic modality must be personalized.
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Affiliation(s)
- Dávid Molnár
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Centre, Hungarian Defence Forces, Budapest, HUN.,Department of Anatomy, Histology and Embryology, Semmelweis University, Budapet, HUN
| | - Marléne Mező
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Centre, Hungarian Defence Forces, Budapest, HUN
| | - Zita Vaska
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Centre, Hungarian Defence Forces, Budapest, HUN
| | - Zsuzsanna Sevecsek
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Centre, Hungarian Defence Forces, Budapest, HUN
| | - Frigyes Helfferich
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Centre, Hungarian Defence Forces, Budapest, HUN
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Tulmac OB, Simsek G. Assessment of the effects of menopause on semicircular canal using the video head impulse test. J OBSTET GYNAECOL 2020; 41:939-945. [PMID: 33228415 DOI: 10.1080/01443615.2020.1819213] [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: 10/22/2022]
Abstract
This cross-sectional study included early menopausal and late menopausal women aged between 40 and 60 years to evaluate the effects of menopause on semicircular canal function. A video head impulse test (vHIT) was performed for all subjects. Vestibulo-ocular reflex (VOR) mean gains of each semicircular canal and gain asymmetry were compared between groups. Of the 87 subjects, 37(42.5%) were reproductive age 28(32.5%) were early menopausal and 22(25.3%) were late menopausal patients. VOR gain of semicircular canals or gain asymmetry values did not differ between groups. In postmenopausal women, presence of vasomotor symptoms was associated with higher gain asymmetry of the left anterior-right posterior (LARP) plane (p = .01), and presence of balance problems was associated with lower right anterior (RA) VOR gain (p = .01). In conclusion semicircular canal function in postmenopausal women was similar to that in women of reproductive age.IMPACT STATEMENTWhat is already known on this subject? During menopause, women face potential risks such as dizziness, balance problems, falls and fractures. Postmenopausal patients were tested with dynamic posturography to measure balance before and after oestrogen treatment, and it was shown that balance problems significantly improved with oestrogen treatment. Healthy vestibular system is one of the components for sustaining normal balance.What do the results of this study add? In postmenopausal women the function of the semicircular canals is normal and the balance deficit in postmenopausal women may not be caused by the vestibular system. In this study changes within normal limits were observed in vestibular system of postmenopausal women.What are the implications of these findings for clinical practice and/or further research? Reported balance deficits might have been due to central origin. Further research to differentiate origin of balance deficits are needed. Specific research on symptomatic postmenopausal patients would reveal more information.
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Affiliation(s)
- Ozlem Banu Tulmac
- Department of Obsterics and Gynecology, Kırıkkale University, Kirikkale, Turkey
| | - Gokce Simsek
- Department of Otolaryngology, Kirikkale University, Kirikkale, Turkey
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Curthoys IS, Manzari L. A Simple Specific Functional Test for SCD: VEMPs to High Frequency (4,000Hz) Stimuli-Their Origin and Explanation. Front Neurol 2020; 11:612075. [PMID: 33329372 PMCID: PMC7720427 DOI: 10.3389/fneur.2020.612075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, The University of Sydney, Darlington, NSW, Australia.,MSA ENT Academy Center, Cassino, Italy
| | - Leonardo Manzari
- Vestibular Research Laboratory, School of Psychology, The University of Sydney, Darlington, NSW, Australia.,MSA ENT Academy Center, Cassino, Italy
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Barbara M, Margani V, Voltattorni A, Monini S, Covelli E. Concomitant Dehiscences of the Temporal Bone: A Case-Based Study. Ear Nose Throat J 2020; 101:NP324-NP328. [PMID: 33175590 DOI: 10.1177/0145561320973782] [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: 11/15/2022] Open
Abstract
Otic capsule dehiscences create a pathological third window in the inner ear that results in a dissipation of the acoustic energy consequent to the lowered impedance. Superior semicircular canal dehiscence (SSCD) was identified by Minor et al in 1998 as a syndrome leading to vertigo and inner ear conductive hearing loss. The authors also reported the relation between the dehiscence and pressure- or sound-induced vertigo (Tullio's phenomenon). Prevalence rates of SSCD in anatomical studies range from 0.4% to 0.7% with a majority of patients being asymptomatic. The observed association with other temporal bone dehiscences, as well as the propensity toward a bilateral or contralateral "near dehiscence," raises the question of whether a specific local bone demineralization or systemic mechanisms could be considered. The present report regard a case of a patient with a previous episode of meningitis, with a concomitant bilateral SSCD and tegmen tympani dehiscence from the side of meningitis. The patient was affected by dizziness, left moderate conductive hearing loss, and pressure/sound-induced vertigo. Because of disabling vestibular symptoms, the patient underwent surgical treatment. A middle cranial fossa approach allowed to reach both dehiscences on the symptomatic side, where bone wax and fascia were used for repair. At 6 months from the procedure, hearing was preserved, and the vestibular symptoms disappeared.
