ABSTRACT
In contrast to the large body of findings confirming the influence of auditory cues on body perception and movement-related activity, the influence of body representation on spatial hearing remains essentially unexplored. Here, we use a disorientation task to assess whether a change in the body's orientation in space could lead to an illusory shift in the localization of a sound source. While most of the participants were initially able to locate the sound source with great precision, they all made substantial errors in judging the position of the same sound source following the body orientation-altering task. These results demonstrate that a change in body orientation can have a significant impact on the auditory processes underlying sound localization. The illusory errors not only confirm the strong connection between the auditory system and the representation of the body in space but also raise questions about the importance of hearing in determining spatial position.
ABSTRACT
OBJECTIVES: To evaluate the sensitivity and the specificity of summating potential (SP)/action potential (AP) area under the curve (AUC) ratio by a transtympanic electrode and a click stimulus (TT-CS), SP/AP AUC ratio by an extratympanic electrode and a click stimulus (ET-CS) and SP amplitude value by a transtympanic electrode and tone burst stimulus (TT-TBS) in regard of Ménière's disease (MD) diagnosis. This is the first study that compares SP amplitude value performed by a TT-TBS and the SP/AP AUC ratio performed by a TT-CS. STUDY DESIGN: Retrospective comparative study. SETTINGS: Ninety-five patients met the inclusion criteria for electrocochleography (ECochG) testing in a tertiary care center. METHODS: The sensitivity and specificity of our different ECochG protocols were calculated in regard of the diagnosis of MD. RESULTS: The patients' mean age was 54 years old (female predominance). The sensitivity and the specificity of SP/AP area ratio by a TT-CS were 88.5% and 70.0%, respectively. On the other hand, the sensitivity and specificity for the SP amplitude value by a TT-TBS were 60.0% and 55.6%, respectively. SP/AP area ratio by TT-CS was statistically better than SP amplitude value by TT-TBS to detect MD disease (P = .016). However, no difference was identified between SP/AP area ratio by ET-CS and SP amplitude value by a TT-TBS (P = .573). CONCLUSION: SP/AP area ratio by click stimulation has higher sensitivity and specificity to detect MD compared to SP amplitude value by tone burst stimulation. ECochG would be extremely useful in the diagnosis of MD if we use the SP/AP area ratio (sensitivity: 88.5%); therefore, it changes the bad reputation of ECochG sensitivity using SP/AP amplitude ratio (sensitivity: 51.7%) for the diagnosis of MD.
Subject(s)
Audiometry, Evoked Response , Meniere Disease , Sensitivity and Specificity , Humans , Meniere Disease/diagnosis , Meniere Disease/physiopathology , Female , Male , Middle Aged , Retrospective Studies , Adult , Aged , Action Potentials/physiologyABSTRACT
Disruption of conscious access contributes to the advent of psychotic symptoms in schizophrenia but could also explain lack of insight in other psychiatric disorders. In this study, we explored how insight and psychotic symptoms related to disruption of consciousness. We explored consciousness in patients with schizophrenia, patients with obsessive-compulsive disorder (OCD) with good vs. poor insight and matched controls. Participants underwent clinical assessments and performed a visual masking task allowing us to measure individual consciousness threshold. We used a principal component analysis to reduce symptom dimensionality and explored how consciousness measures related to symptomatology. We found that clinical dimensions could be well summarized by a restricted set of principal components which also correlated with the extent of consciousness disruption. More specifically, positive symptoms were associated with impaired conscious access in patients with schizophrenia whereas the level of insight delineated two subtypes of OCD patients, those with poor insight who had consciousness impairments similar to patients with schizophrenia, and those with good insight who resemble healthy controls. Our study provides new insights about consciousness disruption in psychiatric disorders, showing that it relates to positive symptoms in schizophrenia and with insight in OCD. In OCD, it revealed a distinct subgroup sharing neuropathological features with schizophrenia. Our findings refine the mapping between symptoms and cognition, paving the way for a better treatment selection.
