The erbB receptor family consists of erbB1/epidermal growth factor receptor, erbB2/neu, erbB3, and erbB4, all of which have been implicated in cell proliferation, differentiation, and survival in several tissues. In the nervous system, these family members can function in a trophic capacity for certain subpopulations of neurons and some types of non-neuronal cells. Vestibular sensory epithelial cells and vestibular ganglion neurons are derived from ectodermal otic placode and are essential components of the peripheral vestibular system, the sensory system for balance. Recent studies in mammals suggest that certain ligands of the epidermal growth factor receptor can induce proliferation of vestibular sensory epithelial cells. We now show that vestibular ganglion neurons and vestibular sensory epithelial cells express all four erbB receptors in adult rats. Cultured vestibular ganglion neurons also expressed all four erbB family members and were therefore used to analyze the effects of modulating erbB signaling on differentiated vestibular ganglion neurons. Transforming growth factor-alpha (a ligand for epidermal growth factor receptor) and sensory and motor neuron-derived factor (a ligand for erbB3 and erbB4) promoted vestibular ganglion neuron viability, whereas epidermal growth factor (another ligand for epidermal growth factor receptor) did not. Glial growth factor 2 (another ligand for erbB3 and erbB4) and an antibody that blocks erbB2/neu-mediated signaling inhibited vestibular ganglion neuron viability. Collectively, these observations indicate that erbB signaling regulates the viability of differentiated otic placode-derived cells in mammals and suggest that exogenous modulation of erbB signaling in peripheral vestibular tissues may prove therapeutically useful in peripheral vestibular disorders. PMID:11445002
Responses of single vestibular neurons were studied in cats under adequate and electric stimulation of different afferent sources (labyrinths, mixed nerves, n. vagus, n. depressor, limb movements). Different types of responses to the employed stimulation as well as evoked activity as bursts followed by depression of background firing are described. The activity of vestibular neurons is shown to depend on extralabyrinthal stimulation. The role of muscle-joint receptors is distinguished from natural stimulation of the vestibular apparatus during the head tilting. Somatotopic organization of vestibular nuclei and convergence of different afferental impulses to the neurons forming the vestibulospinal tract are discussed. PMID:1086438
Requirement for Lmo4 in the vestibular morphogenesis of mouse inner ear
During development, compartmentalization of an early embryonic structure produces blocks of cells with distinct properties and developmental potentials. The auditory and vestibular components of vertebrate inner ears are derived from defined compartments within the otocyst during embryogenesis. The vestibular apparatus, including three semicircular canals, saccule, utricle, and their associated sensory organs, detects angular and linear acceleration of the head and relays the information through vestibular neurons to vestibular nuclei in the brainstem. How the early developmental events manifest vestibular structures at the molecular level is largely unknown. Here, we show that LMO4, a LIM-domain-only transcriptional regulator, is required for the formation of semicircular canals and their...
Orientation adaptation of eye movement-related vestibular neurons due to prolonged head tilt.
Sixteen neurons, including vestibular-only (VO), eye-head velocity (EHV), and position-vestibular-pause (PVP) neurons sensitive to head tilt were recorded in the rostromedial and in superior vestibular nuclei. Projection of the otolith polarization vector to the horizontal plane (response vector orientation [RVO]) was determined before and after prolonged head orientation in side-down position. The RVO of VO neurons shifted toward alignment with the axis of gravity when the head was in the position of adaptation. PVP neurons had similar changes in RVO. There were also changes in RVO in some EHV neurons, but generally in directions not related to gravity. Modeling studies have suggested that the tendency to align RVOs with gravity leads to tuning of gravity-dependent angular vestibular ocular reflex (aVOR) gain changes to the position of adaptation. Thus, coding of orientation in PVP neurons would contribute significantly to the gravity-dependent adaptation of the aVOR. PMID:21950996
Vestibular information is critical for the maintenance of balance and posture and for the control of eye movements. The eighth nerve carries vestibular information to four brainstem nuclei called the vestibular nuclear complex (VNC); these nuclei relay vestibular signals to several additional brainstem nuclei. The structure, connections, effects of lesions and neuronal response properties of the vestibular brainstem have been studied in many nonhuman species. The development of bipedal locomotion in humans mandates differences in the vestibular control of balance and suggests that there may also be differences in the organization of the human vestibular brainstem. While the four nuclei of the VNC are described in human, there is a lot of variability among reports in their borders and exten...
Basic and Clinical Ocular Motor and Vestibular Research
Sixteen neurons, including vestibular-only (VO), eye-head velocity (EHV), and position-vestibular-pause (PVP) neurons sensitive to head tilt were recorded in the rostromedial and in superior vestibular nuclei. Projection of the otolith polarization vector to the horizontal plane (response vector orientation [RVO]) was determined before and after prolonged head orientation in side-down position. The RVO of VO neurons shifted toward alignment with the axis of gravity when the head was in the position of adaptation. PVP neurons had similar changes in RVO. There were also changes in RVO in some EHV neurons, but generally in directions not related to gravity. Modeling studies have suggested that the tendency to align RVOs with gravity leads to tuning of gravity-dependent angular vestibular ocul...
FMRFamide-related peptide expression in the vestibular-afferent neurons
Vestibular-afferent neurons innervate hair cells from the sensory epithelia of vestibular end-organs and their action-potential discharge dynamics are driven by linear and angular accelerations of the head. The electrical activity of the vestibular-afferent neurons depends on their intrinsic properties and on the synaptic input from hair cells and from the terminals of the efferent system. Here we report that vestibular-afferent neurons of the rat are immunoreactive to RFamide-related peptides, and that the stronger signal comes from calyx-shaped neuron dendrites, with no signal detected in hair cells or supporting cells. The whole-cell voltage clamp recording of isolated afferent neurons showed that they express robust acid-sensing ionic currents (ASICs). Extracellular multiunit recording...
The objective of this study was to make direct comparisons of the estimates of spiral and vestibular neuronal number in human archival temporal bone specimens using design-based stereology with those using the assumption-based Abercrombie method. Archival human temporal bone specimens from subjects ranging in age from 16 to 80 years old were used. The number of spiral and vestibular ganglia neurons within the counting areas was estimated using the stereology-optical disector technique and compared with estimates obtained using the assumption-based Abercrombie method on the same specimens. Using the optical disector method, there was an average of 41,480 (coefficient of variation=0.12) spiral ganglia neurons and 28,930 (coefficient of variation=0.15) vestibular ganglia neurons. The mean coefficient of error was 0.076 for the spiral ganglion estimates, and 0.091 for the vestibular ganglion estimates. Using the Abercrombie correction method of two-dimensional analysis, an average of 23,110 (coefficient of variation of 0.08) spiral ganglia neurons, and 16,225 vestibular ganglia neurons (coefficient of variation of 0.15) was obtained. We found that there was a large disparity between the estimates with a significant 44% underestimation of the spiral and vestibular ganglion counts obtained using the Abercrombie method when compared with estimates using the optical disector method. PMID:21219929
In order to see clearly when a target is moving slowly, primates with high acuity foveae use smooth-pursuit and vergence eye movements. The former rotates both eyes in the same direction to track target motion in frontal planes, while the latter rotates left and right eyes in opposite directions to track target motion in depth. Together, these two systems pursue targets precisely and maintain their images on the foveae of both eyes. During head movements, both systems must interact with the vestibular system to minimize slip of the retinal images. The primate frontal cortex contains two pursuit-related areas; the caudal part of the frontal eye fields (FEF) and supplementary eye fields (SEF). Evoked potential studies have demonstrated vestibular projections to both areas and pursuit neurons in both areas respond to vestibular stimulation. The majority of FEF pursuit neurons code parameters of pursuit such as pursuit and vergence eye velocity, gaze velocity, and retinal image motion for target velocity in frontal and depth planes. Moreover, vestibular inputs contribute to the predictive pursuit responses of FEF neurons. In contrast, the majority of SEF pursuit neurons do not code pursuit metrics and many SEF neurons are reported to be active in more complex tasks. These results suggest that FEF- and SEF-pursuit neurons are involved in different aspects of vestibular-pursuit interactions and that eye velocity coding of SEF pursuit neurons is specialized for the task condition. PMID:16917164
Vestibular histopathology of the human temporal bone. What can we learn?
Histologic sections of the human temporal bone display snapshots of the entire lifetime integrated into the moment the bone enters fixative. The bulk of the literature on vestibular histopathology is anecdotal and descriptive in nature, rather than quantitative. This is because the means of describing and measuring patients' vestibular symptoms are poorly developed, and the complex geometry of the vestibular labyrinth complicates efforts to study it in serial histologic sections. Histopathologic findings in the common peripheral vestibulopathies, including Meniere's syndrome, benign paroxysmal positional vertigo, viral labyrinthitis, vestibular neuronitis, and ototoxicity, have all been described. A new quantitative method for assessment of vestibular otopathology using Nomarski optics has recently been reported. It has been successfully applied to create a normative database of age-related changes in the vestibular hair cell populations which, in turn, has been used to study the effects of aminoglycoside ototoxicity and Meniere's syndrome. These data provide the first meaningful opportunity to make structure-function correlations between vestibular function testing and temporal bone pathology in humans. Wider clinical application of vestibular function testing and postmortem temporal bone donation should be promoted by all investigators interested in accumulating the resources necessary to gain a deeper understanding of the human vestibular system in health and disease. PMID:11710467
The vestibular system sends projections to brainstem autonomic nuclei that modulate heart rate and blood pressure in response to changes in head and body position with regard to gravity. Consistent with this, binaural sinusoidally modulated galvanic vestibular stimulation (sGVS) in humans causes vasoconstriction in the legs, while low frequency (0.02-0.04?Hz) sGVS causes a rapid drop in heart rate and blood pressure in anesthetized rats. We have hypothesized that these responses occur through activation of vestibulo-sympathetic pathways. In the present study, c-Fos protein expression was examined in neurons of the vestibular nuclei and rostral ventrolateral medullary region (RVLM) that were activated by low frequency sGVS. We found c-Fos-labeled neurons in the spinal, medial, and superior vestibular nuclei (SpVN, MVN, and SVN, respectively) and the parasolitary nucleus. The highest density of c-Fos-positive vestibular nuclear neurons was observed in MVN, where immunolabeled cells were present throughout the rostro-caudal extent of the nucleus. c-Fos expression was concentrated in the parvocellular region and largely absent from magnocellular MVN. c-Fos-labeled cells were scattered throughout caudal SpVN, and the immunostained neurons in SVN were restricted to a discrete wedge-shaped area immediately lateral to the IVth ventricle. Immunofluorescence localization of c-Fos and glutamate revealed that approximately one third of the c-Fos-labeled vestibular neurons showed intense glutamate-like immunofluorescence, far in excess of the stain reflecting the metabolic pool of cytoplasmic glutamate. In the RVLM, which receives a direct projection from the vestibular nuclei and sends efferents to preganglionic sympathetic neurons in the spinal cord, we observed an approximately threefold increase in c-Fos labeling in the sGVS-activated rats. We conclude that localization of c-Fos protein following sGVS is a reliable marker for sGVS-activated neurons of the vestibulo-sympathetic pathway. PMID:22403566
The role of gaze in compensation of vestibular disfunction: the gaze substitution hypothesis
The vestibular system sends projections to brainstem autonomic nuclei that modulate heart rate and blood pressure in response to changes in head and body position with regard to gravity. Consistent with this, binaural sinusoidally modulated galvanic vestibular stimulation (sGVS) in humans causes vasoconstriction in the legs, while low frequency (0.02–0.04?Hz) sGVS causes a rapid drop in heart rate and blood pressure in anesthetized rats. We have hypothesized that these responses occur through activation of vestibulo-sympathetic pathways. In the present study, c-Fos protein expression was examined in neurons of the vestibular nuclei and rostral ventrolateral medullary region (RVLM) that were activated by low frequency sGVS. We found c-Fos-labeled neurons in the spinal, medial, and superior vestibular nuclei (SpVN, MVN, and SVN, respectively) and the parasolitary nucleus. The highest density of c-Fos-positive vestibular nuclear neurons was observed in MVN, where immunolabeled cells were present throughout the rostro-caudal extent of the nucleus. c-Fos expression was concentrated in the parvocellular region and largely absent from magnocellular MVN. c-Fos-labeled cells were scattered throughout caudal SpVN, and the immunostained neurons in SVN were restricted to a discrete wedge-shaped area immediately lateral to the IVth ventricle. Immunofluorescence localization of c-Fos and glutamate revealed that approximately one third of the c-Fos-labeled vestibular neurons showed intense glutamate-like immunofluorescence, far in excess of the stain reflecting the metabolic pool of cytoplasmic glutamate. In the RVLM, which receives a direct projection from the vestibular nuclei and sends efferents to preganglionic sympathetic neurons in the spinal cord, we observed an approximately threefold increase in c-Fos labeling in the sGVS-activated rats. We conclude that localization of c-Fos protein following sGVS is a reliable marker for sGVS-activated neurons of the vestibulo-sympathetic pathway. PMID:3064159
Correlation of Fos expression and circling asymmetry during gerbil vestibular compensation
Vestibular compensation is a central nervous system process resulting in recovery of functional movement and control following a unilateral vestibular lesion. Small pressure injections of phosphorothioate 20mer oligonucleotides were used to probe the role of the Fos transcription protein during vestibular compensation in the gerbil brainstem. During isoflurane gas anesthesia, antisense probes against the c-fos mRNA sequence were injected into the medial vestibular and prepositus nuclei unilaterally prior to a unilateral surgical labyrinthectomy. Anionic dyes, which did not interact with the oligonucleotides, were used to mark the injection site and help determine the extent of diffusion. The antiFos oligonucleotide injections reduced Fos expression at the injection site in neurons which normally express Fos after the lesion, and also affected circling behavior induced by hemilabyrinthectomy. With both ipsilateral and contralateral medial vestibular and prepositus nuclei injections, less ipsilateral and more contralateral circling was noted in animals injected with antiFos injections as compared to non-injected controls. The degree of change in these behaviors was dependent upon the side of the injection. Histologically, antiFos injections reduced the number of Fos immunolabeled neurons around the injection site, and increased Fos expression contralaterally. The correlation of the number of neurons with Fos expression to turning behavior was stronger for contralateral versus ipsilateral turns, and for neurons in the caudal and ipsilateral sub-regions of the medial vestibular and prepositus nuclei. The results are discussed in terms of neuronal firing activity versus translational activity based on the asymmetrical expression of the Fos inducible transcription factor in the medial vestibular and prepositus nuclei. Although ubiquitous in the brain, transcription factors like Fos can serve localized and specific roles in sensory-specific adaptive stimuli. Antisense injections can be an effective procedure for localized intervention into complex physiological functions, e.g. vestibular compensation. Copyright 1999 Elsevier Science B.V.
The objective of this study was to make direct comparisons of the estimates of spiral and vestibular neuronal number in human archival temporal bone specimens using design-based stereology with those using the assumption-based Abercrombie method. Archival human temporal bone specimens from subjects ranging in age from 16 to 80 years old were used. The number of spiral and vestibular ganglia neurons within the counting areas was estimated using the stereology-optical disector technique and compared with estimates obtained using the assumption-based Abercrombie method on the same specimens. Using the optical disector method, there was an average of 41,480 (coefficient of variation=0.12) spiral ganglia neurons and 28,930 (coefficient of variation=0.15) vestibular ganglia neurons. The mean coe...
Spatial properties of central vestibular neurons.
We studied the spatial characteristics of 45 vestibular-only (VO) and 12 vestibular-plus-saccade (VPS) neurons in two cynomolgus monkeys using angular rotation and static tilt. The purpose was to determine the contribution of canal and otolith-related inputs to central vestibular neurons whose activity is associated with the central velocity storage integrator. Lateral canal-related neurons responded maximally during vertical axis rotation when the head was tilted 25 +/- 6 and 22 +/- 3 degrees forward relative to the axis of rotation in the two animals, and vertical canal-related neurons responded maximally with the head tilted back 63+/- 5 and 57 +/- 7 degrees . The origin of the vertical canal-related input was verified by rotation about a spatial horizontal axis. Thirty-one percent of cells received input in a single canal plane. Sixty-seven percent of canal-related cells received otolith input, 31% of vertical canal neurons had lateral canal input, and 43% of lateral canal neurons had vertical canal input. Twenty percent of neurons had convergent input from the lateral canals, the vertical canals, and the otolith organs. Some VO and VPS cells had spatial-temporal convergent (STC) properties; more of these cells had STC properties at lower frequencies of rotation. Thus VO and VPS neurons associated with velocity storage receive a broad range of convergent inputs from each portion of the vestibular labyrinth. This convergence could provide the basis for gravity-dependent eye velocity orientation induced through velocity storage. PMID:16192336
Inwardly rectifying potassium (Kir) channel Kir4.1 (also called Kcnj10) is expressed in various cells such as satellite glial cells. It is suggested that these cells would absorb excess accumulated K(+) from intercellular space which is surrounded by these cell membranes expressing Kir4.1. In the vestibular system, loss of Kir4.1 results in selective degeneration of type I hair cells despite normal development of type II hair cells. The mechanisms underlying this developmental disorder have been unclear, because it was thought that Kir4.1 is only expressed in glial cells throughout the entire nervous system. Here, we show that Kir4.1 is expressed not only in glial cells but also in neurons of the mouse vestibular system. In the vestibular ganglion, Kir4.1 mRNA is transcribed in both satellite cells and neuronal somata, whereas Kir4.1 protein is expressed only in satellite cells. On the other hand, in the vestibular sensory epithelia, Kir4.1 protein is localized at the calyx endings of vestibular afferents, which surround type I hair cells. Kir4.1 protein expression in the vestibular sensory epithelia is detected beginning after birth, and its localization gradually adopts a calyceal shape until type I hair cells are mature. Kir4.1 localized at the calyx endings may play a role in the K(+)-buffering action of vestibular afferents surrounding type I hair cells. PMID:22546335
Evidence for a Viral Neuropathy in Recurrent Vertigo
Abstract The concept that reactivation of latent neurotropic viruses (i.e. Herpesviridae group) in the vestibular ganglion is responsible for recurrent vestibulopathies is presented. A similar histopathologic degeneration of vestibular ganglion cells in vestibular neuronitis (VN), Meniere's disease and benign paroxysmal positional vertigo is presented to support this concept. The clinical response (relief of vertigo) to the administration of antiviral medication in these syndromes provides practical evidence of a viral neuropathy in patients with recurrent vertigo. Relief of vertigo after this treatment was 90% in VN, Meniere's disease and VN. The relief of positional vertigo (benign paroxysmal positional vertigo) was 66%.Copyright Copyright 2008 S. Karger AG, Basel
Meniere's Disease Is a Viral Neuropathy
Abstract Morphological and clinical evidence supports a viral neuropathy in Meniere's disease (MD). Quantitative examination of 11 sectioned temporal bones (TBs) from 8 patients with a history of MD revealed a significant loss of vestibular ganglion cells in both the endolymph hydropic (EH) and non-EH ears. Transmission electron microscopy of vestibular ganglion cells excised from a patient with MD revealed viral particles enclosed in transport vesicles. Antiviral treatment controlled vertigo in 73 of 86 patients with vestibular neuronitis (85%) and 32 of 35 patients with MD (91%). Copyright Copyright 2009 S. Karger AG, Basel
Vestibular information is critical for the control of balance, posture, and eye movements. Signals from the receptors, the semicircular canals and otoliths, are carried by the eighth nerve and distributed to the four nuclei of the vestibular nuclear complex, the VNC. However, anatomical and physiological data suggest that many additional brainstem nuclei are engaged in the processing of vestibular signals and generation of motor responses. To assess the role of these structures in vestibular functions, we have used the expression of the immediate early gene c-Fos as a marker for neurons activated by stimulation of the otoliths or the semicircular canals. Excitation of the otolith organs resulted in widespread c-Fos expression in the VNC, but also in other nuclei, including the external cun...
The three faces of vestibular ganglionitis.
We present temporal bone and clinical evidence that common syndromes of recurrent vertigo are caused by a viral infection of the vestibular ganglion. In the present series, histopathologic and radiologic changes in the vestibular ganglion and meatal ganglion were consistent with a viral inflammation of ganglion cells in cases of Meniere's disease, benign paroxysmal positional vertigo, and vestibular neuronitis. Clinical observations of multiple neuropathies involving cranial nerves V, VII, and VIII on the same side in patients with recurrent vertigo are best explained by a cranial polyganglionitis caused by a neurotrophic virus, which is reactivated by a stressful event later in life. The reactivation of the latent virus may manifest as one of the above vertigo syndromes, depending on the part of the vestibular ganglion that is inflamed, the type and strain of the virus, and host resistance. PMID:11860061
Ultrastructure of vestibular commissural neurons related to velocity storage in the monkey.
The angular vestibulo-ocular reflex maintains gaze during head movements. It is thought to be mediated by two components: direct and velocity storage pathways. The direct angular vestibulo-ocular reflex is conveyed by a three neuron chain from the labyrinth to the ocular motoneurons. The indirect pathway involves a more complex neural network that utilizes a portion of the vestibular commissure. The purpose of the present study was to identify the ultrastructural characteristics of commissural neurons in the medial vestibular nucleus that are related to the velocity storage component of the angular vestibulo-ocular reflex. Ultrastructural studies of degenerating medial vestibular nucleus neurons were conducted in monkeys following midline section of rostral medullary commissural fibers with subsequent behavioral testing. After this lesion, oculomotor and vestibular functions attributable to velocity storage were abolished, whereas the direct angular vestibulo-ocular reflex pathway remained intact. Since this damage was functionally discrete, degenerating neurons were interpreted as potential participants in the velocity storage network. Ultrastructural observations indicate that commissural neurons related to velocity storage are small and medium sized cells having large nuclei with deep indentations and relatively little cytoplasm, which are located in the lateral crescents of rostral medial vestibular nucleus. The morphology of degenerating dendritic profiles varied. Some contained numerous round or tubular mitochondria in a pale cytoplasmic matrix with few other organelles, while others had few mitochondria but many cisterns and vacuoles in dense granular cytoplasm. The commissural nature of these cells was further suggested by the presence of two different types of degenerating axon terminals in the rostral medial vestibular nucleus: those with a moderate density of large spherical synaptic vesicles, and those with pleomorphic, primarily ellipsoid synaptic vesicles. The recognition of two types of degenerating terminals further supports our interpretation that at least two morphological types of commissural neurons participate in the velocity storage network. The degenerating boutons formed contacts with a variety of postsynaptic partners. In particular, synapses were observed between degenerating boutons and non-degenerating dendrites, and between intact terminals and degenerating dendrites. However, degenerating pre- and postsynaptic elements were rarely observed in direct contact, suggesting that additional neurons are interposed in the indirect pathway commissural system. On the basis of these ultrastructural observations, it is concluded that vestibular commissural neurons involved in the mediation of velocity storage have distinguishing ultrastructural features and synaptology, that are different from those of direct pathway neurons. PMID:10430480
Adaptation of Orientation of Central Otolith-only Neurons
Otolith-only neurons were recorded extracellularly in the vestibular nuclei before and after cynomolgus monkeys were held on-side for up to 3 hr. The aim was to determine whether the polarization vectors of these neurons reorient toward the spatial vertical as do canal-otolith convergent neurons. Otolith input was characterized by tilting the animal 30degree from the upright position while positioning the head in different directions in yaw. This determined the response vector orientation (RVO), that is, the projection of the otolith polarization vector onto the head horizontal plane. Changes in the RVO of otolith-only neurons ranged from 2degree-16degree, which was on average considerably less than the changes previously noted in canal-otolith convergent vestibulo-only (VO) and vestibular...
AbstractBackground and Objective The optical stimulation of neurons from pulsed infrared lasers has appeared over the last years as an alternative to classical electric stimulations based on conventional electrodes. Laser stimulation could provide a better spatial selectivity allowing single-cell stimulation without prerequisite contact. In this work we present relevant physical characteristics of a non-lethal stimulation of cultured mouse vestibular and retinal ganglion neurons by single infrared laser pulses. Study Design/Materials and Methods Vestibular and retinal ganglion neurons were stimulated by a 100-400-mW pulsed laser diode beam (wavelengths at 1,470, 1,535, 1,875-nm) launched into a multimode optical fiber positioned at a few hundred micrometers away from the neurons. Ionic exc...
Procedures for restoring vestibular disorders
This paper will discuss therapeutic possibilities for disorders of the vestibular organs and the neurons involved, which confront ENT clinicians in everyday practice. Treatment of such disorders can be tackled either symptomatically or causally. The possible strategies for restoring the body's vesti...
Nitric Oxide Modulation of the Spontaneous Firing of Rat Medial Vestibular Nuclear Neurons
Modulation of the spontaneous activity of rat medial vestibular nuclear neurons by nitric oxide was investigated using the whole-cell patch-clamp technique. The spike frequency was increased by sodium nitroprusside (SNP), a nitric oxide liberating agent, and it was also increased by another nitric oxide liberating agent, sodium-nitroso-N-acetylpenicillamine. L-Arginine, the substrate of nitric oxide synthase, increased the firing of the neurons. The increased SNP-induced firing was inhibited by 1H-[1,2,4]oxadiazolo[4,3-a]quinozalin-1-one (ODQ), a specific inhibitor of guanylate cyclase. These results suggest that nitric oxide increases the neuronal excitability of the neurons by a cGMP-dependent mechanism.
The molecular and cellular origin of the primary neurons of the inner ear, the vestibular and spiral neurons, is reviewed including how they connect to the specific sensory epithelia and what the molecular nature of their survival is. Primary neurons of the ear depend on a single basic Helix-Loop-Helix (bHLH) protein for their formation, neurogenin 1 (ngn1). An immediate downstream gene is the bHLH gene neuronal differentiation (NeuroD). Targeted null mutations of ngn1 results in absence of primary neuron formation; targeted null mutation of NeuroD results in loss of almost all spiral and many vestibular neurons. NeuroD and a later expressed gene, Brn3a, play a role in pathfinding to and within sensory epithelia. The molecular nature of this pathfinding property is unknown. Reduction of hair cells in ngn1 null mutations suggests a clonal relationship with primary neurons. This relationship may play some role in specifying the identity of hair cells and the primary neurons that connect with them. Primary neuron neurites growth to sensory epithelia is initially independent of trophic factors released from developing sensory epithelia, but becomes rapidly dependent on those factors. Null mutations of specific neurotrophic factors lose distinct primary neuron populations which undergo rapid embryonic cell death.
Experiments were performed to study the projection of the group y of the vestibular nuclei and the dentate and fastigial nuclei of the cerebellum to the interstitial nucleus of Cajal (INC) in cats by using retrograde axonal transport of horseradish peroxidase (HRP) and electrophysiological methods; and to study the vestibular responses of such projection neurons. Following injections of HRP into the unilateral INC, with partial involvement of the surrounding reticular formation, including the nucleus of Darkschewitsch (ND), many retrogradely labeled neurons were found in the dorsal part of the group y nucleus contralateral to the injection site. Labeled cells were also seen in the contralateral dentate nucleus, frequently in its caudal-ventral part, and in the contralateral fastigial nucleus at all rostrocaudal levels, but most frequently in its caudal part. In electrophysiological experiments performed on cats anesthetized with alpha-chloralose or N2O and paralyzed with gallamine, group y, dentate and fastigial nuclei neurons were antidromically activated by weak stimuli that were confined to the contralateral INC. Depth-threshold curves for antidromic activation of such neurons revealed that the lowest threshold points were within the INC, but not in the ND. The INC-projecting neurons in the group y and dentate nuclei did not respond to electrical stimulation of the ipsilateral or contralateral vestibular nerve, indicating that they do not receive direct labyrinthine inputs. On the contrary, many fastigial neurons projecting to the INC responded to labyrinthine stimulation, suggesting that they may be involved in the vestibular reflexes. These results suggest a difference in properties of INC-projecting neurons in these nuclei. PMID:3725220
The primate frontal cortex contains two areas related to smooth-pursuit: the frontal eye fields (FEFs) and supplementary eye fields (SEFs). To distinguish the specific role of the SEFs in pursuit, we examined discharge of a total of 89 pursuit-related neurons that showed consistent modulation when head-stabilized Japanese monkeys pursued a spot moving sinusoidally in fronto-parallel planes and/or in depth and with or without passive whole body rotation. During smooth-pursuit at different frequencies, 43% of the neurons tested (17/40) exhibited discharge amplitude of modulation linearly correlated with eye velocity. During cancellation of the vestibulo-ocular reflex and/or chair rotation in complete darkness, the majority of neurons tested (91% = 30/33) responded. However, only 17% of the responding neurons (4/30) were modulated in proportion to gaze (eye-in-space) velocity during pursuit-vestibular interactions. When the monkeys fixated a stationary spot, 20% of neurons tested (7/34) responded to motion of a second spot. Among the neurons tested for both smooth-pursuit and vergence tracking (n = 56), 27% (15/56) discharged during both, 62% (35/56) responded during smooth-pursuit only, and 11% (6/56) during vergence tracking only. Phase shifts (relative to stimulus velocity) of responding neurons during pursuit in frontal and depth planes and during chair rotation remained virtually constant (< or =1 Hz). These results, together with the robust vestibular-related discharge of most SEF neurons, show that the discharge of the majority of SEF pursuit-related neurons is quite distinct from that of caudal FEF neurons in identical task conditions, suggesting that the two areas are involved in different aspects of pursuit-vestibular interactions including predictive pursuit. PMID:14711976
Convergent properties of vestibular-related brain stem neurons in the gerbil
Three classes of vestibular-related neurons were found in and near the prepositus and medial vestibular nuclei of alert or decerebrate gerbils, those responding to: horizontal translational motion, horizontal head rotation, or both. Their distribution ratios were 1:2:2, respectively. Many cells responsive to translational motion exhibited spatiotemporal characteristics with both response gain and phase varying as a function of the stimulus vector angle. Rotationally sensitive neurons were distributed as Type I, II, or III responses (sensitive to ipsilateral, contralateral, or both directions, respectively) in the ratios of 4:6:1. Four tested factors shaped the response dynamics of the sampled neurons: canal-otolith convergence, oculomotor-related activity, rotational Type (I or II), and the phase of the maximum response. Type I nonconvergent cells displayed increasing gains with increasing rotational stimulus frequency (0.1-2.0 Hz, 60 degrees /s), whereas Type II neurons with convergent inputs had response gains that markedly decreased with increasing translational stimulus frequency (0.25-2.0 Hz, +/-0.1 g). Type I convergent and Type II nonconvergent neurons exhibited essentially flat gains across the stimulus frequency range. Oculomotor-related activity was noted in 30% of the cells across all functional types, appearing as burst/pause discharge patterns related to the fast phase of nystagmus during head rotation. Oculomotor-related activity was correlated with enhanced dynamic range compared with the same category that had no oculomotor-related response. Finally, responses that were in-phase with head velocity during rotation exhibited greater gains with stimulus frequency increments than neurons with out-of-phase responses. In contrast, for translational motion, neurons out of phase with head acceleration exhibited low-pass characteristics, whereas in-phase neurons did not. Data from decerebrate preparations revealed that although similar response types could be detected, the sampled cells generally had lower background discharge rates, on average one-third lower response gains, and convergent properties that differed from those found in the alert animals. On the basis of the dynamic response of identified cell types, we propose a pair of models in which inhibitory input from vestibular-related neurons converges on oculomotor neurons with excitatory inputs from the vestibular nuclei. Simple signal convergence and combinations of different types of vestibular labyrinth information can enrich the dynamic characteristics of the rotational and translational vestibuloocular responses.