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Affiliation(s)
- Maurizio Barbara
- NESMOS Department, ENT Clinic, Sant'Andrea University Hospital, 9311Sapienza University, Rome, Italy
| | - Valerio Margani
- NESMOS Department, ENT Clinic, Sant'Andrea University Hospital, 9311Sapienza University, Rome, Italy
| | - Anna Voltattorni
- NESMOS Department, ENT Clinic, Sant'Andrea University Hospital, 9311Sapienza University, Rome, Italy
| | - Simonetta Monini
- NESMOS Department, ENT Clinic, Sant'Andrea University Hospital, 9311Sapienza University, Rome, Italy
| | - Edoardo Covelli
- NESMOS Department, ENT Clinic, Sant'Andrea University Hospital, 9311Sapienza University, Rome, Italy
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袁 庆, 李 昕, 张 悦, 刘 得. [A follow-Up Study with the Video Head Impulse Test for the patients with vestibular neuritis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 34:990-998. [PMID: 33254316 PMCID: PMC10133134 DOI: 10.13201/j.issn.2096-7993.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Indexed: 06/12/2023]
Abstract
Objective:To detect the impairment degree and recovery process of the semicircular canals of patients with vestibular neuritis(VN) by video head impulse test(vHIT) over different periods. Method:The clinical data of patients with VN, who were diagnosed by Vertigo clinic'physicians in the Department of ENT, Dalian Municipal Central Hospital from Sept. 2018 to Sept. 2019, were analyzed and followed up at 1 and 3 month. The damage degree and recovery process of each semicircular canal function were evaluated by vHIT. Result:During the onset period, 89.7% horizontal semicircular canal HSC, 86.2% anterior semicircular canal ASC and 44.8% posterior semicircular canal PSC were abnormal in 29 patients. 23.8% HSC were back to normal, 75.0% ASC were back to normal, 15.4% PSC were back to normal at 1 month; 47.1% HSC were back to normal, 87.5%ASC were back to normal, 25.0% PSC were back to normal at 3 month. Conclusion:vHIT can effectively and dynamically detect the damage and recovery of the high-frequency region of the semicircular canal in patients with VN; the damaged function of the ASC is best recovered, followed by the HSC.
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Affiliation(s)
- 庆 袁
- 大连市中心医院耳鼻咽喉头颈外科(辽宁大连,116000)Department of Otolaryngology Head and Neck Surgery, Dalian Municipal Central Hospital, Dalian, 116000, China
| | - 昕英 李
- 大连市中心医院耳鼻咽喉头颈外科(辽宁大连,116000)Department of Otolaryngology Head and Neck Surgery, Dalian Municipal Central Hospital, Dalian, 116000, China
| | - 悦 张
- 大连市中心医院耳鼻咽喉头颈外科(辽宁大连,116000)Department of Otolaryngology Head and Neck Surgery, Dalian Municipal Central Hospital, Dalian, 116000, China
| | - 得龙 刘
- 大连市中心医院耳鼻咽喉头颈外科(辽宁大连,116000)Department of Otolaryngology Head and Neck Surgery, Dalian Municipal Central Hospital, Dalian, 116000, China
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Leng Y, Liu B. Dissociation of Caloric and Video Head Impulse Tests in Patients With Delayed Endolymphatic Hydrops. Front Neurol 2020; 11:362. [PMID: 32528397 PMCID: PMC7247804 DOI: 10.3389/fneur.2020.00362] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Delayed endolymphatic hydrops (DEH) represents a rare clinical entity characterized by intermittent vertigo attacks mimicking those of Ménière's disease (MD) in a patient with a prior sensorineural hearing loss. Some vestibular tests have been employed in patients with DEH. These tests provide useful diagnostic information and facilitate clinical decision-making. Here, we retrospectively studied the features of video head impulse test (vHIT) and examined its relationship with caloric test used in DEH patients. Included in this study were 17 patients with ipsilateral DEH and 2 with contralateral DEH. Among them, 73.7% (14/19) showed abnormal caloric test response (76.5% in ipsilateral DEH and 50% in contralateral DEH). Meanwhile, only 15.8% (3/19) of patients yielded abnormal horizontal vHIT results (11.8% in ipsilateral DEH and 50% in contralateral DEH). Abnormal caloric response in the presence of a preserved vHIT was common in DEH patients, especially those with ipsilateral DEH. This dissociation might be a distinctive pattern of vestibular deficit in DEH.
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Affiliation(s)
- Yangming Leng
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lambert FM, Bacqué-Cazenave J, Le Seach A, Arama J, Courtand G, Tagliabue M, Eskiizmirliler S, Straka H, Beraneck M. Stabilization of Gaze during Early Xenopus Development by Swimming-Related Utricular Signals. Curr Biol 2020; 30:746-753.e4. [PMID: 31956031 DOI: 10.1016/j.cub.2019.12.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/12/2019] [Revised: 11/26/2019] [Accepted: 12/13/2019] [Indexed: 01/01/2023]
Abstract
Locomotor maturation requires concurrent gaze stabilization improvement for maintaining visual acuity [1, 2]. The capacity to stabilize gaze, in particular in small aquatic vertebrates where coordinated locomotor activity appears very early, is determined by assembly and functional maturation of inner ear structures and associated sensory-motor circuitries [3-7]. Whereas utriculo-ocular reflexes become functional immediately after hatching [8, 9], semicircular canal-dependent vestibulo-ocular reflexes (VORs) appear later [10]. Thus, small semicircular canals are unable to detect swimming-related head oscillations, despite the fact that corresponding acceleration components are well-suited to trigger an angular VOR [11]. This leaves the utricle as the sole vestibular origin for swimming-related compensatory eye movements [12, 13]. We report a remarkable ontogenetic plasticity of swimming-related head kinematics and vestibular end organ recruitment in Xenopus tadpoles with beneficial consequences for gaze-stabilization. Swimming of older larvae generates sinusoidal head undulations with small, similar curvature angles on the left and right side that optimally activate horizontal semicircular canals. Young larvae swimming causes left-right head undulations with narrow curvatures and strong, bilaterally dissimilar centripetal acceleration components well suited to activate utricular hair cells and to substitute the absent semicircular canal function at this stage. The capacity of utricular signals to supplant semicircular canal function was confirmed by recordings of eye movements and extraocular motoneurons during off-center rotations in control and semicircular canal-deficient tadpoles. Strong alternating curvature angles and thus linear acceleration profiles during swimming in young larvae therefore represents a technically elegant solution to compensate for the incapacity of small semicircular canals to detect angular acceleration components.
