Vestibular migraine treatment: a comprehensive practical review.

Vestibular migraine is an underdiagnosed but increasingly recognized neurological condition that causes episodic vertigo associated with other features of migraine. It is now thought to be the most common cause of spontaneous (non-positional) episodic vertigo, affecting up to 1% of the population. A meta-analysis of preventative treatments for vestibular migraine was published in 2021, but the authors were unable to establish a preferred treatment strategy due to low quality of evidence and heterogeneity of study design and outcome reporting. Therefore, there remains a clinical need for pragmatic management guidelines specific to vestibular migraine using the available evidence. Here, we provide a practical review utilizing a systematic qualitative assessment of the evidence for abortive and preventative interventions in adults. The overall evidence base for vestibular migraine treatment is of low quality. Nevertheless, we provide practical treatment recommendations based on the available evidence and our experience to help guide clinicians treating patients with vestibular migraine. We also discuss how future clinical trials could be designed to improve the quality of evidence in this condition.

Vestibular and Multi-Sensory Influences Upon Self-Motion Perception and the Consequences for Human Behavior.

In this manuscript, we comprehensively review both the human and animal literature regarding vestibular and multi-sensory contributions to self-motion perception. This covers the anatomical basis and how and where the signals are processed at all levels from the peripheral vestibular system to the brainstem and cerebellum and finally to the cortex. Further, we consider how and where these vestibular signals are integrated with other sensory cues to facilitate self-motion perception. We conclude by demonstrating the wide-ranging influences of the vestibular system and self-motion perception upon behavior, namely eye movement, postural control, and spatial awareness as well as new discoveries that such perception can impact upon numerical cognition, human affect, and bodily self-consciousness.

HOPE: Hybrid-Drive Combining Optogenetics, Pharmacology and Electrophysiology.

Understanding the neural mechanisms underlying human cognition and determining the causal factors for the development of brain pathologies are among the greatest challenges for society. Electrophysiological recordings offer remarkable observations of brain activity as they provide highly precise representations of information coding in both temporal and spatial domains. With the development of genetic tools over the last decades, mice have been a key model organism in neuroscience. However, conducting chronic in vivo electrophysiology in awake, behaving mice remains technically challenging, and this difficulty prevents many research teams from acquiring critical recordings in their mouse models. Behavioral training, implant fabrication, brain surgery, data acquisition and data analysis are all required steps that must be mastered in order to perform cutting-edge experiments in systems neuroscience. Here, we present a new method that simplifies the construction of a drivable and multi-task electrophysiological recording implant without loss of flexibility and recording power. The hybrid-drive combining optogenetics, pharmacology and electrophysiology (HOPE) can support up to 16 tetrodes, attached to a single drive mechanism, organized in two bundles of eight tetrodes, allowing recordings in two different mouse brain regions simultaneously with two optical fibers for optogenetic manipulation or two injection cannulas for drug-delivery experiments. Because it can be printed with a latest-generation desktop 3D printer, the production cost is low compared to classical electrophysiology implants, and it can be built within a few hours. The HOPE implant is also reconfigurable to specific needs as it has been created in a computer-aided design (CAD) software and all the files used for its construction are open-source.