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1.
Int J Pediatr Otorhinolaryngol ; 179: 111935, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38574650

RESUMO

OBJECTIVES: To identify the etiology of vertigo/dizziness and determine the effectiveness of the video-head impulse test (vHIT) and the suppression head impulse paradigm (SHIMP) tests in distinguishing between peripheral and non-peripheral etiologies in children who presented to the otolaryngology department with complaints of vertigo/dizziness. METHODS: The vHIT and SHIMP tests were applied to the children. The vestibulo-ocular reflex (VOR) gain and saccade parameters were compared. RESULTS: In 27 children presenting with vertigo/dizziness, the most common etiological factor was inner ear malformation (IEM) (n = 6/27, 22.2%), followed by cochlear implant surgery (11.1%) and migraine (11.1%). Vestibular hypofunction was indicated by the vHIT results at a rate of 60% (9/15 children) and SHIMP results at 73.3% (11/15 children) among the children with a peripheral etiology, while these rates were 8.3% (1/12 children) and 25% (3/12 children), respectively, in the non-peripheral etiology group. SHIMP-VOR and vHIT-VOR gain values had a moderate positive correlation (p = 0.01, r = 0.349). While there were overt/covert saccades in the vHIT, anti-compensatory saccade (ACSs) were not observed in the SHIMP test (p = 0.041). The rates of abnormal vHIT-VOR gain (p = 0.001), over/covert saccades (p = 0.019), abnormal vHIT response (p = 0.014), ACSs (p = 0.001), and abnormal SHIMP response (p = 0.035) were significantly higher in the peripheral etiology group. CONCLUSIONS: IEM was the most common etiological cause, and the rate of vestibular hypofunction was higher in these children with peripheral vertigo. vHIT and SHIMP are effective and useful vestibular tests for distinguishing peripheral etiology from non-peripheral etiology in the pediatric population with vertigo/dizziness. These tests can be used together or alone, but the first choice should be the SHIMP test, considering its short application time (approximately 4-5 min) and simplicity.


Assuntos
Tontura , Teste do Impulso da Cabeça , Criança , Humanos , Teste do Impulso da Cabeça/métodos , Vertigem/diagnóstico , Vertigem/etiologia , Movimentos Sacádicos , Reflexo Vestíbulo-Ocular/fisiologia
2.
J Neurosci ; 44(17)2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38527808

RESUMO

Throughout life, the cerebellum plays a central role in the coordination and optimization of movements, using cellular plasticity to adapt a range of behaviors. Whether these plasticity processes establish a fixed setpoint during development, or continuously adjust behaviors throughout life, is currently unclear. Here, by spatiotemporally manipulating the activity of protein phosphatase 2B (PP2B), an enzyme critical for cerebellar plasticity in male and female mice, we examined the consequences of disrupted plasticity on the performance and adaptation of the vestibulo-ocular reflex (VOR). We find that, in contrast to Purkinje cell (PC)-specific deletion starting early postnatally, acute pharmacological as well as adult-onset genetic deletion of PP2B affects all forms of VOR adaptation but not the level of VOR itself. Next, we show that PC-specific genetic deletion of PP2B in juvenile mice leads to a progressive loss of the protein PP2B and a concurrent change in the VOR, in addition to the loss of adaptive abilities. Finally, re-expressing PP2B in adult mice that lack PP2B expression from early development rescues VOR adaptation but does not affect the performance of the reflex. Together, our results indicate that chronic or acute, genetic, or pharmacological block of PP2B disrupts the adaptation of the VOR. In contrast, only the absence of plasticity during cerebellar development affects the setpoint of VOR, an effect that cannot be corrected after maturation of the cerebellum. These findings suggest that PP2B-dependent cerebellar plasticity is required during a specific period to achieve the correct setpoint of the VOR.