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Affiliation(s)
| | | | - Anne Le Seach
- Integrative Neuroscience and Cognition Center, CNRS UMR 8002, Université de Paris, F-75270 Paris, France
| | - Jessica Arama
- Integrative Neuroscience and Cognition Center, CNRS UMR 8002, Université de Paris, F-75270 Paris, France
| | - Gilles Courtand
- INCIA, CNRS UMR 5287, Université de Bordeaux, F-33076 Bordeaux, France
| | - Michele Tagliabue
- Integrative Neuroscience and Cognition Center, CNRS UMR 8002, Université de Paris, F-75270 Paris, France
| | - Selim Eskiizmirliler
- Integrative Neuroscience and Cognition Center, CNRS UMR 8002, Université de Paris, F-75270 Paris, France
| | - Hans Straka
- Department Biology II, Ludwig-Maximilians-University Munich, Grosshaderner Str. 2, 82152 Planegg, Germany
| | - Mathieu Beraneck
- Integrative Neuroscience and Cognition Center, CNRS UMR 8002, Université de Paris, F-75270 Paris, France.
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Ihtijarevic B, Janssens de Varebeke S, Mertens G, Dekeyzer S, Van de Heyning P, Van Rompaey V. Correlations Between Vestibular Function and Imaging of the Semicircular Canals in DFNA9 Patients. Front Neurol 2020; 10:1341. [PMID: 31998212 PMCID: PMC6965155 DOI: 10.3389/fneur.2019.01341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 12/05/2019] [Indexed: 11/25/2022] Open
Abstract
Background and Purpose: Radiologic abnormalities on computed tomography (CT), including narrowing or sclerosis of the semicircular canals (SCCs), and T2-weighted magnetic resonance imaging (MRI), including signal loss in the SCC, have been reported as potential biomarkers in patients with P51S mutations in the COCH gene (i.e., DFNA9). The aim of our study was to correlate caloric responses through electronystagmography (ENG) data with imaging results in DFNA9 patients. Materials and Methods: A retrospective study was performed in 45 patients; therefore, 90 ears with P51S mutations in the COCH gene were tested. Caloric responses and CT and MRI data were analyzed from June 2003 until May 2014. More than half of patients (54%) were candidates for cochlear implantation. Results: In our population, 91% of tested ears had sclerotic lesions and/or narrowing in one or more SCCs on CT scan. All tested ears had narrowing or signal loss in at least one SCC on T2-weighted MRI. The lateral SCC was affected in 87% on CT scan and 92% on MRI. However, in 83% of tested ears, all three SCCs were affected on MRI. Furthermore, in 77% of tested ears, caloric responses were reduced bilaterally, while 11.5% showed unilateral hypofunction and the other 11.5% had normal caloric responses. CT abnormalities correlated with hypofunction of caloric responses. This statistically significant difference was present if abnormalities were observed in at least one of the SCCs as well as in ipsilateral lateral SCC function loss. MRI abnormalities in at least one of the SCCs correlated with ENG hypofunction, but there was no direct correlation between lateral SCC abnormalities on MRI and caloric responses of the investigated lateral canal. Conclusion: Our retrospective analysis confirms the presence of CT and MRI abnormalities in DFNA9 patients with the P51S mutation in the COCH gene. A correlation between these radiologic features and vestibular function (tested by means of caloric response) was found in this population.
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Affiliation(s)
- Berina Ihtijarevic
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Sebastien Janssens de Varebeke
- Department of Otorhinolaryngology and Head and Neck Surgery, Jessa Hospital, Hasselt, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Sven Dekeyzer
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Zou SZ, Li JR, Liu Y, Ding YL, Wang YQ. [Preliminary study on age stability of VOR gain values of video head impulse test in healthy subjects]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 33:393-397. [PMID: 31163543 DOI: 10.13201/j.issn.1001-1781.2019.05.003] [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] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Indexed: 11/12/2022]
Abstract
Objective: To explore the age stability of the video head impulse test(vHIT) in healthy subjects. Method: This was a prospective study on healthy subjects referred to our department. One hundred and eighty healthy subjects(age range 21-80) without any current or previous history of brain disorder, vertigo, neck stiffness or eye diseases participated in this study and the vHIT was carried out in all 180 cases. The relationship between VOR gain and age was analysed using univariate regression model and one-way ANOVA for subjects. Result: The VOR gains of the left horizontal semicircular canal, posterior semicircular canal and anterior semicircular canal were 1.02±0.12, 1.04± 0.15 and 0.94±0.16 respectively. The VOR gains of the right horizontal semicircular canal, posterior semicircular canal and anterior semicircular canal were 1.05±0.14, 1.00±0.16, 0.97±0.15 respectively. The difference of VOR gain between left and right corresponding semicircular canals was not statistically significant(P>0.05). For male subjects, the VOR gains of horizontal, anterior and posterior semicircular canal were 1.05±0.13, 1.02±0.16, 0.99±0.16 respectively, and for female subjects, the VOR gains of horizontal, anterior and posterior semicircular canal were 1.05±0.13, 1.01±0.16, 0.97±0.16 respectively. There was no significant difference in VOR gain of three semicircular canals between male and female(P>0.05). The VOR gain in different age groups was analyzed by one-way ANOVA. There was no significant difference in the VOR gain among different age groups(P>0.05). Univariate linear regression analysis was performed between the age and the VOR gain of the three semicircular canals. The slopes of the regression equations were 0.001 8, 0.000 2 and 0.000 3, respectively. Conclusion:The VOR gain of the six semicircular canals in healthy subjects is not significantly influenced by gender, and it varies slightly with age without requirement for adjustment with age. .