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INTRODUCTION: Mal de debarquement syndrome (MdDS) is a rare and poorly understood clinical entity defined as a persistent sensation of rocking and swaying that can severely affect the quality of life. To date, the treatment options are very limited. Even though vestibular rehabilitation (VR) efficacy following peripheral vestibular lesion is well-documented, little is known about its influence on MdDS. The objective of the study was to explore the influence of traditional VR program on postural control in a patient diagnosed with MdDS. METHODS: We assessed 3 different participants: 1 healthy control; 1 participant with identified peripheral vestibular impairment (VI); 1 participant diagnosed with MdDS. Postural control was assessed using a force plate (AMTI, Accusway). Participants were assessed following the modified Clinical Test Sensory Integration Balance protocol (mCTSIB, eyes open on firm surface/eyes closed on firm surface/eyes open on foam/eyes closed on foam). The raw data were exported and analyzed in a custom-made Matlab script (Matlab R2020a). We retrieved the center of pressure velocity in both anterior-posterior and mediolateral directions and performed an analysis of the frequency content using Daubechies wavelet of order 4 with 6 levels of decomposition. Protocol VI and MdDS patients performed a 4-week VR program. Postural control, using a force plate, and Dizziness Handicap Inventory (DHI) were assessed before and after the VR program. Healthy control was assessed twice separated by 1 week without any specific intervention. RESULTS: VI participant showed clear improvement on DHI and sway velocity on condition eyes closed with foam. Accordingly, a reduction of energy content within frequency bands (0.39-0.78 Hz and 0.78-1.56 Hz) was observed post-rehabilitation for VI participant in both conditions with foam. Interestingly, MdDS participant demonstrated a reduction in sway velocity in most of the conditions but the frequency content was not modified by VR and was comparable to healthy control. Accordingly, the DHI of the MdDS participant failed to demonstrate any difference following VR. CONCLUSION: The results of the present study question the use of VR as an efficient treatment option for MdDS. Future studies must recruit a larger sample size and focus on the relationship between illusion of movement and postural characteristics such as sway velocity.
Subject(s)
Quality of Life , Travel-Related Illness , Humans , Dizziness , Vertigo , Postural BalanceABSTRACT
There is growing evidence linking hearing impairments and the deterioration of postural stability in older adults. To our knowledge, however, no study to date has investigated the effect of age-related hearing loss on the sensory reweighting process during postural control. In the absence of data, much is unknown about the possible mechanisms, both deleterious and compensatory, that could underly the deterioration of postural control following hearing loss in the elderly. The aim of this study was to empirically examine sensory reweighting for postural control in older adults with age-related hearing loss as compared to older adults with normal hearing. The center of pressure of all participants was recorded using a force platform and the modified clinical test of sensory interaction and balance protocol. The results suggest that individuals with age-related hearing loss displayed increased somatosensory reliance relative to normal hearing younger adults. This increased reliance on somatosensory input does not appear to be effective in mitigating the loss of postural control, probably due to the concomitant deterioration of tactile and proprioceptive sensitivity and acuity associated with aging. Beyond helping to further define the role of auditory perception in postural control, these results further the understanding of sensory-related mechanisms associated with postural instability in older adults.
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Long-term dance training is known to improve postural control, especially in challenging postural tasks. However, the effect of dance training on the vestibulo-ocular reflex (VOR) has yet to be properly assessed. This study directly investigated whether VOR parameters are influenced by long-term dance training by testing dancers and controls using the video head impulse test. VOR gains using two of the most common methods (area ratio and instantaneous gains), latency and amplitude of the first saccade, if applicable, were computed. Results revealed a larger VOR gain as measured by area gain and instantaneous gain at 40 ms specifically for left-head impulses, but not right-head impulses. No significant differences in saccade frequency, amplitude, or latency were observed between groups. These differences appear to stem from a modified eye-to-head relationship during high-velocity head impulses in dancers. More specifically, the dancers' eyes lead head movement during passively applied head impulses, which result in higher VOR gain.NEW & NOTEWORTHY This study demonstrates, for the first time, that long-term dance training results in a nonlinear relationship between eye and head velocity within the first milliseconds following passive head impulse. The data also suggest a larger VOR gain in dancers. This finding suggests that dance training may modify eye-head relationship in passive high-frequency head movements. This is of particular interest for vestibular rehabilitation.