Antiepileptic treatment and oculomotor neurons.
This report describes the changes of the spontaneous firing rate due to an acute non-toxic dose of phenytoin (PHT), a drug commonly used in antiepileptic therapy, in the pre-motor neurons involved in saccadic movement. The drug (500 mg/kg of a 10% PHT suspension in arabic gum) was orally administered, and plasma and brain levels were regularly evaluated (EMIT assay). Results show that PHT significantly modifies the spontaneous electrical activity of the pre-motor neurons localized in the paramedian pontine reticular formation by inducing excitation, inhibition, or a biphasic effect. PHT action was observed 10-15 min after drug administration, when plasma and brain concentrations were still very low. The oculomotor system neurons appear to be a more specific target to this drug in comparison to the cerebellum and the vestibular system. Since the PHT action was observed 1 hour after drug administration in the vestibular nuclei and the cerebellum, which are extensively connected with the oculomotor neurons, it is possible to hypothesize that PHT can affect the oculomotor neurons directly and, with longer latency, indirectly through the vestibular nuclei and the cerebellum. PMID:8962692
An electronic prosthesis mimicking the dynamic vestibular function
This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular motion is translated into voltage pulses. The voltage pulses are converted into current pulses and are delivered through specially designed electrodes, conditioned to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular neurons to those in animal models reported in the literature. The proposed design is scalable; the sensing unit, pulse generator, and the current source can be potentially implemented on a single chip using integrated MEMS technology.
Morphologic changes in ipsilateral superior vestibulo-ocular neurons (SVON) and the vestibular nerve were measured in 4 cats 8 weeks after labyrinthectomy and 4 cats 1 year after labyrinthectomy. There is a 20% decrease in SVON size and 30% decrease in rough endoplasmic reticulum and ribosomes with no change in the volume fractions of Golgi apparatus or mitochondria. In the central nervous system degeneration of the vestibular nerve terminals ipsilateral to the labyrinthectomy was represented by a 25% loss of synaptic profiles (SP) on SVON at 8 weeks and 57% loss of SP at 1 year after labyrinthectomy. There was no significant loss of fiber number in the vestibular nerve at 8 weeks post lesion but a 35% loss of fibers primarily of the large size at 1 year post lesion. PMID:7856448
Inwardly rectifying potassium (Kir) channel Kir4.1 (also called Kcnj10) is expressed in various cells such as satellite glial cells. It is suggested that these cells would absorb excess accumulated K+ from intercellular space which is surrounded by these cell membranes expressing Kir4.1. In the vestibular system, loss of Kir4.1 results in selective degeneration of type I hair cells despite normal development of type II hair cells. The mechanisms underlying this developmental disorder have been unclear, because it was thought that Kir4.1 is only expressed in glial cells throughout the entire nervous system. Here, we show that Kir4.1 is expressed not only in glial cells but also in neurons of the mouse vestibular system. In the vestibular ganglion, Kir4.1 mRNA is transcribed in both satellit...
Vestibular toxicity of cis-2-pentenenitrile in the rat
cis-2-Pentenenitrile, an intermediate in the synthesis of nylon and other products, causes permanent behavioral deficits in rodents. Other low molecular weight nitriles cause degeneration either of the vestibular sensory hair cells or of selected neuronal populations in the brain. Adult male Long-Evans rats were exposed to cis-2-pentenenitrile (0, 1.25, 1.50, 1.75, or 2.0mmol/kg, oral, in corn oil) and assessed for changes in open field activity and rating scores in a test battery for vestibular dysfunction. Surface preparations of the vestibular sensory epithelia were observed for hair cell loss using scanning electron microscopy. A separate experiment examined the impact of pre-treatment with the universal CYP inhibitor,1-aminobenzotriazole, on the effect of cis-2-pentenenitrile on vesti...
Adaptation of orientation of central otolith-only neurons.
Otolith-only neurons were recorded extracellularly in the vestibular nuclei before and after cynomolgus monkeys were held on-side for up to 3 hr. The aim was to determine whether the polarization vectors of these neurons reorient toward the spatial vertical as do canal-otolith convergent neurons. Otolith input was characterized by tilting the animal 30 degrees from the upright position while positioning the head in different directions in yaw. This determined the response vector orientation (RVO), that is, the projection of the otolith polarization vector onto the head horizontal plane. Changes in the RVO of otolith-only neurons ranged from 2 degrees -16 degrees , which was on average considerably less than the changes previously noted in canal-otolith convergent vestibulo-only (VO) and vestibular plus saccade (VPS) neurons, which ranged up to 109 degrees. Some of the otolith-only neurons had marked sensitivity changes. These findings suggest that otolith-only neurons tend to maintain a head-fixed orientation during prolonged head tilts relative to gravity. In contrast, canal-convergent VO and VPS neurons optimize their response vector orientation to gravity when the head is oriented for prolonged periods. PMID:19645928
The perception of self-motion is a product of the integration of information from both visual and non-visual cues, to which the vestibular system is a central contributor. It is well documented that vestibular dysfunction leads to impaired movement and balance, dizziness and falls, and yet our knowledge of the neuronal processing of vestibular signals remains relatively sparse. In this study, high-density electroencephalographic recordings were deployed to investigate the neural processes associated with vestibular detection of changes in heading. To this end, a self-motion oddball paradigm was designed. Participants were translated linearly 7.8 cm on a motion platform using a one second motion profile, at a 45° angle leftward or rightward of straight ahead. These headings were presented with a stimulus probability of 80-20 %. Participants responded when they detected the infrequent direction change via button-press. Event-related potentials (ERPs) were calculated in response to the standard (80 %) and target (20 %) movement directions. Statistical parametric mapping showed that ERPs to standard and target movements differed significantly from 490 to 950 ms post-stimulus. Topographic analysis showed that this difference had a typical P3 topography. Individual participant bootstrap analysis revealed that 93.3 % of participants exhibited a clear P3 component. These results indicate that a perceived change in vestibular heading can readily elicit a P3 response, wholly similar to that evoked by oddball stimuli presented in other sensory modalities. This vestibular-evoked P3 response may provide a readily and robustly detectable objective measure for the evaluation of vestibular integrity in various disease models. PMID:22434342
Interstitiospinal neurons were activated by antidromic stimulation of the spinal cord ventromedial funiculus at C1 and C4 in cerebellectomized cats under chloralose anesthesia. Neurons responding only to C1 were classified as N cells and those responding both to C1 and C4 were classified as D cells, as in previous experiments (Fukushima et al. 1980a). Vestibular branching interstitiospinal and reticulospinal neurons were also identified as in the previous experiments. Stimulation of the ipsilateral pericruciate cortex evoked firing in 31% of N cells, 41% of D cells and 35% of the vestibular branching neurons, while stimulation of the contralateral cortex excited 6% of N cells, 29% of D cells and 14% of vestibular branching neurons. Response latencies ranged from 2 to 15 ms after the effective pulse. By measuring the thresholds of activation of these neurons while changing the depth of the stimulating electrodes, and by mapping the cortical areas, it was shown that the lowest threshold areas were in the frontal eye fields and the anterior sigmoid gyrus near the presylvian sulcus (Area 6). Stimulation of the latter area often evoked neck or shoulder muscles contraction. Stimulation in the deep layers of the ipsilateral superior colliculus evoked firing in about 20% of interstitiospinal neurons and about 42% of vestibular branching neurons, with typical latencies 2-3 ms after the effective pulse, while stimulation of the contralateral superior colliculus was rarely effective. N cells and D cells responded similarly. Thresholds for activation were high in the intermediate tectal layers and declined as the electrodes entered the underlying tegmentum. This suggests that the superior colliculus is not the main source of synaptic inputs to these neurons. Low threshold points were found above the deep fiber layer when stimulating electrodes were inserted into the pretectum. Stimulation of the C2 biventer cervicis nerve excited about 8% of N cells, 18% of D cells, and 15% of vestibular branching neurons bilaterally with typical latencies around 10 ms. Similar results were obtained when C2 splenius nerves were stimulated. The fibers responsible for such excitation are probably group II, since stimuli stronger than 1.8 times threshold of the lowest threshold fibers were needed to evoke excitation. Response decrement was often observed when stimuli were repeated at 1/s, while no such decrement was observed at the rate of 1/3 s. When the convergence of cortical and labyrinthine excitatory inputs was studied, 36% of interstitiospinal neurons received single inputs either from the pericruciate cortex or from the labyrinth, 22% of neurons received convergent excitation from both and the remaining 42% did not respond to either stimulus. Although vestibular branching neurons rarely received labyrinthine inputs, they frequently showed convergence of excitation to stimulation of the frontal cortex, superior colliculus and vestibular nuclei. PMID:7286102
Requirement for Lmo4 in the vestibular morphogenesis of mouse inner ear.
During development, compartmentalization of an early embryonic structure produces blocks of cells with distinct properties and developmental potentials. The auditory and vestibular components of vertebrate inner ears are derived from defined compartments within the otocyst during embryogenesis. The vestibular apparatus, including three semicircular canals, saccule, utricle, and their associated sensory organs, detects angular and linear acceleration of the head and relays the information through vestibular neurons to vestibular nuclei in the brainstem. How the early developmental events manifest vestibular structures at the molecular level is largely unknown. Here, we show that LMO4, a LIM-domain-only transcriptional regulator, is required for the formation of semicircular canals and their associated sensory cristae. Targeted disruption of Lmo4 resulted in the dysmorphogenesis of the vestibule and in the absence of three semicircular canals, anterior and posterior cristae. In Lmo4-null otocysts, canal outpouches failed to form and cell proliferation was reduced in the dorsolateral region. Expression analysis of the known otic markers showed that Lmo4 is essential for the normal expression of Bmp4, Fgf10, Msx1, Isl1, Gata3, and Dlx5 in the dorsolateral domain of the otocyst, whereas the initial compartmentalization of the otocyst remains unaffected. Our results demonstrate that Lmo4 controls the development of the dorsolateral otocyst into semicircular canals and cristae through two distinct mechanisms: regulating the expression of otic specific genes and stimulating the proliferation of the dorsolateral part of the otocyst. PMID:19913004
Convergent inputs from the lateral and vertical semicircular canals (LC and VC) to 31 central vestibular-only (VO) and vestibular-plus-saccade (VPS) neurons were determined by oscillating monkeys about a spatial vertical axis while the head was tilted forward and backward up to 90 degrees. Activity of each neuron varied as a function of head tilt. Seven neurons had maximal activation when the head was tilted approximately 30 degrees forward (spatial phase), indicating convergent inputs from the LC, while peak activation of 10 units occurred with the head tilted back approximately 50 degrees, indicating VC input. Fourteen neurons had spatial phases that deviated more that 15 degrees from the LC and VC planes, indicating convergent inputs from LC and VC. Seven of these neurons had a spatial phase less than 15 degrees forward and 35 degrees back, indicating canal inputs from both sides. Seven other neurons had spatial phases more that 45 degrees forward and 65 degrees back, indicating inputs from canals located on the same side. Thus, there are two groups of central vestibular neurons: one group responds maximally when the head is rotated about a spatial vertical axis in an upright position, declining as the head is tilted away from this position. Another group responds minimally to rotation in an upright head orientation, increasing as the head is tilted away from the upright. A majority of the cells also had convergent otolith input. The otolith and canal inputs superposed when the animals were rotated about roll and pitch axes from an upright position. This insured that these neurons would respond over a broad frequency range from very low to high frequencies. PMID:18718319
For accurate visual information about objects of interest moving slowly in three-dimensional (3D) space, primates with binocular fields use both frontal smooth-pursuit (frontal-pursuit) and vergence eye movements (i.e., depth pursuit) to maintain the images of the objects precisely on the foveae of left and right eyes. Moreover, during head or whole-body movement, both frontal- and depth-pursuit systems must interact with the vestibular system to minimize slip of the retinal images that degrades image quality considerably. The caudal part of the frontal eye fields (FEF) contains many frontal-pursuit neurons. Previous studies have shown that a majority of pursuit neurons there discharge for both frontal pursuit and vergence and carry pursuit-in-3D signals. To understand how vestibular inputs interact with pursuit-in-3D signals, three different experiments that examined the nature of vestibular signals in the caudal FEF are described in this review. A majority of caudal FEF pursuit neurons responded to whole-body rotation with preferred directions similar to frontal-pursuit directions and carried frontal gaze (eye-in-space) velocity signals. They were activated in association with adaptive pursuit eye movements induced by cross-axis pursuit-vestibular interactions. During fore/aft and right/left translation in complete darkness, they were also modulated with preferred directions of many neurons similar to pursuit-preferred directions. Previous studies showed that caudal FEF pursuit neurons also receive visual signals about target motion. Taken together, these results suggest that the caudal FEF coordinates its various inputs to provide signals for accurate eye-movement-in-space commands. PMID:15826981
In situ hybridization was used to study the site and timing of the expression of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3), and neurotrophin 5 (NT-5) mRNAs in the developing inner ear of the rat. In the sensory epithelia, the levels of NGF and NT-5 mRNAs were below the detection limit. NT-3 and BDNF mRNAs were expressed in the otic vesicle in overlapping but also in distinct regions. Later in development, NT-3 transcripts were localized to the differentiating sensory and supporting cells of the auditory organ and vestibular maculae. In these sensory epithelia, the intensity of NT-3 mRNA expression decreased in parallel with maturation. The expression of BDNF mRNA was restricted to the sensory cells of both the auditory and vestibular organs, including ampullary cristae. In bioassays, BDNF and NT-3, but not NGF, at physiological concentrations induced neurite outgrowth from the statoacoustic ganglion explants. These results demonstrate that NT-3 and BDNF, rather than NGF and NT-5, are the primary neurotrophins present in the target fields of the cochlear and vestibular neurons. Expression of NT-3 and BDNF mRNAs in the otic vesicle before and during the ingrowth of neurites from the statoacoustic ganglion suggests that NT-3 or BDNF or both may serve as chemoattractants for the early nerve fibers. The results also suggest that these neurotrophins have a role in later development of the cochlear and vestibular neurons. PMID:1409719
Effect of hypergravity on the development of vestibulocerebellar afferent fibers
Gravity is a critical factor in the normal development of the vestibular system, as prolonged prenatal exposures to either micro- or hypergravity will alter the pattern of projections from specific vestibular organs to specific targets in the vestibular nuclei. This study addresses the effect of gravity on the development of vestibulocerebellar projections. In adult rats the semicircular canal afferents project mainly to the cerebellar nodulus whereas the otolith maculae project mainly to the ventral uvula of the cerebellum. To determine if the distribution pattern of these afferents is altered by exposures to altered gravity, 10 pregnant rats were exposed to hypergravity (1.5g) from embryonic day 12 (before vestibular ganglion neurons contact vestibular nuclei) to embryonic day 21 (near the time when the vestibular system becomes functional). Controls were exposed to Earth's gravity but otherwise received the same treatment. At the end of the exposure the embryos were deeply anesthetized and fixed by transcardiac perfusion with 4% paraformaldehyde in 0.1 M phosphate buffer (pH7.4). Filter strips coated with DiI and PTIR were implanted into the saccule (gravistatic vestibular receptor) or into the posterior vertical canal (angular acceleration receptor), and allowed to diffuse for 2 weeks at 37°C. Then the brains were dissected and sectioned for fluorescent confocal imaging. Examination of the control cerebella revealed that the canal and otolith afferents have reached the nodulus and uvula, and axons extend into the internal granular, Purkinje, and molecular layers. Projections from the saccule and posterior vertical canal were partially segregated into their respective domains, the uvula and nodulus. In contrast, in hypergravity-exposed rat fetuses the saccule and posterior vertical canal projections were poorly segregated, and both organs contributed labeled fibers to all layers of the nodulus and uvula. This contrasts with the increased afferent segregation patterns observed in the vestibular nuclei after hypergravity exposures. Together these results suggest that hypergravity exposure delays the development of afferent segregation in the cerebellum, and furthermore that each vestibular target responds differently to the influence of gravity. Supported by NASA grant NAG2-1353.
Abstract Conclusion: The excessive glutamate released from the type I and type II hair cells and the supporting cells injure the bouton-type endings and the nerve chalices in 30 min ischemia, and neuronal damage of glutamate was slight in 10 min ischemia. Objective: In the present study, we investigated by means of post-embedding immunoelectron microscopic analysis whether neuronal damage in the vestibular end organs is associated with the change of cellular glutamate concentration during ischemia. Methods: Transient local anoxia (10 min, 30 min) of guinea pig inner ear was induced by pressing the left labyrinthine artery. The right sides were used as controls. The morphological changes of the vestibular end organs and the areal gold particle densities representing glutamate were compared ...
Input/output properties of the lateral vestibular nucleus
This article is a review of work in three species, squirrel monkey, cat, and rat studying the inputs and outputs from the lateral vestibular nucleus (LVN). Different electrophysiological shock paradigms were used to determine the synaptic inputs derived from thick to thin diameter vestibular nerve afferents. Angular and linear mechanical stimulations were used to activate and study the combined and individual contribution of inner ear organs and neck afferents. The spatio-temporal properties of LVN neurons in the decerebrated rat were studied in response to dynamic acceleration inputs using sinusoidal linear translation in the horizontal head plane. Outputs were evaluated using antidromic identification techniques and identified LVN neurons were intracellularly injected with biocytin and their morphology studied.
Nitric Oxide Signaling in Hypergravity-Induced Neuronal Plasticity
The goal of this research project was to identify the neurons and circuits in the vestibular nuclei and nucleus prepositus hypoglossi that utilize nitric oxide (NO) for intercellular signaling during gravity-induced plasticity. This objective was pursued using histochemical and immunocytochemical approaches to localize NO-producing neurons and characterize the fine morphology of the cells in ground-based studies of normal rats, rats adapted to hypergravity, and rats adapted to hypergravity and then re-adapted to the 1G environment. NO-producing neurons were identified and studied using four methodologies: i) immunocytochemistry employing polyclonal antibodies directed against neuronal nitric oxide synthase (nNOS), to provide an indication of the capacity of a cell for NO production; ii) immunocytochemistry employing a monoclonal antibody directed against L-citrulline, to provide an indirect index of the enzyme's activity; iii) histochemistry based on the NADPH-diaphorase reaction, for fuI1 cytological visualization of neurons; and iv) double immunofluorescence to co-localize nNOS and L-citrulline in individual vestibular nuclei (VN) and neurons.
Properties of cerebellar fastigial neurons during translation, rotation, and eye movements
The most medial of the deep cerebellar nuclei, the fastigial nucleus (FN), receives sensory vestibular information and direct inhibition from the cerebellar vermis. We investigated the signal processing in the primate FN by recording single-unit activities during translational motion, rotational motion, and eye movements. Firing rate modulation during horizontal plane translation in the absence of eye movements was observed in all non-eye-movement-sensitive cells and 26% of the pursuit eye-movement-sensitive neurons in the caudal FN. Many non-eye-movement-sensitive cells recorded in the rostral FN of three fascicularis monkeys exhibited convergence of signals from both the otolith organs and the semicircular canals. At low frequencies of translation, the majority of these rostral FN cells changed their firing rates in phase with head velocity rather than linear acceleration. As frequency increased, FN vestibular neurons exhibited a wide range of response dynamics with most cells being characterized by increasing phase leads as a function of frequency. Unlike cells in the vestibular nuclei, none of the rostral FN cells responded to rotational motion alone, without simultaneously exhibiting sensitivity to translational motion. Modulation during earth-horizontal axis rotation was observed in more than half (77%) of the neurons, although with smaller gains than during translation. In contrast, only 47% of the cells changed their firing rates during earth-vertical axis rotations in the absence of a dynamic linear acceleration stimulus. These response properties suggest that the rostral FN represents a main processing center of otolith-driven information for inertial motion detection and spatial orientation.
Anterograde labeling techniques were used to examine peripheral innervation patterns of vestibular efferent neurons in the crista ampullares of the gerbil. Vestibular efferent neurons were labeled by extracellular injections of biocytin or biotinylated dextran amine into the contralateral or ipsilateral dorsal subgroup of efferent cell bodies (group e) located dorsolateral to the facial nerve genu. Anterogradely labeled efferent terminal field varicosities consist mainly of boutons en passant with fewer of the terminal type. The bouton swellings are located predominately in apposition to the basolateral borders of the afferent calyces and type II hair cells, but several boutons were identified close to the hair cell apical border on both types. Three-dimensional reconstruction and morphological analysis of the terminal fields from these cells located in the sensory neuroepithelium of the anterior, horizontal, and posterior cristae were performed. We show that efferent neurons densely innervate each end organ in widespread terminal fields. Subepithelial bifurcations of parent axons were minimal, with extensive collateralization occurring after the axons penetrated the basement membrane of the neuroepithelium. Axonal branching ranged between the 6th and 27th orders and terminal field collecting area far exceeds that of the peripheral terminals of primary afferent neurons. The terminal fields of the efferent neurons display three morphologically heterogeneous types: central, peripheral, and planum. All cell types possess terminal fields displaying a high degree of anisotropy with orientations typically parallel to or within +/-45 degrees of the longitudinal axis if the crista. Terminal fields of the central and planum zones predominately project medially toward the transverse axis from the more laterally located penetration of the basement membrane by the parent axon. Peripheral zone terminal fields extend predominately toward the planum semilunatum. The innervation areas of efferent terminal fields display a trend from smallest to largest for the central, peripheral, and planum types, respectively. Neurons that innervate the central zone of the crista do not extend into the peripheral or planum regions. Conversely, those neurons with terminal fields in the peripheral or planum regions do not innervate the central zone of the sensory neuroepithelium. The central zone of the crista is innervated preferentially by efferent neurons with cell bodies located in the ipsilateral group e. The peripheral and planum zones of the crista are innervated preferentially by efferent neurons with cell bodies located in the contralateral group e. A model incorporating our anatomic observations is presented describing an ipsilateral closed-loop feedback between ipsilateral efferent neurons and the periphery and an open-loop feed-forward innervation from contralateral efferent neurons. A possible role for the vestibular efferent neurons in the modulation of semicircular canal afferent response dynamics is proposed.
Thirty-seven neurons were recorded in the superior vestibular nucleus (SVN) of two cynomolgus monkeys 1-2 yr after bilateral lateral canal nerve section to test whether the central neurons had spatially adapted for the loss of lateral canal input. The absence of lateral canal function was verified with eye movement recordings. The relation of unit activity to the vertical canals was determined by oscillating the animals about a horizontal axis with the head in various orientations relative to the axis of rotation. Animals were also oscillated about a vertical axis while upright or tilted in pitch. In the second test, the vertical canals are maximally activated when the animals are tilted back about -50 degrees from the spatial upright and the lateral canals when the animals are tilted forward about 30 degrees . We reasoned that if central compensation occurred, the head orientation at which the response of the vertical canal-related neurons was maximal should be shifted toward the plane of the lateral canals. No lateral canal-related units were found after nerve section, and vertical canal-related units were found only in SVN not in the rostral medial vestibular nucleus. SVN canal-related units were maximally activated when the head was tilted back at -47 +/- 17 and -50 +/- 12 degrees (means +/- SD) in the two animals, close to the predicted orientation of the vertical canals. This indicated that spatial adaptation of vertical canal-related vestibular neurons had not occurred. There were substantial neck and/or otolith-related inputs activating the vertical canal-related neurons in the nerve-sectioned animals, which could have contributed to oculomotor compensation after nerve section. PMID:15987758
Adaptation of orientation vectors of otolith-related central vestibular neurons to gravity.
Behavioral experiments indicate that central pathways that process otolith-ocular and perceptual information have adaptive capabilities. Because polarization vectors of otolith afferents are directly related to the electro-mechanical properties of the hair cell bundle, it is unlikely that they change their direction of excitation. This indicates that the adaptation must take place in central pathways. Here we demonstrate for the first time that otolith polarization vectors of canal-otolith convergent neurons in the vestibular nuclei have adaptive capability. A total of 10 vestibular-only and vestibular-plus-saccade neurons were recorded extracellularly in two monkeys before and after they were in side-down positions for 2 h. The spatial characteristics of the otolith input were determined from the response vector orientation (RVO), which is the projection of the otolith polarization vector, onto the head horizontal plane. The RVOs had no specific orientation before animals were in side-down positions but moved toward the gravitational axis after the animals were tilted for extended periods. Vector reorientations varied from 0 to 109 degrees and were linearly related to the original deviation of the RVOs from gravity in the position of adaptation. Such reorientation of central polarization vectors could provide the basis for changes in perception and eye movements related to prolonged head tilts relative to gravity or in microgravity. PMID:18497367
The firing behavior of 51 non-eye movement related central vestibular neurons that were sensitive to passive head rotation in the plane of the horizontal semicircular canal was studied in three squirrel monkeys whose heads were free to move in the horizontal plane. Unit sensitivity to active head movements during spontaneous gaze saccades was compared with sensitivity to passive head rotation. Most units (29/35 tested) were activated at monosynaptic latencies following electrical stimulation of the ipsilateral vestibular nerve. Nine were vestibulo-spinal units that were antidromically activated following electrical stimulation of the ventromedial funiculi of the spinal cord at C1. All of the units were less sensitive to active head movements than to passive whole body rotation. In the majority of cells (37/51, 73%), including all nine identified vestibulo-spinal units, the vestibular signals related to active head movements were canceled. The remaining units (n = 14, 27%) were sensitive to active head movements, but their responses were attenuated by 20-75%. Most units were nearly as sensitive to passive head-on-trunk rotation as they were to whole body rotation; this suggests that vestibular signals related to active head movements were cancelled primarily by subtraction of a head movement efference copy signal. The sensitivity of most units to passive whole body rotation was unchanged during gaze saccades. A fundamental feature of sensory processing is the ability to distinguish between self-generated and externally induced sensory events. Our observations suggest that the distinction is made at an early stage of processing in the vestibular system.
Modeling spatial tuning of adaptation of the angular vestibulo-ocular reflex
Gain adaptation of the yaw angular vestibular ocular reflex (aVOR) induced in side-down positions has gravity-independent (global) and -dependent (localized) components. When the head oscillation angles are small during adaptation, localized gain changes are maximal in the approximate position of adaptation. Concurrently, polarization vectors of canal?otolith vestibular neurons adapt their orientations during these small-angle adaptation paradigms. Whether there is orientation adaptation with large amplitude head oscillations, when the head is not localized to a specific position, is unknown. Yaw aVOR gains were decreased by oscillating monkeys about a yaw axis in a side-down position in a subject?stationary visual surround for 2 h. Amplitudes of head oscillation ranged from 15° to 180°. T...
Twenty contralateral superior vestibulo-ocular neurons (SVON) from 3 cats were studied morphologically one year after a right vestibular neurectomy. Eighteen SVON contained a smooth or slightly crenated nuclear membrane, a 63% loss of synaptic profiles (SP) and a 22% decrease in size compared to control SVON. Two cells contained nuclear membrane invaginations, a 40% loss of SP and a 31% size decrease compared to control SVON. The volume fractions of rough endoplasmic reticulum and ribosomes were decreased in these two cell groups but no change was noted in Golgi apparatus and mitochondria. These contralateral SVON reached a size, innervation density and content of organelles similar to ipsilateral SVON at one year following vestibular neurectomy. PMID:1605013
A role for orexin in central vestibular motor control.
The absence of orexin results in narcolepsy-cataplexy. While the function of the central orexinergic system in sleep regulation has been well studied, the role of orexin in motor control is largely unknown. Here, we show that orexin-A acts via OX(1) and OX(2) receptors to directly depolarize neurons in the rat lateral vestibular nucleus (LVN), a subcortical motor center, and enhance their sensitivity. A dual ionic mechanism involving both Na+-Ca²+ exchangers and inward rectifier K+ channels underlies these effects. Furthermore, orexin-A regulates central vestibular-mediated posture, motor balance and negative geotaxis. Orexin is critical when an animal is facing a major motor challenge as opposed to during rest and general movements. Therefore, orexin participates not only in sleep and emotion (nonsomatic) but also in motor (somatic) regulation, suggesting that the central orexinergic system plays an important role in somatic-nonsomatic integration. These findings may account for why the absence of orexin results in narcolepsy-cataplexy. PMID:21338887
A nonlinear model of the neural integrator improves detection of deficits in the human VOR.