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Affiliation(s)
- S Z Zou
- Department of Otorhinolaryngology Head and Neck Surgery, PLA General Hospital No.6 Medical Center, Beijing, 100048, China
| | - J R Li
- Department of Otorhinolaryngology Head and Neck Surgery, PLA General Hospital No.6 Medical Center, Beijing, 100048, China
| | - Y Liu
- Department of Otorhinolaryngology Head and Neck Surgery, PLA General Hospital No.6 Medical Center, Beijing, 100048, China
| | - Y L Ding
- Department of Otorhinolaryngology Head and Neck Surgery, PLA General Hospital No.6 Medical Center, Beijing, 100048, China
| | - Y Q Wang
- Department of Otorhinolaryngology Head and Neck Surgery, PLA General Hospital No.6 Medical Center, Beijing, 100048, China
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Ramaioli C, Cuturi LF, Ramat S, Lehnen N, MacNeilage PR. Vestibulo-Ocular Responses and Dynamic Visual Acuity During Horizontal Rotation and Translation. Front Neurol 2019; 10:321. [PMID: 31024422 PMCID: PMC6467074 DOI: 10.3389/fneur.2019.00321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/14/2019] [Indexed: 11/13/2022] Open
Abstract
Dynamic visual acuity (DVA) provides an overall functional measure of visual stabilization performance that depends on the vestibulo-ocular reflex (VOR), but also on other processes, including catch-up saccades and likely visual motion processing. Capturing the efficiency of gaze stabilization against head movement as a whole, it is potentially valuable in the clinical context where assessment of overall patient performance provides an important indication of factors impacting patient participation and quality of life. DVA during head rotation (rDVA) has been assessed previously, but to our knowledge, DVA during horizontal translation (tDVA) has not been measured. tDVA can provide a valuable measure of how otolith, rather than canal, function impacts visual acuity. In addition, comparison of DVA during rotation and translation can shed light on whether common factors are limiting DVA performance in both cases. We therefore measured and compared DVA during both passive head rotations (head impulse test) and translations in the same set of healthy subjects (n = 7). In addition to DVA, we computed average VOR gain and retinal slip within and across subjects. We observed that during translation, VOR gain was reduced (VOR during rotation, mean ± SD: position gain = 1.05 ± 0.04, velocity gain = 0.97 ± 0.07; VOR during translation, mean ± SD: position gain = 0.21 ± 0.08, velocity gain = 0.51 ± 0.16), retinal slip was increased, and tDVA was worse than during rotation (average rDVA = 0.32 ± 0.15 logMAR; average tDVA = 0.56 ± 0.09 logMAR, p = 0.02). This suggests that reduced VOR gain leads to worse tDVA, as expected. We conclude with speculation about non-oculomotor factors that could vary across individuals and affect performance similarly during both rotation and translation.
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Affiliation(s)
- Cecilia Ramaioli
- German Center for Vertigo and Balance Disorders, University Hospital Munich, Munich, Germany.,Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Luigi F Cuturi
- Unit for Visually Impaired People, Italian Institute of Technology, Genoa, Italy
| | - Stefano Ramat
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Nadine Lehnen
- German Center for Vertigo and Balance Disorders, University Hospital Munich, Munich, Germany.,Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Paul R MacNeilage
- Department of Psychology, Cognitive and Brain Sciences, University of Nevada, Reno, NV, United States
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Li SS, Han X, Wang W, Xu KX, Liu Q, Wen C, Chen TS, Lin P. [The characteristics of semicircular canal injury frequency in vestibular neuritis patients]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 33:216-219. [PMID: 30813688 DOI: 10.13201/j.issn.1001-1781.2019.03.008] [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] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Indexed: 11/12/2022]
Abstract
Objective:To evaluate the frequency characteristics of semicircular canal injury in patients with vestibular neuritis. Method:Fifty-three patients with vestibular neuritis were respectively evaluated by caloric test(CT),head shaking test(HST),video head impulse test (vHIT),which reflects semicircular canal function in the low, middle, high frequency region. The asymmetric value of CT unilateral semicircular canal reaction (UW), head shaking nystagmus induced by HST, gain value of VHIT (VHIT-G) and presence or absence of saccade (VHIT-S) were used as observation indicators. The data were analyzed by SPSS 17.0 statistical software.The characteristics of the results of the three tests in patients with vestibular neuritis was analyzed and the functional status of the high, middle and low frequency regions of the semicircular canal was evaluated. Result:The positive rates of CT, HST, VHIT-G and VHIT-S in 53 patients with vestibular neuritis were 94.3%(50/53),75.5%(40/53),81.1%(43/53),96.2%(51/53),respectively. The positive rates of CT, HST, VHIT-G and VHIT-S were 92.9%(26/28),89.3%(25/28),92.9%(26/28),96.4%(27/28)in 28 cases with disease course ≤ 7 days, and the positive rates in 25 patients with disease course >7 days were 96.0%(24/25),60.0%(15/25),68.0%(17/25),96.0%(24/25),respectively. Compared with the positive rate of each index, CT and VHIT-G (P=0.076), HST and VHIT-G (P=0.480) had no statistical significance. The difference between CT and HST (P=0.015), VHIT-G and VHIT-S(P=0.032) was statistically significant. The positive rates of CT, HST, VHIT-G and VHIT-saccade in patients with course of disease ≤7 days were compared, and there was no significant difference. In patients with disease course >7 days, except HST and VHIT-G, there were statistical differences in other indexes. The correlation test between VHIT-G and VHIT-S:r=-0.437, P=0.006. Conclusion:The vestibular injury in patients with vestibular neuritis showed in a manner of full frequency injury. The multi-frequency detection technique is helpful for the clinical diagnosis of vestibular neuritis, and also can reflect the compensation and recovery of vestibular function.