Assuntos
Cerebelo , Plasticidade Neuronal , Reflexo Vestíbulo-Ocular , Animais , Reflexo Vestíbulo-Ocular/fisiologia , Plasticidade Neuronal/fisiologia , Camundongos , Cerebelo/crescimento & desenvolvimento , Cerebelo/fisiologia , Masculino , Feminino , Células de Purkinje/fisiologia , Adaptação Fisiológica/fisiologia , Camundongos Endogâmicos C57BL , Camundongos Knockout
3.
Bioelectromagnetics ; 45(4): 171-183, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38348647

RESUMO

In recent years, an increasing number of studies have discussed the mechanisms of vestibular activation in strong magnetic field settings such as occur in a magnetic resonance imaging scanner environment. Amid the different hypotheses, the Lorentz force explanation currently stands out as the most plausible mechanism, as evidenced by activation of the vestibulo-ocular reflex. Other hypotheses have largely been discarded. Nonetheless, both human data and computational modeling suggest that electromagnetic induction could be a valid mechanism which may coexist alongside the Lorentz force. To further investigate the induction hypothesis, we provide, herein, a first of its kind dosimetric analysis to estimate the induced electric fields at the vestibular system and compare them with what galvanic vestibular stimulation would generate. We found that electric fields strengths from induction match galvanic vestibular stimulation strengths generating vestibular responses. This review examines the evidence in support of electromagnetic induction of vestibular responses, and whether movement-induced time-varying magnetic fields should be further considered and investigated.


Assuntos
Reflexo Vestíbulo-Ocular , Vestíbulo do Labirinto , Humanos , Estimulação Elétrica/métodos , Reflexo Vestíbulo-Ocular/fisiologia , Vestíbulo do Labirinto/fisiologia , Fenômenos Eletromagnéticos , Imageamento por Ressonância Magnética
4.
Adv Physiol Educ ; 48(2): 211-214, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38234296

RESUMO

The study aims to develop a novel methodology to demonstrate the vestibulo-ocular reflex (VOR) and nystagmus by caloric stimulation in an undergraduate medical physiology laboratory. The experimental setup involved two sets of electrodes: one set positioned laterally to both eyes, and another set positioned vertically over either the right or left eye. The caloric method is used to stimulate ears, which involves irrigation of warm (44°C) and cold (30°C) water into the ears while maintaining a temperature difference of approximately ±7°C from the body temperature. The changes in chorioretinal potential were calibrated to angular displacement by a two-point calibration method, and angular velocity was derived after taking the first-time derivative. The results obtained from the digital data acquisition system were compared to the traditional instrument used in our Otorhinolaryngology Department [Interacoustics Videonystagmography (VNG) System for hospitals, medical grade] for the normal subject's data. No significant differences in angular velocity were noted (P > 0.05). The cold stimuli elicit a more pronounced VOR compared to the warm stimuli. It has been consistently observed that the onset of nystagmus occurs approximately 20 s after irrigation, reaching its peak intensity between 45 and 90 s, and gradually diminishing until it ceases after approximately 200 s. Our developed methodology enables the recording and quantification of nystagmus using easily accessible equipment. This study serves the goal of visualizing the physiological process of VOR and thereby fulfills the goal of an effective teaching tool for demonstrating to undergraduate medical students.NEW & NOTEWORTHY We developed a novel methodology to demonstrate and visualize the most common and important physiological phenomenon like the vestibulo-ocular reflex as a teaching module for undergraduate students.


Assuntos
Temperatura Baixa , Reflexo Vestíbulo-Ocular , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Olho , Estudantes
5.
J Neurophysiol ; 131(1): 16-27, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37964728

RESUMO

Retinal image slip during head rotation drives motor learning in the rotational vestibulo-ocular reflex (VOR) and forms the basis of gaze-stability exercises that treat vestibular dysfunction. Clinical exercises, however, are unengaging, cannot easily be titrated to the level of impairment, and provide neither direct feedback nor tracking of the patient's adherence, performance, and progress. To address this, we have developed a custom application for VOR training based on an interactive computer game. In this study, we tested the ability of this game to induce VOR learning in individuals with normal vestibular function, and we compared the efficacy of single-step and incremental learning protocols. Eighteen participants played the game twice on different days. All participants tolerated the game and were able to complete both sessions. The game scenario incorporated a series of brief head rotations, similar to active head impulses, that were paired with a dynamic acuity task and with a visual-vestibular mismatch (VVM) intended to increase VOR gain (single-step: 300 successful trials at ×1.5 viewing; incremental: 100 trials each of ×1.13, ×1.33, and ×1.5 viewing). Overall, VOR gain increased by 15 ± 4.7% (mean ± 95% CI, P < 0.001). Gains increased similarly for active and passive head rotations, and, contrary to our hypothesis, there was little effect of the learning strategy. This study shows that an interactive computer game provides robust VOR training and has the potential to deliver effective, engaging, and trackable gaze-stability exercises to patients with a range of vestibular dysfunctions.NEW & NOTEWORTHY This study demonstrates the feasibility and efficacy of a customized computer game to induce motor learning in the high-frequency rotational vestibulo-ocular reflex. It provides a physiological basis for the deployment of this technology to clinical vestibular rehabilitation.