A nonlinear model has been proposed to describe the set-point-dependent characteristics of the neural integrator (NI) in the oculomotor system. It was shown to yield improved prediction of slow-phase eye position in the vestibulo-ocular reflex (VOR) of normal subjects, when compared to the classical linear model of the NI. In this paper, we compare the parameters of this nonlinear NI model fitted to VOR data from: 1) compensated subjects diagnosed with vestibular deficiencies such as vestibular neuronitis and Meniere's disease and 2) normal (symptom-free) subjects. The identified models exhibit more severe nonlinearity in VOR patients than the normal controls. Several of the identified parameters in patients unmask asymmetries and more context dependence in the NI and in the VOR gain that are consistent with the lesioned side and could serve to support detection of lesions even after compensation. PMID:19272974
Premotor neurons encode torsional eye velocity during smooth-pursuit eye movements
Responses to horizontal and vertical ocular pursuit and head and body rotation in multiple planes were recorded in eye movement-sensitive neurons in the rostral vestibular nuclei (VN) of two rhesus monkeys. When tested during pursuit through primary eye position, the majority of the cells preferred either horizontal or vertical target motion. During pursuit of targets that moved horizontally at different vertical eccentricities or vertically at different horizontal eccentricities, eye angular velocity has been shown to include a torsional component the amplitude of which is proportional to half the gaze angle ("half-angle rule" of Listing's law). Approximately half of the neurons, the majority of which were characterized as "vertical" during pursuit through primary position, exhibited significant changes in their response gain and/or phase as a function of gaze eccentricity during pursuit, as if they were also sensitive to torsional eye velocity. Multiple linear regression analysis revealed a significant contribution of torsional eye movement sensitivity to the responsiveness of the cells. These findings suggest that many VN neurons encode three-dimensional angular velocity, rather than the two-dimensional derivative of eye position, during smooth-pursuit eye movements. Although no clear clustering of pursuit preferred-direction vectors along the semicircular canal axes was observed, the sensitivity of VN neurons to torsional eye movements might reflect a preservation of similar premotor coding of visual and vestibular-driven slow eye movements for both lateral-eyed and foveate species.
Baclofen, motion sickness susceptibility and the neural basis for velocity storage.
Reduction of the dominant time constant (T(VOR)) of the angular vestibulo-ocular reflex (aVOR) by habituation is associated with a decrease in motion sickness susceptibility. Baclofen, a GABA(b) agonist, reduces the time constant of the velocity storage integrator in the aVOR in a dose-dependent manner. The high frequency aVOR gain is unaltered by baclofen. Here we demonstrate that the reduction in T(VOR) produced by oral administration of 20 mg of baclofen causes a significant reduction in motion sickness susceptibility, tested with roll while rotating (RWR). These data show that motion sickness susceptibility can be pharmacologically manipulated with a GABA(b) agonist and support our conclusion that motion sickness is generated through velocity storage. We also show how baclofen acts on velocity storage at the neural level. A vestibular-plus-saccade (VPS) neuron was recorded in the rostral medial vestibular nucleus (rMVN) of a cynomolgus monkey, an area where we postulate that velocity storage is generated. The cell had a time constant during steps of velocity that was close to that of the T(VOR). After parenteral administration of baclofen, there was a similar decrease in the time constants of the VPS neuron and the T(VOR). This is the first demonstration of the concurrence of unit and aVOR time constants before and after baclofen. The data support the hypothesis that the velocity storage integrator is generated through activity of vestibular-only (VO) and VPS neurons in rMVN and suggest that GABA(b) synapses on VO and VPS neurons are likely to be involved in the baclofen-induced reduction in motion sickness susceptibility. PMID:18718351
Neurotrophins have multiple functions during peripheral nervous system development such as controlling neuronal survival, target innervation and synaptogenesis. Neurotrophin specificity has been attributed to the selective expression of the Trk tyrosine kinase receptors in different neuronal subpopulations. However, despite overlapping expression of TrkB and TrkC in many sensory ganglia, brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT3) null mutant mice display selective losses in neuronal subpopulations. In the present study we have replaced the coding part of the BDNF gene in mice with that of NT3 (BDNF(NT3/NT3)) to analyse the specificity and selective roles of BDNF and NT3 during development. Analysis of BDNF(NT3/NT3) mice showed striking differences in the ability of NT3 to promote survival, short-range innervation and synaptogenesis in different sensory systems. In the cochlea, specificity is achieved by a tightly controlled spatial and temporal ligand expression. In the vestibular system TrkB or TrkC activation is sufficient to promote vestibular ganglion neuron survival, while TrkB activation is required to promote proper innervation and synaptogenesis. In the gustatory system, NT3 is unable to replace the actions of BDNF possibly because of a temporally selective expression of TrkB in taste neurons. We conclude that there is no general mechanism by which neurotrophin specificity is attained and that specificity is achieved by (i) a tightly controlled spatial and temporal expression of ligands, (ii) different Trk receptors playing distinct roles within the same neuronal subpopulation, or (iii) selective receptor expression in sensory neuron subpopulations. PMID:12620975
As a part of the study of the vestibular-autonomic pathways involved in motion sickness, the location and the morphology of preganglionic sympathetic neurons (PSNs) projecting via the greater splanchnic nerve were examined. Retrograde labeling of neurons was obtained by application of horseradish peroxidase to the cut end of the greater splanchnic nerve. Labeled PSNs were found, ipsilaterally, within the T1 to T11 spinal cord segments, with the highest density of neurons in T6. Most PSNs were located within the intermediolateral column, but a significant portion also occurred within the lateral funiculus, the intercalated region, and the central autonomic area; the proportion of labeling between the four regions depended on the spinal cord segment.
Changes in Nitric Oxide Synthase-Containing Neurons in the Brain of Thiamine-Deficient Mice
We examined nitric oxide synthase (NOS)?containing neurons in thiamine?deficient mice histochemically using NADPH?diaphorase (NADPH?d). Decreases in the number of cell bodies and the densities of fibers in NADPH?d?containing neurons were detected in selective areas of the thalamus, the lateral habenular nucleus, the dorsal raphe nucleus and the medial vestibular nucleus, and decreases in the density of the fibers were also detected in the caudal part of the medial portion of the medial mammillary nucleus in thiamine?deficient mice. A marked loss of NADPH?d?containing neurons was also noted in the hippocampus. The results suggest that NOS is associated with neuropathological vulnerability of the brain in experimental thiamine deficiency.
Pathoanatomy of Parkinson's disease.
The vestibular nuclear complex (VNC) consists of a collection of sensory relay nuclei that integrates and relays information essential for coordination of eye movements, balance, and posture. Spanning the majority of the hindbrain alar plate, the rhombomere (r) origin and projection pattern of the VNC have been characterized in descriptive works using neuroanatomical tracing. However, neither the molecular identity nor developmental regulation of individual nucleus of the VNC has been determined. To begin to address this issue, we found that Hoxb1 is required for the anterior-posterior (AP) identity of precursors that contribute to the lateral vestibular nucleus (LVN). Using a gene-targeted Hoxb1-GFP reporter in the mouse, we show that the LVN precursors originate exclusively from r4 and project to the spinal cord in the stereotypic pattern of the lateral vestibulospinal tract that provides input into spinal motoneurons driving extensor muscles of the limb. The r4-derived LVN precursors express the transcription factors Phox2a and Lbx1, and the glutamatergic marker Vglut2, which together defines them as dB2 neurons. Loss of Hoxb1 function does not alter the glutamatergic phenotype of dB2 neurons, but alters their stereotyped spinal cord projection. Moreover, at the expense of Phox2a, the glutamatergic determinants Lmx1b and Tlx3 were ectopically expressed by dB2 neurons. Our study suggests that the Hox genes determine the AP identity and diversity of vestibular precursors, including their output target, by coordinating the expression of neurotransmitter determinant and target selection properties along the AP axis. PMID:10991663
Hoxb1 controls anteroposterior identity of vestibular projection neurons.
The vestibular nuclear complex (VNC) consists of a collection of sensory relay nuclei that integrates and relays information essential for coordination of eye movements, balance, and posture. Spanning the majority of the hindbrain alar plate, the rhombomere (r) origin and projection pattern of the VNC have been characterized in descriptive works using neuroanatomical tracing. However, neither the molecular identity nor developmental regulation of individual nucleus of the VNC has been determined. To begin to address this issue, we found that Hoxb1 is required for the anterior-posterior (AP) identity of precursors that contribute to the lateral vestibular nucleus (LVN). Using a gene-targeted Hoxb1-GFP reporter in the mouse, we show that the LVN precursors originate exclusively from r4 and project to the spinal cord in the stereotypic pattern of the lateral vestibulospinal tract that provides input into spinal motoneurons driving extensor muscles of the limb. The r4-derived LVN precursors express the transcription factors Phox2a and Lbx1, and the glutamatergic marker Vglut2, which together defines them as dB2 neurons. Loss of Hoxb1 function does not alter the glutamatergic phenotype of dB2 neurons, but alters their stereotyped spinal cord projection. Moreover, at the expense of Phox2a, the glutamatergic determinants Lmx1b and Tlx3 were ectopically expressed by dB2 neurons. Our study suggests that the Hox genes determine the AP identity and diversity of vestibular precursors, including their output target, by coordinating the expression of neurotransmitter determinant and target selection properties along the AP axis. PMID:22485187
Otoneurologisk udredning ved akut opstået svimmelhed
Benign paroxysmal positional vertigo, vestibular neuronitis and Menière's disease cause most cases of acute vertigo. However, doctors must consider central neurological reasons to vertigo. If it is determined that a patient has oto-neurological vertigo, the next task is to determine whether the patient has a peripheral or a central cause of vertigo, if the condition is potentially lethal and if there is a need for acute radiological imaging and/or medical intervention. This review highlights the oto-neurological approach to the dizzy patient with particular focus on the patient's history, clinical tests and treatment.
In this study we show that high frequency stimulation (HFS, 100Hz) of afferent fibers to the medial vestibular nucleus (MVN) can induce opposite long-term modifications of synaptic responses in the type B neurons depending upon the stimulation pattern. Long burst stimulation (LBS: 2s) and short burst stimulation (SBS: 0.55s) were applied with different burst number (BN) and inter-burst intervals (IBI). It results that both LBS and SBS can induce either N-methyl-d aspartate receptors (NMDARs)-mediated long-term potentiation (LTP) or long-term depression (LTD), depending on temporal organization of repetitive bursts. In particular, the IBI plays a relevant role in guiding the shift from LTP to LTD since by using both LBS and SBS LTP is induced by shorter IBI than LTD. By contrast, the sign of long-term effect does not depend on the mean impulse frequency evaluated within the entire stimulation period. Therefore, the patterns of repetitive vestibular activation with different ratios between periods of increased activity and periods of basal activity may lead to LTP or LTD probably causing different levels of postsynaptic Ca(2+). On the whole, this study demonstrates that glutamatergic vestibular synapse in the MVN can undergo NMDAR-dependent bidirectional plasticity and puts forward a new aspect for understanding the adaptive and compensatory plasticity of the oculomotor responses. PMID:22863673
Cephalic sensory influence on forelimb movement in newborn opossums, Monodelphis domestica.
Like other marsupials, the opossum Monodelphis domestica is born very immature and crawls, unaided by the mother, from the urogenital opening to a nipple where it attaches and pursues its development. If the alternate, rhythmic movements of the forelimbs which allow this locomotion are generated by the developing spinal motor networks, sensory information is nonetheless needed to guide the newborn to a nipple. Behavioral, anatomical and physiological studies suggest that the auditory and the visual systems are insufficiently developed in newborn opossums to influence spinal motor centers, while the vestibular, trigeminal, and olfactory systems are likelier candidates. The trigeminal, vestibular and olfactory regions of the brain were electrically stimulated to test their relative effectiveness at eliciting forelimb movement in newborn opossums, using in vitro preparations of brain-spinal cord with the limbs attached. The minimal stimulation of the cervical spinal cord needed to induce forelimb movement was considered as threshold (T). Stimulations of the trigeminal ganglion (5G) at ?2T and of the vestibular complex at ?20T could induce the same movement, and were not statistically different, in contrast to the ?600T necessary for the olfactory bulb (OB). Neurofilament-200 immunohistochemistry and retrograde tracing with Texas-Red conjugated Dextran Amines were used to study trigeminal innervation of the facial skin and pathways by which trigeminal inputs may be relayed to the spinal cord. Numerous nerve fibers were observed in the snout dermis, especially in the maxillary region, but also elsewhere in the head skin. Some 5G cells project to the upper spinal cord, but more project to the caudal medulla where they could contact secondary trigeminal neurons or reticular cells projecting to the spinal cord. These results support a significant influence of the trigeminal and the vestibular systems, but not of olfaction, on forelimb movement of neonatal opossums. PMID:23103914
Response properties of gerbil otolith afferents to small angle pitch and roll tilts
The responses from isolated single otolith afferent fibers were obtained to small angle sinusoidal pitch and roll tilts in anesthetized gerbils. The stimulus directions that produced the maximum (response vector) and minimum response sensitivities were determined for each otolith afferent, with response vectors for the units being spread throughout the horizontal plane, similar to those reported for other species. A breadth of tuning measure was derived, with narrowly tuned neurons responding maximally to stimulation in one direction and minimally along an orthogonal ('null') direction. Most (approximately 80%) otolith afferents are narrowly tuned, however, some fibers were broadly tuned responding significantly to stimulations in any direction in the horizontal plane. The number of broadly tuned otolith afferents (approximately 20%) differs significantly from the more substantial number of broadly tuned vestibular nuclei neurons (88%) recently reported in rats.
TRPV4 channels mediate the infrared laser-evoked response in sensory neurons.
Infrared laser irradiation has been established as an appropriate stimulus for primary sensory neurons under conditions where sensory receptor cells are impaired or lost. Yet, development of clinical applications has been impeded by lack of information about the molecular mechanisms underlying the laser-induced neural response. Here, we directly address this question through pharmacological characterization of the biological response evoked by midinfrared irradiation of isolated retinal and vestibular ganglion cells from rodents. Whole cell patch-clamp recordings reveal that both voltage-gated calcium and sodium channels contribute to the laser-evoked neuronal voltage variations (LEVV). In addition, selective blockade of the LEVV by micromolar concentrations of ruthenium red and RN 1734 identifies thermosensitive transient receptor potential vanilloid channels as the primary effectors of the chain reaction triggered by midinfrared laser irradiation. These results have the potential to facilitate greatly the design of future prosthetic devices aimed at restoring neurosensory capacities in disabled patients. PMID:22442563
The Molecular Architecture of Ribbon Presynaptic Terminals
The primary receptor neurons of the auditory, vestibular, and visual systems encode a broad range of sensory information by modulating the tonic release of the neurotransmitter glutamate in response to graded changes in membrane potential. The output synapses of these neurons are marked by structures called synaptic ribbons, which tether a pool of releasable synaptic vesicles at the active zone where glutamate release occurs in response to calcium influx through L-type channels. Ribbons are composed primarily of the protein, RIBEYE, which is unique to ribbon synapses, but cytomatrix proteins that regulate the vesicle cycle in conventional terminals, such as Piccolo and Bassoon, also are found at ribbons. Conventional and ribbon terminals differ, however, in the size, molecular composition,...
Origin and plasticity of the subdivisions of the inferior olivary complex
The precerebellar nuclei (PCN) originate from the rhombic lip, a germinal neuroepithelium adjacent to the roof plate of the fourth ventricle. We first report here that, in chicken, the Brn3a-expressing postmitotic medullary cells that produce the inferior olive (ION, the source of cerebellar climbing fibres) originate from a dorso-ventral domain roughly coinciding with the hindbrain vestibular column. Whereas Foxd3 expression labels the whole mature ION but is only detected in a subpopulation of ION neuroblasts initiating their migration, we report that Brn3a allows the visualization of the whole population of ION neurons from the very beginning of their migration. We show that Brn3a-positive neurons migrate tangentially ventralwards through a characteristic dorso-ventral double submargina...
Can Electrical Vestibular Noise Be Used for the Treatment of Brain Diseases?
The therapy currently available for the treatment of degenerative neurological diseases is far from satisfactory, and a novel therapeutic strategy, especially for pharmacologically unresponsive patients, would be welcomed. The vestibular nerves are known to influence neuronal circuits in the medullary cardiovascular areas and, through the cerebellar vermis, the basal ganglia and the limbic system. By means of noisy galvanic vestibular stimulation (GVS), it may now be possible to ameliorate blunted responsiveness of degenerated neuronal circuits in the brains of multiple system atrophy (MSA) and/or Parkinson's disease (PD) patients, through a mechanism known as stochastic resonance. We evaluate the effect of 24-hour noisy GVS on long-term heart rate dynamics in seven MSA patients, and on daytime locomotor activity dynamics in twelve patients with either PD or levodopa unresponsive parkinsonism. Short-range heart rate variability and long-range anti-correlation of trunk activity are significantly increased by the noisy GVS compared with sham stimulation, suggestive of improved autonomic and motor responsiveness. The noisy GVS is effective in boosting the neuro-degenerative brains of MSA and/or PD patients, including those unresponsive to standard levodopa therapy.
We show that trkB and trkC mRNAs, encoding the high-affinity receptor tyrosine kinases for brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), respectively, as well as low-affinity nerve growth factor receptor (p75LNGFR) mRNA are expressed in the cochleovestibular ganglion (CVG) before and during innervation of the target fields. Correspondingly, from preinnervation stages onward, BDNF and NT-3, but neither nerve growth factor (NGF) nor neurotrophin-4 (NT-4) mRNAs are expressed in the sensory epithelium of the otic vesicle, the peripheral target field of CVG neurons. No neurotrophin transcripts were detected by in situ hybridization in the medullary central targets. In explant cultures, neuritogenesis from both the cochlear and vestibular part of the CVG was promoted by BDNF, while NT-3 evoked neurites mainly from the cochlear neurons. Also NT-4 stimulated neurite outgrowth from the CVG in vitro. In dissociated neuron-enriched cultures, NT-3 and BDNF promoted survival of overlapping subsets of CVG neurons and, correspondingly, results from in situ hybridization showed that both trkC and trkB mRNAs were expressed in most neurons of this ganglion. The negligible effect of NGF seen in the bioassays agrees well with the expression of only a few trkA transcripts, encoding the high-affinity receptor for NGF, in the CVG. Based on the spatiotemporal expression patterns and biological effects in vitro, peripherally-synthesized BDNF and NT-3 regulate the survival of CVG neurons as well as the establishment of neuron-target cell contacts in the early-developing inner ear. In addition, the expression of trkB mRNA, more specifically its truncated form, and trkC as well as p75LNGFR mRNAs in distinct non-neuronal structures indicates novel roles for these molecules during development. PMID:8071140
The neurology of balance: Function and dysfunction of the vestibular system in dogs and cats
Disorders affecting the vestibular system are a common neurological problem encountered in small animal practice. As a result, veterinarians are often faced with determining the underlying etiology of affected animals. In order to establish an accurate etiological diagnosis, proper interpretation of neurological deficits and precise neuroanatomical localization are essential. Neurological examination can confirm whether the vestibular dysfunction is of peripheral or central nervous system origin. Peripheral vestibular diseases include idiopathic vestibular syndrome, which has some similarities with vestibular neuritis in humans. Central vestibular diseases in general have a poor prognosis in comparison to those affecting the peripheral vestibular system.
Altered vestibular function in fetal and newborn rats gestated in space
Researchers evaluated vestibular development and function in rat pups flown during gestation on the NASA-NIH R1 and R2 missions. Fetal and postnatal vestibular function were examined. Altered vestibular-mediated responses in the experimental fetal pups are attributed to either direct effect of gravity on the vestibular system or indirect effects of microgravity transduced through the mother. The postnatal tests confirmed the hypothesis that the vestibular system continually adapts and responds to tonic stimulation.
Elucidating the causal role of head and eye movement signaling during cerebellar-dependent oculomotor behavior and plasticity is contingent on knowledge of precerebellar structure and function. To address this question, single-unit extracellular recordings were made from hindbrain Area II neurons that provide a major mossy fiber projection to the goldfish vestibulolateral cerebellum. During spontaneous behavior, Area II neurons exhibited minimal eye position and saccadic sensitivity. Sinusoidal visual and vestibular stimulation over a broad frequency range (0.1-4.0 Hz) demonstrated that firing rate mirrored the amplitude and phase of eye or head velocity, respectively. Table frequencies >1.0 Hz resulted in decreased firing rate relative to eye velocity gain, while phase was unchanged. During visual steps, neuronal discharge paralleled eye velocity latency (approximately 90 ms) and matched both the build-up and the time course of the decay (approximately 19 s) in eye velocity storage. Latency of neuronal discharge to table steps (40 ms) was significantly longer than for eye movement (17 ms), but firing rate rose faster than eye velocity to steady-state levels. The velocity sensitivity of Area II neurons was shown to equal (+/- 10%) the sum of eye- and head-velocity firing rates as has been observed in cerebellar Purkinje cells. These results demonstrate that Area II neuronal firing closely emulates oculomotor performance. Conjoint signaling of head and eye velocity together with the termination pattern of each Area II neuron in the vestibulolateral lobe presents a unique eye-velocity brain stem-cerebellar pathway, eliminating the conceptual requirement of motor error signaling. PMID:16775207
Properties, developmental regulation, and cAMP modulation of the hyperpolarization-activated current (I(h)) were investigated by the whole cell patch-clamp technique in vestibular ganglion neurons of the rat at two postnatal stages (P7-10 and P25-28). In addition, by RT-PCR and immunohistochemistry the identity and distribution of hyperpolarization-activated and cyclic nucleotide-gated channel (HCN) isoforms that generate I(h) were investigated. I(h) current density was larger in P25-28 than P7-10 rats, increasing 410% for small cells (30 pF). The half-maximum activation voltage (V(1/2)) of I(h) was -102 mV in P7-10 rats and in P25-28 rats shifted 7 mV toward positive voltages. At both ages, intracellular cAMP increased I(h) current density, decreased its activation time constant (?), and resulted in a rightward shift of V(1/2) by 9 mV. Perfusion of 8-BrcAMP increased I(h) amplitude and speed up its activation kinetics. I(h) was blocked by Cs(+), zatebradine, and ZD7288. As expected, these drugs also reduced the voltage sag caused with hyperpolarizing pulses and prevented the postpulse action potential generation without changes in the resting potential. RT-PCR analysis showed that HCN1 and HCN2 subunits were predominantly amplified in vestibular ganglia and end organs and HCN3 and HCN4 to a lesser extent. Immunohistochemistry showed that the four HCN subunits were differentially expressed (HCN1 > HCN2 > HCN3 ? HCN4) in ganglion slices and in cultured neurons at both P7-10 and P25-28 stages. Developmental changes shifted V(1/2) of I(h) closer to the resting membrane potential, increasing its functional role. Modulation of I(h) by cAMP-mediated signaling pathway constitutes a potentially relevant control mechanism for the modulation of afferent neuron discharge. PMID:22832570
We have utilized intracellular recording techniques to investigate the cholinoceptivity of rat medial vestibular nucleus (MVN) neurons in a submerged brain slice preparation. Exogenous application of the mixed cholinergic agonists, acetylcholine (ACh) or carbachol (CCh), produced predominantly membrane depolarization, induction of action potential firing, and decreased input resistance. Application of the selective muscarinic receptor agonist muscarine (MUSC), or the selective nicotinic receptor agonists nicotine (NIC) or 1,1-dimethyl-4-phenylpiperazinium (DMPP) also produced membrane depolarizations. The MUSC-induced depolarization was accompanied by decreased conductance, while an increase in conductance appeared to underlie the NIC- and DMPP-induced depolarizations. The muscarinic and nicotinic receptor mediated depolarizations persisted in tetrodotoxin and/or low Ca2+/high Mg2+ containing media, suggesting direct postsynaptic receptor activation. The MUSC-induced depolarization could be reversibly blocked by the selective muscarinic-receptor antagonist, atropine, while the DMPP-induced depolarization could be reversibly suppressed by the selective ganglionic nicotinic-receptor antagonist, mecamylamine. Some neurons exhibited a transient membrane hyperpolarization during the depolarizing response to CCh or MUSC application. This transient inhibition could be reversibly blocked by the gamma-aminobutyric acid (GABA) antagonist, bicuculline, suggesting that the underlying hyperpolarization results indirectly from the endogenous release of GABA acting at GABA receptors. This study confirms the cholinoceptivity of MVN neurons and establishes that individual MVN cells possess muscarinic as well as nicotinic receptors. The data provide support for a prominent role of cholinergic mechanisms in the direct and indirect regulation of the excitability of MVN neurons.
Modeling spatial tuning of adaptation of the angular vestibulo-ocular reflex.
Gain adaptation of the yaw angular vestibular ocular reflex (aVOR) induced in side-down positions has gravity-independent (global) and -dependent (localized) components. When the head oscillation angles are small during adaptation, localized gain changes are maximal in the approximate position of adaptation. Concurrently, polarization vectors of canal-otolith vestibular neurons adapt their orientations during these small-angle adaptation paradigms. Whether there is orientation adaptation with large amplitude head oscillations, when the head is not localized to a specific position, is unknown. Yaw aVOR gains were decreased by oscillating monkeys about a yaw axis in a side-down position in a subject-stationary visual surround for 2 h. Amplitudes of head oscillation ranged from 15° to 180°. The yaw aVOR gain was tested in darkness at 0.5 Hz, with small angles of oscillation (±15°) while upright and in tilted positions. The peak value of the gain change was highly tuned for small angular oscillations during adaptation and significantly broadened with larger oscillation angles during adaptation. When the orientation of the polarization vectors associated with the gravity-dependent component of the neural network model was adapted toward the direction of gravity, it predicted the localized learning for small angles and the broadening when the orientation adaptation was diminished. The model-based analysis suggests that the otolith orientation adaptation plays an important role in the localized behavior of aVOR as a function of gravity and in regulating the relationship between global and localized adaptation. PMID:22660376
We examined the afferent pathways and terminations in the thalamus from the medial vestibular nudeus (MVe) and the spinal vestibular nucleus (SpVe) with anterograde transport of Phaseolus vulgaris leucoagglutinin (PHAL) and retrograde transport of wheat germ agglutinin conjugated horseradish peroxidase (WGA-HRP). Following PHAL injection into the MVe, many anterogradely labeled fibers and terminal-like boutons were recognized in the central lateral nucleus of the thalamus. Sparse projections were found in the zona incerta, the ventral lateral geniculate nudeus and the compact region of the laterodorsal thalamic nudeus. When PHAL was injected into the SpVe, labeled ascending fibers ran along the lateral lemniscus forming a loose bundle, and terminated in the medial part of the rostrocaudal extent of the medial geniculate body, and the posterior and ventral thalamic nuclei. Futhermore, a few fibers projected to the central lateral nudeus. In order to confirm the indirect thalamic afferents via the spinal trigeminal nudeus, we injected WGA-HRP into the submedius nucleus of the thalamus after PHAL injection into the SpVe. Many anterogradely labeled terminal-like boutons from SpVe were recognized apposing retrogradely labeled spinal trigeminal neurons. Thus, the present results indicate the existence of dual vestibulo-thalamic pathways; a direct projection to the thalamus, and an indirect projection to the submedius nucleus via the spinal trigeminal nucleus.
Functional ligand-gated purinergic receptors (P2X) in rat vestibular ganglion neurons
The expression of purinergic receptors (P2X) on rat vestibular ganglion neurons (VGNs) was examined using whole-cell patch-clamp recordings. An application of adenosine 5prime-triphosphate (ATP; 100mM) evoked inward currents in VGNs at a holding potential of -60mV. The decay time constant of the ATP-evoked currents was 2-4s, which is in between the values for rapidly desensitizing subgroups (P2X1 and P2X3) and slowly desensitizing subgroups (P2X2, P2X4, etc.), suggesting the heterogeneous expression of P2X receptors. A dose-response experiment showed an EC50 of 11.0mM and a Hill’s coefficient of 0.82. Suramin (100mM) reversibly inhibited the ATP-evoked inward currents. Alpha, beta-methylene ATP (100mM), a P2X-specific agonist, also evoked inward currents but less extensively than AT...
Cor pulmonale in a patient with Brown-Vialetto-Van Laere syndrome: a case report.
Brown-Vialetto-Van Laere syndrome (BVVLS) is a rare neurological disease characterized by sensorineural hearing loss and multiple cranial nerve palsies, usually involving the VIIth and IXth to XIIth cranial nerves. We describe the clinical and pathological features of a 33-year-old woman with BVVLS. The patient developed progressive exertional dyspnea, with clinical and laboratory findings of right-sided heart failure and pulmonary hypertension. She developed status epilepticus in the setting of cardiac deterioration and respiratory infection, and died of cardiogenic and septic shock. Autopsy disclosed bilateral neuronal loss and gliosis in the inferior colliculi, locus coeruleus and facial and vestibular nuclei. Cor pulmonale is a complication of hypoventilation-induced hypoxia and hypercapnia and had not yet been reported in BVVLS. PMID:21055769
Benign paroxysmal positional vertigo.
Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disorder affecting the posterior semicircular canal. It is most often idiopathic in nature, though it has been known to occur in patients following head injury, Meniere's disease, acoustic neuroma and viral neuronitis. Two basic theories of the pathology of BPPV include cupulolithiasis and canalithiasis. Diagnosis is made by instituting the Hallpike-Dix maneuver to elicit the positional vertigo and nystagmus. While many patients suffer from BPPV on a limited basis, treatment options are available for those individuals with recurrent episodes and permanent BPPV, including surgery and conservative medical exercises and maneuvers. Nursing care is aimed toward teaching the exercises and maneuvers and assisting the patient to adjust the individual lifestyle movements that may precipitate an attack. PMID:7706835
In the course of a densitometric evaluation, the histochemically demonstrated reactivity of succinic acid dehydrogenase (SDH) and of NADPH-diaphorase (NADPHD) was determined in different brain nuclei of two teleost fish (cichlid fish Oreochromis mossambicus, swordtail fish Xiphophorus helleri), which had been kept under 3g hyper-gravity for 8 days. SDH was chosen since it is a rate limiting enzyme of the Krebs cycle and therefore it is regarded as a marker for metabolic and neuronal activity. NADPHD reactivity reflects the activity of nitric oxide synthase. Nitric oxide (NO) is a gaseous intercellular messenger that has been suggested to play a major role in several different in vivo models of neuronal plasticity including learning. Within particular vestibulum-connected brain centers, significant effects of hyper-gravity were obtained, e.g., in the magnocellular nucleus, a primary vestibular relay ganglion of the brain stem octavolateralis area, in the superior rectus subdivision of the oculomotoric nucleus and within cerebellar eurydendroid cells, which in teleosts possibly resemble the deep cerebellar nucleus of higher vertebrates. Non-vestibulum related nuclei did not respond to hypergravity in a significant way. The effect of hyper-gravity found was much less distinct in adult animals as compared to the circumstances seen in larval fish (Anken et al., Adv. Space Res. 17, 1996), possibly due to a development correlated loss of neuronal plasticity.