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Affiliation(s)
- S S Li
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
| | - X Han
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
| | - W Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
| | - K X Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
| | - Q Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
| | - C Wen
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
| | - T S Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
| | - P Lin
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, 300192, China
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Zhu ZJ, Liu Q. [Clinical analysis for 16 cases with atypical nystagmus of posterior semicircular canal benign paroxysmal positional vertigo]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 32:1687-1690;1695. [PMID: 30716795 DOI: 10.13201/j.issn.1001-1781.2018.22.001] [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] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Indexed: 11/12/2022]
Abstract
Objective:To study clinical features and evaluate the efficacy of manual reduction in treatment of atypical nystagmus in patients with posterior semicircular canal benign paroxysmal positional vertigo(PSC-BPPV). Method:Sixteen cases of atypical nystagmus in patients with PSC-BPPV were retrospectively analyzed. The results were compared with 28 patients of typical nystagmus with PSC-BPPV.All the patients were followed up for 3 months. Statistical data analysis was carried out with SPSS 20.0. Result:Sixteen cases of atypical nystagmus patients with PSC-BPPV included 5 cases of left 31.25%(5/16) and 11 cases of right 68.75%(11/16), 5 patients showed typical nystagmus in the straight-head hanging position and without vertical down-beating in returning to the sitting positions with torsional component pointed to intact side,4 patients showed same nystagmus in hanging position and vertical down-beating in returning to the sitting positions without torsional component, one patient showed nystagmus of vertical up-beating and vertical down-beating in Dix-Hallpike test without torsional component,2 patients showed unobservable nystagmus in Dix-Hallpike test but showed nystagmus of vertical up-beating with torsional component pointed to affected side in the roll test position,4 patients showed nystagmus of vertical down-beating in the straight-head hanging position with torsional component pointed to intact side and reversible direction nystagmus in returning to the sitting positions.One patient's nystagmus time of duration was longer than 1 min,while 15 patients' nystagmus duration were shorter than 1 min.Twenty-eight patients with typical nystagmus in PSC-BPPV nystagmus duration were shorter than 1 min.No patient had been affected bilateral in two groups. All patients received manual reduction treatment according to the nystagmus direction and time of duration. The effective rate after the first day was 62.50%(10/16) in atypical nystagmus patients with PSC-BPPV group and 92.86%(26/28) in typical nystagmus with PSC-BPPV group, the difference was significant(χ²=5.134,P=0.015). The total effective rate was 93.75%(15/16)after more than once in atypical group and 100.00%(28/28) in typical group, the difference was not significant(χ²=2.780,P=0.095).The numbers of circulation of first success in manual reduction management were(2.76±1.13)times in atypical group and (1.68±0.61)times in typical group.The difference was significant(t=4.293,P=0.000). The recurrence rate was 18.75% in atypical group and 14.28% in typical group after during follow-up for 6 months, the difference was not significant(χ²=1.681,P=0.509). Conclusion:It showed that clinical manifestation with atypical nystagmus in patients with PSC-BPPV was complicated. Some patients' nystagmus could change to typical after treatment.The manual reduction was an effective treatment.The effective rate after first manual reduction was lower than typical group, it's needed more circulation of first success in manual reduction management. The recurrence rate was not significant in two groups.
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Affiliation(s)
- Z J Zhu
- Department of Otolaryngology Head and Neck Surgery,Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan,250001,China
| | - Q Liu
- Department of Otolaryngology Head and Neck Surgery,Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan,250001,China
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Tawfik KO, Leader BA, Walters ZA, Choo DI. Relative Preservation of Superior Semicircular Canal Architecture in CHARGE Syndrome. Otolaryngol Head Neck Surg 2019; 160:1095-1100. [PMID: 30667318 DOI: 10.1177/0194599818824306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/16/2022]
Abstract
OBJECTIVES (1) Describe common patterns of semicircular canal (SCC) anomalies in CHARGE syndrome (CS) and (2) recognize that in CS, the architecture of the superior SCC may be relatively preserved. STUDY DESIGN This is a retrospective review of temporal bone imaging studies. SETTING Quaternary care center. SUBJECTS AND METHODS A sample of 37 patients with CS. All subjects met clinical diagnostic criteria for CS. The presence/absence of anomalies of the middle ear, mastoid, temporal bone venous anatomy, inner ear, and internal auditory canal was recorded. Anomalies of each SCC were considered separately and by severity (normal, dysplasia, aplasia). RESULTS Thirty-seven subjects (74 temporal bones) were reviewed. Thirty-four (92.0%) patients demonstrated bilateral SCC anomalies. Three (8.0%) had normal SCCs. In patients with SCC anomalies, all canals demonstrated bilateral abnormalities. Thirty-two (86.5%) patients had bilateral horizontal SCC aplasia. These 32 patients also demonstrated posterior SCC aplasia in at least 1 ear. Of 74 temporal bones, 37 (50.0%) had superior SCC dysplasia. All dysplastic superior SCCs showed preservation of the anterior limb. Complete superior SCC aplasia was found in 28 (37.8%) temporal bones. CONCLUSION SCC anomalies occur with high frequency in CS. Complete absence of the horizontal and posterior canals is typical and usually bilateral. By contrast, the superior SCC often demonstrates relative preservation of the anterior limb.