Subject(s)
Dancing , Reflex, Vestibulo-Ocular/physiology , Eye Movements , Saccades , Head Movements/physiologyABSTRACT
BACKGROUND: Falls are a major health concern with potentially dramatic consequences for people over 65 years of age. One crucial determinant in the risk of falls in older adults is postural control, a complex process that requires the contribution of different sensory modalities, namely visual, vestibular, auditory, and somatosensory. While there are well established methods to screen for age-related vision, hearing, tactile and vestibular impairments, there are very few widely available methods to screen for somatosensory function, but studies indicate that ankle audiometry (vibration thresholds) using a common B-71 bone vibrator can serve that purpose. To date, unfortunately, this technique has received little attention as a tool to measure postural instability in older adults. PURPOSE: The objective of the present study was to examine postural control in older adults with and without degradation of the somatosensory functions, as determined with ankle audiometry. RESEARCH DESIGN: Standard group comparison. STUDY SAMPLE: 36 healthy elderly aged between 65-80 years old divided in two groups (low vibration threshold (n=18) and high vibration threshold (n=18). DATA COLLECTION AND ANALYSIS: Standard audiometry, video head impulse test, vibration thresholds (big toe, ankle and tibia) and static postural control task using a force platform was performed. RESULTS: Greater postural instability in participants with higher (worse) vibration thresholds as compared to participants with lower (better) vibration thresholds was observed even though both groups were comparable on hearing threshold and vestibular function. CONCLUSION: The results indicate that performing a simple vibration threshold evaluation, using a clinically available B-71 with a cut-off value of 42 dB HL could be an effective, fast and easy to use procedure for detecting people at risk of falls.
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BACKGROUND: Galvanic vestibular stimulation (GVS) uses at least one electrode placed on the mastoid process with one or multiple placed over other head areas to stimulate the vestibular system. The exact electrode size used is not given much importance in the literature and has not been reported in several studies. In a previous study, we compared the clinical effects of using different electrode sizes (3 cm2 and 35 cm2) with placebo but with the same injected current, on postural control. We observed significant improvement using the smaller size electrode but not with the bigger size electrode. The goal of this study was to simulate the current flow patterns with the intent to shed light and potentially explain the experimental outcome. METHODS: We used an ultra-high-resolution structural dataset and developed a model to simulate the application of different electrode sizes. We considered current flow in the brain and in the vestibular labyrinth. RESULTS: Our simulation results verified the focality increase using smaller electrodes that we postulated as the main reason for our clinical effect. The use of smaller size electrodes in combination with the montage employed also result in higher induced electric field (E-field) in the brain. CONCLUSIONS: Electrode size and related current density is a critical parameter to characterize any GVS administration as the choice impacts the induced E-field. It is evident that the higher induced E-field likely contributed to the clinical outcome reported in our prior study.
Subject(s)
Brain , Vestibule, Labyrinth , Vestibule, Labyrinth/physiology , Postural Balance/physiology , Vestibular Nerve/physiology , Electrodes , Electric Stimulation/methodsABSTRACT
Detecting and learning temporal regularities is essential to accurately predict the future. A long-standing debate in cognitive science concerns the existence in humans of a dissociation between two systems, one for handling statistical regularities governing the probabilities of individual items and their transitions, and another for handling deterministic rules. Here, to address this issue, we used finger tracking to continuously monitor the online build-up of evidence, confidence, false alarms and changes-of-mind during sequence processing. All these aspects of behaviour conformed tightly to a hierarchical Bayesian inference model with distinct hypothesis spaces for statistics and rules, yet linked by a single probabilistic currency. Alternative models based either on a single statistical mechanism or on two non-commensurable systems were rejected. Our results indicate that a hierarchical Bayesian inference mechanism, capable of operating over distinct hypothesis spaces for statistics and rules, underlies the human capability for sequence processing.