An improved method for the estimation of firing rate dynamics using an optimal digital filter.
In most neural systems, neurons communicate by means of sequences of action potentials or 'spikes'. Information encoded by spike trains is often quantified in terms of the firing rate which emphasizes the frequency of occurrence of action potentials rather than their exact timing. Common methods for estimating firing rates include the rate histogram, the reciprocal interspike interval, and the spike density function. In this study, we demonstrate the limitations of these aforementioned techniques and propose a simple yet more robust alternative. By convolving the spike train with an optimally designed Kaiser window, we show that more robust estimates of firing rate are obtained for both low and high-frequency inputs. We illustrate our approach by considering spike trains generated by simulated as well as experimental data obtained from single-unit recordings of first-order sensory neurons in the vestibular system. Improvements were seen in the prevention of aliasing, phase and amplitude distortion, as well as in the noise reduction for sinusoidal and more complex input profiles. We review the generality of the approach, and show that it can be adapted to describe neurons with sensory or motor responses that are characterized by marked nonlinearities. We conclude that our method permits more robust estimates of neural dynamics than conventional techniques across all stimulus conditions. PMID:18577401
Vestibular evoked myogenic potentials in multiple sclerosis : clinical and imaging correlations
Patients with multiple sclerosis (MS) frequently report symptoms related to vestibular disorders in the course of their disease. At present, the fundamental tests assessing vestibulospinal involvement are posturography and vestibular evoked myogenic potentials (VEMPs). While posturography cannot be ...
The distribution of calcitonin-gene-related peptide-like immunoreactivity (CGRP-IR) was studied in sections of decalcified rat head and selected whole-mount preparations in order to address the complex peptidergic innervation patterns in peripheral cephalic specialized zones and to examine neuronal ganglia in situ. Labeled neuron somata in trigeminal, glossopharyngeal, and vagal ganglia comprised a large proportion of small to medium size type B ganglion cells. Parasympathetic ganglia (ciliary, otic, sphenopalatine, submandibular) revealed a small population of labeled somata and numerous perisomatic IR axons, whereas sympathetic ganglion cells (superior cervical) were devoid of label though richly innervated by perisomatic IR axons. The gustatory geniculate ganglion contained only a few labeled neurons and axons. Coarse peripheral CGRP-IR axons were traced to skeletal muscle motor end plates (e.g., lingual, tensor tympani, etc.), and thin sensory axons most densely innervated the cornea, iris, general integument, all mucosal epithelia lining the tympanic, nasal, sinus and oropharyngeal cavities, and the cerebral meninges. Blood vessels, glands, ducts, and their orifices were often heavily innervated, and specific specializations and exceptions are discussed. Distinctive patterns of IR innervation characterized the various specialized sensory systems, including 1) cochlear and vestibular hair cells; 2) lingual, palatal, oropharyngeal, and laryngoepiglottal taste buds; 3) main olfactory epithelium and axons projecting to glomeruli in specific sectors of main olfactory bulb; 4) septal-olfactory organ; 5) vomeronasal organ; and 6) the nervus terminalis system. Secretory epithelia (ciliary body, choroid plexus, and stria vascularis) were notably lacking in CGRP-IR. Despite the multiplicity of functionally distinct CGRP neuronal and axonal populations, certain generalizations merit consideration. The extensive innervation of chemosensory nasal and oral epithelia may contribute to specific chemical sensitivities (e.g., relating to olfactory and gustatory senses) as well as evoking "nociceptive" responses to chemical irritants as part of a "common chemical sense." An efferent role for some of these peptidergic afferent axons may also be inferred from their specific distributions. Sites involved in regulating access to and sensitivity of sense organs to external stimuli (e.g., cochlear and vestibular hair cells, taste bud orifices, and main olfactory epithelium) are heavily innervated. Other IR axons are in position to exert control over airflow through nasal turbinates, glandular secretion, blood circulation, and duct transport systems.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2784449
Reversible Bilateral Vestibular Impairment Caused by Fourth Ventricle Epidermoid Tumor
A 26-year-old man presented with an epidermoid tumor of the fourth ventricle manifesting as headache with nausea and vertigo. Neurological examination revealed no cerebellar signs, except nystagmus. Bilateral vestibular impairment was identified by the caloric test. The tumor was removed via the midline suboccipital approach. The bilateral peripheral vestibular function recovered remarkably postoperatively. This marked improvement suggests that the bilateral vestibular impairment was caused by compression of the vestibular nuclei by the tumor.
Consciousness, biology and quantum hypotheses.
Natural phenomena are reducible to quantum events in principle, but quantum mechanics does not always provide the best level of analysis. The many-body problem, chaotic avalanches, materials properties, biological organisms, and weather systems are better addressed at higher levels. Animals are highly organized, goal-directed, adaptive, selectionist, information-preserving, functionally redundant, multicellular, quasi-autonomous, highly mobile, reproducing, dissipative systems that conserve many fundamental features over remarkably long periods of time at the species level. Animal brains consist of massive, layered networks of specialized signaling cells with 10,000 communication points per cell, and interacting up to 1000 Hz. Neurons begin to divide and differentiate very early in gestation, and continue to develop until middle age. Waking brains operate far from thermodynamic equilibrium under delicate homeostatic control, making them extremely sensitive to a range of physical and chemical stimuli, highly adaptive, and able to produce a remarkable range of goal-relevant actions. Consciousness is "a difference that makes a difference" at the level of massive neuronal interactions in the most parallel-interactive anatomical structure of the mammalian brain, the cortico-thalamic (C-T) system. Other brain structures are not established to result in direct conscious experiences, at least in humans. However, indirect extra-cortical influences on the C-T system are pervasive. Learning, brain plasticity and major life adaptations may require conscious cognition. While brains evolved over hundreds of millions of years, and individual brains grow over months, years and decades, conscious events appear to have a duty cycle of ?100 ms, fading after a few seconds. They can of course be refreshed by inner rehearsal, re-visualization, or attending to recurrent stimulus sources. These very distinctive brain events are needed when animals seek out and cope with new, unpredictable and highly valued life events, such as evading predators, gathering critical information, seeking mates and hunting prey. Attentional selection of conscious events can be observed behaviorally in animals showing coordinated receptor orienting, flexible responding, alertness, emotional reactions, seeking, motivation and curiosity, as well as behavioral surprise and cortical and autonomic arousal. Brain events corresponding to attentional selection are prominent and widespread. Attention generally results in conscious experiences, which may be needed to recruit widespread processing resources in the brain. Many neuronal processes never become conscious, such as the balance system of the inner ear. An air traveler may "see" the passenger cabin tilt downward as the plane tilts to descend for a landing. That visual experience occurs even at night, when the traveler has no external frame of spatial reference. The passenger's body tilt with respect to gravity is detected unconsciously via the hair cells of the vestibular canals, which act as liquid accelerometers. However, that sensory activity is not experienced directly. It only becomes conscious via vision and the body senses. The vestibular sense is therefore quite different from visual perception, which "reports" accurately to a conscious field of experience, so that we can point accurately to a bright star on a dark night. Vestibular input is also precise but unconscious. Conscious cognition is therefore a distinct kind of brain event. Many of its features are well established, and must be accounted for by any adequate theory. No non-biological examples are known. Penrose and Hameroff have proposed that consciousness may be viewed as a fundamental problem in quantum physics. Specifically, their 'orchestrated objective reduction' (Orch-OR) hypothesis posits that conscious states arise from quantum computations in the microtubules of neurons. However, a number of microtubule-associated proteins are found in both plant and animal cells (like neurons) and plants are not generally con
Consciousness, biology and quantum hypotheses
Natural phenomena are reducible to quantum events in principle, but quantum mechanics does not always provide the best level of analysis. The many-body problem, chaotic avalanches, materials properties, biological organisms, and weather systems are better addressed at higher levels.Animals are highly organized, goal-directed, adaptive, selectionist, information-preserving, functionally redundant, multicellular, quasi-autonomous, highly mobile, reproducing, dissipative systems that conserve many fundamental features over remarkably long periods of time at the species level. Animal brains consist of massive, layered networks of specialized signaling cells with 10,000 communication points per cell, and interacting up to 1000 Hz. Neurons begin to divide and differentiate very early in gestation, and continue to develop until middle age.Waking brains operate far from thermodynamic equilibrium under delicate homeostatic control, making them extremely sensitive to a range of physical and chemical stimuli, highly adaptive, and able to produce a remarkable range of goal-relevant actions.Consciousness is "a difference that makes a difference" at the level of massive neuronal interactions in the most parallel-interactive anatomical structure of the mammalian brain, the cortico-thalamic (C-T) system. Other brain structures are not established to result in direct conscious experiences, at least in humans. However, indirect extra-cortical influences on the C-T system are pervasive. Learning, brain plasticity and major life adaptations may require conscious cognition.While brains evolved over hundreds of millions of years, and individual brains grow over months, years and decades, conscious events appear to have a duty cycle of ˜100 ms, fading after a few seconds. They can of course be refreshed by inner rehearsal, re-visualization, or attending to recurrent stimulus sources.These very distinctive brain events are needed when animals seek out and cope with new, unpredictable and highly valued life events, such as evading predators, gathering critical information, seeking mates and hunting prey. Attentional selection of conscious events can be observed behaviorally in animals showing coordinated receptor orienting, flexible responding, alertness, emotional reactions, seeking, motivation and curiosity, as well as behavioral surprise and cortical and autonomic arousal. Brain events corresponding to attentional selection are prominent and widespread. Attention generally results in conscious experiences, which may be needed to recruit widespread processing resources in the brain.Many neuronal processes never become conscious, such as the balance system of the inner ear. An air traveler may "see" the passenger cabin tilt downward as the plane tilts to descend for a landing. That visual experience occurs even at night, when the traveler has no external frame of spatial reference. The passenger?s body tilt with respect to gravity is detected unconsciously via the hair cells of the vestibular canals, which act as liquid accelerometers. However, that sensory activity is not experienced directly. It only becomes conscious via vision and the body senses. The vestibular sense is therefore quite different from visual perception, which "reports" accurately to a conscious field of experience, so that we can point accurately to a bright star on a dark night. Vestibular input is also precise but unconscious.Conscious cognition is therefore a distinct kind of brain event. Many of its features are well established, and must be accounted for by any adequate theory. No non-biological examples are known.Penrose and Hameroff have proposed that consciousness may be viewed as a fundamental problem in quantum physics. Specifically, their 'orchestrated objective reduction' (Orch-OR) hypothesis posits that conscious states arise from quantum computations in the microtubules of neurons. However, a number of microtubule-associated proteins are found in both plant and animal cells (like neurons) and plants are not generally con
Responses of the cat spinal interneurons were studied under electrical stimulation of dorsal roots and adequate stimulation of vestibular apparatus. The evoked activity of interneurons in response to electrical stimulation of dorsal roots had different forms. Three types of responses to adequate stimulation of vestibular apparatus were observed. The patterns of convergence of afferent and vestibular impulses on the interneurons are discussed. PMID:1079495
This pilot study aimed at assessing the feasibility and the effectiveness of an electro-tactile vestibular substitution system (EVSS) in patients with unilateral vestibular loss under normal and altered somatosensory conditions from the foot and ankle. Four unilateral vestibular-defective patients v...
Giray M, Kirazli Y, Karapolat H, Celebisoy N, Bilgen C, Kirazli T. Short-term effects of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction: a randomized controlled study. Objective To evaluate the short-term effects of vestibular rehabilitation on symptom, disability, balance, and postural stability in patients with chronic unilateral vestibular dysfunction. Design Randomized controlled trial. Setting Department of Physical Medicine and Rehabilitation, University Hospital. Participants Patients (N=42) with chronic vestibular dysfunction were divided into either a rehabilitation group (group 1) or a control group (group 2). Interventions Patients in group 1 were treated with a customized exercise program for 4 weeks, while the patients in the control group...
Top-down approach to vestibular compensation: Translational lessons from vestibular rehabilitation
This review examines vestibular compensation and vestibular rehabilitation from a unified translational research perspective. Laboratory studies illustrate neurobiological principles of vestibular compensation at the molecular, cellular and systems levels in animal models that inform vestibular rehabilitation practice. However, basic research has been hampered by an emphasis on ‘naturalistic’ recovery, with time after insult and drug interventions as primary dependent variables. The vestibular rehabilitation literature, on the other hand, provides information on how the degree of compensation can be shaped by specific activity regimens. The milestones of the early spontaneous static compensation mark the re-establishment of static gaze stability, which provides a common coo...
Abstract This article reviews vestibular pathology and the requirements and progress made in the design and construction of a vestibular prosthesis. Bilateral loss of vestibular sensation is disabling. When vestibular hair cells are injured by ototoxic medications or other insults to the labyrinth, the resulting loss of sensory input disrupts vestibulo-ocular reflexes (VORs) and vestibulo-spinal reflexes that normally stabilize the eyes and body. Affected individuals suffer poor vision during head movement, postural instability, chronic disequilibrium, and cognitive distraction. Although most individuals with residual sensation compensate for their loss over time, others fail to do so and have no adequate treatment options. A vestibular prosthesis analogous to cochlear implants but designe...
Following spinal cord injury, axons fail to regenerate without exogenous intervention. In this study we report that aligned microfiber-based grafts foster robust regeneration of vascularized CNS tissue. Film, random, and aligned microfiber-based conduits were grafted into a 3 mm thoracic rat spinal cord gap created by complete transection. Over the course of 4 weeks, microtopography presented by aligned or random poly-L-lactic acid microfibers facilitated infiltration of host tissue, and the initial 3 mm gap was closed by endogenous cell populations. This bulk tissue response was composed of regenerating axons accompanied by morphologically aligned astrocytes. Aligned fibers promoted long distance (2055 ± 150 ?m), rostrocaudal axonal regeneration, significantly greater than random fiber (1162 ± 87 ?m) and film (413 ± 199 ?m) controls. Retrograde tracing indicated that regenerating axons originated from propriospinal neurons of the rostral spinal cord, and supraspinal neurons of the reticular formation, red nucleus, raphe and vestibular nuclei. Our findings outline a form of regeneration within the central nervous system that holds important implications for regeneration biology. PMID:21636129
Immunolabeling patterns of the immediate early gene-related protein Fos in the gerbil brainstem were studied following stimulation of the sacculus by both hypergravity and galvanic stimulation. Head-restrained, alert animals were exposed to a prolonged (1 h) inertial vector of 2 G (19.6 m/s2) head acceleration directed in a dorso-ventral head axis to maximally stimulate the sacculus. Fos-defined immunoreactivity was quantified, and the results compared to a control group. The hypergravity stimulus produced Fos immunolabeling in the dorsomedial cell column (dmcc) of the inferior olive independently of other subnuclei. Similar dmcc labeling was induced by a 30 min galvanic stimulus of up to -100 microA applied through a stimulating electrode placed unilaterally on the bony labyrinth overlying the posterior canal (PC). The pattern of vestibular afferent firing activity induced by this galvanic stimulus was quantified in anesthetized gerbils by simultaneously recording from Scarpa's ganglion. Only saccular and PC afferent neurons exhibited increases in average firing rates of 200-300%, suggesting a pattern of current spread involving only PC and saccular afferent neurons at this level of stimulation. These results suggest that alteration in saccular afferent firing rates are sufficient to induce Fos-defined genomic activation of the dmcc, and lend further evidence to the existence of a functional vestibulo-olivary-cerebellar pathway of adaptation to novel gravito-inertial environments.
Experiments performed in decerebrate cats have shown that unilateral microinjection into the cerebellar anterior vermis of a GABAA (muscimol) or a GABAB agonist (baclofen) decreased the gain of the vestibulospinal reflex involving the ipsilateral triceps brachii (iVSR). On the contrary, the phase angle of the reflex was not significantly modified. These effects started 5 to 10 min after the injection and persisted for at least 1 to 2 h before disappearing. Just the opposite changes in gain of the VSR were obtained after local microinjection of the GABAA (bicuculline) or the GABAB antagonist (saclofen). The area on which the GABAergic agents were effective was located within the third and/or the fourth folium rostral to the fissura prima (culmen), at the laterality of 1.0 to 1.4 mm with respect to the midline. This vermal region corresponded to the zone B of the cerebellar cortex, which receives a labyrinth input and projects to the ipsilateral lateral vestibular nucleus, where it exerts a prominent inhibitory influence. It is suggested that GABA agonists inhibit the Purkinje (P)-cells' activity, thus reducing the labyrinthine-induced modulation of the firing rate of these neurons by mossy and climbing fiber afferents. Since the vermal P-cells discharge outphase with respect to the excitatory VS neurons, we may explain why a reduced output of these P-cells results in a reduced gain of the VSR. These experiments provide evidence that the cerebellar anterior vermis exerts a positive influence on the basic VSR gain. PMID:7921344
Neurotransmitter effects on inhibitory burst neurons in the cat.
The present experiment was designed to determine which neurotransmitter influences the burst pattern in the firing of the inhibitory burst neurons (IBN) during vestibular nystagmus. Cats were anesthetized with ether and mounted in a stereotaxic apparatus on a turntable, implanted stimulation electrodes, removed occipital bone and aspirated the vermal part of cerebellum. After the operation ether was discontinued. The recordings took place with the cats in an alert condition created by upper cervical cord transsection, artificial respiration and local anesthesia by infiltrating 0.5% lidocaine into the semilunar ganglions every two hours. We also employed iontophoretic application of the various drugs: GABA, muscimol, glycine, serotonin (5-HT) and bicuculline through seven-barrelled glass micropipettes. GABA or muscimol did not influence nystagmus rhythm, but both chemicals caused strong suppression of burst activities in IBN. Since this inhibitory effect of GABA was suppressed by the simultaneous application of bicuculline, IBNs appear to be controlled by GABAA receptor. Glycine and 5-HT did not change the firing pattern of IBN. Application of bicuculline itself caused an increase of tonic discharges of IBN. These findings suggest that IBN receive inhibitory impulses from the higher GABAergic neurons. PMID:2576838
Variation and type specificity in the bacterial species Haemophilus influenzae.
Background The homeobox gene Prox1 is required for lens, retina, pancreas, liver, and lymphatic vasculature development and is expressed in inner ear supporting cells and neurons. Methodology/Principal Findings We have investigated the role of Prox1 in the developing mouse ear taking advantage of available standard and conditional Prox1 mutant mouse strains using Tg(Pax2-Cre) and Tg(Nes-Cre). A severe reduction in the size of the canal cristae but not of other vestibular organs or the cochlea was identified in the E18.5 Prox1Flox/Flox; Tg(Pax2-Cre) mutant ear. In these mutant embryos, hair cell differentiated; however, their distribution pattern was slightly disorganized in the cochlea where the growth of type II nerve fibers to outer hair cells along Prox1 expressing supporting cells was severely disrupted. In the case of Nestin-Cre, we found that newborn Prox1Flox/Flox; Tg(Nestin-Cre) exhibit only a disorganized innervation of outer hair cells despite apparently normal cellular differentiation of the organ of Corti, suggesting a cell-autonomous function of Prox1 in neurons. Conclusions/Significance These results identify a dual role of Prox1 during inner ear development; growth of the canal cristae and fiber guidance of Type II fibers along supporting cells in the cochlea. PMID:19869858
Expression of the LIM-homeodomain gene Lmx1a in the postnatal mouse central nervous system.
The LIM-homeodomain transcription factor Lmx1a plays critical roles in roof plate formation as well as in the cell fate determination of midbrain dopaminergic neurons during embryonic development, but its function in the adult brain remains unknown. In the present study, as the first step in exploring its function in adult brain, we examined the expression of Lmx1a in the mouse central nervous system (CNS) from birth to adulthood by in situ hybridization. Lmx1a was expressed at high levels in the posterior hypothalamic area, supremammillary nucleus, ventral premammillary nucleus, subthalamic nucleus, ventral tegmental area, compact part of the substantia nigra and parabrachial nucleus from birth to adulthood, and co-localized with its paralogue Lmx1b in these regions. On the other hand, Lmx1a expression in the cochlear nuclei, medial cerebellar nucleus and superior vestibular nucleus was only observed until postnatal day (P) 30 and showed no colocalization with Lmx1b. Lmx1a-expressing neurons in the ventral midbrain were dopaminergic as evidenced by co-expression with tyrosine hydroxylase in these regions. Furthermore, Lmx1a expression was also found in the choroid plexuses and ependymal cells, although its expression was only detected during the first two postnatal weeks. These results suggest that Lmx1a may be involved in postnatal development as well as in maintenance of some aspects of normal brain function. PMID:19111912
Electrical stimulation of vestibular-nerve afferents innervating the semicircular canals has been used to identify the extraocular muscles receiving activation or inhibition by individual ampullary nerves. This technique was originally developed by Szentagothai (1950) and led to the description of three neuron reflex arcs that connect each semicircular canal through an interneuron traversing in the region of the medial longitudinal fasciculus to one ipsilateral and one contralateral eye muscle. Selective ampullary nerve stimulation was subsequently used by Cohen and colleagues (Cohen and Suzuki, 1963; Cohen et al., 1964; Suzuki et al., 1964; Cohen et al., 1966) to study movements of the eyes and activation of individual extraocular muscles in response to stimulation of combinations of ampullary nerves. This work led to a description of the now familiar relationships between activation of a semicircular canal ampullary nerves and the anticipated movement in each eye. Disconjugacy of eye movements induced by individual vertical canal stimulation and dependence of the pulling direction of vertical recti and oblique muscles on eye position were also defined in these experiments. Subsequent studies have defined the mechanisms by which externally applied galvanic currents result in a change in vestibular-nerve afferent discharge. The currents appear to act at the spike trigger site. Perilymphatic cathodal currents depolarize the trigger site and lead to excitation whereas anodal currents hyperpolarize and result in inhibition. Afferents innervating all five vestibular endorgans appear to be affected equally by the currents (Goldberg et al., 1984). Irregularly discharging afferents are about 5-10 times more sensitive than regularly discharging ones because of the steeper slope of the former's faster postspike recovery of excitability in encoder sensitivity (Smith and Goldberg, 1986). Response adaptation similar to that noted during acceleration steps is apparent for longer periods of current administration. This adaptation is manifested as a perstimulus return toward resting discharge and poststimulus after-response in the opposite direction (Goldberg et al., 1984; Minor and Goldberg, l991). Cathodal currents (with respect to the perilymphatic space of the vestibule) are excitatory whereas anodal currents are inhibitory. Horizontal eye movements evoked by unilateral galvanic polarizations administered through chronically implanted labyrinthine stimulating electrodes have been studied in alert squirrel monkeys (Minor and Goldberg, 1991). We sought to extend this analysis by recording three-dimensional eye movements during galvanic stimulation. As predicted based upon roughly equal stimulation of ampullary nerves innervating the vertical canals, a substantial torsional component to the nystagmus is noted. The trajectory of torsional slow phases and nystagmus profile after the polarization provide insight into the central mechanisms that influence these responses.
A neural network model was developed to explain the gravity-dependent properties of gain adaptation of the angular vestibuloocular reflex (aVOR). Gain changes are maximal at the head orientation where the gain is adapted and decrease as the head is tilted away from that position and can be described by the sum of gravity-independent and gravity-dependent components. The adaptation process was modeled by modifying the weights and bias values of a three-dimensional physiologically based neural network of canal-otolith-convergent neurons that drive the aVOR. Model parameters were trained using experimental vertical aVOR gain values. The learning rule aimed to reduce the error between eye velocities obtained from experimental gain values and model output in the position of adaptation. Although the model was trained only at specific head positions, the model predicted the experimental data at all head positions in three dimensions. Altering the relative learning rates of the weights and bias improved the model-data fits. Model predictions in three dimensions compared favorably with those of a double-sinusoid function, which is a fit that minimized the mean square error at every head position and served as the standard by which we compared the model predictions. The model supports the hypothesis that gravity-dependent adaptation of the aVOR is realized in three dimensions by a direct otolith input to canal-otolith neurons, whose canal sensitivities are adapted by the visual-vestibular mismatch. The adaptation is tuned by how the weights from otolith input to the canal-otolith-convergent neurons are adapted for a given head orientation. PMID:16971684
The acquisition of ion channels is critical to the formation of neuronal pathways in the peripheral and central nervous systems. This study describes the different types of inward currents (Ii) recorded from the soma of isolated cochleovestibular ganglion (CVG) cells of the embryonic chicken, Gallus gallus. Cells were isolated for whole-cell tight-seal recording from embryonic day (ED) 3, an age when the CVG is a cell cluster, to ED 9, an age when the cochlear and vestibular ganglia (CG, VG) are distinct structures. Results show Na+ and Ca2+ currents (INa and ICa) are acquired by ED 3, although INa dominates with greater density levels that peak by ED 6-7 in VG neurons. In the CG, INa acquisition is slower, reaching peak values by ED 8-9. Isolation of ICa, using Ba2+ as the charge carrier, showed both transient (IBaT)- and sustained (IBaL)-type currents on ED 3. Unlike INa, IBa density varied with age and ganglion. Total IBa increased steadily, showing a decline only in CG cells on ED 8-9 as a result of a decrease in IBaT. IBaL density increased over time, reaching a maximum on ED 6-7 in VG cells, followed by a decline on ED 8-9. In comparison, IBaL in CG neurons, did not increase significantly beyond mean values measured on ED 5. The early onset of these currents and the variations in Ca2+ channel expression between the ganglia suggests that intracellular signals relevant to phenotypic differentiation begin within these early time frames. PMID:16447282
Abstract in portuguese A presença do elemento químico zinco na via auditiva e a sua provável participação na gênese de alguns tipos de disacusia estão bem documentadas, porém não há estudos funcionais que mostrem os impacto da deficiência sistêmica de zinco no sistema vestibular, nem estudos anatômicos descritivos comprovando a existência do íon nas estruturas da via vestibular. OBJETIVO: Este estudo foi realizado com o objetivo de relacionar a alteração na homeostase do zinco (more) com anormalidades do funcionamento da via vestibular. MATERIAL E MÉTODOS: Este é um estudo de casos, retrospectivo, clínico, onde nove indivíduos portadores de deficiência crônica de zinco, entre outros distúrbios nutricionais, consequentes à síndrome de má absorção, foram submetidos à avaliação vestibular. Os resultados deste grupo foram comparados com os resultados de um grupo considerado normal do ponto de vista nutricional (grupo controle). RESULTADOS: Todos os parâmetros da análise vestibular do grupo experimental mostraram-se alterados em comparação com o grupo controle. CONCLUSÃO: A comparação entre os grupos mostrou diferenças significativas em diversos parâmetros da análise vestibular e chamou a atenção para uma possível participação das alterações disabsortivas na origem das desordens vestibulares. Abstract in english The presence of zinc in the auditory pathways and its probable participation in tinnitus and hearing loss are known facts, although there are no clinical trials and experimental studies showing the impact of hypozincemia in the vestibular system and zinc existence in the vestibular pathway, respectively. AIM: This study is an attempt to correlate hypozincemia and abnormal vestibular function. METHODS: This is a clinical retrospective case study where nine patients sufferi (more) ng of chronic zinc deficiency had their serum zinc determined and were submitted to videonystagmography. Results were compared to a normal (control) group. RESULTS: All vestibular test parameters were altered when we compared experimental and control groups. CONCLUSION: Comparison between groups shows significant differences in many aspects of the vestibular analysis and calls our attention towards a possible participation of zinc on the genesis of vestibular disorders.
Abstract in portuguese OBJETIVO: verificar os achados vestibulares em pacientes com perda auditiva neurossenssorial usuários de aparelho de amplificação sonora individual. MÉTODOS: vinte pacientes, 11 do sexo feminino e nove do sexo masculino, com idades entre 39 e 85 anos, com perda auditiva neurossenssorial bilateral de grau moderado e severo foram atendidos em uma Instituição de Ensino Superior e submetidos a uma anamnese, inspeção otológica, avaliação audiológica, imitanciometri (more) a e ao exame vestibular por meio da vectoeletronistagmografia. RESULTADOS: a) dos 20 pacientes avaliados, 18 (90%) apresentaram queixa de zumbido, 15 (75%) queixa de tontura e oito (40%) queixa de cefaléia; b) houve predomínio de alteração na prova calórica e no sistema vestibular periférico; c) o resultado do exame vestibular esteve alterado em 14 pacientes (70%), sendo, oito casos (40%) de síndrome vestibular periférica irritativa e seis casos (30%) de síndrome vestibular periférica deficitária; d) verificou-se diferença significativa entre o resultado do exame vestibular e o tempo de uso do aparelho de amplificação sonora individual; e) dos cinco pacientes que não referiram nenhum sintoma vestibular, quatro (80%) apresentaram alteração no exame. CONCLUSÃO: ressalta-se a sensibilidade e importância do estudo funcional do sistema do equilíbrio neste tipo de população, uma vez que podem ocorrer alterações na avaliação labiríntica independente da presença de sintomas. Abstract in english PURPOSE: to check vestibular findings in patients with sensoneural hearing loss, hearing aid users. METHODS: 20 patients (eleven females and nine males) aging from 39 to 85-year-old with bilateral sensorineural hearing loss, from moderate to severe degrees, were attended in a higher education institution evaluated by medical history, otological inspections, complete basic conventional audiological evaluations, acoustic impedance tests and vectoeletronystagmography. RESULT (more) S: a) from the 20 evaluated patients, 18 (90%) showed tinnitus complaint, 15 (75%) dizziness complaint and eight (40%) headache complaint; b) There was a prevalence of alterations in the caloric test and in the peripheral vestibular system; c) the results of the vestibular exam showed alterations in 14 patients (70%) being, eight cases (40%) of peripheral vestibular irritative syndromes and six cases (30%) of peripheral vestibular deficiency syndromes; d) we verified significant difference between the vestibular exam results and how long the patient had use the hearing aid; e) from the five patients that did not related vestibular symptoms four (80%) showed alterations in the vestibular exam. CONCLUSION: the importance and sensibility of the functional study regarding the balance system in this type of population must be emphasized because same disorders may occur in the vestibular exam in spite of symptom presence.