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Affiliation(s)
- Kareem O Tawfik
- 1 Division of Otolaryngology-Head & Neck Surgery, University of California, San Diego School of Medicine, San Diego, California, USA
| | - Brittany A Leader
- 2 Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Zoe A Walters
- 3 University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Daniel I Choo
- 2 Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,4 Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Meredith FL, Rennie KJ. Regional and Developmental Differences in Na + Currents in Vestibular Primary Afferent Neurons. Front Cell Neurosci 2018; 12:423. [PMID: 30487736 PMCID: PMC6246661 DOI: 10.3389/fncel.2018.00423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/29/2018] [Indexed: 02/04/2023] Open
Abstract
The vestibular system relays information about head position via afferent nerve fibers to the brain in the form of action potentials. Voltage-gated Na+ channels in vestibular afferents drive the initiation and propagation of action potentials, but their expression during postnatal development and their contributions to firing in diverse mature afferent populations are unknown. Electrophysiological techniques were used to determine Na+ channel subunit types in vestibular calyx-bearing afferents at different stages of postnatal development. We used whole cell patch clamp recordings in thin slices of gerbil crista neuroepithelium to investigate Na+ channels and firing patterns in central zone (CZ) and peripheral zone (PZ) afferents. PZ afferents are exclusively dimorphic, innervating type I and type II hair cells, whereas CZ afferents can form dimorphs or calyx-only terminals which innervate type I hair cells alone. All afferents expressed tetrodotoxin (TTX)-sensitive Na+ currents, but TTX-sensitivity varied with age. During the fourth postnatal week, 200–300 nM TTX completely blocked sodium currents in PZ and CZ calyces. By contrast, in immature calyces [postnatal day (P) 5–11], a small component of peak sodium current remained in 200 nM TTX. Application of 1 μM TTX, or Jingzhaotoxin-III plus 200 nM TTX, abolished sodium current in immature calyces, suggesting the transient expression of voltage-gated sodium channel 1.5 (Nav1.5) during development. A similar TTX-insensitive current was found in early postnatal crista hair cells (P5–9) and constituted approximately one third of the total sodium current. The Nav1.6 channel blocker, 4,9-anhydrotetrodotoxin, reduced a component of sodium current in immature and mature calyces. At 100 nM 4,9-anhydrotetrodotoxin, peak sodium current was reduced on average by 20% in P5–14 calyces, by 37% in mature dimorphic PZ calyces, but by less than 15% in mature CZ calyx-only terminals. In mature PZ calyces, action potentials became shorter and broader in the presence of 4,9-anhydrotetrodotoxin implicating a role for Nav1.6 channels in firing in dimorphic afferents.
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Affiliation(s)
- Frances L Meredith
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Katherine J Rennie
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, United States.,Department of Physiology & Biophysics, University of Colorado School of Medicine, Aurora, CO, United States
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Moriguchi T, Hoshino T, Rao A, Yu L, Takai J, Uemura S, Ise K, Nakamura Y, Lim KC, Shimizu R, Yamamoto M, Engel JD. A Gata3 3' Distal Otic Vesicle Enhancer Directs Inner Ear-Specific Gata3 Expression. Mol Cell Biol 2018; 38:e00302-18. [PMID: 30126893 DOI: 10.1128/MCB.00302-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/13/2018] [Indexed: 12/21/2022] Open
Abstract
Transcription factor GATA3 plays vital roles in inner ear development, while regulatory mechanisms controlling its inner ear-specific expression are undefined. We demonstrate that a cis-regulatory element lying 571 kb 3' to the Gata3 gene directs inner ear-specific Gata3 expression, which we refer to as the Gata3 otic vesicle enhancer (OVE). In transgenic murine embryos, a 1.5-kb OVE-directed lacZ reporter (TgOVE-LacZ) exhibited robust lacZ expression specifically in the otic vesicle (OV), an inner ear primordial tissue, and its derivative semicircular canal. To further define the regulatory activity of this OVE, we generated Cre transgenic mice in which Cre expression was directed by a 246-bp core sequence within the OVE element (TgcoreOVE-Cre). TgcoreOVE-Cre successfully marked the OV-derived inner ear tissues, including cochlea, semicircular canal and spiral ganglion, when crossed with ROSA26 lacZ reporter mice. Furthermore, Gata3 conditionally mutant mice, when crossed with the TgcoreOVE-Cre, showed hypoplasia throughout the inner ear tissues. These results demonstrate that OVE has a sufficient regulatory activity to direct Gata3 expression specifically in the otic vesicle and semicircular canal and that Gata3 expression driven by the OVE is crucial for normal inner ear development.