Assuntos
Reflexo Vestíbulo-Ocular , Vestíbulo do Labirinto , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Adaptação Fisiológica/fisiologia , Terapia por Exercício , Movimentos da Cabeça/fisiologia
6.
Exp Brain Res ; 242(1): 99-108, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37966504

RESUMO

Vestibular nuclei and cerebellar function comprise vestibular neural networks that control vestibular-related responses. However, the vestibular-related responses to simultaneous stimulation of these regions are unclear. This study aimed to examine whether the combination of noisy galvanic vestibular stimulation (nGVS) and cerebellar transcranial direct current stimulation (ctDCS) using a complex transcranial electrical stimulation device alters vestibular-dominant standing stability and vestibulo-ocular reflex (VOR) function. The center of foot pressure (COP) sway and VOR of participants (28 healthy, young adults) were assessed under four conditions of transcranial electrical stimulation using nGVS and ctDCS. The COP was calculated with the participant standing on a soft-foam surface with eyes closed using a force plate to evaluate body sway. VOR measurements were collected via passive head movements and fixation on a target projected onto the front wall using a video head impulse test (vHIT). VOR gain was calculated in six directions using a semicircular canal structure based on the ratio of eye movement to head movement. The nGVS + ctDCS and nGVS + sham ctDCS conditions decreased COP sway compared to the sham nGVS + ctDCS and sham nGVS + sham ctDCS conditions. No significant differences were observed in the main effect of stimulation or the interaction of stimulation and direction on the vHIT parameters. The results of this study suggest that postural stability may be independently affected by nGVS. Our findings contribute to the basic neurological foundation for the clinical application of neurorehabilitation using transcranial electrical stimulation of the vestibular system.


Assuntos
Estimulação Transcraniana por Corrente Contínua , Vestíbulo do Labirinto , Adulto Jovem , Humanos , Equilíbrio Postural/fisiologia , Vestíbulo do Labirinto/fisiologia , Canais Semicirculares/fisiologia , Movimentos Oculares , Reflexo Vestíbulo-Ocular/fisiologia , Estimulação Elétrica
7.
Cerebellum ; 23(1): 136-143, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36680705

RESUMO

Long-term deficits of the vestibulo-ocular reflex (VOR) elicited by head rotation can be partially compensated by catch-up saccades (CuS). These saccades are initially visually guided, but their latency can greatly decrease resulting in short latency CuS (SL-CuS). It is still unclear what triggers these CuS and what are the underlying neural circuits. In this study, we aimed at evaluating the impact of cerebellar pathology on CuS by comparing their characteristics between two groups of patients with bilateral vestibular hypofunction, with or without additional cerebellar dysfunction. We recruited 12 patients with both bilateral vestibular hypofunction and cerebellar dysfunction (BVH-CD group) and 12 patients with isolated bilateral vestibular hypofunction (BVH group). Both groups were matched for age and residual VOR gain. Subjects underwent video head impulse test recording of the horizontal semicircular canals responses as well as recording of visually guided saccades in the step, gap, and overlap paradigms. Latency and gain of the different saccades were calculated. The mean age for BVH-CD and BVH was, respectively, 67.8 and 67.2 years, and the mean residual VOR gain was, respectively, 0.24 and 0.26. The mean latency of the first catch-up saccade was significantly longer for the BVH-CD group than that for the BVH group (204 ms vs 145 ms, p < 0.05). There was no significant difference in the latency of visually guided saccades between the two groups, for none of the three paradigms. The gain of covert saccades tended to be lower in the BVH-CD group than in BVH group (t test; p = 0.06). The mean gain of the 12° or 20° visually guided saccades were not different in both groups. Our results suggest that the cerebellum plays a role in the generation of compensatory SL-CuS observed in BVH patients.