Recovery of vestibular function following hair cell destruction by streptomycin
Can the vestibular periphery of warm-blooded vertebrates recover functionally from severe sensory hair cell loss? Recent findings in birds suggest a mechanism for recovery but in fact no direct functional evidence has been reported. We produced vestibular hair cell lesions using the ototoxic agent streptomycin sulfate (600 mg/kg/day, 8 days, chicks, Gallus domesticus). Compound action potentials of the vestibular nerve were used as a direct measure of peripheral vestibular function. Vestibular thresholds, neural activation latencies and amplitudes were documented. Eight days of drug treatment elevated thresholds significantly (P < 0.001) and eliminated all but remnants of vestibular activity. Virtually complete physiological recovery occurred in all animals studied over a period of 70 days following treatment. Thresholds recovered within two weeks of drug treatment whereas the return of response morphologies including activation latencies and amplitudes required an additional 6-8 weeks.
SummaryThe vestibular aqueduct is a bony canal related to the bony labyrinth of the inner ear and represents the non-sensory components of the endolymph-filled, closed, membranous labyrinth. The association of congenital sensorineural hearing loss with a large or enlarged vestibular aqueduct is well known as the large vestibular aqueduct syndrome (LVAS). The enlarged VA (EVA) comprises abnormalities not only in the structure of the inner ear, but also in the physiology of the auditory and vestibular systems. The clinical picture of this clinical entity is variable [Yetiser S, Kertment M, Ozkaptan Y. Vestibular disturbance in patients with Large Vestibular Aqueduct Syndrome (LVAS). Acta Otolaryngol (StochK) 1999;119: 641-646]. Signs and symptoms of the auditory impairment are more commonly ...
Basic and Clinical Ocular Motor and Vestibular Research
Studies of compensation of injury to the human vestibular system have, in the main, focused on the vestibular-ocular reflex. Probing vestibular perception allows more of the sensory pathway to be assessed. We present a novel paradigm for simultaneously testing vestibular perceptual and nystagmic thresholds to angular acceleration around an earth vertical axis. The perceptual thresholds can be modulated asymmetrically in normal subjects by DC galvanic stimulation with the head flexed in the roll plane, as expected from the main torsional plane of action of the galvanic stimulus. The perceptual and nystagmic thresholds were bilaterally elevated in acute vestibular neuritis, a unilateral condition, possibly due to central suppression of vestibular input. The degree of asymmetry in thresholds ...
The Anatomical and Physiological Framework for Vestibular Prostheses
Abstract This article reviews the structure function of the vestibular system and its pathology with respect to requirements for the design and construction of a functional vestibular prosthesis. The ultimate goal of a vestibular prosthesis is to restore balance and equilibrium through direct activation of vestibular nerve fibers. An overview of the peripheral and central vestibular systems that highlights their most important functional aspects re: the design of a prosthesis is provided. Namely, the peripheral labyrinth faithfully transduces head motion and gravity in both the time and frequency domains. These signals are described in hopes that they may be prosthetically replicated. The peripheral and central connections of the vestibular nerve are also discussed in detail, as are the ve...
This article reviews vestibular pathology and the requirements and progress made in the design and construction of a vestibular prosthesis. Bilateral loss of vestibular sensation is disabling. When vestibular hair cells are injured by ototoxic medications or other insults to the labyrinth, the resulting loss of sensory input disrupts vestibulo-ocular reflexes (VORs) and vestibulo-spinal reflexes that normally stabilize the eyes and body. Affected individuals suffer poor vision during head movement, postural instability, chronic disequilibrium, and cognitive distraction. Although most individuals with residual sensation compensate for their loss over time, others fail to do so and have no adequate treatment options. A vestibular prosthesis analogous to cochlear implants but designed to modulate vestibular nerve activity during head movement should improve quality of life for these chronically dizzy individuals. We describe the impact of bilateral loss of vestibular sensation, animal studies supporting feasibility of prosthetic vestibular stimulation, the current status of multichannel vestibular sensory replacement prosthesis development, and challenges to successfully realizing this approach in clinical practice. In bilaterally vestibular-deficient rodents and rhesus monkeys, the Johns Hopkins multichannel vestibular prosthesis (MVP) partially restores the three-dimensional (3D) VOR for head rotations about any axis. Attempts at prosthetic vestibular stimulation of humans have not yet included the 3D eye movement assays necessary to accurately evaluate VOR alignment, but these initial forays have revealed responses that are otherwise comparable to observations in animals. Current efforts now focus on refining electrode design and surgical technique to enhance stimulus selectivity and preserve cochlear function, optimizing stimulus protocols to improve dynamic range and reduce excitation-inhibition asymmetry, and adapting laboratory MVP prototypes into devices appropriate for use in clinical trials. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc. PMID:23044664
The influence of aging on hearing and vestibular function in patients with auditory neuropathy has not been investigated. The purpose of this study was to investigate how hearing and vestibular function in this disease change with aging. The subjects were three female patients with auditory neuropathy. We checked their hearing and vestibular function by speech discrimination tests, ABR, ECochG, DPOAE, caloric test, damped-rotational chair test, and VEMPs. In all three patients, speech discrimination ability and vestibular function markedly declined with aging. However, speech language understanding and higher brain function were less affected by aging. PMID:21198343
Abstract The influence of aging on hearing and vestibular function in patients with auditory neuropathy has not been investigated. The purpose of this study was to investigate how hearing and vestibular function in this disease change with aging. The subjects were three female patients with auditory neuropathy. We checked their hearing and vestibular function by speech discrimination tests, ABR, ECochG, DPOAE, caloric test, damped-rotational chair test, and VEMPs. In all three patients, speech discrimination ability and vestibular function markedly declined with aging. However, speech language understanding and higher brain function were less affected by aging.
Bilateral vestibular schwannomas are the hallmark of neurofibromatosis type 2 (NF2), and these tumors impair hearing and frequently lead to deafness. Neurosurgical intervention, the only established treatment, often damages the vestibular nerve. We report 2 cases in which treatment with bevacizumab (for 3 months in one case and 6 months in the other) induced regression of progressive vestibular schwannomas by more than 40% and substantially improved hearing in the patient treated for 6 months. Bevacizumab therapy may thus provide an effective treatment for progressive vestibular schwannomas in patients with NF2.
Because the cause of vestibular neuritis is unknown, this disorder is best understood as a constellation of characteristic clinical symptoms and signs. The differential diagnosis includes peripheral otologic disorders, including Meniere's disease, perilymph fistula, and vestibular atelectasis; and central disorders, including vascular insufficiency, acoustic neuroma, migraine equivalent, paraneoplastic syndrome, metastatic carcinoma, and multiple sclerosis. The site of lesion, as evaluated by clinical signs and symptoms, is controversial because concomitant central nervous system abnormalities have been described. The histopathology of temporal bones from persons who in life had symptoms characteristic of vestibular neuritis demonstrates degeneration of branches of the vestibular nerve and the neuroepithelium of vestibular end organs. Possible causes of vestibular neuritis include viral or other infectious agents and vascular or immune-mediated disorders. The natural history of this disorder is variable. In some patients complete recovery of acute signs and symptoms, including loss of vestibular response, is seen, whereas in others permanent changes have been reported. Initial treatment is generally symptomatic only. Patients with poor recovery may benefit from vestibular rehabilitation or, occasionally, from surgical intervention. The elucidation of the pathogenesis of vestibular neuritis and the development of logical guidelines for individual rehabilitation are needed. PMID:7816452
Abstract in portuguese O objetivo desse estudo foi analisar a eficácia do exercício de reabilitação vestibular em dois casos de esclerose múltipla remitente-recorrente. Ambos os casos foram encaminhados do Hospital de Clínicas para o Laboratório de Otoneurologia de uma instituição de ensino e foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular e aplicação do Dizziness Handicap Inventory pré e pós reabilitação vestibular utilizando (more) -se o protocolo de Cawthorne e Cooksey. No primeiro caso, gênero feminino, 35 anos, tempo de doença de seis anos, referiu tontura há três anos, de intensidade moderada de ocorrência frequente, cefaléia, quedas, desvio de marcha à direita e sensação de desmaio (sic). Apresentou no exame labiríntico, síndrome vestibular periférica deficitária bilateral. No segundo caso, gênero feminino, 49 anos, tempo de doença de dois anos, referiu desvio de marcha à direita, dificuldade e/ou dor ao movimento do pescoço, formigamento de extremidade e alteração vocal. Apresentou no exame labiríntico, síndrome vestibular periférica deficitária à direita. Houve melhora significativa em ambos os casos dos aspectos físico, funcional e emocional do Dizziness Handicap Inventory após a realização da reabilitação vestibular. O protocolo utilizado promoveu melhora na qualidade de vida e auxiliou no processo de compensação vestibular. Abstract in english The aim of the present study was to analyze the effectiveness of vestibular rehabilitation exercises in two cases of remittent-recurrent multiple sclerosis. Both cases were referred from the Clinics Hospital to the Laboratory of Otoneurology of the same institution and were submitted to the following procedures: anamnesis, otological inspection, vestibular evaluation, and application of the Dizziness Handicap Inventory before and after vestibular rehabilitation using the (more) Cawthorne and Cooksey protocol. The first case was a 35-year-old female, diagnosed for six years, who referred frequent dizziness of moderate intensity for three years, headaches, falls, deviation of gait to the right and fainting sensations (sic). In the vestibular exam, she presented bilateral peripheral vestibular deficiency syndrome. The second case was a 49-year-old female, diagnosed for two years, who referred deviation of gait to the right, difficulty and/or pain with neck movement, paraesthesia of the extremities and vocal alteration. In the vestibular exam, she presented peripheral vestibular deficiency syndrome to the right. Both cases had significant improvements regarding physical, functional and emotional aspects of the Dizziness Handicap Inventory after vestibular rehabilitation. The protocol used benefitted the subjects' quality of life and favored the process of vestibular compensation.
A vestibular phenotype for Waardenburg syndrome?
OBJECTIVE: To investigate vestibular abnormalities in subjects with Waardenburg syndrome. STUDY DESIGN: Retrospective record review. SETTING: Tertiary referral neurotology clinic. SUBJECTS: Twenty-two adult white subjects with clinical diagnosis of Waardenburg syndrome (10 type I and 12 type II). INTERVENTIONS: Evaluation for Waardenburg phenotype, history of vestibular and auditory symptoms, tests of vestibular and auditory function. MAIN OUTCOME MEASURES: Results of phenotyping, results of vestibular and auditory symptom review (history), results of vestibular and auditory function testing. RESULTS: Seventeen subjects were women, and 5 were men. Their ages ranged from 21 to 58 years (mean, 38 years). Sixteen of the 22 subjects sought treatment for vertigo, dizziness, or imbalance. For subjects with vestibular symptoms, the results of vestibuloocular tests (calorics, vestibular autorotation, and/or pseudorandom rotation) were abnormal in 77%, and the results of vestibulospinal function tests (computerized dynamic posturography, EquiTest) were abnormal in 57%, but there were no specific patterns of abnormality. Six had objective sensorineural hearing loss. Thirteen had an elevated summating/action potential (>0.40) on electrocochleography. All subjects except those with severe hearing loss (n = 3) had normal auditory brainstem response results. CONCLUSION: Patients with Waardenburg syndrome may experience primarily vestibular symptoms without hearing loss. Electrocochleography and vestibular function tests appear to be the most sensitive measures of otologic abnormalities in such patients.
Experimental and clinical study of EHF treatment of vascular-vestibular dysfunction
The authors present the results of a study of the effectiveness of EHF radiation on the cerebral hemodynamics, bioelectrical activity of the cerebral cortex, and functional state of the vestibular analyzer in chronic studies of cats using a model of vascular-vestibular dysfunction. The clinical part of the work reflects the results of studies of the functional state of cerebral blood circulation and the vestibular analyzer during the EHF treatment of angiovertebrogenic vestibular dysfunction in a background of initial manifestations of cerebral blood supply deficiency (angiodistonic variant).
Radiosurgery has become an accepted treatment option for vestibular schwannomas. Nevertheless, predictors of tumor control and treatment toxicity in current radiosurgery of vestibular schwannomas are not well understood. To generate new information on predictors of tumor control and cranial nerve toxicity of single-fraction radiosurgery of vestibular schwannomas, we conducted a single-institution long-term observational study of radiosurgery for sporadic vestibular schwannomas. Minimum follow-up was 3 years. Investigated as potential predictors of tumor control and cranial nerve toxicity were treatment technology; tumor resection preceding radiosurgery; tumor size; gender; patient age; history of cancer, vascular disease, or metabolic disease; tumor volume; radiosurgical prescription dose;...
Importancia clínica de la prueba calórica mínima/ Clinical importance of the minimal caloric test
Abstract in spanish Introducción: En la evaluación de la patología vestibular habitualmente se utiliza la prueba calórica clásica de Fitzgerald y Hallpike (PCC). Sin embargo, esta sólo evalúa la función del nervio vestibular superior a través de la estimulación del canal semicircular lateral. La prueba calórica mínima (PCM) permite evaluar tanto la función del nervio vestibular superior como del nervio vestibular inferior a través de la estimulación del canal semicircular late (more) ral y posterior respectivamente. Se desconoce el real impacto de la PCM en la evaluación clínica de pacientes con sintomatología vestibular. Objetivo: Cuantificar la utilidad diagnóstica de la PCM en pacientes con sintomatología vestibular. Material y método: Estudio diagnóstico transversal. Se obtuvo la sensibilidad y especificidad de la PCM al comparar la respuesta del canal semicircular lateral en la PCM con la prueba calórica convencional. Se evaluó en cuántos casos la información sobre la función del nervio vestibular inferior aportada por la PCM fue relevante en el diagnóstico vestibular. Resultados: Se estudió a 44 pacientes. Tanto la sensibilidad como la especificidad de la PCM para detectar patología al estimular el canal semicircular lateral fue de 93% (IC95%: 84%-100% y 80%-100% respectivamente). En 16% (N =7) de los casos la PCM detectó patología del nervio vestibular inferior con PCC normal. Conclusiones: La PCM es un examen complementario útil en la evaluación de pacientes con sintomatología vestibular, puesto que tiene una alta sensibilidad y especificidad para detectar patología del nervio vestibular superior a través de la estimulación del canal semicircular lateral y además, aporta información sobre el estado del nervio vestibular inferior a través de la estimulación del canal semicircular posterior, que no aporta la PCC Abstract in english Introduction: The classic Fitzgerald-Hallpike caloric test (CCT) is usually utilized for evaluation of vestibular pathology. With this test, however, superior vestibular nerve function is assessed through stimulation of the lateral semicircular canal only. The minimal caloric test (MCT) allows for evaluation of both superior and inferior vestibular nerve function, through horizontal and posterior semicircular canals stimulation, respectively. The actual impact of MCT on t (more) he clinical evaluation of patients presenting with vestibular symptoms is unknown. Purpose: To quantify the diagnostic usefulness of MCT in patients with vestibular symptoms. Material and Method: Transversal diagnostic study. Sensitivity and specificity of MCT were obtained by comparing the lateral semicircular canal response in both MCT and the conventional caloric test. We assessed the number of cases in which the vestibular nerve function information obtained with MCT was relevant for vestibular diagnostic. Results: 44 patients were studied. The sensitivity and specificity of MCT to detect pathologic conditions via lateral semicircular canal stimulation were 93% (Cl 95%: 84%-100% and 80%-100%, respectively). In 16% (n =7) of the cases, MCT detected inferior vestibular nerve involvement with normal CCT Conclusions: MCT is a complementary test, which can be useful for evaluation of patients with vestibular symptoms, given its high sensitivity and specificity to detect superior vestibular nerve pathology through lateral semicircular canal stimulation. In addition, it provides information on the inferior vestibular nerve status, through posterior semicircular canal stimulation. The latter is not provided by conventional CCT
Spinocerebellar ataxia type 1 (SCA1): New pathoanatomical and clinico-pathological insights.
Aims: Aims: Spinocerebellar ataxia type 1 (SCA1) represents the first molecular genetically characterized autosomal dominantly inherited cerebellar ataxia (ADCA) and is assigned to the CAG-repeat, or polyglutamine diseases. Owing to limited knowledge about SCA1 neuropathology, appropriate pathoanatomical correlates of a large variety of SCA1 disease symptoms are missing and the neuropathological basis for further morphological and experimental SCA1 studies is still fragmentary. Methods: Methods: In the present study we investigated for the first time serial tissue sections through the complete brains of clinically diagnosed and genetically confirmed SCA1 patients. Results: Brain damage in the three SCA1 patients studied went beyond the well-known brain predilection sites of the underlying pathological process. Along with neuronal loss in the primary motor cortex, it included widespread degeneration of gray components of the basal forebrain, thalamus, brainstem, and cerebellum, as well as of white matter components in the cerebellum and brainstem. It involved the motor cerebellothalamocortical and basal ganglia-thalamocortical circuits, the visual, auditory, somatosensory, oculomotor, vestibular, ingestion-related, precerebellar, basal forebrain cholinergic and midbrain dopaminergic systems. Conclusions: These findings show for the first time that the extent and severity of brain damage in SCA1 is very similar to that of clinically closely related spinocerebellar ataxias (i.e. SCA2, SCA3 and SCA7). They offer suitable explanations for poorly understood SCA1 disease symptoms and will facilitate the interpretation of further morphological and experimental SCA1 studies. © 2012 The Authors. Neuropathology and Applied Neurobiology © 2012 British Neuropathological Society. PMID:22309224
Multimodal imaging of the human temporal bone: A comparison of CT and optical scanning techniques
A collaborative effort between Washington University in St. Louis and Spencer Technologies in Seattle, WA has been undertaken to create a multimodal 3D reconstruction of the human cochlea and vestibular system. The goal of this project is to improve the accuracy of in vivo CT reconstructions of implanted cochleae, and to expand the knowledge of high-resolution anatomical detail provided by orthogonal-plane optical sectioning (OPFOS). At WUSL, computed tomography (CT) images of the cochlea are used to determine the position of cochlear implant electrodes relative to target auditory neurons. The cochlear implant position is determined using pre- and post-operative CT scans. The CT volumes are cross-registered to align the semicircular canals and internal auditory canal, which have a unique configuration in 3-D space. The head of a human body donor was scanned with a clinical CT device, after which the temporal bones were removed, fixed in formalin and trimmed prior to scanning with a laboratory Micro CT scanner. Following CT, the temporal bones were sent to the OPFOS Imaging Lab at Spencer Technologies for a further analysis. 3-D reconstructions of CT and OPFOS imaging modalities were compared, and results are presented. [Work supported by NIDCD Grants R44-03623-5 and R01-00581-13.
A clinical epidemiological study in 187 patients with vertigo.
A retrospective study to investigate the clinical epidemiological characteristics of vertigo was carried out on 187 patients with vertigo. A clinical history for each patient was recorded precisely about the attack, frequency, and development of vertigo, its duration, intensity, and the accompanied symptoms including the risk factors for cerebrovascular disease, etc. All the patients were subjected to physical examination with special attention to neurologic systems and Dix-Hallpike maneuver, computed tomography/computed tomography-angiography (CT/CTA) and MRI scan were performed when necessary. Majority of the patients in this study suffered with posterior circulation ischemia (59.89%) and benign paroxysmal positional vertigo (16.04%). Other ailments that affected these patients included migraine, Meniere's disease (1.6%), sudden hearing loss (1.07%), vestibular neuronitis, multiple sclerosis, acute viral encephalitis, meningioma, neurosis, posttraumatic vertigo, acute myocardial infarction (0.53%), and neurosis (14.97%). It appeared that in comparison to younger patients the elderly population is likely to be more susceptible to vertigo. Vertigo attacks patients with various diseases, which pre-dispose the patients to this disease. Presentation of vertigo can be clinically diagnosed in most cases of patients suffering from posterior circulation ischemia. PMID:20976571
Herpes simplex polyganglionitis.
Evidence suggests that many cranial nerve syndromes, such as migraine headache, acute vestibular neuronitis, globus hystericus, carotidynia, acute facial paralysis (Bell's palsy), and Meniere's disease, are caused by the neurotropic herpes simplex virus (HSV). Because transitory cranial nerve dysfunction during acute HSV infection can be asymptomatic but often occurs in conjunction with mucocutaneous vesicles, we tested five subjects with herpes labialis for cranial nerve dysfunction. Four of the subjects had hypesthesia of the trigeminal nerve (which recurred in two); four, hypesthesia of the glossopharyngeal nerve; and two, hypesthesia of the second cervical nerve. Three of the subjects had positional or spontaneous nystagmus (which recurred in one); one of the subjects had a unilateral, decreased caloric response of 50%. Unilateral weakness of the cricothyroid muscle or the palate occurred in three of the subjects (and recurred in one). Volitional electromyograms were normal in all the subjects, but two of the subjects had increased facial nerve latency (which recurred in one). Similar findings of an acute, transitory nature should suggest to the clinician a viral polyganglionitis caused by HSV infection. PMID:7402669
Models of combined eye-head gaze shifts all aim to realistically simulate behaviorally observed movement dynamics. One of the most problematic features of such models is their inability to determine when a saccadic gaze shift should be initiated and when it should be ended. This is commonly referred to as the switching mechanism mediated by omni-directional pause neurons (OPNs) in the brain stem. Proposed switching strategies implemented in existing gaze control models all rely on a sensory error between instantaneous gaze position and the spatial target. Accordingly, gaze saccades are initiated after presentation of an eccentric visual target and subsequently terminated when an internal estimate of gaze position becomes nearly equal to that of the target. Based on behavioral observations, we demonstrate that such a switching mechanism is insufficient and is unable to explain certain types of movements. We propose an improved hypothesis for how the OPNs control gaze shifts based on a visual-vestibular interaction of signals known to be carried on anatomical projections to the OPN area. The approach is justified by the analysis of recorded gaze shifts interrupted by a head brake in animal subjects and is demonstrated by implementing the switching mechanism in an anatomically based gaze control model. Simulated performance reveals that a weighted sum of three signals: gaze motor error, head velocity, and eye velocity, hypothesized as inputs to OPNs, successfully reproduces diverse behaviorally observed eye-head movements that no other existing model can account for. PMID:17108091
Vestibular involvement in spasmodic torticollis.
Vestibular findings in a group of 35 patients with spasmodic torticollis without other otological or neurological symptoms were reviewed. The most consistent abnormality, present in more than 70% of cases, was a directional preponderance of vestibular nystagmus in the dark in a direction opposite to...
The effect of sensory noise created by compliant and sway ...
Corresponding author: William H. Paloski, Ph.D. ... differential effects on postural stability of introducing somatosensory noise via compliant ... sensory noise by deviating the vestibular system from its optimal orientation for balance control. ... example, sensory noise in vestibular inputs can increase with age-related hair cell ...
Involvement of peripheral vestibular nerve in individuals with auditory neuropathy.
The vestibulocochlear nerve is a sensory nerve that serves the organs of hearing and equilibrium. Neuropathies of the nerve, particularly auditory neuropathy may be caused by primary demyelination or by axonal diseases. In disorders affecting the cochlear nerve, it is probable that the vestibular nerve is involved as well. There are isolated reports of the involvement of the inferior vestibular nerve (using vestibular-evoked myogenic potentials) in individuals with AN. However, there is a dearth of information on the involvement of the superior vestibular nerve and other functions such as optokinetic, saccade and vestibulo-occular reflex. A total of three subjects diagnosed as having auditory neuropathy, underwent an extensive vestibular assessment consisting of clinical tests of stability (Romberg, Fukuda stepping test), administration of dizziness questionnaire developed by Maryland hearing and balance centre, cervical vestibular-evoked myogenic potentials and a standard electronystagmography test battery. In the present study, the entire subject population assessed showed hypofunctional caloric responses and absent VEMPs. Two out of the three subjects were asymptomatic of vestibular dysfunction. On the clinical tests of stability, two subjects showed deviations to the right, while one subject performed normally. Thus, the present study indicates a possible involvement of peripheral vestibular nerve involvement in individuals with auditory neuropathy. PMID:23143643
Molecular genetic analysis of the NF2 gene in young patients with unilateral vestibular schwannomas
Neurofibromatosis type 2 (NF2) must be suspected in patients presenting with a unilateral vestibular schwannoma at a young age who are therefore at theoretical risk of developing bilateral disease. We identified 45 patients aged 30 years or less at the onset of symptoms of a unilateral vestibular ...
A striking feature of vestibular hair cells is the polarized arrangement of their stereocilia as the basis for their directional sensitivity. In mammals, each of the vestibular end organs is characterized by a distinct distribution of these polarized cells. We utilized the technique of post-fixation...
Long-term mobile phone use and the risk of vestibular schwannoma: a Danish nationwide cohort study
Vestibular schwannomas grow in the region within the brain where most of the energy by radiofrequency electromagnetic fields from using mobile phones is absorbed. The authors used 2 Danish nationwide cohort studies, one a study of all adult Danes subscribing for a mobile phone in 1995 or earlier and one on sociodemographic factors and cancer risk, and followed subjects included in both cohorts for occurrence of vestibular schwannoma up to 2006 inclusively. In this study including 2.9 million subjects, a long-term mobile phone subscription of =11 years was not related to an increased vestibular schwannoma risk in men (relative risk estimate = 0.87, 95% confidence interval: 0.52, 1.46), and no vestibular schwannoma cases among long-term subscribers occurred in women versus 1.6 expected. Vestibular schwannomas did not occur more often on the right side of the head, although the majority of Danes reported holding their mobile phone to the right ear. Vestibular schwannomas in long-term male subscribers were not oflarger size than expected. Overall, no evidence was found that mobile phone use is related to the risk of vestibular schwannoma. Because of the usually slow growth of vestibular schwannoma and possible diagnostic delay, further surveillance is indicated.
Adaptations of the vestibular system to short and long-term exposures to altered gravity
Long-term space flight creates unique environmental conditions to which the vestibular system must adapt for optimal survival of a given organism. The development and maintenance of vestibular connections are controlled by environmental gravitational stimulation as well as genetically controlled molecular interactions. This paper describes the effects of hypergravity on axonal growth and dendritic morphology, respectively. Two aspects of this vestibular adaptation are examined: (1) How does long-term exposure to hypergravity affect the development of vestibular axons? (2) How does short-term exposure to extremely rapid changes in gravity, such as those that occur during shuttle launch and landing, affect dendrites of the vestibulocerebellar system? To study the effects of longterm exposures to altered gravity, embryonic rats that developed in hypergravity were compared to microgravity-exposed and control rats. Examination of the vestibular projections from epithelia devoted to linear and angular acceleration revealed that the terminal fields segregate differently in rat embryos that gestated in each of the gravitational environments.To study the effects of short-term exposures to altered gravity, mice were exposed briefly to strong vestibular stimuli and the vestibulocerebellum was examined for any resulting morphological changes. My data show that these stimuli cause intense vestibular excitation of cerebellar Purkinje cells, which induce up-regulation of clathrin-mediated endocytosis and other morphological changes that are comparable to those seen in long-term depression. This system provides a basis for studying how the vestibular environment can modify cerebellar function, allowing animals to adapt to new environments.
Vestibular autonomic regulation (including motion sickness and the mechanism of vomiting)
Autonomic manifestations of vestibular dysfunction and motion sickness are well established in the clinical literature. Recent studies of 'vestibular autonomic regulation' have focused predominantly on autonomic responses to stimulation of the vestibular sense organs in the inner ear. These studies have shown that autonomic responses to vestibular stimulation are regionally selective and have defined a 'vestibulosympathetic reflex' in animal experiments. Outside the realm of experimental preparations, however, the importance of vestibular inputs in autonomic regulation is unclear because controls for secondary factors, such as affective/emotional responses and cardiovascular responses elicited by muscle contraction and regional blood pooling, have been inadequate. Anatomic and physiologic evidence of an extensive convergence of vestibular and autonomic information in the brainstem suggests though that there may be an integrated representation of gravitoinertial acceleration from vestibular, somatic, and visceral receptors for somatic and visceral motor control. In the case of vestibular dysfunction or motion sickness, the unpleasant visceral manifestations (e.g. epigastric discomfort, nausea or vomiting) may contribute to conditioned situational avoidance and the development of agoraphobia.
Aim of the study was to investigate, in a randomized prospective trial, air-conducted vestibular evoked myogenic potentials (AC-VEMPs) and bone-conducted vestibular evoked myogenic potentials (BC-VEMPs) before and after successful stapedotomy. Enrolled in the study were 41 consecutive patients (32 f...
Vertigo and dizziness are very common symptoms, nevertheless specific drugs are very few, therefore vestibular rehabilitation is the main therapy for persistent unbalance and dizziness. In this work we present a short history of the vestibular rehabilitation and its principles from Cawthorne-Cooksey...
Expression of nerve growth factor (NGF) receptors in the developing inner ear of chick and rat.