Subject(s)
Learning , Negotiating , Bayes Theorem , Cognitive Science , Humans , ProbabilityABSTRACT
Gaze stabilization performance has been shown to be influenced differently when the head is either passively or actively moved in normal healthy participants. However, for a visual fixation suppression task, it remains unknown if the pattern of coordinated head and eye movement is influenced differently by passive or active head movements. We used a suppression head impulse paradigm (SHIMP), where the subject's goal was to maintain gaze stabilized on a visual target that moved with the head during rapid impulsive head movements, to evaluate gaze fixation performance in three conditions: (1) passive-unpredictable where the examiner applied impulsive head yaw rotations with random timing and direction, (2) passive-predictable where the direction of head rotation was announced and then the examiner repeatedly applied impulses in the same direction, and (3) active where the test subject self-generated their head movements. Thirteen young healthy adults performed all three conditions to assess the percentage of early saccades that initiated the gaze shift toward the final visual target position and the latency of first saccades. Early saccades were defined as those occurring within the duration of the head impulse. Results showed that active head impulses generated the greatest percentage of early saccades, followed by predictable and unpredictable. Among the two passive conditions, predictability shortened the first saccade onset latencies. Active condition onset latencies were shorter than in either of the passive conditions, showing a consistent head-leads-eye pattern defining a specific behavioral pattern that could vary across patient groups leading to insights into central neural mechanisms that control eye-head coordination.
Subject(s)
Reflex, Vestibulo-Ocular , Saccades , Adult , Eye Movements , Fixation, Ocular , Head Impulse Test , Head Movements , HumansABSTRACT
It has been well established that eye movements have an impact on balance, and it has been hypothesized that extraocular oculomotor signals could play a significant role in this effect. Unfortunately, this hypothesis could not be confirmed as the previous methodology did not allow for the independent assessment of the differential effects of visual and oculomotor stimulation. The objective of the present study is to examine the impact of motor movements of the eyes without visual stimulation on balance. Static postural control, a prerequisite for balance, was assessed using a force platform in 20 participants. They were asked either to remain still without moving or to make movements of the tongue or eyes at a rate of two cycles per second. Movements were monitored using electrophysiological recordings. Each of the conditions was performed with eyes open and with eyes closed. Significant changes in postural control were observed due to eye movements when the eyes were open, but no significant differences were found between the conditions when the eyes were closed. The results confirm that the visual system provides important spatial cues for balance, allowing the body to be better positioned in space, and reject the possibility that extraocular signals are directly involved in postural stability.
Subject(s)
Eye Movements/physiology , Postural Balance/physiology , Adult , Cues , Female , Humans , Male , Photic StimulationABSTRACT
Compare the sensitivity and specificity of cVEMP (500 Hz), oVEMP (500 Hz and 4 kHz) in the identification of SSCD. A secondary objective was to identify the influence of dehiscence size and location on cVEMP and oVEMP responses. Methods: Individuals with unilateral (n = 16) and bilateral (n = 10) scan confirmed SSCD were assessed using air-conducted cVEMP and oVEMP Results: For cVEMP, an amplitude cutoff of 286.9 µV or a threshold cutoff of 67.5 dBnHL revealed, respectively, a sensitivity of 75% and 70.6% and a specificity of 69.4% and 100%. For oVEMP (500 Hz), an amplitude cutoff of 10.8 µV or a threshold cutoff of 77.5 dBnHL revealed a sensitivity of 83.33% and a specificity of 87.5% and 80%, respectively. oVEMP (4 kHz), an amplitude cutoff of 3.1 µV, revealed a high specificity of 100% but a low sensitivity of 47.2%. A positive correlation was noted between the length of the SSCD and the cVEMP and oVEMP (500 Hz) thresholds and cVEMP amplitude. Conclusions: Our results support the use of oVEMP in the identification of SSCD. The presence of oVEMP (500 Hz) with an amplitude higher or equal to 10.8 µV, a threshold lower or equal to 77.5 dBnHL or oVEMP (4 kHz) amplitude of 3.1 µV represents the most useful to identify SSCD.