Assuntos
Doenças Cerebelares , Movimentos Sacádicos , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Teste do Impulso da Cabeça/métodos , Cerebelo
8.
Otolaryngol Head Neck Surg ; 170(2): 515-521, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37787037

RESUMO

OBJECTIVE: To evaluate the older adults with chronic dizziness using the Barany Society's presbyvestibulopathy (PVP) diagnostic criteria and to assess the clinical usability of the criteria. STUDY DESIGN: Retrospective study. SETTING: Single tertiary medical center. METHODS: Among a total of 1964 patients aged 60 years or older, 55 patients who had symptoms suitable for the PVP criteria and who underwent all 3 vestibular function tests were analyzed. Of these 55 patients, 13 patients were diagnosed with PVP based on the peripheral vestibular hypofunction criteria; the remaining 42 patients were categorized as patients without PVP. RESULTS: In both patients with PVP and patients without PVP, postural imbalance or unsteadiness was the most frequently reported vestibular symptom. The rotatory chair test contributed the most to the quantitative diagnosis of PVP (6 of 13), followed by the caloric response test (3 of 13) and video head impulse test (vHIT; 2 of 13). When we included the presence of catch-up saccades in addition to the vHIT gain in the diagnostic criteria, 5 patients without PVP were additionally diagnosed with PVP. Furthermore, when accounting for the inclusion of catch-up saccades, patients who experienced recurrent falls demonstrated a significantly higher rate of impairments in the lateral and posterior semicircular canals according to the multivariate analysis. CONCLUSION: Considering the catch-up saccades in addition to vHIT gain seemed to contribute to the diagnosis of PVP and prediction of recurrent fall risks in older adults. Further studies are needed to solidify the diagnostic criteria for PVP.


Assuntos
Tontura , Testes de Função Vestibular , Humanos , Idoso , Tontura/diagnóstico , Tontura/etiologia , Estudos Retrospectivos , Testes Calóricos , Teste do Impulso da Cabeça , Canais Semicirculares , Reflexo Vestíbulo-Ocular/fisiologia
9.
Acta Otolaryngol ; 143(10): 849-855, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38088257

RESUMO

BACKGROUND: Vestibular stimulation causes postural unsteadiness accompanied by a sensation of tilt. AIMS/OBJECTIVES: The mechanism of the sensation of tilt needs to be assessed by accurate calculation of the rotational axis of torsional eye position under various vestibular stimulations. MATERIAL AND METHODS: Twenty-two healthy subjects participated in the study. Thirteen subjects underwent bilateral vestibular stimulation by on-axis yaw rotation under various head positions, and eighteen subjects underwent unilateral vestibular stimulation by caloric irrigation under various head positions. Listing's Plane was plotted for the eye movement data obtained by three-dimensional video-oculography. RESULTS: The offset of Listing's Plane showed sustained deviation of torsional eye position that was more prominent in head positions that stimulated lateral semicircular canals more than vertical semicircular canals. There was a less prominent and directionally reversed offset in head positions that stimulated vertical canals more than lateral semicircular canals. CONCLUSION AND SIGNIFICANCE: The sustained torsional eye position was validated by accurate assessment using Listing's Plane. The mechanism behind the deviation may be due to a combination of multiple anatomical components within the vestibular apparatus, with potentially stronger influence from lateral semicircular canals.


Assuntos
Reflexo Vestíbulo-Ocular , Vestíbulo do Labirinto , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Movimentos Oculares , Canais Semicirculares/fisiologia , Vestíbulo do Labirinto/fisiologia , Rotação
10.
J Neurophysiol ; 130(4): 999-1007, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37702547

RESUMO

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.