The expression of nerve growth factor receptors (NGFRs) was studied in the developing inner ear with in situ hybridization in chick embryos and with immunocytochemistry in rat embryos to determine sites of possible functions of NGF or NGF-like molecules in inner ear development. NGFR expression in the chick otocyst and acoustic ganglion is compared with epithelial differentiation and the onset of afferent innervation as determined with fluorescent carbocyanine tracers. In the inner ear of the chick embryo, NGFR mRNA expression shows an alternating pattern in mesenchymal and epithelial tissues. NGFR mRNA is heavily expressed in the mesenchyme surrounding the otocyst (E2-3), ceases at E3-5, and reappears in a thin layer of mesenchymal cells surrounding the membraneous epithelia (E5-13). In the otocyst epithelium, NGFR mRNA expression develops in one anterior and one posterior focus at E3-4.5. NGFR mRNA is expressed in the primordia of the ampullary cristae (E5-7) and possibly the anlage of the utricle; label transiently concentrates in the planum semilunatum of the cristae ampullares and in superior portions of the semicircular canals at E9, but is not seen in differentiating hair cells. In the acoustic ganglion, NGFR mRNA expression begins at E4; at the same time, the first peripheral acoustic nerve processes penetrate the otic epithelium (E4-4.5). The acoustic ganglia remain weakly NGFR mRNA-labeled in the posthatch animal. In the rat embryo, NGFR immunoreactivity is present in the auditory placode at E9, in the periotic mesenchyme at E9-10, and in the medial half of the otocyst at E10-11. At E12, epithelial NGFR expression becomes restricted anteriorly and posteriorly in a pattern similar to that of the chick otocyst and ceases at E13. NGFR immunoreactivity appears transiently in pillar cells of the cochlea in the third week of gestation. NGFR and NGFR mRNA is expressed after E11 in the acoustic ganglia. While NGFR transcripts are expressed in the cochlear ganglion cell bodies, NGFR protein becomes restricted to neuronal processes by the third week of gestation. The vestibular, but not the cochlear (spiral) ganglia remain NGFR-labeled in the adult rat. Onset of NGFR mRNA expression in the acoustic ganglion during the period of afferent fiber ingrowth into the otocyst epithelium is consistent with the hypothesis that NGF-like molecules may have a neurotrophic function for acoustic ganglion cells. Transient expression of NGFRs in secretory cells of the vestibular endorgan and pillar cells in the organ of Corti implicate a role for neurotrophins in the differentiation of these epithelial cell types. PMID:1664321
The Development and Validation of the Vestibular Activities and Participation Measure
Alghwiri AA, Whitney SL, Baker CE, Sparto PJ, Marchetti GF, Rogers JC, Furman JM. The development and validation of the Vestibular Activities and Participation measure. Objectives To develop and validate a new self-report outcome measure named the Vestibular Activities and Participation (VAP) for people with vestibular disorders to examine their activities and participation according to the International Classification of Functioning Disability and Health. Design Delphi iterative survey for the development of the VAP and validation study. Setting Tertiary balance clinic. Participants A panel of worldwide experts (n=17) in vestibular dysfunction participated in the development of the VAP, and patients (N=58) with vestibular disorders were enrolled in the validation of the VAP. Intervention ...
Spatial perception and vestibular function
Humans sequentially perceive spatial information surrounding them when performing intended motor movements. Precise spatial information is constructed in the brain by integrating sensory information such as visual, vestibular, and somatosensory inputs. Visual input is considered an essential source of stable spatial perception in our daily lives. In addition, and in parallel with visual function, vestibular and somatosensory systems have important roles in spatial perception, particularly when unconscious. Although the vestibular system is not considered one of the “five senses” of human sensation, this system serves a couple of important functions. One important function is the prompt stabilization of the head and body against outer disturbances. In addition, vestibular signals are utilized in the higher order of the brain for construction of three-dimensional spatial perception. In this review, the functional properties, as well as the neural system, of the vestibular system are introduced in relation to spatial perception.
Vestibular information is essential for the control of posture, balance, and eye movements. The vestibular nerve projects to the four nuclei of the vestibular nuclear complex (VNC), as well as to several additional brainstem nuclei and the cerebellum. We have found that expression of the calcium-binding proteins calretinin (CR) and calbindin (CB), and the synthetic enzyme for nitric oxide synthase (nNOS) define subdivisions of the medial vestibular nucleus (MVe) and the nucleus prepositus (PrH), in cat, monkey, and human. We have asked if the pattern of expression of nonphosphorylated neurofilament protein (NPNFP) might define additional subdivisions of these or other nuclei that participate in vestibular function. We studied the distribution of cells immunoreactive to NPNFP in the brainst...
Abstract Conclusion: In the current study, hair cells of vestibular terminal organs in rats were completely eliminated with trans-scala vestibuli injection of neomycin, and then the Math1 gene was transferred. It was shown that type I vestibular hair cells were regenerated and synapses were formed. Objectives: The objective of this study was to identify the cell type of the regenerated vestibular hair cells and relative innervation and synaptic linkage after hair cells of vestibular terminal organs in rats were completely eliminated. Methods: Neomycin injection was used to eliminate all the vestibular terminal organs, and then the animals were treated with an injection of Ad-Math1-EGFP in the scala vestibuli of the cochlea. Results: Math1 gene transfer into the inner ear induced type I hai...
Anatomical and Physiological Considerations in Vestibular Dysfunction and Compensation.
Sensory information from the vestibular, visual, and somatosensory/proprioceptive systems are integrated in the brain in complex ways to produce a final motor output to muscle groups for maintaining gaze, head and body posture, and controlling static and dynamic balance. The balance system is complex, which can make differential diagnosis of dizziness quite challenging. On the other hand, this complex system is organized anatomically in a variety of pathways and some of these pathways have been well studied. The vestibulo-ocular reflex (VOR) is one such pathway. Understanding the anatomy and physiology of the VOR facilitates our understanding of normal and abnormal eye movements and research is advancing our understanding of the plasticity of the vestibular system. This review highlights anatomical and physiological features of the normal vestibular system, applies these concepts to explain some clinical findings in some common peripheral vestibular disorders, and discusses some of the research investigating the anatomical and physiological basis for vestibular compensation. PMID:21072129
Update: Direct and indirect costs of arthritis and other rheumatic conditions-United States, 1997
Sensory information from the vestibular, visual, and somatosensory/proprioceptive systems are integrated in the brain in complex ways to produce a final motor output to muscle groups for maintaining gaze, head and body posture, and controlling static and dynamic balance. The balance system is complex, which can make differential diagnosis of dizziness quite challenging. On the other hand, this complex system is organized anatomically in a variety of pathways and some of these pathways have been well studied. The vestibulo-ocular reflex (VOR) is one such pathway. Understanding the anatomy and physiology of the VOR facilitates our understanding of normal and abnormal eye movements and research is advancing our understanding of the plasticity of the vestibular system. This review highlights anatomical and physiological features of the normal vestibular system, applies these concepts to explain some clinical findings in some common peripheral vestibular disorders, and discusses some of the research investigating the anatomical and physiological basis for vestibular compensation. PMID:11448282
Vestibular-evoked myogenic potentials in chronic noise-induced hearing loss
ObjectiveTo investigate the effect of chronic noise exposure on vestibular-evoked myogenic potentials.Study DesignProspective study.Subjects and MethodsTwenty patients with chronic noise-induced hearing loss, presenting as bilateral notched audiogram at 4 kHz, underwent audiometry, caloric, and vestibular-evoked myogenic potential tests.ResultsCaloric and vestibular-evoked myogenic potential tests revealed abnormal responses in nine (45%) and 10 (50%) patients, respectively. However, when both results were considered together, the abnormal rate reached 70% (14 of 20). The hearing threshold of 4 kHz significantly associated with vestibular-evoked myogenic potential results (ie, vestibular-evoked myogenic potential was abnormal in patients with greater degrees of hearing loss), but not with ...
Abstract in portuguese TEMA: o envelhecimento populacional é um processo natural, manifesta-se por um declínio das funções de diversos órgãos. A reabilitação vestibular (RV) é um processo terapêutico que visa promover a redução significativa dos sintomas labirínticos. OBJETIVO: verificar os benefícios dos exercícios de RV por meio da avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) - adaptação brasileira. MÉTODO: participaram deste estudo (more) oito idosos com queixa de tontura, na faixa etária de 63 a 82 anos, três do sexo masculino e cinco do sexo feminino. Realizaram-se os seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular por meio da vectoeletronistagmografia (VENG), aplicação do questionário DHI e dos exercícios de RV de Cawthorne (1944) e Cooksey (1946). RESULTADOS: com relação as queixas auditivas e vestibulares, observou-se a incidência do zumbido, da hipoacusia, da vertigem postural e do desequilíbrio; na avaliação da função vestibular, constataram-se alterações em todos os idosos; as alterações foram na sua maioria na prova calórica com predomínio da hiporreflexia uni e bilateral; constataram-se, no exame vestibular, três casos de síndrome vestibular periférica deficitária unilateral, três casos de síndrome vestibular periférica deficitária bilateral, um caso de síndrome vestibular central deficitária bilateral e um caso de síndrome vestibular central irritativa bilateral; houve melhora significativa dos aspectos físico (p = 0,00413), funcional (p = 0,00006) e emocional (p = 0,03268) após a realização dos exercícios de RV. CONCLUSÃO: o protocolo utilizado de RV promoveu melhora na qualidade de vida dos idosos e auxiliou no processo de compensação vestibular. Abstract in english BACKGROND: the aging of the population is a natural process and is manifested by a decline in the functions of several organs. Vestibular rehabilitation (VR) is a therapeutic process that seeks to promote a significant reduction in the symptoms of the labyrinth. AIM: to verify the benefits of VR exercises through the application of the Dizziness Handicap Inventory (DHI) questionnaire - Brazilian version - pre and post rehabilitation. METHOD: participants of this study wer (more) e eight elderly patients with dizziness, ages between 63 and 82 years, three male and five female. The following procedures were carried out: medical history, otologic inspection, vestibular evaluation with vectoelectronystagmography (VENG), application of the DHI questionnaire and of the Cawthorne (1944) and Cooksey (1946) VR exercises. RESULTS: regarding the auditory and vestibular complaints which were referred to in the medical history, the following was observed: presence of tinnitus, hearing loss, postural vertigo and of unbalance. In the evaluation of the vestibular function alterations were observed for all of the participants, mainly in the caloric test, with a prevalence of unilateral and bilateral hypofunction. In the vestibular exam the following was observed: three cases of unilateral peripheral vestibular deficit syndrome, three cases of bilateral peripheral vestibular deficit syndrome, one case of bilateral central vestibular deficit syndrome and one case of irritating bilateral central vestibular syndrome. There was a statistically significant improvement of the following aspects after VR: physical (p=0.00413), functional (p=0.00006) and emotional (p=0.03268). CONCLUSION: the VR protocol favored the improvement of life quality of the participants and was of assistance in the process of vestibular compensation.
The morphology and immunohistochemistry of inducible nitric oxide synthase (iNOS) and nuclear factorkappa B (NF-KB) were studied on the spiral and vestibular ganglion of young and old ddy mice. The significant decrease in the number of the spiral ganglion cells and a significant expression of iNOS and NF-KB were observed in old mice. In contrast, in the vestibular ganglion of all animals examined, decrease in the number of the ganglion cells or expression of iNOS and NF-KB were not observed. Although the relevance of enzymatic systems for the protection of vestibular ganglion cells in old individuals from harmful oxidative stress increased with aging should be further clarified, lack of harmful stress due to nitric oxide (NO) may be one of the plausible reasons for that the vestibular ganglion cells were not decreased in number with aging, since iNOS was not detected in the vestibular ganglion cells in the animals tested in the present study.
Usher syndrome (USH) is the most frequent cause of combined deaf-blindness in man. It is clinically and genetically heterogeneous and at least 12 chromosomal loci are assigned to three clinical USH types, namely USH1A-G, USH2A-C, USH3A (Davenport, S.L.H., Omenn, G.S., 1977. The heterogeneity of Usher syndrome. Vth Int. Conf. Birth Defects, Montreal; Petit, C., 2001. Usher syndrome: from genetics to pathogenesis. Annu. Rev. Genomics Hum. Genet. 2, 271-297). Mutations in USH type 1 genes cause the most severe form of USH. In USH1 patients, congenital deafness is combined with a pre-pubertal onset of retinitis pigmentosa (RP) and severe vestibular dysfunctions. Those with USH2 have moderate to severe congenital hearing loss, non-vestibular dysfunction and a later onset of RP. USH3 is characterized by variable RP and vestibular dysfunction combined with progressive hearing loss. The gene products of eight identified USH genes belong to different protein classes and families. There are five known USH1 molecules: the molecular motor myosin VIIa (USH1B); the two cell-cell adhesion cadherin proteins, cadherin 23 (USH1D) and protocadherin 15, (USH1F) and the scaffold proteins, harmonin (USH1C) and SANS (USH1G). In addition, two USH2 genes and one USH3A gene have been identified. The two USH2 genes code for the transmembrane protein USH2A, also termed USH2A ("usherin") and the G-protein-coupled 7-transmembrane receptor VLGR1b (USH2C), respectively, whereas the USH3A gene encodes clarin-1, a member of the clarin family which exhibits 4-transmembrane domains. Molecular analysis of USH1 protein function revealed that all five USH1 proteins are integrated into a protein network via binding to PDZ domains in the USH1C protein harmonin. Furthermore, this scaffold function of harmonin is supported by the USH1G protein SANS. Recently, we have shown that the USH2 proteins USH2A and VLGR1b as well as the candidate for USH2B, the sodium bicarbonate co-transporter NBC3, are also integrated into this USH protein network. In the inner ear, these interactions are essential for the differentiation of hair cell stereocilia but may also participate in the mechano-electrical signal transduction and the synaptic function of maturated hair cells. In the retina, the co-expression of all USH1 and USH2 proteins at the synapse of photoreceptor cells indicates that they are organized in an USH protein network there. The identification of the USH protein network indicates a common pathophysiological pathway in USH. Dysfunction or absence of any of the molecules in the mutual "interactome" related to the USH disease may lead to disruption of the network causing senso-neuronal degeneration in the inner ear and the retina, the clinical symptoms of USH. PMID:16545802
Abstract in portuguese Ometabolismo da glicose tem muita influência na fisiologia da orelha interna e pequenas variações glicêmicas podem provocar alterações na audição e no equilíbrio corporal. OBJETIVO: Verificar as manifestações vestibulococleares em pacientes com diabetes melito tipo I. FORMA DE ESTUDO: Coorte contemporânea com corte transversal. MATERIAL E MÉTODO: Avaliaram-se 30 pacientes (17 homens e 13 mulheres) encaminhados do Hospital de Clínicas da UFPr para o Laborató (more) rio de Otoneurologia da Universidade Tuiuti do Paraná no período de março/2004 a fevereiro/2005. Realizaram-se os seguintes procedimentos: anamnese, inspeção otológica, avaliação audiológica convencional, medida de imitância acústica e avaliação vestibular. RESULTADOS: Observaram-se entre as queixas otoneurológicas a prevalência de cefaléia (23,3%), tontura rotatória (16,6%) e zumbido (13,3%). Nas queixas associadas e hábitos, a prevalência foi do abuso de cafeína (20,0%), álcool e alergia (10,0%), em cada. Houve prevalência de limiares auditivos normais (90,0%). A medida de imitância acústica mostrou-se sem alteração. O exame vestibular esteve alterado em 60,0%. Houve predomínio das síndromes vestibulares periféricas deficitárias. CONCLUSÕES: Verificou-se um maior número de alteração do sistema vestibular (60,0%) em relação ao sistema auditivo (10,0%). Houve predomínio da normalidade no exame auditivo. Houve prevalência de alteração no sistema vestibular periférico e da síndrome vestibular periférica deficitária. Abstract in english Glucose metabolism has a significant impact on inner ear physiology, and small changes may result in hearing and balance disorders. AIM: To investigate vestibulocochlear symptoms in patients with type I diabetes mellitus. STUDY DESIGN: a cross-sectional study of a contemporary group. MATERIAL AND METHOD: 30 patients referred from Clinical Hospital-UFPR to the Laboratory of Otoneurology-UTP between Mar/2004 to Feb/2005 were evaluated. The following procedures were carried (more) out: a medical history, otological inspections, audiometry, acoustic impedance tests, and vestibular function tests. RESULTS: The prevalence of otoneurologic complaints was: headache (23.3%), vertigo (16.6%), and tinnitus (13.3%). The prevalence of associated complaints and habits was: caffeine abuse (20.0%), allergies (10.0%), and alcohol abuse (10.0%). The prevalence of normal auditory thresholds was 90.0%. Acoustic impedance showed no changes. The vestibular test showed changes in 60.0% of cases. Peripheral vestibular deficiency syndromes were also found. CONCLUSIONS: Significant vestibular system changes were found (60.0%) compared to the auditory system (10.0%). Audiometry revealed mostly normal results. The vestibular test showed changes in the peripheral vestibular system and the peripheral vestibular deficiency syndrome.
The Effect of Spaceflight on the Ultrastructure of the Cerebellum
In weightlessness, astronauts and cosmonauts may experience postural illusions as well as motion sickness symptoms known as the space adaptation syndrome. Upon return to Earth, they have irregularities in posture and balance. The adaptation to microgravity and subsequent re-adaptation to Earth occurs over several days. At the cellular level, a process called neuronal plasticity may mediate this adaptation. The term plasticity refers to the flexibility and modifiability in the architecture and functions of the nervous system. In fact, plastic changes are thought to underlie not just behavioral adaptation, but also the more generalized phenomena of learning and memory. The goal of this experiment was to identify some of the structural alterations that occur in the rat brain during the sensory and motor adaptation to microgravity. One brain region where plasticity has been studied extensively is the cerebellar cortex-a structure thought to be critical for motor control, coordination, the timing of movements, and, most relevant to the present experiment, motor learning. Also, there are direct as well as indirect connections between projections from the gravity-sensing otolith organs and several subregions of the cerebellum. We tested the hypothesis that alterations in the ultrastructural (the structure within the cell) architecture of rat cerebellar cortex occur during the early period of adaptation to microgravity, as the cerebellum adapts to the absence of the usual gravitational inputs. The results show ultrastructural evidence for neuronal plasticity in the central nervous system of adult rats after 24 hours of spaceflight. Qualitative studies conducted on tissue from the cerebellar cortex (specifically, the nodulus of the cerebellum) indicate that ultrastructural signs of plasticity are present in the cerebellar zones that receive input from the gravity-sensing organs in the inner ear (the otoliths). These changes are not observed in this region in cagematched ground control animals. The specific changes include the formation of lamellar bodies, profoundly enlarged Purkinje cell mitochondria, the presence of inter-neuronal cellular protrusions in the molecular layer, and signs of degeneration in the distal dendrites of the Purkinje cells. Since these morphologic signs are not apparent in the control animals, they are not likely to be due to caging or tissue processing effects. The particular nature of the structural alterations in the nodulus, most notably the formation of lamellar bodies and the presence of degeneration, further suggests that excitotoxicity (damaging overstimulation of neurons) may play a role in the short-term neural response to spaceflight. These findings suggest a structural basis for the neuronal and synaptic plasticity accompanying the central nervous system response to altered gravity and help identify the cellular bases underlying the vestibular abnormalities experienced by astronauts during periods of adaptation and re-adaptation to different gravitational forces. Also, since the short- and long-term changes in neural structure occurring during such periods of adaptation resemble the neuronal alterations that occur in some neurologic disorders such as stroke, these findings may offer guidance in the development of strategies for rehabilitation and treatment of such disorders.
The preplate of the cerebral cortex contains projection neurons that connect the cortical primordium with the subpallium. These are collectively named pioneer neurons. After preplate partition, most of these pioneer neurons become subplate neurons. Certain preplate neurons, however, never associate ...
Evidence of unilateral isolated utricular hypofunction
Abstract Conclusions: The findings demonstrate that an enduring unilateral utricular dysfunction, possibly together with canal hypofunction, can occur after labyrinthine disease or injury. They also suggest that unilateral, isolated utricular dysfunction - or utricle paresis - can occur, representing a novel entity in the differential diagnosis of peripheral vestibular function. The occurrence of subjective visual vertical (SVV) asymmetry in the presence of symmetric vestibular evoked myogenic potentials (VEMPs) also confirms that the information from the utricles, rather than the saccules, dominates SVV estimation. Objectives: To determine the incidence of unilateral utricular hypofunction. Methods: The retrospective clinical study deals with a selection of those vestibular patients who s...
Abstract in portuguese OBJETIVO: avaliar o comportamento vestibular em pacientes com disfunção temporomandibular. MÉTODOS: avaliaram-se 27 pacientes do sexo feminino, na faixa etária de 30 a 53 anos, encaminhadas do Centro de Diagnóstico e Tratamento da Articulação Temporomandibular para o Laboratório de Otoneurologia da Universidade Tuiuti do Paraná. Realizaram-se os seguintes procedimentos: anamnese, inspeção otológica e avaliação vestibular por meio da vectoeletronistagmografia (more) . RESULTADOS: as queixas mais freqüentes foram: dificuldade ou dor ao movimento do pescoço (77,7%), dor irradiada para ombro/braço (77,7%), zumbido e formigamento de extremidade superior (77,7%), tontura e dor de cabeça (66,6%), ansiedade (55,5%), sensação de cabeça oca (51,8%), agitação durante o sono (51,8%) e depressão (51,8%). O exame vestibular esteve alterado em 20 pacientes (74,0%) na prova calórica. Houve freqüência de alteração no sistema vestibular periférico. Houve predomínio das síndromes vestibulares periféricas deficitárias. CONCLUSÃO: ressalta-se a importância de se estudar a relação do sistema vestibular com a disfunção temporomandibular uma vez que observamos, na presente pesquisa, um número elevado de alteração no exame labiríntico. Abstract in english PURPOSE: to evaluate the vestibular functioning in patients with temporomandibular joint dysfunction. METHODS: 27 female patients were evaluated, with age varying from 30 to 53-year-old, referred from the Centre of Diagnosis and Treatment of Temporomandibular Joint Dysfunction to the Otoneurological Laboratory of Tuiuti University of Paraná. The following exams were carried out: anamnesis, otoscopy and vestibular evaluations through vectoelectronystagmography. RESULTS: t (more) he most frequent complaints were: difficulty or pain with movement of the neck (77.7%), pain irradiated to the shoulder/arm (77.7%), tinnitus and paresthesia of superior extremities (77.7%) in each one, dizziness and headaches (66,6%), anxiety (55.5%), empty head sensations, agitation during sleep and depression (51.8%) in each one. The vestibular exam showed alterations in 20 patients (74.0%) in the caloric test. There was a prevalence of alterations in the peripheral vestibular system. There was a prevalence of deficient peripheral vestibular syndrome. CONCLUSION: the importance of studying the relationship between the vestibular system and temporomandibular joint dysfunction is emphasized, since a high number of alterations in the labyrinthic exam have been noted in this research.
Vestibular schwannomas show a large variation in growth rate, making prediction and anticipation of tumor growth difficult. More accurate prediction of clinical behavior requires better understanding of tumor biological factors influencing tumor progression. Biological processes like intratumoral hemorrhage, cell proliferation, microvessel density, and inflammation were analyzed in order to determine their role in vestibular schwannoma development. Tumor specimens of 67 patients surgically treated for a histologically proven unilateral vestibular schwannoma were studied. Preoperative magnetic resonance imaging (MRI) scans were used to determine tumor size and to classify tumors as homogeneous, inhomogeneous, and cystic. Immunohistochemical studies evaluated cell proliferation (histone H3 a...
Abstract in portuguese INTRODUÇÃO: A fibromialgia (FM) é uma síndrome musculoesquelética não inflamatória, de caráter crônico, de etiologia desconhecida, caracterizada por dor difusa, aumento da sensibilidade na palpação e por sintomas como fadiga, insônia, ansiedade, depressão, intolerância ao frio e queixas otológicas. OBJETIVO: Avaliar o comportamento vestibular em pacientes portadores de fibromialgia. MÉTODO: Foi realizado um estudo retrospectivo de corte transversal. Avalia (more) ram-se 25 pacientes na faixa etária entre 26 e 65 anos (média de idade - 52,2 anos e desvio padrão - 10,3 anos), submetidos aos seguintes procedimentos: anamnese, avaliação otorrinolaringológica e vestibular por meio da vectoeletronistagmografia. RESULTADOS: a) Os sintomas otoneurológicos mais evidenciados foram: dificuldade ou dor ao movimento do pescoço e dor irradiada para ombro ou braço (92,0%) em cada, tontura (84,0%) e cefaleia (76,0%). Os sintomas clínicos diversos mais relatados foram: depressão (80,0%), ansiedade (76,0%) e insônia (72,0%); b) O exame vestibular esteve alterado em 12 pacientes (48,0%) sendo localizado na prova calórica; c) Houve prevalência de alteração no sistema vestibular periférico e, d) Houve predomínio das disfunções vestibulares periféricas deficitárias. CONCLUSÃO: Este estudo permitiu verificar a importância do exame labiríntico o que ressalta que esse tipo de população deveria ser melhor estudada, uma vez que diversas doenças reumatológicas pelas suas manifestações e áreas de comprometimento podem gerar alterações vestibulares importantes. Abstract in english INTRODUCTION: Fibromyalgia (FM) is a non-inflammatory musculoskeletal chronic syndrome, whose etiology is unknown, characterized by a diffuse pain, increase in palpation sensitivity and such symptoms as tiredness, insomnia, anxiety, depression, cold intolerance and otologic complaints. OBJECTIVE: Evaluate the vestibular behavior in fibromyalgia patients. METHOD: A retrospective transversal study was performed. 25 patients aged between 26 and 65 (average age - 52. 2 and st (more) andard deviation - 10. 3) were evaluated and submitted to the following procedures: anamnesis, otorhinolaryngologic and vestibular evaluation by way of vector electronystamography. RESULTS: a) The most evident otoneurologic symptoms were: difficulty or pain when moving the neck and pain was spread to an arm or shoulder (92. 0%) in each, dizziness (84. 0%) and headache (76. 0%). The different clinical symptoms mostly reported were: depression (80. 0%), anxiety (76. 0%) and insomnia (72. 0%); b) vestibular examination showed an alteration in 12 patients (48. 0%) in the caloric test; c) an alteration in the peripheral vestibular system prevailed, and d) deficient peripheral vestibular disorders were prevalent. CONCLUSION: This study enabled the importance of the labyrinthic test to be verified, thus emphasizing that this kind of people must be studied better, since a range of rheumatologic diseases can cause severe vestibular changes as a result of their manifestations and impairment areas.
Radiation therapy and radiosurgery for vestibular schwannomas: indications, techniques, and results.
This article describes in detail the uses of and distinctions between stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) for vestibular schwannoma (VS). The authors discuss devices and techniques used in SRS and SRT and, additionally, present readers the approach used by surgeons at Mayo Clinic. They discuss indications and results for both approaches in patients with vestibular schwannoma. Treatment of small and large tumors is discussed, along with cystic tumors and NF2-associated VS. Repeating SRS for vestibular schwannoma is also mentioned. PMID:22483821
[Participation of the vestibular apparatus in regulating shivering].
Participation of the vestibular apparatus in the control of bioelectrical activity and function of muscle motor units was studied in experiments on cats with cold shivering. It was shown that the shivering was suppressed by limitation of the vestibulospinal effects whereas stimulation of the vestibular apparatus enhanced it. Suppression of the shivering after delabyrinthation manifested both in the increased frequencies of impulses in the active motor units and in the recruitment of new units, previously "silent". Participation of the vestibular apparatus in cold shivering control and the mechanism by which the animal's posture is formed thereby restricting the heat-release surface are discussed. PMID:6973372
Squirrel Monkeys and Space Motion Sickness
Studies of the vestibular system in squirrel monkeys in consideration of space motion sickness (SMS) or space adaptation syndrome (SAS) were reviewed. First, the phylogenetic position of the squirrel monkey was considered. Then the anatomico-physiological studies of both the peripheral and the central vestibular systems were described, because the vestibular system is crucially important in the genesis of SMS (SAS). In this connection, the ablation studies of labyrinth, semicircular canals, and other SAS-related areas were referred to, and consideration was made for experiments about caloric irrigation of the ear. A hypothetic model was then proposed for the genesis of SAS.
Vestibular-induced vomiting after vestibulocerebellar lesions
Vestibular stimulation, by sinusoidal electrical polarization of the labyrinths of decerebrate cats which can produce vomiting and related activity which resembles motion sickness was examined. The symptoms include panting, salivation, swallowing, and retching as well as vomiting. These symptoms can be produced in cats with lesions of the posterior cerebellar vermis. It is suggested that a transcerebellar pathway from the vestibular apparatus through the nodulus and uvula to the vomiting center is not essential for vestibular induced vomiting and the occurrence of many symptoms of motion.
We have previously shown that sinusoidal galvanic vestibular stimulation, a means of selectively modulating vestibular afferent activity, can cause partial entrainment of sympathetic outflow to muscle and skin in human subjects. However, it influences the firing of afferents from the entire vestibular apparatus, including the semicircular canals. Here, we tested the hypothesis that selective stimulation of one set of otolithic organs?those located in the utricle, which are sensitive to displacement in the horizontal axis?could entrain sympathetic nerve activity. Skin sympathetic nerve activity (SSNA) was recorded via tungsten microelectrodes inserted into cutaneous fascicles of the common peroneal nerve in 10 awake subjects, seated (head vertical, eyes closed) on a motorised platform. Slow...
Previous studies have shown that housing mice with toys and running wheels increases adult hippocampal neurogenesis and enhances performance on the water maze. However, the relative contribution of running versus enrichment to the neurogenic and pro-cognitive effects is not clear. Recently, it was demonstrated that enrichment devoid of running wheels does not significantly enhance adult hippocampal neurogenesis in female C57BL/6J mice. However, novel toys were not rotated into the cages, and dietary enrichment was not included, so it could be argued that the environment was not enriched enough. In addition, only females were studied, and animals were group-housed, making it impossible to record individual running behavior or to determine the time spent running versus exploring the toys. Therefore, we repeated the study in singly housed male C57BL/6J mice and enhanced enrichment by rotating novel tactile, visual, dietary, auditory, and vestibular stimuli into the cages. Mice were housed for 32 days in one of four groups: running-only, enrichment-only, running plus enrichment, and standard cage. The first 10 days bromodeoxyuridine (BrdU) was administered to label dividing cells. The last 5 days mice were tested on the water maze, and then euthanized to measure number of BrdU cells co-labeled with neuronal nuclear marker (NeuN) in the dentate gyrus. Mice in the running-only group ran, on average, equivalent distances as animals in the running plus enrichment group. The combination of enrichment and running did not significantly increase hippocampal neurogenesis any more than running alone did. Animals in the running-only condition were the only group to show enhanced acquisition on water maze relative to standard cage controls. We confirm and extend the conclusion that environmental enrichment alone does not significantly increase hippocampal neurogenesis or bestow spatial learning benefits in male C57BL/6J mice, even when the modalities of enrichment are very broad. PMID:22698691
Neurotransmitter phenotypes of descending systems in the rat lumbar spinal cord.