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Checking behavior is a natural and adaptive strategy for resolving uncertainty in everyday situations. Here, we aimed at investigating the psychological drivers of checking and its regulation by uncertainty, in non-clinical participants and controlled experimental settings. We found that the sensitivity of participants' explicit confidence judgments to actual performance (explicit metacognition) predicted the extent to which their checking strategy was regulated by uncertainty. Yet, a more implicit measure of metacognition (derived from asking participants to opt between trials) did not contribute to the regulation of checking behavior. Meanwhile, how participants scaled on questionnaires eliciting self-beliefs such as self-confidence and self-reported obsessive-compulsive symptoms also predicted participants' uncertainty-guided checking tendencies. Altogether, these findings demonstrate that checking behavior is likely the outcome of a core explicit metacognitive process operating at the scale of single decisions, while remaining influenced by general self-beliefs. Our findings are thus consistent with two mechanisms (micro vs. macro) through which this otherwise adaptive behavior could go awry in certain psychiatric disorders such as obsessive-compulsive disorder.
Subject(s)
Compulsive Behavior/etiology , Compulsive Behavior/psychology , Culture , Metacognition/physiology , Obsessive Behavior/etiology , Obsessive Behavior/psychology , Uncertainty , Adaptation, Psychological , Female , Humans , Judgment , Male , Self Concept , Surveys and QuestionnairesABSTRACT
Recent evidences suggest that binaural vestibular stimulation affects tactile temporal processing. However, it remains difficult to determine the physiological mechanisms supporting the vestibular-somatosensory interactions observed during a TOJ task. Controlling the activation of the right or left vestibular system separately could allow to better understand the physiological bases of these findings and reconcile previous studies. The objective of the present study was to examine tactile temporal processing using a temporal order judgment task following selective stimulation of the right and left vestibular system with bi-thermal caloric vestibular stimulation (CVS). A total of 24 right-handed participants received bi-thermal CVS either in the right ear (n = 12) or the left ear (n = 12). Participants held vibrators in both hands which delivered a signal temporally separated by a variable asynchrony. Participants had to report the hand where the vibration was perceived first. The task was performed in three different CVS conditions: (1) baseline, (2) warm CVS, and (3) cold CVS. Analysis of the logistics curve parameters-just noticeable difference (JND) and point of subjective simultaneity (PSS)-for each participant in each CVS conditions revealed an increase in JND greater following warm CVS. A significant increase in JND following warm CVS was measured bilaterally. However, cold CVS increased JND only when CVS was applied in the left ear, but not in the right ear. Finally, no influence of CVS on PSS was observed.
Subject(s)
Time Perception , Vestibule, Labyrinth , Hand , Humans , Judgment , TouchABSTRACT
BACKGROUND: Cervical Vestibular Evoked Myogenic Potentials (cVEMP) is an electromyogenic measure commonly used in clinic to assess saccule function. The main parameters are peak-peak amplitude and interaural asymmetry ratio (IAR). Several non-vestibular factors may influence these parameters. Notably, a greater EMG contraction level prior to stimulation leads to an increased amplitude. As aging impacts both vestibular structures and muscle propreties, it is still a matter of debate whether the decrease in cVEMP amplitude observed in normal aging is due to EMG differences prior to stimulation or to the effect of aging on the sacculo-collic reflex pathway. At the clinical level, understanding the effect of aging on the relationship between EMG activity and cVEMP response (amplitude, asymmetry ratio) and the effect of normalization is crucial to improving the categorization of healthy versus pathological responses. OBJECTIVE: To investigate whether normalization modifies cVEMP amplitude and asymmetry ratios differently in younger and older heatlhy adults. METHOD: cVEMP recordings were conducted in 42 normal healthy participants divided in two age groups: younger (nâ=â29): meanâ=â22.79 years old SDâ=â1.66; and older (nâ=â13): meanâ=â69.00 years old SDâ=â3.61. Air-conducted cVEMP were recorded using Eclipse (Interacoustics, Denmark). The stimulus was a 95âdBnHL tone burst (500âHz) with rise, plateau and fall time of 1âms. cVEMP were recorded only when EMG levels were between 50µV and 150µV, using the Eclipse (Interacoustic, Denmark) monitoring system. RESULTS: No significant differences were observed for prestimulus EMG levels between younger and older participants (F(1,83)â=â1.13, pâ=â0.291). However, significant differences between groups were observed for raw cVEMP amplitude (F(1,83)â=â14.78; pâ<â0.001) and corrected cVEMP amplitude (F(1,83)â=â21.85; pâ<â0.0001). A significant positive linear relationship between prestimulus EMG contraction level (RMS) and raw cVEMP amplitude was observed in younger participants (r2â=â0.234; pâ<â0.001), but not in older adults (r2â=â-0.0144; pâ=â0.056). Finally, no significant differences between younger and older participants were observed for raw amplitude asymmetry ratios (F(1,41)â=â0.124, pâ=â0.726) or normalized asymmetry ratios (F(1,41)â=â0.726, pâ=â0.508). CONCLUSION: Our results suggest that when EMG is monitored and activation of the SCM is sufficient, the observed decline in cVEMP amplitude with normal aging does not seem to be caused by EMG differences and is therefore likely due to the known histopathological modifications of the vestibular system that occurs with normal aging.