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Chen L, Halmagyi GM. Central Lesions With Selective Semicircular Canal Involvement Mimicking Bilateral Vestibulopathy. Front Neurol 2018; 9:264. [PMID: 29740388 PMCID: PMC5928296 DOI: 10.3389/fneur.2018.00264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 11/17/2022] Open
Abstract
Bilateral vestibulopathy (BVP), which is due to peripheral lesions, may selectively involve certain semicircular canal (SCC). Recent eye movement recordings with search coil and video head impulse test (HIT) have provided insight in central lesions that can cause bilateral and selective SCC deficit mimicking BVP. Since neurological signs or ocular motor deficits maybe subtle or absent, it is critical to recognize central lesions correctly since there is prognostic and treatment implication. Acute floccular lesions cause bilateral horizontal SCC (HC) impairment while leaving vertical SCC function unaffected. Vestibular nuclear lesions affect bilateral HC and posterior SCC (PC) function, but anterior SCC (AC) function is spared. When both eyes are recorded, medial longitudinal fasciculus lesions cause horizontal dysconjugacy in HC function and catch-up saccades, as well as selective deficiency of PC over AC function. Combined peripheral and central lesions may be difficult to distinguish from BVP. Anterior inferior cerebellar artery stroke causes two types of deficits: 1. ipsilateral pan-SCC deficits and contralateral HC deficit and 2. bilateral HC deficit with vertical SCC sparing. Metabolic disorders such as Wernicke encephalopathy characteristically involve HC but not AC or PC function. Gaucher disease causes uniform loss of all SCC function but with minimal horizontal catch-up saccades. Genetic cerebellar ataxias and cerebellar-ataxia neuropathy vestibular areflexia syndrome typically do not spare AC function. While video HIT does not replace the gold-standard, search coil HIT, clinicians are now able to rapidly and accurately identify specific pattern of SCC deficits, which can aid differentiation of central lesions from BVP.
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Affiliation(s)
- Luke Chen
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Newlands SD, Abbatematteo B, Wei M, Carney LH, Luan H. Convergence of linear acceleration and yaw rotation signals on non-eye movement neurons in the vestibular nucleus of macaques. J Neurophysiol 2018; 119:73-83. [PMID: 28978765 DOI: 10.1152/jn.00382.2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 02/01/2023] Open
Abstract
Roughly half of all vestibular nucleus neurons without eye movement sensitivity respond to both angular rotation and linear acceleration. Linear acceleration signals arise from otolith organs, and rotation signals arise from semicircular canals. In the vestibular nerve, these signals are carried by different afferents. Vestibular nucleus neurons represent the first point of convergence for these distinct sensory signals. This study systematically evaluated how rotational and translational signals interact in single neurons in the vestibular nuclei: multisensory integration at the first opportunity for convergence between these two independent vestibular sensory signals. Single-unit recordings were made from the vestibular nuclei of awake macaques during yaw rotation, translation in the horizontal plane, and combinations of rotation and translation at different frequencies. The overall response magnitude of the combined translation and rotation was generally less than the sum of the magnitudes in responses to the stimuli applied independently. However, we found that under conditions in which the peaks of the rotational and translational responses were coincident these signals were approximately additive. With presentation of rotation and translation at different frequencies, rotation was attenuated more than translation, regardless of which was at a higher frequency. These data suggest a nonlinear interaction between these two sensory modalities in the vestibular nuclei, in which coincident peak responses are proportionally stronger than other, off-peak interactions. These results are similar to those reported for other forms of multisensory integration, such as audio-visual integration in the superior colliculus. NEW & NOTEWORTHY This is the first study to systematically explore the interaction of rotational and translational signals in the vestibular nuclei through independent manipulation. The results of this study demonstrate nonlinear integration leading to maximum response amplitude when the timing and direction of peak rotational and translational responses are coincident.
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Affiliation(s)
- Shawn D Newlands
- Department of Otolaryngology, University of Rochester Medical Center , Rochester, New York.,Department of Neuroscience, University of Rochester Medical Center , Rochester, New York
| | - Ben Abbatematteo
- Department of Biomedical Engineering, University of Rochester , Rochester, New York
| | - Min Wei
- Department of Otolaryngology, University of Rochester Medical Center , Rochester, New York
| | - Laurel H Carney
- Department of Biomedical Engineering, University of Rochester , Rochester, New York.,Department of Neuroscience, University of Rochester Medical Center , Rochester, New York
| | - Hongge Luan
- Department of Otolaryngology, University of Rochester Medical Center , Rochester, New York
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Abstract
In 1988, we introduced impulsive testing of semicircular canal (SCC) function measured with scleral search coils and showed that it could accurately and reliably detect impaired function even of a single lateral canal. Later we showed that it was also possible to test individual vertical canal function in peripheral and also in central vestibular disorders and proposed a physiological mechanism for why this might be so. For the next 20 years, between 1988 and 2008, impulsive testing of individual SCC function could only be accurately done by a few aficionados with the time and money to support scleral search-coil systems—an expensive, complicated and cumbersome, semi-invasive technique that never made the transition from the research lab to the dizzy clinic. Then, in 2009 and 2013, we introduced a video method of testing function of each of the six canals individually. Since 2009, the method has been taken up by most dizzy clinics around the world, with now close to 100 refereed articles in PubMed. In many dizzy clinics around the world, video Head Impulse Testing has supplanted caloric testing as the initial and in some cases the final test of choice in patients with suspected vestibular disorders. Here, we consider seven current, interesting, and controversial aspects of video Head Impulse Testing: (1) introduction to the test; (2) the progress from the head impulse protocol (HIMPs) to the new variant—suppression head impulse protocol (SHIMPs); (3) the physiological basis for head impulse testing; (4) practical aspects and potential pitfalls of video head impulse testing; (5) problems of vestibulo-ocular reflex gain calculations; (6) head impulse testing in central vestibular disorders; and (7) to stay right up-to-date—new clinical disease patterns emerging from video head impulse testing. With thanks and appreciation we dedicate this article to our friend, colleague, and mentor, Dr Bernard Cohen of Mount Sinai Medical School, New York, who since his first article 55 years ago on compensatory eye movements induced by vertical SCC stimulation has become one of the giants of the vestibular world.