Assuntos
Dança , Reflexo Vestíbulo-Ocular/fisiologia , Movimentos Oculares , Movimentos Sacádicos , Movimentos da Cabeça/fisiologia
11.
Neurology ; 101(19): e1913-e1921, 2023 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-37748887

RESUMO

BACKGROUND AND OBJECTIVES: Anecdotal studies have reported the presence of antiganglioside antibodies in acute unilateral peripheral vestibulopathy (AUPV). This study aimed to determine the prevalence, clinical characteristics, and neurotologic findings of AUPV associated with antiganglioside antibodies. METHODS: Serum antigangliosides were measured in consecutive patients with AUPV according to the Bárány Society criteria during the acute and recovery phases in a referral-based university hospital in South Korea from September 2019 to January 2023. Clinical characteristics and neurotologic findings were compared between those with and without antiganglioside antibodies. The results of video-oculography, video head impulse and bithermal caloric tests, and other neurotologic evaluations including ocular and cervical vestibular-evoked myogenic potentials and subjective visual vertical were compared between the 2. MRIs dedicated to the inner ear were also conducted when considered necessary. RESULTS: One hundred five patients (mean age ± SD = 60 ± 13 years, 57 male) were included for analyses. During the acute phase, 12 patients (12/105, 11%) were tested positive for serum antiganglioside antibodies, including anti-GQ1b immunoglobulin (Ig) G (n = 5) or IgM (n = 4), anti-GM1 IgM (n = 3), and anti-GD1a IgG (n = 1, including 1 patient with a positive anti-GQ1b antibody). Patients with antiganglioside antibodies showed lesser intensity of spontaneous nystagmus (median [interquartile range] = 1.8 [1.2-2.1] vs 3.4 [1.5-9.5], p = 0.003) and a lesser degree of canal paresis (30 [17-47] vs 58 [34-79], p = 0.028) and gain asymmetry of the vestibulo-ocular reflex for the horizontal semicircular canal during head impulse tests (0.07 [-0.04 to 0.61] vs 0.36 [0.18-0.47], p = 0.032) than those without antibodies. Negative conversion of antibodies and vestibular recovery were observed in most patients (6/8, 75%). Among 30 patients with AUPV with 4-hour delayed 3D fluid-attenuated inversion recovery dedicated to the inner ear, gadolinium enhancement was observed in 18 (18/30, 60%), either in the vestibule (n = 9), semicircular canal (n = 6), or vestibular nerve (n = 5). The positivity rates based on specific antibodies could not be determined due to limited sample sizes. DISCUSSION: The association between antiganglioside antibodies and AUPV suggests an immune-mediated mechanism in acute vestibular failure and extends the clinical spectrum of antiganglioside antibody syndrome.


Assuntos
Meios de Contraste , Neuronite Vestibular , Humanos , Masculino , Gadolínio , Teste do Impulso da Cabeça , Imunoglobulina G , Imunoglobulina M , Reflexo Vestíbulo-Ocular/fisiologia
12.
J Vestib Res ; 33(6): 367-376, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37574748

RESUMO

BACKGROUND: The video head impulse test (vHIT) is a common assessment of semicircular canal function during high-speed impulses. Reliability of the vHIT for assessing vertical semicircular canals is uncertain. Vertical head impulses require a complex head movement, making it difficult to isolate a single semicircular canal and interpret resulting eye rotations. OBJECTIVE: The purpose of this study was to provide descriptive head kinematics and vestibular stimuli during vertical plane impulses to ultimately improve impulse delivery and interpretation of vHIT results for vertical semicircular canals. METHODS: Six participants received right anterior (RA) and left posterior (LP) semicircular canal impulses. Linear displacements, rotational displacements, and rotational velocities of the head were measured. Peak velocities in semicircular canal planes and peak-to-peak gravitoinertial accelerations at the otolith organs were derived from head kinematics. RESULTS: The largest rotational velocities occurred in the target semicircular canal plane, with non-negligible velocities occurring in non-target planes. Larger vertical displacements and accelerations occurred on the right side of the head compared to the left for RA and LP impulses. CONCLUSIONS: These results provide a foundation for designing protocols to optimize stimulation applied to a singular vertical semicircular canal and for interpreting results from the vHIT for vertical semicircular canals.