Subject(s)
Vestibular Evoked Myogenic Potentials , Acoustic Stimulation , Adult , Aged , Aging , Electromyography , Humans , Neck Muscles , Young AdultABSTRACT
Working memory capacity can be improved by recoding the memorized information in a condensed form. Here, we tested the theory that human adults encode binary sequences of stimuli in memory using an abstract internal language and a recursive compression algorithm. The theory predicts that the psychological complexity of a given sequence should be proportional to the length of its shortest description in the proposed language, which can capture any nested pattern of repetitions and alternations using a limited number of instructions. Five experiments examine the capacity of the theory to predict human adults' memory for a variety of auditory and visual sequences. We probed memory using a sequence violation paradigm in which participants attempted to detect occasional violations in an otherwise fixed sequence. Both subjective complexity ratings and objective violation detection performance were well predicted by our theoretical measure of complexity, which simply reflects a weighted sum of the number of elementary instructions and digits in the shortest formula that captures the sequence in our language. While a simpler transition probability model, when tested as a single predictor in the statistical analyses, accounted for significant variance in the data, the goodness-of-fit with the data significantly improved when the language-based complexity measure was included in the statistical model, while the variance explained by the transition probability model largely decreased. Model comparison also showed that shortest description length in a recursive language provides a better fit than six alternative previously proposed models of sequence encoding. The data support the hypothesis that, beyond the extraction of statistical knowledge, human sequence coding relies on an internal compression using language-like nested structures.
Subject(s)
Memory, Short-Term/physiology , Models, Psychological , Adult , Algorithms , Computational Biology , Data Compression , Humans , Language , Models, StatisticalABSTRACT
Previous studies have reported an important relationship between increasing age, vestibular impairment, and increased risk of falls. Recently, noisy galvanic vestibular stimulation (nGVS) has been shown to improve postural control in older adults during and potentially following stimulation. However, this effect of nGVS in older adults has not been examined in interaction with the integrity of the vestibular function. We aimed at determining the effect of nGVS on postural control in older adults with and without vestibular impairment and examining the sustained effect of nGVS as compared with a sham stimulation. Thirty-six older adults were assigned to the nGVS group (n = 24) or the sham group (n = 12). In the nGVS group, 12 participants had normal vestibular function and 12 had vestibular impairment. Static postural control was assessed prior to stimulation, during stimulation, and immediately following 30 min of nGVS. Results showed that nGVS induced a significant improvement in sway velocity (P < 0.001) and path length (P < 0.001) compared with sham stimulation. Furthermore, nGVS induced a significantly greater improvement of sway velocity (P < 0.05) and path length (P < 0.05) in older adults with vestibular impairment compared with older adults with normal vestibular function. Improvements in sway velocity (P < 0.001) and path length (P < 0.001) induced by nGVS were sustained immediately following stimulation. These findings suggest that nGVS improves postural control in older adults, and that the effect of nGVS varies depending on the integrity of the vestibular function. Results also show that nGVS effect on postural control, compared with a sham stimulation, can be sustained after the end of stimulation.NEW & NOTEWORTHY The present study is the first study to investigate the impact of vestibular function on the improvement of postural control induced by nGVS in older adults and to compare the improvement of postural control of older adults with and without vestibular impairment. Our results also suggest that nGVS is beneficial for all older adults, and even more for those with a vestibular impairment. Therefore, it could be an approach to reduce falls.