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Affiliation(s)
- G M Halmagyi
- Neurology Department, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Luke Chen
- Neurology Department, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Hamish G MacDougall
- Vestibular Research Laboratory, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Konrad P Weber
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Leigh A McGarvie
- Neurology Department, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Bertolini G, Durmaz MA, Ferrari K, Küffer A, Lambert C, Straumann D. Determinants of Motion Sickness in Tilting Trains: Coriolis/Cross-Coupling Stimuli and Tilt Delay. Front Neurol 2017; 8:195. [PMID: 28555125 PMCID: PMC5430385 DOI: 10.3389/fneur.2017.00195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 04/21/2017] [Indexed: 11/13/2022] Open
Abstract
Faster trains require tilting of the cars to counterbalance the centrifugal forces during curves. Motion sensitive passengers, however, complain of discomfort and overt motion sickness. A recent study comparing different control systems in a tilting train, suggested that the delay of car tilts relative to the curve of the track contributes to motion sickness. Other aspects of the motion stimuli, like the lateral accelerations and the car jitters, differed between the tested conditions and prevented a final conclusion on the role of tilt delay. Nineteen subjects were tested on a motorized 3D turntable that simulated the roll tilts during yaw rotations experienced on a tilting train, isolating them from other motion components. Each session was composed of two consecutive series of 12 ideal curves that were defined on the bases of recordings during an actual train ride. The simulated car tilts started either at the beginning of the curve acceleration phase (no-delay condition) or with 3 s of delay (delay condition). Motion sickness was self-assessed by each subject at the end of each series using an analog motion sickness scale. All subjects were tested in both conditions. Significant increases of motion sickness occurred after the first sequence of 12 curves in the delay condition, but not in the no-delay condition. This increase correlated with the sensitivity of motion sickness, which was self-assessed by each subject before the experiment. The second sequence of curve did not lead to a significant further increase of motion sickness in any condition. Our results demonstrate that, even if the speed and amplitude are as low as those experienced on tilting trains, a series of roll tilts with a delay relative to the horizontal rotations, isolated from other motion stimuli occurring during a travel, generate Coriolis/cross-coupling stimulations sufficient to rapidly induce motion sickness in sensitive individuals. The strength and the rapid onset of the motion sickness reported confirm that, even if the angular velocity involved are low, the Coriolis/cross-coupling resulting from the delay is a major factor in causing sickness that can be resolved by improving the tilt timing relative to the horizontal rotation originating from the curve.
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Affiliation(s)
- Giovanni Bertolini
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Meek Angela Durmaz
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Kim Ferrari
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Neuroscience Center, University and ETH Zurich, Zurich, Switzerland
| | - Alexander Küffer
- Department of Neurosurgery, Zurich University Hospital, Zurich, Switzerland
| | - Charlotte Lambert
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Dominik Straumann
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
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Dietrich H, Glasauer S, Straka H. Functional Organization of Vestibulo-Ocular Responses in Abducens Motoneurons. J Neurosci 2017; 37:4032-45. [PMID: 28292832 DOI: 10.1523/JNEUROSCI.2626-16.2017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 12/21/2022] Open
Abstract
Vestibulo-ocular reflexes (VORs) are the dominating contributors to gaze stabilization in all vertebrates. During horizontal head movements, abducens motoneurons form the final element of the reflex arc that integrates visuovestibular inputs into temporally precise motor commands for the lateral rectus eye muscle. Here, we studied a possible differentiation of abducens motoneurons into subtypes by evaluating their morphology, discharge properties, and synaptic pharmacology in semi-intact in vitro preparations of larval Xenopus laevis Extracellular nerve recordings during sinusoidal head motion revealed a continuum of resting rates and activation thresholds during vestibular stimulation. Differences in the sensitivity to changing stimulus frequencies and velocities allowed subdividing abducens motoneurons into two subgroups, one encoding the frequency and velocity of head motion (Group I), and the other precisely encoding angular velocity independent of stimulus frequency (Group II). Computational modeling indicated that Group II motoneurons are the major contributor to actual eye movements over the tested stimulus range. The segregation into two functional subgroups coincides with a differential activation of glutamate receptor subtypes. Vestibular excitatory inputs in Group I motoneurons are mediated predominantly by NMDA receptors and to a lesser extent by AMPA receptors, whereas an AMPA receptor-mediated excitation prevails in Group II motoneurons. Furthermore, glycinergic ipsilateral vestibular inhibitory inputs are activated during the horizontal VOR, whereas the tonic GABAergic inhibition is presumably of extravestibular origin. These findings support the presence of physiologically and pharmacologically distinct functional subgroups of extraocular motoneurons that act in concert to mediate the large dynamic range of extraocular motor commands during gaze stabilization.SIGNIFICANCE STATEMENT Outward-directed gaze-stabilizing eye movements are commanded by abducens motoneurons that combine different sensory inputs including signals from the vestibular system about ongoing head movements (vestibulo-ocular reflex). Using an amphibian model, this study investigates whether different types of abducens motoneurons exist that become active during different types of eye movements. The outcome of this study demonstrates the presence of specific motoneuronal populations with pharmacological profiles that match their response dynamics. The evolutionary conservation of the vestibulo-ocular circuitry makes it likely that a similar motoneuronal organization is also implemented in other vertebrates. Accordingly, the physiological and pharmacological understanding of specific motoneuronal contributions to eye movements might help in designing drug therapies for human eye movement dysfunctions such as abducens nerve palsy.
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