Assuntos
Reflexo Vestíbulo-Ocular , Vestíbulo do Labirinto , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Reprodutibilidade dos Testes , Fenômenos Biomecânicos , Canais Semicirculares/fisiologia , Teste do Impulso da Cabeça/métodos
13.
Otol Neurotol ; 44(10): 1038-1044, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37641367

RESUMO

HYPOTHESIS: Prosthetic electrical stimulation can evoke compensatory eye and head movement despite vestibular implant electrode insertion occurring years after prior labyrinthectomy. BACKGROUND: Vestibular implants sense head rotation and directly stimulate the vestibular nerve, bypassing damaged end organs. Animal research and current clinical trials have demonstrated the efficacy of this approach. However, candidacy criteria for vestibular implants currently require presence of a patent labyrinth in the candidate ear and at least aidable hearing in the opposite ear, thus excluding patients who have undergone prior labyrinthectomy for unilateral Menière's disease that later progressed to bilateral vestibular hypofunction. METHODS: Eight years after right unilateral labyrinthectomy, we implanted stimulating electrodes in the previously exenterated right ear ampullae of a rhesus macaque monkey. The left labyrinth had long-standing hypofunction due to intratympanic gentamicin injection and surgical disruption. We used three-dimensional video-oculography to measure eye movement responses to prosthetic electrical stimulation. We also measured head-movement responses to prosthetic stimulation with the head unrestrained. RESULTS: Bilateral vestibular hypofunction was confirmed by absence of vestibuloocular reflex responses to whole-body rotation without prosthetic stimulation. For a subset of the implanted electrodes, prosthetic vestibular stimulation evoked robust compensatory eye and head movements. One electrode reliably elicited responses aligned with the implanted ear's anterior canal nerve regardless of the return electrode used. Similarly, a second electrode also elicited responses consistent with excitation of the horizontal canal nerve. Responses grew quasilinearly with stimulation rate and current amplitude. CONCLUSION: Prosthetic electrical stimulation targeting the vestibular nerve can be effective years after labyrinthectomy, if at least some parts of the vestibular nerve's ampullary branches remain despite destruction or removal of the membranous labyrinth.


Assuntos
Movimentos da Cabeça , Vestíbulo do Labirinto , Animais , Humanos , Nervo Vestibular/cirurgia , Macaca mulatta , Reflexo Vestíbulo-Ocular/fisiologia , Vestíbulo do Labirinto/cirurgia , Eletrodos Implantados , Estimulação Elétrica
14.
Harefuah ; 162(7): 434-439, 2023 Aug.
Artigo em Hebraico | MEDLINE | ID: mdl-37561033

RESUMO

INTRODUCTION: Machado-Joseph disease (MJD) is an inherited neurodegenerative disease with progressive cerebellar ataxia manifested through lack of coordination and balance. MJD patients also present significant Vestibulo-Ocular Reflex (VOR) deficit but their whole vestibular features have not been previously evaluated. We aimed to evaluate whether MJD patients have vestibular features fitting the diagnostic criteria of Bilateral Vestibulopathy established by the International Society for Neuro-otology. METHODS: Sixteen MJD patients and 21 healthy controls underwent a detailed clinical neuro-otological examination including a quantitative evaluation of the VOR gain using the video Head Impulse Test (vHIT). Vestibular-related symptoms were evaluated by the Dizziness Handicap Inventory (DHI), the Activities-specific Balance Confidence Scale (ABC), the Vertigo Visual Scale (VVS). In addition, anxiety that is frequently present in vestibular disorders, was evaluated by the Beck Anxiety Inventory (BAI). RESULTS: MJD patients had significantly reduced horizontal VOR gain with significantly higher scores in all vestibular-related symptoms questionnaires. These symptoms scores were like those reported in studies evaluating patients with bilateral peripheral vestibular loss. CONCLUSIONS: Beyond the cerebellar deficits, MJD patients have vestibular signs and symptoms fitting the diagnostic criteria of Bilateral Vestibulopathy established by the International Society for Neuro-otology. These findings are of relevance not only for the diagnosis and evaluation of progressive cerebellar diseases but also for the possible beneficial effect of vestibular rehabilitation techniques on dizziness, balance and the emotional, physiological and functional aspects of MJD.