Descending systems from the brain exert a major influence over sensory and motor processes within the spinal cord. Although it is known that many descending systems have an excitatory effect on spinal neurons, there are still gaps in our knowledge regarding the transmitter phenotypes used by them. In this study we investigated transmitter phenotypes of axons in the corticospinal tract (CST); the rubrospinal tract (RST); the lateral component of the vestibulospinal tract (VST); and the reticulospinal tract (ReST). They were labelled anterogradely by stereotaxic injection of the b subunit of cholera toxin (CTb) into the motor cortex, red nucleus, lateral vestibular nucleus and medial longitudinal fascicle (MLF) to label CST, RST, VST and ReST axons respectively. Neurotransmitter content of labelled axons was investigated in lumbar segments by using immunoflurescence; antibodies against vesicular glutamate transporters (VGLUT1 and VGLUT2) were used to identify glutamatergic terminals and the vesicular GABA transporter (VGAT) was used to identify GABA- and glycinergic terminals. The results show that almost all CST (96%) axons contain VGLUT1 whereas almost all RST (97%) and VST (97%) axons contain VGLUT2. Although the majority of ReST axons contain VGLUT2 (59%), a sizable minority contains VGAT (20%) and most of these terminals can be subdivided into those that are GABAergic or those that are glycinergic because only limited evidence for co-localisation was found for the two transmitters. In addition, there is a population of ReST terminals that apparently does not contain markers for the transmitters tested and is not serotoninergic. We can conclude that the CST, RST and VST are 'pure' excitatory systems whereas the ReST consists of a heterogeneous population of excitatory and inhibitory axons. It is anticipated that this information will enable inputs to spinal networks to be defined with greater confidence. PMID:23018001
Horseradish peroxidase (HRP) was used to identify parts of the presumptive neural pathway for gill cover erection, a behavioral display pattern performed by Siamese fighting fish (Betta splendens) during aggressive interactions. Motor, motor integration and sensory areas were identified in the medulla and mesencephalon. Motor neurons of the dilator operculi muscle, the effector muscle for gill cover erection, are located in the lateral and medial parts of the caudal trigeminal motor nucleus. Iontophoretic injections of HRP into the lateral trigeminal motor nucleus resulted in labeled cell bodies in two motor areas (medial part of the trigeminal motor nucleus, anterior part of the motor nucleus of cranial nerve IX-X), two parts of the reticular formation (medial and inferior reticular areas), and two nuclei of the octavolateralis system (nucleus medialis, magnocellular octaval nucleus). The HRP injections in the medial part of the caudal trigeminal motor nucleus resulted in labeled cells in the lateral part of the nucleus and in the medial reticular nucleus. Discrete injections of HRP into nucleus medialis revealed a strong axonal projection that terminated in the torus semicircularis. The medial reticular area and both of the octavolateralis nuclei received projections from their contralateral counterparts. Connections between motor areas, and between parts of the reticular formation, may coordinate the performance of gill cover erection with other behavioral patterns used during aggressive display. Connections with the octavolateralis system may provide information on the strength of an opponent's tail beats via the lateral-line system, as well as vestibular information about the fish's own orientation during aggressive display. The organization of inputs to the trigeminal motor nucleus in Betta, a perciform fish, was found to differ from that reported in the common carp, a cypriniform fish. These differences may underlie the different behavioral capabilities of the two groups of fish. PMID:2279236
Postural control and adaptation to threats to balance stability
Postural control is the ability to maintain equilibrium and orientation in a gravitational environment. It is dependent on feedback and feedforward mechanisms that generate appropriate corrective movement based on body-sway motion detected primarily by visual, vestibular, and proprioceptive sensory ...
Presbivértigo: ejercicios vestibulares/ Presbivertigo: vestibular exercises
Abstract in spanish El uso de ejercicios en el tratamiento de pacientes con déficit vestibular crónico está incrementándose de forma notable, lo que evidencia que se trata de un procedimiento que resulta beneficioso para este tipo de pacientes. Los buenos resultados que se obtienen sugieren que los ejercicios vestibulares dan lugar a una estabilidad postural y a una disminución de la sensación de desequilibrio. Abstract in english The use of exercises in the treatment of patients with vestibular deficits is increasing in a representative way, what evidences this is a profitable process for this kind of patients. The good results suggest that vestibular exercises permit a postural stability and a decrease in the perception of disequilibrium.
We describe a rarely encountered case of coexisting bilateral multicanal benign paroxysmal positional vertigo (BPPV) and vestibular schwannoma in a 56-year-old woman. The patient had presented with a 10-year history of dizziness and imbalance, and her vestibular findings were perplexing. We decided on a working diagnosis of BPPV and began treatment. After several months of canalith repositioning maneuvers had failed to resolve her symptoms, we obtained magnetic resonance imaging, which revealed the presence of the vestibular schwannoma. This case serves as a reminder of the importance of differentiating between central and peripheral vestibular disorders, as well as central and anterior canal BPPV-induced down-beating nystagmus in order to establish the correct diagnosis and initiate appropriate treatment. PMID:21229492
USSR Space Life Sciences Digest, issue 2
(See also Cardiovascular and Respiratory Systems: P55; Hematology: ...... suspension is the most acceptable ground-based model for simulating .... nystagmus parameters, indicating that vestibular impairment ...... fatigue from changes in the microstructure of cognitive processes and ..... processing of numerical data, etc.
Abstract in portuguese Há controvérsias sobre a interferência da cafeína no teste vestibular. O café é a fonte mais rica em cafeína. Enquanto em alguns serviços os pacientes são orientados a suspender a ingestão de café 24 a 48 horas antes da realização do teste, outros não consideram necessária a suspensão da ingestão dessa bebida. OBJETIVO: Avaliar o efeito da cafeína no resultado do teste vestibular. FORMA DE ESTUDO: clínico com coorte transversal. MATERIAL E MÉTODO: Estu (more) do comparativo, transversal, pareado. O teste vestibular foi realizado em duplicidade, com intervalo máximo de cinco dias entre um e outro exame. No primeiro teste, os pacientes foram orientados a não ingerir café 24 horas antes do exame; no segundo teste, os pacientes foram orientados a beber café como de costume. Todos os participantes tinham indicação clínica de se submeter ao teste vestibular e tinham o hábito de tomar café. RESULTADOS: Participaram do estudo 19 mulheres com idade média de 49,5 anos. O consumo médio de café foi de três xícaras por dia. As queixas de ansiedade e cefaléia foram associadas ao teste realizado com suspensão do café. Não houve diferença estatisticamente significante nos resultados dos exames realizados com e sem ingestão de café. CONCLUSÃO: A ingestão moderada de café não interferiu no resultado do teste vestibular. Considerando ser recomendável que o paciente esteja tranqüilo ao se submeter ao teste vestibular e que a meia-vida da cafeína é de apenas seis horas, sugerimos que a orientação para a suspensão súbita e completa da ingestão moderada de café antes do teste vestibular para os indivíduos habituados à ingestão diária seja reavaliada. Abstract in english Exist controversy about the interference of the caffeine in the vestibular test. Coffee is the richest source of caffeine. While in some services, the patients were orient to suspend the ingestion of caffeine 24 to 48 hours before the vestibular test, other not consider the suspension of this drink necessary. AIM: To evaluate the effect of caffeine in the vestibular test result. STUDY DESIGN: clinical with transversal cohort. MATERIAL AND METHOD: Seccional and matched res (more) earch. The vestibular test was performed twice in the same patient, with five days interval between the exams. In the first test, the patient did not drink coffee 24 hours before the exam; in the second, the patient drunk coffee as usual. All of the participants had clinical indication for vestibular test and were used to drinking coffee. RESULTS: Nineteen women, medium age of 49,5 years, participated. The average coffee consumption was three cups per day. The complaints of anxiety and headache were associated with the submission to the vestibular test without coffee. The exams were not statistically different comparing the results of the tests performed with and without the coffee ingestion. CONCLUSION: The moderate ingestion of coffee was not shown to interfere in the results of the vestibular test. Considering that it is recommended that the patient be calm to be submitted to the vestibular test and that the half-life of the caffeine is only of six hours, we suggest that the orientation of complete and abrupt drinking coffee suspension of moderate dose before the vestibular test for the individuals used to daily drinking coffee be reevaluated.
Objective To determine whether the first negative component (n10) of the ocular vestibular-evoked myogenic potential (oVEMP) to bone-conducted vibration (BCV) is due primarily to activation of the utricular macula. Study Design The n10 was recorded in response to brief BCV at the midline of the forehead at the hairline (Fz). If the n10 is due primarily to utricular activation, then diseases that affect only the superior division of the vestibular nerve in which all utricular afferents course (i.e., superior vestibular neuritis [SVN]) should reduce or eliminate n10 beneath the contralesional eye, whereas the n10 beneath the ipsilesional eye and the sacculo-collic cervical vestibular-evoked myogenic potential (cVEMP) on the ipsilesional side should be preserved. Setting A prospective study a...
The critical role of velocity storage in production of motion sickness
We propose that motion sickness is mediated through the orientation properties of velocity storage in the vestibular system that tend to align eye velocity produced by the angular vestibulo-ocular reflex (aVOR) with gravito-inertial acceleration (GIA). (GIA is the sum of the linear accelerations acting on the head. In the absence of translational accelerations, gravity is the GIA.) We further postulate that motion sickness produced by cross-coupled vestibular stimulation can be characterized by a metric composed of the disparity between the axis of eye rotation and the GIA, the strength of the response to angular motion, and the response duration, as determined by the central vestibular time constant, that is, by the time constant of velocity storage. The nodulus and uvula of the vestibulocerebellum are likely to be the central sites where the disparity is sensed, where the vestibular time constants are habituated, and where links are made to the autonomic system to produce the symptoms and signs.
Manual control of yaw motion with combined visual and vestibular cues
Measurements are made of manual control performance in the closed-loop task of nulling perceived self-rotation velocity about an earth-vertical axis. Self-velocity estimation was modelled as a function of the simultaneous presentation of vestibular and peripheral visual field motion cues. Based on measured low-frequency operator behavior in three visual field environments, a parallel channel linear model is proposed which has separate visual and vestibular pathways summing in a complementary manner. A correction to the frequency responses is provided by a separate measurement of manual control performance in an analogous visual pursuit nulling task. The resulting dual-input describing function for motion perception dependence on combined cue presentation supports the complementary model, in which vestibular cues dominate sensation at frequencies above 0.05 Hz. The describing function model is extended by the proposal of a non-linear cue conflict model, in which cue weighting depends on the level of agreement between visual and vestibular cues.
Vestibular schwannomas (VS) are a common posterior fossa brain tumor, and though benign can cause significant morbidity, particularly loss of hearing, tinnitus, vertigo and facial paralysis. The current treatment options for VS include microsurgical resection, stereotactic radiosurgery or close surv...
Artifacts produced during electrical stimulation of the vestibular nerve in cats
Evidence is presented to indicate that evoked potentials in the recurrent laryngeal, the cervical sympathetic, and the phrenic nerve, commonly reported as being elicited by vestibular nerve stimulation, may be due to stimulation of structures other than the vestibular nerve. Experiments carried out in decerebrated cats indicated that stimulation of the petrous bone and not that of the vestibular nerve is responsible for the genesis of evoked potentials in the recurrent laryngeal and the cervical sympathetic nerves. The phrenic response to electrical stimulation applied through bipolar straight electrodes appears to be the result of stimulation of the facial nerve in the facial canal by current spread along the petrous bone, since stimulation of the suspended facial nerve evoked potentials only in the phrenic nerve and not in the recurrent laryngeal nerve. These findings indicate that autonomic components of motion sickness represent the secondary reactions and not the primary responses to vestibular stimulation.
Spatial and non-spatial performance in mutant mice devoid of otoliths
Vestibular deafferentation induces strong spatial memory impairments in rodents and dorsal hippocampal atrophy in humans, suggesting that vestibular information plays an important role in spatial-memory processes. However, previous studies have not discriminated between the role of the semi-circular canals, gravisensors and cochlear sense organ in such impairments due to complete damage of the vestibular and cochlear organs in their models of lesions. This is the first time that mutant mice (het/het) devoid of otoconia (lack of vestibular gravisensors) have been evaluated in behavioral tests. Results show different levels of achievement in the tests. The rotarod and elevated plus-maze were not executable, the rotarod being a safer test for differentiating the het/het mouse phenotype compar...
Characteristics and clinical applications of ocular vestibular evoked myogenic potentials
Recently, ocular vestibular evoked myogenic potentials (oVEMPs) have been described and added to the neuro-otologic test battery as a new measure for the vestibulo-ocular reflex. oVEMPs represent extraocular muscle activity in response to otolith stimulation e.g. by air-conducted sound or bone-conducted vibration. In response to vestibular stimulation, electromyographic activity of the extraocular muscles can be recorded by means of surface electrodes placed beneath the contralateral eye. oVEMPs are likely to reflect predominantly utricular function, while the widely established cervical vestibular evoked myogenic potentials (cVEMPs) assess saccular function. Thus, measuring oVEMPs and cVEMPs in addition to caloric and head impulse testing provides further evaluation of the vestibular syst...
Response to Vestibular Sensory Events in Autism
The purpose of this study was to examine the response to vestibular sensory events in persons with autism. The data for this study was collected as part of a cross-sectional study that examined sensory processing (using the Sensory Profile) in 103 persons with autism, 3-43 years of age, compared to age- and gender-matched community controls. The Vestibular Processing section of the Sensory Profile was used. The results showed that Vestibular Processing (both high and low threshold processing) on the Sensory Profile was significantly different in persons with autism as compared to community controls, with persons with autism engaging in the behaviors more frequently than the controls. Vestibular processing differences could explain certain problems in autism. It is important to try to understand sensory problems in autism because it can enable us to better understand the needs of persons with autism, and in turn, influence treatment protocols.
Vestibular neuritis (VN) mostly involves the superior portion of the vestibular nerve and labyrinth. This study aimed to describe the clinical features of VN involving the inferior vestibular labyrinth and its afferents only. Of the 703 patients with a diagnosis of VN or labyrinthitis at Seoul National University Bundang Hospital from 2004 to 2010, we retrospectively recruited 9 patients (6 women, age range 15?75) with a diagnosis of isolated inferior VN. Diagnosis of isolated inferior VN was based on torsional downbeating spontaneous nystagmus, abnormal head-impulse test (HIT) for the posterior semicircular canal (PC), and abnormal cervical vestibular-evoked myogenic potentials (VEMP) in the presence of normally functioning horizontal and anterior semicircular canals, as determined by nor...
Vestibular dysfunction in humans is associated with anxiety and cognitive disorders. However, various animal studies of the effects of vestibular loss have yielded conflicting results, from reduced anxiety to increased anxiety, depending on the particular model of vestibular dysfunction and the anxiety test used. In this study we revisited the question of whether rats with surgical bilateral vestibular deafferentation (BVD) exhibit changes in anxiety-related behaviour by testing them in the open field maze (OFM), elevated plus maze (EPM) and elevated T maze (ETM) in the presence of a non-sedating anxiolytic drug, buspirone, or an anxiogenic drug, FG-7142. We also tested the animals in a spatial T maze (STM) in order to evaluate their cognitive function under the same set of conditions. We ...
Stereotactic radiosurgery has become a more frequently used treatment modality for vestibular schwannomas; a few reports of malignant transformation and/or radiation-associated tumors have surfaced. The majority of these reported cases were in patients with underlying neurofibromatosis. The authors ...
Radiochirurgie et radiotherapie stereotaxique des schwannomes vestibulaires
Purpose of the study: In order to investigate the role of radiosurgery and stereotactic radiotherapy in the management of vestibular schwannomas, we have reviewed our own prospective cohort and the main series of the modern literature. Patients and methods: Between July 14th 1992 and June 1st 2011, 2991 vestibular schwannomas were operated on the Stereotactic and Functional Neurosurgery Department of Timone University Hospital. All the patients have been evaluated prospectively, with a follow up longer than 3 years for 2336 patients, excluding patients suffering from type 2 neurofibromatosis (148 patients). In 7% of the patients, the vestibular schwannoma had previously been resected. According to Koos classification, in 17.6% of the patients, vestibular schwannomas were stage I, 51.8% sta...
Audiovestibular dysfunction associated with adoptive cell immunotherapy for melanoma.
Objective To understand the audiologic and vestibular toxicities associated with adoptive cell immunotherapy (ACI) targeting pigment-pathway antigens on melanoma and to investigate the use of intratympanic steroid injections in the treatment of these toxicities. Study Design Prospective nonrandomized study. Setting Tertiary clinical research center. Methods Thirty-two patients with progressive metastatic melanoma who failed conventional therapy underwent ACI with T cells genetically modified to target MART-1 (n = 18) or gp100 (n = 14). All patients received serial audiometric testing. Vestibular testing was performed on patients with vestibular complaints. Patients with significant deficits received intratympanic steroid injections. Results Of 32 patients, 15 had no hearing change, 9 had mild hearing loss, and 8 had moderate hearing loss following treatment. Ten patients received intratympanic steroid injections for mild (n = 2) or moderate (n = 7) hearing loss or for significant imbalance (n = 1). Of those with mild hearing loss (n = 9), all but 1 recovered to pretreatment hearing levels. Four of 8 patients with moderate hearing loss recovered to baseline hearing levels, and 4 had partial recovery. All 7 patients with posttreatment vestibular complaints had demonstrable vestibular dysfunction. Three of these patients demonstrated recovery to normal vestibular function. The number of modified T cells infused for therapy correlated with the degree of audiovestibular deficit. Conclusion Adoptive cell immunotherapy targeting pigment-pathway cell proteins, a novel therapy for melanoma, can induce hearing loss and vestibular dysfunction. The presumed mechanism of autoimmune attack on normal melanocytes in the cochlear stria vascularis and in the vestibular organs demonstrates the importance of melanocytes in normal inner ear function. PMID:22597578
Abstract in portuguese OBJETIVO: Avaliar a eficácia dos exercícios de reabilitação vestibular (RV) por meio de avaliação pré e pós-aplicação da versão brasileira do questionário Dizziness Handicap Inventory (DHI). MÉTODO: Estudou-se 12 pacientes e realizaram-se os seguintes procedimentos: anamnese, avaliação otorrinolaringológica, vestibular e aplicação do DHI pré e pós RV. RESULTADOS: Do ponto de vista clínico, o tremor de repouso e a instabilidade postural subjetiva foram (more) às queixas motoras mais freqüentes associadas às queixas de vertigem em 12 casos (100%); no exame vestibular, todos os pacientes apresentaram anormalidades, com freqüência das síndromes vestibulares periféricas deficitárias uni e bilaterais em 10 casos (83,3%); houve melhora significativa dos aspectos físico, funcional e emocional do DHI após a realização da RV. CONCLUSÃO: A RV seguindo o protocolo de Cawthorne e Cooksey mostrou-se útil no manejo de queixas subjetivas de diversos aspectos avaliados neste protocolo. Abstract in english OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjecti (more) ve postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. CONCLUSION: The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.
To visualize endolymph as bright signal after intravenous injection of single-dose gadodiamide, we shortened the inversion time of heavily T2-weighted 3-dimensional (3D) fluid-attenuated inversion recovery (FLAIR) to 2050 ms. In 14 patients with suspected Ménière's disease, we observed high signal of vestibular endolymph in all ears, including 6 ears without vestibular endolymphatic hydrops. We observed high signal of cochlear endolymph in 17 ears with cochlear endolymphatic hydrops but not 11 ears without cochlear endolymphatic hydrops.
Abstract in portuguese Os potenciais evocados miogênicos vestibulares são reflexos vestíbulo-cervicais, decorrentes da estimulação do sáculo com sons de forte intensidade. São necessários parâmetros de normalidade para indivíduos jovens normais, utilizando-se estímulos a baixas frequências, as quais configuram a região de maior sensibilidade desse órgão sensorial. OBJETIVO: Realizar normatização do potencial evocado miogênico vestibular para baixas frequências de estimulaçã (more) o. MATERIAL E MÉTODO: Captou-se o potencial evocado miogênico vestibular em 160 orelhas, no músculo esternocleidomastoideo, de forma ipsilateral, por meio da promediação de 200 tone bursts, frequência de 250 Hz, intensidade de 95 dB NAn. FORMA DE ESTUDO: Estudo de coorte contemporânea com corte transversal. RESULTADOS: Aplicando-se o teste T de Student ou o Teste de Mann-Whitney, não foi constatada diferença significativa para parâmetros do potencial evocado miogênico vestibular entre os gêneros, para p Abstract in english Vestibular evoked myogenic potentials are vestibulocervical reflexes resulting from sacculus stimulation with strong intensity sounds. Normality parameters are necessary for young normal individuals, using low frequency stimuli, which configure the most sensitive region of this sensory organ. AIM: To establish vestibular evoked myogenic potential standards for low frequency stimulation. MATERIAL AND METHOD: Vestibular evoked myogenic potential was captured from 160 ears, (more) in the ipsilateral sternocleidomastoid muscle, using 200 averaged tone-burst stimuli, at 250 Hz, with an intensity of 95 dB NAn. CASE STUDY: Clinical observational cross-sectional. RESULTS: Neither the student's t-test nor the Mann-Whitney test showed a significant difference in latency or vestibular evoked myogenic potential amplitudes, for p
Balancing bistable perception during self-motion.
In two experiments we investigated whether bistable visual perception is influenced by passive own body displacements due to vestibular stimulation. For this we passively rotated our participants around the vertical (yaw) axis while observing different rotating bistable stimuli (bodily or non-bodily) with different ambiguous motion directions. Based on previous work on multimodal effects on bistable perception, we hypothesized that vestibular stimulation should alter bistable perception and that the effects should differ for bodily versus non-bodily stimuli. In the first experiment, it was found that the rotation bias (i.e., the difference between the percentage of time that a CW or CCW rotation was perceived) was selectively modulated by vestibular stimulation: the perceived duration of the bodily stimuli was longer for the rotation direction congruent with the subject's own body rotation, whereas the opposite was true for the non-bodily stimulus (Necker cube). The results found in the second experiment extend the findings from the first experiment and show that these vestibular effects on bistable perception only occur when the axis of rotation of the bodily stimulus matches the axis of passive own body rotation. These findings indicate that the effect of vestibular stimulation on the rotation bias depends on the stimulus that is presented and the rotation axis of the stimulus. Although most studies on vestibular processing have traditionally focused on multisensory signal integration for posture, balance, and heading direction, the present data show that vestibular self-motion influences the perception of bistable bodily stimuli revealing the importance of vestibular mechanisms for visual consciousness. PMID:22923207
Spontaneous Regression of a Growing Vestibular Schwannoma
A 75-year-old woman presented with a small right vestibular schwannoma which enlarged and then spontaneously regressed during conservative management. The tumor increased in size from 5.2 to 16.7 mm over 7 years with worsening symptoms of tinnitus, dizziness, and headache. The tumor then regressed to 8.2 mm and the symptoms improved for 4 years without further treatment. Changes in tumor growth should be carefully monitored during conservative management of patients with vestibular schwannoma.
Vestibulometry and it`s importance in clinical diving medicine
Assessment by vestibulometry of the function of the vestibular system is becoming increasingly available. Normal function of this system is particularly important in divers as even minor disorders can cause symptoms which may be life threatening during diving. The ability to detect and measure disorders of the vestibular system in divers will enable clinicians to restrict them from diving during the period when vestibular dysfunction is present. These effects may vary from simple disorientation to vomiting or loss of consciousness. Vestibular disorders may be detectable clinically or by deduction from the nature of an incident, and due to decompression sickness or other direct pressure effects. Alternatively they may be less definite in origin and detected only by vestibulametry following incidents which do not directly implicate the vestibular system. The first part of this paper describes the background to vestibulometry by electronystagmography, the techniques of testing and the interpretation of results. In the second part of this paper we have surveyed the results from 18 divers in whom we have found vestibular abnormalities. (author)
Vestibular telemedicine and rehabilitation. Applications for virtual reality.
This paper will discuss the use of Virtual Reality (VR) technologies in the rehabilitation of patients with vestibular disorders and in the provision of remote medical consultations for those patients. Patients with a vestibular problem are very common (vertigo is the second most common neurological complaint after headache) and yet there are very few vestibular neurotologists: specialists in their diagnosis and treatment. New treatments for various disorders causing vertigo now exist. This means that appropriate diagnosis can significantly improve patients' well-being. Remote medical diagnosis and treatment facilities could make the few vestibular disorder specialists much more available to patients. An analysis of the technological and economic factors influencing the provision of this service is necessary. The main long term effect of many vestibular disorders is damage to the sensing apparatus of the inner ear. The damage can lead to inappropriate interaction between visually driven orientation sensing and sensing of orientation by the inner ear. The consequence for the patient is vertigo (a sensation of turning), motion sickness and imbalance. Current rehabilitation efforts are intended to drive the nervous system to adapt to the disordered vestibular input. Adaptation appears to occur slowly in many subjects, even those within rehabilitation programs. An appropriately designed VR experience could greatly increase the rate of adaptation in these patients. PMID:10163763
Toxicity of aminoglycoside antibiotics.
In cats, aminoclycosides cause vestibular damage followed in a few days by renal damage. The reverse is true in the dog, except that streptomycin causes vestibular damage prior to renal damage. To avoid toxicities, therapeutic doses of aminoglycosides should not be given longer than a week and they should be given cautiously in animals with renal impairment. Failure of the kidneys to eliminate aminoglycosides will result in very high blood levels, even with therapeutic doses, that can cause further renal and vestibular damage. The oral administration of aminoglycosides is seldom dangerous when normal therapeutic doses are employed. Although it is remote, the possibility exists that animals with renal impairment and intestinal obstruction may become intoxicated. Kanamycin is less nephrotoxic to dogs than neomycin and it is less destructive to the auditory nerve than vestibular damage than streptomycin. Gentamicin in cats is twice as toxic to the vestibular apparatus as streptomycin and more toxic to the cochlea than streptomycin or dihydrostreptomycin. Neomycin is more toxic than kanamycin, gentamicin, and streptomycin to both cats and dogs. Amikacin causes renal damage in dogs similar to other aminoglycosides. It also causes vestibular damage. PMID:329097
Abstract in portuguese Verificar se os potenciais evocados miogênicos vestibulares podem apresentar anormalidades na orelha comprometida e na orelha assintomática em pacientes com hipótese diagnóstica de doença de Ménière definida unilateral. FORMA DE ESTUDO: Transversal coorte. MATERIAL E MÉTODO: Foram avaliados os potenciais evocados miogênicos vestibulares de 20 pacientes com doença de Ménière definida unilateral. A seleção dos indivíduos baseou-se na história e na avaliaçã (more) o clínica sugestivas de doença de Ménière definida unilateral, e eletrococleografia com anormalidades na orelha comprometida. Os potenciais evocados miogênicos vestibulares foram avaliados em ambas as orelhas de cada paciente por meio da latência absoluta de p13 e n23, diferença interaural da latência dos picos p13 e n23 e índice de assimetria da amplitude de p13-n23. RESULTADO: Os potenciais evocados miogênicos vestibulares estavam alterados em 35,0% das orelhas comprometidas e em 25,0% das orelhas assintomáticas. As alterações foram: ausência de resposta em sete casos, aumento da latência absoluta de p13 em três casos, e aumento do índice de assimetria da amplitude em um caso. CONCLUSÃO: Os potenciais evocados miogênicos vestibulares podem apresentar anormalidades nas orelhas comprometida e assintomática de pacientes com hipótese diagnóstica de doença de Ménière definida unilateral. Abstract in english AIM: To verify whether vestibular evoked myogenic potentials can present abnormalities in the affected ear and in the asymptomatic ear in patients with diagnosis of unilateral Ménière's disease. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: The vestibular evoked myogenic potentials of 20 patients with unilateral Ménière's disease were analyzed. The selection of individuals was based on the history and in clinical evaluation suggestive of unilaterally defined (more) Ménière's disease, and with electrocochleography abnormalities in the affected ear. Vestibular evoked myogenic potentials were evaluated in both ears of each patient through absolute latencies of p13 and n23, interaural difference of latency of peaks p13 and n23 and amplitude p13-n23 asymmetry rate. RESULTS: Vestibular evoked myogenic potentials were altered in 35.0% of the affected ears and in 25.0% of the asymptomatic ears. The alterations were: absence of responses in seven cases, prolongation of p13 latency in three cases, and increase in interaural amplitude difference ratio in one case. CONCLUSION: The vestibular evoked myogenic potentials can present abnormalities in the affected and asymptomatic ears in patients with diagnosis of unilaterally defined Ménière's disease.
Abstract in portuguese Fatores cognitivos e emocionais podem afetar o equilíbrio, portanto, condições psiquiátricas são comuns em pacientes otoneurológicos. O tratamento dado ao sujeito vertiginoso pode ser mais influenciado pelo sofrimento e comportamento da doença do que pela gravidade da patologia orgânica. OBJETIVO: Este estudo teve como objetivo verificar a associação entre os resultados do exame vestibular e queixa psicológica autorrelatada, em indivíduos atendidos no ano de 2 (more) 009, no serviço de audiologia de um hospital em Porto Alegre. MATERIAL E MÉTODO: Foi realizado um estudo retrospectivo, descritivo-exploratório, consultando-se a base de dados dos softwares VecWin® e VecWin® 2 da marca Neurograff®. Foram investigados os resultados do exame vestibular, as queixas referentes aos sintomas psicológicos relatados espontaneamente e idade, sexo e queixa de vertigem e/ou tontura. O trabalho foi realizado em três etapas: agrupamento, exclusão/inclusão e quantificação. CONCLUSÃO: A faixa etária da amostra, o sexo e a presença ou ausência de vertigem e/ou tontura não foram variáveis de influência sobre o resultado do exame vestibular. Houve associação significativa entre a presença de queixa psicológica autorrelatada e o resultado normal do exame vestibular. Assim, é fundamental que os profissionais deem atenção às questões psicológicas relatadas pelo indivíduo na ocasião da anamnese vestibular. Abstract in english Cognitive and emotional factors may affect balance; psychiatric conditions are a common component in patient dizziness. The treatment of patients with vertigo may be affected to a greater degree by the suffering due to this disease than by the severity of organic changes. OBJECTIVE: This study aimed to investigate associations between vestibular test results and self-reported psychological complaints in patients evaluated during 2009 in an audiology unit at a hospital in (more) Porto Alegre. METHODS: We conducted a retrospective, descriptive-exploratory study of data taken from a database of the software VecWin® and VecWin® 2, developed by Neurograff®. We investigated vestibular test results, reports of psychological symptoms reported spontaneously, and information such as age, sex and the presence of vertigo and/or dizziness. This study consisted of three steps: clustering, exclusion/inclusion and quantification. CONCLUSION: Age and gender and the presence or absence of vertigo and/or dizziness were not variables that influenced the outcomes of vestibular testing. There was a significant association between the presence of self-reported psychological complaints and normal vestibular test results. Thus, it is crucial that professionals pay attention to psychological issues reported by patients when the vestibular history is taken.