Subject(s)
Aging/physiology , Postural Balance , Vestibule, Labyrinth/physiology , Aged , Electric Stimulation , Humans , Vestibule, Labyrinth/growth & developmentABSTRACT
Meniere's disease (MD) is an inner ear disorder inducing tinnitus, aural fullness, sensorineural hearing loss, and vertigo episodes. In the past few years, efforts have been made to develop objective measures able to distinguish MD from other pathologies. Indeed, some authors investigated electrophysiological measures, such as electrocochleography and vestibular evoked myogenic potentials or imaging techniques. More recently, the video head impulse test (vHIT) was developed to assess the vestibulo-ocular reflex (VOR). In the last few years, authors aimed at identifying how vHIT may help to identify MD. The objective of this manuscript is to review the different vHIT results in MD patients. We will discuss the usefulness of these findings in the identification of MD, how these results may be explained by pathophysiological mechanisms associated with MD, and finally provide directions for future studies.
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BACKGROUND: Ototoxicity induced by organic solvents has been identified in several groups of workers. Little is known, however, about the effects of organic solvents on the vestibular system. PURPOSE: The aim of the study was to comprehensively assess the vestibular system and auditory functions in a worker exposed to organic solvents. RESEARCH DESIGN: Both behavioral and physiological auditory and vestibular evaluations were performed. RESULTS: No auditory-related findings associated with solvent exposure were found. The vestibulo-ocular reflex gain was abnormal for all semicircular canals with significant catch-up saccades, as measured by the video head impulse test. The cervical vestibular evoked myogenic potentials was absent in the right ear and small but replicable in the left ear. Ocular vestibular evoked myogenic potential were bilaterally absent. CONCLUSIONS: The results suggest a case of vestibulotoxicity induced by a long history of organic solvent exposure. We suggest that solvent-exposed individuals should be evaluated with a comprehensive battery of auditory and vestibular tests.
Subject(s)
Head Impulse Test , Vestibular Evoked Myogenic Potentials , Humans , Reflex, Vestibulo-Ocular , Solvents/adverse effects , Vertigo/chemically induced , Vertigo/diagnosisABSTRACT
Noisy galvanic vestibular stimulation (nGVS) has been shown to enhance postural stability during stimulation, and the enhancing effect has been observed to persist for several hours post-stimulation. However, these effects were observed without proper control (sham condition) and the possibility of experimental bias has not been ruled out. The lasting effect of nGVS on postural stability therefore remains in doubt. We investigated the lasting effect of nGVS on postural stability using a control (sham) condition to confirm or infirm the possibility of experimental bias. 28 participants received either nGVS or a sham stimulation. Static postural control was examined before stimulation, immediately after 30 minutes of nGVS and one-hour post-stimulation. Results showed a significant improvement of sway velocity (p<0.05) and path length (p<0.05) was observed following nGVS, as previously shown. A similar improvement of sway velocity (p<0.05) and path length (p<0.05) was observed in sham group and no significant difference was found between nGVS group and sham group (p>0.05), suggesting that the observed postural improvement in nGVS could be due to a learning effect. This finding suggests the presence of experimental bias in the nGVS effect on postural stability, and highlights the need to use a sham condition in the exploration of the nGVS effect so as to disentangle the direct effect of the electrical stimulation from a learning effect. Furthermore, numerous parameters and populations need to be tested in order to confirm or infirm the presence of a real long-lasting effect of nGVS on postural stability.