Assuntos
Vestibulopatia Bilateral , Doença de Machado-Joseph , Doenças Neurodegenerativas , Humanos , Doença de Machado-Joseph/diagnóstico , Tontura/diagnóstico , Tontura/etiologia , Vestibulopatia Bilateral/diagnóstico , Reflexo Vestíbulo-Ocular/fisiologia
15.
Handb Clin Neurol ; 195: 31-54, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37562876

RESUMO

The vestibular system is an essential sensory system that generates motor reflexes that are crucial for our daily activities, including stabilizing the visual axis of gaze and maintaining head and body posture. In addition, the vestibular system provides us with our sense of movement and orientation relative to space and serves a vital role in ensuring accurate voluntary behaviors. Neurophysiological studies have provided fundamental insights into the functional circuitry of vestibular motor pathways. A unique feature of the vestibular system compared to other sensory systems is that the same central neurons that receive direct input from the afferents of the vestibular component of the 8th nerve can also directly project to motor centers that control vital vestibular motor reflexes. In turn, these reflexes ensure stabilize gaze and the maintenance of posture during everyday activities. For instance, a direct three-neuron pathway mediates the vestibulo-ocular reflex (VOR) pathway to provide stable gaze. Furthermore, recent studies have advanced our understanding of the computations performed by the cerebellum and cortex required for motor learning, compensation, and voluntary movement and navigation. Together, these findings have provided new insights into how the brain ensures accurate self-movement during our everyday activities and have also advanced our knowledge of the neurobiological mechanisms underlying disorders of vestibular processing.


Assuntos
Reflexo Vestíbulo-Ocular , Vestíbulo do Labirinto , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Movimento , Postura , Encéfalo , Neurônios/fisiologia
16.
Neuroimage Clin ; 39: 103469, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37459699

RESUMO

The alpha rhythm is a dominant electroencephalographic oscillation relevant to sensory-motor and cognitive function. Alpha oscillations are reactive, being for example enhanced by eye closure, and suppressed following eye opening. The determinants of inter-individual variability in reactivity in the alpha rhythm (e.g. changes with amplitude following eye closure) are not fully understood despite the physiological and clinical applicability of this phenomenon, as indicated by the fact that ageing and neurodegeneration reduce reactivity. Strong interactions between visual and vestibular systems raise the theoretical possibility that the vestibular system plays a role in alpha reactivity. To test this hypothesis, we applied electroencephalography in sitting and standing postures in 15 participants with reduced vestibular function (bilateral vestibulopathy, median age = 70 years, interquartile range = 51-77 years) and 15 age-matched controls. We found participants with reduced vestibular function showed less enhancement of alpha electroencephalography power on eye closure in frontoparietal areas, compared to controls. In participants with reduced vestibular function, video head impulse test gain - as a measure of residual vestibulo-ocular reflex function - correlated with reactivity in alpha power across most of the head. Greater reliance on visual input for spatial orientation ('visual dependence', measured with the rod-and-disc test) correlated with less alpha enhancement on eye closure only in participants with reduced vestibular function, and this was partially moderated by video head impulse test gain. Our results demonstrate for the first time that vestibular function influences alpha reactivity. The results are partly explained by the lack of ascending peripheral vestibular input but also by central reorganisation of processing relevant to visuo-vestibular judgements.


Assuntos
Ritmo alfa , Vestibulopatia Bilateral , Humanos , Pessoa de Meia-Idade , Idoso , Reflexo Vestíbulo-Ocular/fisiologia , Teste do Impulso da Cabeça , Eletroencefalografia
17.
J Vis Exp ; (196)2023 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-37427914

RESUMO

The optokinetic reflex (OKR) is an essential innate eye movement that is triggered by the global motion of the visual environment and serves to stabilize retinal images. Due to its importance and robustness, the OKR has been used to study visual-motor learning and to evaluate the visual functions of mice with different genetic backgrounds, ages, and drug treatments. Here, we introduce a procedure for evaluating OKR responses of head-fixed mice with high accuracy. Head fixation can rule out the contribution of vestibular stimulation on eye movements, making it possible to measure eye movements triggered only by visual motion. The OKR is elicited by a virtual drum system, in which a vertical grating presented on three computer monitors drifts horizontally in an oscillatory manner or unidirectionally at a constant velocity. With this virtual reality system, we can systematically change visual parameters like spatial frequency, temporal/oscillation frequency, contrast, luminance, and the direction of gratings, and quantify tuning curves of visual feature selectivity. High-speed infrared video-oculography ensures accurate measurement of the trajectory of eye movements. The eyes of individual mice are calibrated to provide opportunities to compare the OKRs between animals of different ages, genders, and genetic backgrounds. The quantitative power of this technique allows it to detect changes in the OKR when this behavior plastically adapts due to aging, sensory experience, or motor learning; thus, it makes this technique a valuable addition to the repertoire of tools used to investigate the plasticity of ocular behaviors.


Assuntos
Reflexo Vestíbulo-Ocular , Reflexo , Feminino , Camundongos , Masculino , Animais , Reflexo Vestíbulo-Ocular/fisiologia , Visão Ocular , Nistagmo Optocinético , Rotação , Face , Estimulação Luminosa
18.
Curr Biol ; 33(12): 2438-2448.e6, 2023 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-37285844

RESUMO

The vestibular system in the inner ear plays a central role in sensorimotor control by informing the brain about the orientation and acceleration of the head. However, most experiments in neurophysiology are performed using head-fixed configurations, depriving animals of vestibular inputs. To overcome this limitation, we decorated the utricular otolith of the vestibular system in larval zebrafish with paramagnetic nanoparticles. This procedure effectively endowed the animal with magneto-sensitive capacities: applied magnetic field gradients induced forces on the otoliths, resulting in robust behavioral responses comparable to those evoked by rotating the animal by up to 25°. We recorded the whole-brain neuronal response to this fictive motion stimulation using light-sheet functional imaging. Experiments performed in unilaterally injected fish revealed the activation of a commissural inhibition between the brain hemispheres. This magnetic-based stimulation technique for larval zebrafish opens new perspectives to functionally dissect the neural circuits underlying vestibular processing and to develop multisensory virtual environments, including vestibular feedback.


Assuntos
Membrana dos Otólitos , Peixe-Zebra , Animais , Membrana dos Otólitos/fisiologia , Peixe-Zebra/fisiologia , Larva , Encéfalo/fisiologia , Fenômenos Magnéticos , Reflexo Vestíbulo-Ocular/fisiologia
19.
IEEE Trans Biomed Eng ; 70(12): 3373-3380, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37318963

RESUMO

A wireless, wearable magnetic eye tracker is described and characterized. The proposed instrumentation enables simultaneous evaluation of eye and head angular displacements. Such a system can be used to determine the absolute gaze direction as well as to analyze spontaneous eye re-orientation in response to stimuli consisting in head rotations. The latter feature has implications to analyze the vestibulo-ocular reflex and constitutes an interesting opportunity to develop medical (oto-neurological) diagnostics. Details of data analysis are reported together with some results obtained in-vivo or with simple mechanical simulators that enable measurements under controlled conditions.


Assuntos
Movimentos Oculares , Dispositivos Eletrônicos Vestíveis , Reflexo Vestíbulo-Ocular/fisiologia , Magnetismo , Fenômenos Magnéticos
20.
Am J Otolaryngol ; 44(5): 103947, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37329697

RESUMO

BACKGROUND: Head rotation produces a vestibulo-ocular reflex (VOR). In horizontal rotation, not only lateral semicircular canals but also posterior semicircular canals are stimulated, because posterior canals cupulae are not horizontal in the sitting position. Therefore, theoretical nystagmus is horizontal and torsional. Convection of endolymph does not occur, because the centre of head rotation is a dens of the second cervical vertebra, not the center of lateral canal. Although per-rotational nystagmus is a result of VOR, whether it could be explained by the movement of cupula remains undetermined. To answer this question, we analysed per-rotational nystagmus using three-dimensional video-oculography. OBJECTIVE: To clarify whether per-rotational nystagmus is the same as the physical movement of cupula (theoretical nystagmus). MATERIALS AND METHODS: Five healthy human were evaluated. The participant's head was rotated (sinusoidal yaw rotation) manually (frequency, 0.33 Hz; amplitude, 60°). The experiment was performed in a dark, with the participant's eyes open. Nystagmus was recorded and converted into digital data. RESULTS: In all participants, the direction of nystagmus was rightward on rightward rotation and leftward on leftward rotation. In all participants, nystagmus was purely horizontal. CONCLUSIONS: Practical per-rotational nystagmus differs completely from the theoretical nystagmus. Therefore, VOR is strongly influenced by the central nervous system.


Assuntos
Nistagmo Patológico , Reflexo Vestíbulo-Ocular , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Nistagmo Patológico/diagnóstico , Canais Semicirculares , Movimento
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