Two mouse models, the Coch(G88E/G88E) or "knock-in" and the Coch(-/-) or "knock-out" (Coch null), have been developed to study the human late-onset, progressive, sensorineural hearing loss and vestibular dysfunction known as DFNA9. This disorder results from missense and in-frame deletion mutations in COCH (coagulation factor C homology), encoding cochlin, the most abundantly detected protein in the inner ear. We have performed hearing and vestibular analyses by auditory brainstem response (ABR) and vestibular evoked potential (VsEP) testing of the Coch(-/-) and Coch(G88E/G88E) mouse models. Both Coch(-/-) and Coch(G88E/G88E) mice show substantially elevated ABRs at 21 months of age, but only at the highest frequency tested for the former and all frequencies for the latter. At 21 months, 9 of 11 Coch(-/-) mice and 4 of 8 Coch(G88E/G88E) mice have absent ABRs. Interestingly Coch(-/+) mice do not show hearing deficits, in contrast to Coch(G88E/+), which demonstrate elevated ABR thresholds similar to homozyotes. These results corroborate the DFNA9 autosomal dominant mode of inheritance, in addition to the observation that haploinsufficiency of Coch does not result in impaired hearing. Vestibular evoked potential (VsEP) thresholds were analyzed using a two factor ANOVA (Age X Genotype). Elevated VsEP thresholds are detected in Coch(-/-) mice at 13 and 21 months, the two ages tested, and as early as seven months in the Coch(G88E/G88E) mice. These results indicate that in both mouse models, vestibular function is compromised before cochlear function. Analysis and comparison of hearing and vestibular function in these two DFNA9 mouse models, where deficits occur at such an advanced age, provide insight into the pathology of DFNA9 and age-related hearing loss and vestibular dysfunction as well as an opportunity to investigate potential interventional therapies. PMID:21073934
Two mouse models, the CochG88E/G88E or “knock-in” and the Coch?/? or “knock-out” (Coch null), have been developed to study the human late-onset, progressive, sensorineural hearing loss and vestibular dysfunction known as DFNA9. This disorder results from missense and in-frame deletion mutations in COCH (coagulation factor C homology), encoding cochlin, the most abundantly detected protein in the inner ear. We have performed hearing and vestibular analyses by auditory brainstem response (ABR) and vestibular-evoked potential (VsEP) testing of the Coch?/? and CochG88E/G88E mouse models. Both Coch?/? and CochG88E/G88E mice show substantially elevated ABRs at 21 months of age, but only at the highest frequency tested for the former and all frequencies for the latter. At 21 months, 9 of 11 Coch?/? mice and 4 of 8 CochG88E/G88E mice have absent ABRs. Interestingly Coch?/+ mice do not show hearing deficits, in contrast to CochG88E/+, which demonstrate elevated ABR thresholds similar to homozyotes. These results corroborate the DFNA9 autosomal dominant mode of inheritance, in addition to the observation that haploinsufficiency of Coch does not result in impaired hearing. Vestibular evoked potential (VsEP) thresholds were analyzed using a two factor ANOVA (Age X Genotype). Elevated VsEP thresholds are detected in Coch?/? mice at 13 and 21 months, the two ages tested, and as early as seven months in the CochG88E/G88E mice. These results indicate that in both mouse models, vestibular function is compromised before cochlear function. Analysis and comparison of hearing and vestibular function in these two DFNA9 mouse models, where deficits occur at such an advanced age, provide insight into the pathology of DFNA9 and age-related hearing loss and vestibular dysfunction as well as an opportunity to investigate potential interventional therapies.
The vestibular function and tracking eye movements were investigated in 12 Russian crew members of ISS missions on days 1(2), 4(5-6), and 8(9-10) after prolonged exposure to microgravity (126 to 195 days). The spontaneous oculomotor activity, static torsional otolith-cervico-ocular reflex, dynamic vestibulo-cervico-ocular responses, vestibular reactivity, tracking eye movements, and gaze-holding were studied using videooculography (VOG) and electrooculography (EOG) for parallel eye movement recording. On post-flight days 1-2 (R+1-2) some cosmonauts demonstrated: - an increased spontaneous oculomotor activity (floating eye movements, spontaneous nystagmus of the typical and atypical form, square wave jerks, gaze nystagmus) with the head held in the vertical position; - suppressed otolith function (absent or reduced by one half amplitude of torsional compensatory eye counter-rolling) with the head inclined statically right- or leftward by 300; - increased vestibular reactivity (lowered threshold and increased intensity of the vestibular nystagmus) during head turns around the longitudinal body axis at 0.125 Hz; - a significant change in the accuracy, velocity, and temporal characteristics of the eye tracking. The pattern, depth, dynamics, and velocity of the vestibular function and tracking eye movements recovery varied with individual participants in the investigation. However, there were also regular responses during readaptation to the normal gravity: - suppression of the otolith function was typically accompanied by an exaggerated vestibular reactivity; - the structure of visual tracking (the accuracy of fixational eye rotations, smooth tracking, and gaze-holding) was disturbed (the appearance of correcting saccades, the transition of smooth tracking to saccadic tracking) only in those cosmonauts who, in parallel to an increased reactivity of the vestibular input, also had central changes in the oculomotor system (spontaneous nystagmus, gaze nystagmus).
Abstract in portuguese As pregas vestibulares participam da emissão vocal com mudanças evidentes de posição e forma durante este processo, porém pouco ou quase nada se conhece sobre o significado desta participação e como se iniciam estes movimentos ativos que mudam sua forma e contorno. Entendemos que o conhecimento da participação das pregas vestibulares na fisiologia laríngea possa ter importante aplicação prática, pois permitirá avaliar melhor o comprometimento funcional em co (more) ndições patológicas, o que auxiliará na definição de estratégias para o adequado tratamento. OBJETIVO: Estudar a configuração da prega vestibular durante a fonação (emissão sustentada do /µ/) comparando exames de indivíduos sem queixa vocal (grupo eufonia) com portadores de queixa de voz (grupo disfonia). FORMA DE ESTUDO: Coorte transversal simples. MATERIAL E MÉTODO: Foram analisados 120 registros de imagens de laringes, sendo 60 de indivíduos eufônicos e 60 de disfônicos, constituído cada grupo de igual número de indivíduos em relação ao gênero. Foi identificada a posição da borda livre de prega vestibular em relação a uma reta que une as inserções anterior e posterior da mesma. Na dependência desta posição, foram descritos três tipos de configurações: côncava, quando estava em posição lateral, convexa quando em posição medial e linear quando paralela ou se sobrepunha. RESULTADOS: Das 240 pregas vestibulares, 158 eram côncavas, 41 convexas e 31 lineares. A forma côncava predominou nos dois grupos em relação às outras, porém as formas convexa e linear aumentaram no grupo disfonia. No feminino, a forma linear teve aumento significante no grupo disfonia, enquanto no masculino o aumento significante ocorreu na forma convexa. CONCLUSÃO: Existe diferença no comportamento da prega vestibular no grupo disfonia em relação à eufonia, sendo que esta diferença ocorre de forma diversa em relação aos gêneros. Abstract in english The real participation of the vestibular folds during phonation mechanism is unknown. How vestibular folds change their configuration during phonation is still unclear. Learning about these changes in the functional mechanism of vestibular fold would be helpful for the evaluation of pathological conditions. AIM: The objective of the present study was to analyze the configuration of laryngeal vestibular folds during phonation (sustained emission of vowel /µ/) by comparing (more) exams of individuals without vocal complaints (the normal voice group) with those with vocal complaints. STUDY DESIGN: Transversal simple study. MATERIAL AND METHOD: 120 images of larynges were analyzed, 60 of normal voice individuals and 60 of dysphonic subjects, with equal gender distribution. The position of the free margin of the vestibular fold was identified in relation to a straight line that brought together the anterior and posterior insertions. Regarding this position, three types of configurations were described: concave, when it was in a lateral position, convex when it was in a medial position, and linear when it overlapped. RESULTS: Out of the 240 vestibular folds, 158 were concave, 41 convex and 31 linear. The concave form was predominant in both groups in relation to the other two forms, although the number of convex and linear forms increased in the dysphonic group. Analyzing the behavior of these forms in each gender we noticed that among women, the linear form was significantly increased in the dysphonic group, whereas among men there was significant increase in convex form. CONCLUSION: We concluded that there were differences in behavior of vestibular folds in the dysphonic group in relation to the normal voice group, and that the differences occurred differently in both gender groups.
Abstract in portuguese O potencial miogênico evocado vestibular (VEMP) é um teste clínico que avalia a função vestibular através de um reflexo vestíbulo-cervical inibitório captado nos músculos do corpo em resposta à estimulação acústica de alta intensidade. OBJETIVO: Verificar e analisar os diversos métodos de registro dos potenciais miogênicos evocados vestibulares no homem e em cobaias. MATERIAL E MÉTODO: Realizou-se busca eletrônica nas bases de dados MEDLINE, LILACS, SCIEL (more) O e COCHRANE. RESULTADOS: Foram verificadas divergências quanto às formas de registro dos potenciais miogênicos evocados vestibulares, relacionadas com os seguintes fatores: posição do paciente no momento do registro, tipo de estímulo sonoro utilizado (clicks ou tone bursts), parâmetros para a promediação dos estímulos (intensidade, freqüência, tempo de apresentação, filtros, ganho de amplificação das respostas e janelas para captação dos estímulos), tipo de fone utilizado e forma de apresentação dos estímulos (monoaural ou binaural, ipsi ou contralateral). CONCLUSÃO: Não existe consenso na literatura quanto ao melhor método de registro dos potenciais evocados miogênicos vestibulares, havendo necessidade de pesquisas mais específicas para comparação entre estes registros e a definição de um modelo padrão para a utilização na prática clínica. Abstract in english The vestibular evoked myogenic potential (VEMP) is a clinical test that assess the vestibular function by means of an inhibitory vestibulo-neck reflex, recorded in body muscles in response to high intensity acoustic stimuli. AIM: To check and analyze the different methods used to record VEMPs in humans and in guinea pigs. MATERIALS AND METHODS: We researched the following databases: MEDLINE, LILACS, SCIELO and COCHRANE. RESULTS: we noticed discrepancies in relation to the (more) ways used to record the vestibular evoked myogenic potentials in relation to the following factors: patient position at the time of recording, type of sound stimulus used (clicks or tone bursts), parameters for stimuli mediation (intensity, frequency, duration of presentation, filters, response amplification gain and windows for stimulus recording), type of phone used and way of stimulus presentation (mono or binaural, ipsi or contralateral). CONCLUSION: There is no consensus in the literature as to the best recording method for vestibular evoked myogenic potentials. We need more specific studies in order to compare these recordings and establish a standard model to use it in the clinical practice.
Abstract in portuguese OBJETIVO: Descrever os principais sintomas e sinais ao exame vestibular computadorizado em pacientes com diagnóstico de esclerose múltipla. MÉTODO:Foram examinados 30 pacientes com diagnóstico de esclerose múltipla. Analisaram-se os dados relativos à sintomatologia e achados ao exame vestibular computadorizado realizado no ambulatório de otoneurologia da Irmandade Santa Casa de Misericórdia de São Paulo, em 2003. RESULTADOS: Em relação aos sintomas relatados, o (more) bservamos desequilíbrio (60%), formigamento de extremidades (43,3%), vertigem (40%), cefaléia e ansiedade (36,7%), zumbido (30%), depressão (26,7%). Ao exame vestibular encontramos alterações do nistagmo de posicionamento (6,7%), nistagmo espontâneo de olhos fechados (30%), nistagmo semi-espontâneo (13,3%), rastreio pendular (3,3%) e prova calórica (63,3%). Na conclusão do exame tivemos prevalência de síndrome vestibular periférica irritativa (60%) e síndrome central (13,4%). CONCLUÇÃO: Concluimos que a realização do exame otoneurológico torna-se imprescindível nos pacientes com esclerose múltipla devido a elevada prevalência de alterações à vectonistagmografia computadorizada e elevada prevalência de sintomas otoneurológicos. Abstract in english OBJETIVE: To identify main symptoms and signs on computerized vestibular testing in patients diagnosed with multiple sclerosis. METHOD: Thirty patients with the diagnosis of multiple sclerosis were studied. We analyzed data related to presented symptoms and the findings from a computerized vestibular testing realized in the otoneurological ambulatory in Santa Casa de Misericórdia de São Paulo in 2003. RESULTS: Reported symptoms consisted mainly of disequilibrium (60%), (more) tingling of limbs (43.3%), vertigo (40%), headache and anxiety (36.7%), tinnitus (30%), depression (26.7%). In vestibular testing we found alterations in positional nystagmus (6.7%), spontaneous nystagmus with the eyes shut (30%), directional nystagmus (13.3%) and caloric testing (63.3%). In the final conclusion of the exam, the diagnosis of irritative type peripheral vestibular syndrome (60%) and central syndrome (13.4%) prevailed. CONCLUSION: We conclude that the realization of an otoneurological exam has become indispensable in patients with multiple sclerosis. This is due to high prevalence of alterations at computerized vestibular exam and of otoneurological symptoms.
Abstract in portuguese INTRODUÇÃO: Afasia é uma alteração neurológica decorrente de uma lesão em áreas cerebrais que são responsáveis pela linguagem. Frequentemente, a afasia ocorre como resultado de um acidente vascular cerebral, comprometendo a linguagem de expressão (afasia de Broca), a linguagem de entendimento (afasia de Wernicke) ou ambas (afasia mista). A avaliação otoneurológica corresponde a um grupo de procedimentos para avaliação sequencial do sistema auditivo e vesti (more) bular a de suas relações com o sistema nervoso central. O sistema auditivo e vestibular são de grande importância no controle dos mecanismos auditivos centrais, no processamento auditivo central, no controle do senso de movimento e no equilíbrio. OBJETIVO: Nosso objetivo foi apresentar a sequência da avaliação neurológica das vias auditivas (periféricas e centrais) e do sistema vestibular em um paciente com afasia de Broca. MÉTODOS: O paciente foi submetido a avaliação otorrinolaringológica, avaliação auditiva (audiometria tonal limiar convencional), testes de imitância acústica, pesquisa do reflexo acústico, avaliação do processamento auditivo central e do sistema vestibular. CONCLUSÃO: Nossos dados demonstram a importância da avaliação neurofisiológica das vias auditivas e do sistema vestibular em pacientes com afasia de Broca, para aprimorar o diagnóstico, tratamento e o acompanhamento evolutivo. Abstract in english INTRODUCTION: Aphasia is a neurological disorder that results from damage to areas of the brain that are responsible for language. Often, the aphasia occurs as the result of a stroke, that leads to language expression impairment (Broca's aphasia), language comprehension impairment (Wernicke's aphasia) or the association of both (mixed aphasia). The otoneurologic evaluation is a group of semiologic standardized procedures that evaluates the relationship between the auditor (more) y and vestibular system and the central nervous system. The auditory pathways and the vestibular system are very important for the control of the central auditory mechanisms, the central auditory processing and the sense of movement and balance controls. OBJECTIVE: Our aim was to present the neurophysiologic evaluation of the auditory pathways (peripheral and central) and the vestibular system in patients with Broca's aphasia. METHODS: The patient was submitted to otorrinolaringologic evaluation, audiologic evaluation (tonal audiometria conventional), acoustics immittance measurements, research of the acoustic reflex and central auditory processing as well as vestibular system evaluation. CONCLUSIONS: Our data demonstrate the importance of the auditory pathways and the vestibular system neurophysiologic evaluation in patients with Broca's aphasia in order to improve the diagnosis, treatment and the follow-up.
Changes in monkey horizontal semicircular canal afferent responses after spaceflight.
Extracellular responses from single horizontal semicircular canal afferents in two rhesus monkeys were studied after recovery from a 14-day biosatellite (COSMOS 2044) orbital spaceflight. On the 1st postflight day, the mean gain for 9 different horizontal canal afferents, tested using one or several different passive yaw rotation waveforms, was nearly twice that for 20 horizontal canal afferents similarly tested during preflight and postflight control studies. Adaptation of the afferent response to passive yaw rotation on the 1st postflight day was also greater. These results suggest that at least one component of the vestibular end organ (the semicircular canals) is transiently modified after exposure to 14 days of microgravity. It is unclear whether the changes are secondary to other effects of microgravity, such as calcium loss, or an adaptive response. If the response is adaptive, then this report is the first evidence that the response of the vestibular end organ may be modified (presumably by the central nervous system via efferent connections) after prolonged unusual vestibular stimulation. If this is the case, the sites of plasticity of vestibular responses may not be exclusively within central nervous system vestibular structures, as previously believed. PMID:1326513
Inner ear dysfunction in myotonic dystrophy type 1.
OBJECTIVES: Myotonic dystrophy type 1 is associated with various oculomotor, vestibular, and auditory abnormalities. However, auditory system investigation has been mainly performed with the subjective method of pure-tone audiometry. In this study, a detailed vestibular and audiological evaluation was undertaken, including the objective and more sensitive method of transiently evoked otoacoustic emissions (TEOAEs). MATERIALS AND METHODS: Twenty-four patients with genetically diagnosed myotonic dystrophy type 1 and 21 controls were studied. Audiological and vestibular investigations included pure-tone audiometry, tympanometry, auditory brainstem responses (ABRs), TEOAEs, and electronystagmography. RESULTS: Hearing impairment was evident in 15 (62.5%) patients and in nine of them (37.5%) ABR abnormalities were found. However, subclinical cochlear damage was found in all patients, as evidenced by absent emissions or lower otoacoustic emission amplitude. Vestibular hypesthesia was found in nine patients (37.5%), accompanied by spontaneous nystagmus in four of them (15.6%). CONCLUSIONS: Auditory and vestibular abnormalities are quite common in patients with myotonic dystrophy type 1. However, it appears that subclinical cochlear damage is an ubiquitous finding of the disease. PMID:23121018
Clinical Application of Sensory Substitution for Balance Control
This clinical trial investigated whether a new rehabilitation therapy using the sensory substitution system was an effective treatment for severe balance disorder in subjects with bilateral vestibular loss. The device which substitutes for vestibular input by transmitting information on head position to the tongue, consists of a tilt sensor for detecting head position, a 10×10 electrode array for interfacing with tongue, and a controller for processing information. Subjects who placed the electrode array on the tongue were trained to maintain a centered body position by keeping the signals on the middle of tongue using the electrode array. All subjects completed 5-20 minute training sessions 2-3 times per day for 8 weeks. Dynamic stability and gait function were tested using the Sensory Organization Test (SOT) and Dynamic Gait Index (DGI), respectively, before and after all training sessions. All subjects showed pronounced improvements in their balance performance. The average of SOT score and DGI had significantly decreased after the last training. Improvements were also noted in quality of life assessments such as the Dizziness Handicap Inventory (DHI) and the Activities-specific Balance Confidence (ABC) Scale. These results suggest that alternative sensory input through the tongue could substitute for vestibular function and the vestibular substitution device is a possible new rehabilitation tool for subjects with a persistent balance disorder who have a long term history of bilateral peripheral vestibular etiologies.
The Effect of Brandt-Daroff Exercise on the Vestibular Organ of Women with Vertigo
[Purpose] The purpose of this study was to find the effects of the Brandt-Daroff exercise on vestibular functions, such as balance, perception of subjective visual vertical (SVV), and nystagmus, in women with vertigo. [Subjects] After asking a group of women five questions about vertigo symptoms, we chose 17 women, in the age range of 19 to 21, who each had more than one symptom to participate in this study. [Methods] Vestibular functions were assessed through the use of a balance pad, subjective visual vertical (SVV), and videonystagmography (VNG). Each subject performed the Brandt-Daroff exercise five times a day for two weeks from May 8th to May 21th in 2010. Afterwards, vestibular functions were assessed by the same measuring instruments. After the intervention, the changes in vestibular functions were analyzed by the Wilcoxon sign rank test and repeated measures ANOVA test with the SPSSWIN (ver 18.0) package program. [Results] After the Brandt-Daroff exercise, perception of SVV in the left eye and right eye improved. In VNG, involuntary eye movement improved after exercise. However, neither measured equilibrium on the balance pad nor SVV in both eyes had changed. [Conclusion] This study revealed that two weeks performance of the Brandt-Daroff exercise improves some vestibular functions of women with vertigo. However, some functions did not change. Therefore, it seems that another study is needed to assess the effects of exercise for more than two weeks.
Spatial and non-spatial performance in mutant mice devoid of otoliths.
Vestibular deafferentation induces strong spatial memory impairments in rodents and dorsal hippocampal atrophy in humans, suggesting that vestibular information plays an important role in spatial-memory processes. However, previous studies have not discriminated between the role of the semi-circular canals, gravisensors and cochlear sense organ in such impairments due to complete damage of the vestibular and cochlear organs in their models of lesions. This is the first time that mutant mice (het/het) devoid of otoconia (lack of vestibular gravisensors) have been evaluated in behavioral tests. Results show different levels of achievement in the tests. The rotarod and elevated plus-maze were not executable, the rotarod being a safer test for differentiating the het/het mouse phenotype compared to the more anxiogenic swimming pool. Y-maze and place recognition tests were achieved, but chance values were not reached in the het/het group. Additionally, het/het mice presented uncommon behavior when faced with objects during the object recognition test. Impairments in het/het mice in the Y-maze test suggest a crucial role of the vestibular gravisensors in spatial-memory processes. PMID:22705908
Modeling postural instability with Galvanic vestibular stimulation.
In this study the effect of a pseudorandom binaural bipolar Galvanic stimulus generated by a sum of nonharmonically related sine waves on postural control was functionally assessed using computerized dynamic posturography (CDP), and the results compared to vestibulopathic patient populations and astronauts exposed to microgravity. The standardized CDP test battery comprised six sensory organization tests (SOTs) that combined three visual conditions (eyes open, eyes closed, and sway-referenced vision) with two proprioceptive conditions (fixed and sway-referenced support surfaces). Subjects (12) performed 18 randomized trials (three trials of each of the six SOTs) as a baseline, repeated the 18 trials with Galvanic vestibular stimulation (GVS), and then performed a post-GVS baseline. A 10 min rest period was inserted between each test battery. Anterioposterior postural sway increased significantly and was in the abnormal range (fifth percentile) during GVS for SOTs where visual input was compromised (sway-referenced surround) or absent. Postural stability returned to baseline when GVS was removed. An analysis of sensory input scores (somatosensory, visual, and vestibular) demonstrated the specificity of GVS in distorting vestibular input to postural control. The SOT scores observed in astronauts on landing day did not differ significantly to that generated by GVS in our normal subjects. GVS also induced a similar pattern of instability on CDP as profound bilateral vestibular loss, although not as severe. The results suggest that unpredictably varying GVS quantitatively and qualitatively models postural instability of vestibular origin. PMID:16432695
Neural substrates linking balance control and anxiety
This communication provides an update of our understanding of the neurological bases for the close association between balance control and anxiety. New data suggest that a vestibulo-recipient region of the parabrachial nucleus (PBN) contains cells that respond to body rotation and position relative to gravity. The PBN, with its reciprocal relationships with the extended central amygdaloid nucleus, infralimbic cortex, and hypothalamus, appears to be an important node in a primary network that processes convergent vestibular, somatic, and visceral information processing to mediate avoidance conditioning, anxiety, and conditioned fear responses. Noradrenergic and serotonergic projections to the vestibular nuclei also have parallel connections with anxiety pathways. The coeruleo-vestibular pathway originates in caudal locus coeruleus (LC) and provides regionally specialized noradrenergic input to the vestibular nuclei, which likely mediate effects of alerting and vigilance on the sensitivity of vestibulo-motor circuits. Both serotonergic and nonserotonergic pathways from the dorsal raphe nucleus and the nucleus raphe obscurus also project differentially to the vestibular nuclei, and 5-HT(2A) receptors are expressed in amygdaloid and cortical targets of the PBN. It is proposed that the dorsal raphe nucleus pathway contributes to both (a) a tradeoff between motor and sensory (information gathering) aspects of responses to self-motion and (b) a calibration of the sensitivity of affective responses to aversive aspects of motion. This updated neurologic model continues to be a synthetic schema for investigating the neurological and neurochemical bases for comorbidity of balance disorders and anxiety disorders.
Institute of Medicine, Committee on Disability in America
Background Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unkown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus® (NWFP) is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy. Methods/Design In a single (assessor) blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP) vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis). Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks) and at 6 months. Discussion Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated. Trial registration Clinical trials.gov identifier: NCT01442623 PMID:16554683
Components of vestibular cortical function.
It is known that the functional response (e.g., nystagmus) to caloric vestibular stimulation is delayed and prolonged compared with the stimulus-response timing of other sensory systems. Imaging studies have used different models to predict cortical responses and to determine the areas of the brain that are involved. These studies have revealed a widespread network of vestibular brain regions. However, there is some disagreement regarding the brain areas involved, which may partly be caused by differences in the models used. This disagreement indicates the possible existence of multiple cortical components with different temporal characteristics that underlie cortical vestibular processing. However, data-driven methods have yet to be used to analyze the underlying hemodynamic components during and after vestibular stimulation. We performed functional magnetic resonance imaging (fMRI) on 12 healthy subjects during caloric stimulation and analyzed these data using a model-free analysis method (ICA). We found seven independent stimulus-induced components that outline a robust pattern of cortical activation and deactivation. These independent components demonstrated significant differences in their time courses. No single-modeled response function was able to cover the entire range of these independent components. The response functions determined in the present study should improve model-based studies investigating vestibular cortical processing. PMID:22960258
Eye velocity produced by the angular vestibulo-ocular reflex (aVOR) tends to align with the summed vector of gravity and other linear accelerations [gravito-inertial acceleration (GIA)]. Defined as "spatial orientation of the aVOR," we propose that it is controlled by the nodulus and uvula of the vestibulocerebellum. Here, electrical stimulation, injections of the GABAA agonist, muscimol, and single-cell recordings were utilized to investigate this spatial orientation. Stimulation, injection, and recording sites in the nodulus were determined in vivo by MRI and verified in histological sections. MRI proved to be a sensitive, reliable way to localize electrode placements. Electrical stimulation at sites in the nodulus and sublobule d of the uvula produced nystagmus whose slow-phase eye-velocity vectors were either head centric or spatially invariant. When head centric, the eye velocity vector remained within +/- 45 degrees of the vector obtained with the animal upright, regardless of head position with respect to gravity. When spatially oriented, the vector remained relatively constant in space in one on-side position, with respect to the vector determined with the animal upright. A majority of induced movements from the nodulus were spatially oriented. Spatially oriented movements were generally followed by after-nystagmus, which had the characteristics of optokinetic after-nystagmus (OKAN), including orientation to the GIA. After muscimol injections, horizontal-to-vertical cross-coupling was lost or reduced during OKAN in tilted positions. This supports the hypothesis that the nodulus mediates yaw-to-vertical or roll cross-coupling. The injections also shortened the yaw-axis time constant and produced contralateral horizontal spontaneous nystagmus, whose velocity varied as a function of head position with regard to gravity. Nodulus units were tested with static head tilt, sinusoidal oscillation around a spatial horizontal axis with the head in different orientations relative to the pitching plane, and off-vertical axis rotation (OVAR). The direction of the response vectors of the otolith-recipient units in the nodulus, determined from static and/or dynamic head tilts, were confirmed by OVAR. These vector directions lay close to the planes of the vertical canals in 7/10 units; many units also had convergent input from the vertical canals. It is postulated that the orientation properties of the aVOR result from a transfer of otolith input regarding head tilt along canal planes to canal-related zones of the nodulus. In turn, Purkinje cells in these zones project to vestibular nuclei neurons to control eye velocity around axes normal to these same canal planes. PMID:10372065
The noradrenergic (NA) afferent projection to the cerebellar cortex, which originates mainly from the locus coeruleus (LC), may act on the target neurons by utilizing both alpha- and beta-adrenoceptors. Experiments performed in decerebrate cats have shown that unilateral injection into the vermal cortex of the cerebellar anterior lobe of 0.25 microliter of the alpha 1-adrenergic agonist metoxamine or the alpha 2-agonist clonidine (at 2-8 micrograms/microliters of saline) as well as of the non-selective beta-agonist isoproterenol (at 8-16 micrograms/microliters) decreased the postural activity in the ipsilateral forelimb, while the extensor tonus either remained unmodified or slightly increased on the contralateral side. The same agents also increased the gain of the vestibulospinal (VS) reflexes elicited by recording the multiunit EMG responses of the ipsilateral and the contralateral triceps brachii to roll tilt of the animal (at 0.15 Hz, +/- 10 degrees), leading to sinusoidal stimulation of labyrinth receptors. The crossed effects were more prominent for the alpha 2- than for the alpha 1- and beta-agonists. Only slight changes in the phase angle of the responses were observed. The effects described above appeared 5-10 min after the injection, reached the peak values after 15-30 min and disappeared within 2 h. The effective area was located within the third and/or the fourth folium of the culmen rostral to the fissura prima, 1.4-1.8 mm lateral to the midline. This area corresponded to zone B of the cerebellar cortex, which projects to the ipsilateral lateral vestibular nucleus (LVN), on which it exerts a prominent inhibitory influence. In fact, monopolar stimulation of this area with three negative pulses (at 300/sec) performed prior to the local injection inhibited the spontaneous EMG activity of the ipsilateral triceps brachii. The effects described above were dose-dependent; injection of an equal volume of saline was ineffective. All changes in posture and reflexes elicited by metoxamine or clonidine were impaired by previous injection into the same corticocerebellar area of the corresponding alpha 1- or alpha 2-adrenergic antagonist prazosin or yohimbine, respectively (0.25 microliters at 8-16 micrograms/microliters). However, cross-interactions between alpha 1- and alpha 2-adrenergic agonists and antagonists were also observed. In fact, injection of the alpha 2-adrenergic antagonist yohimbine prevented the occurrence of all the metoxamine effects, while administration of the alpha 1-adrenergic antagonist prazosin prevented the occurrence of the ipsilateral, but not of the contralateral effects induced by clonidine injection.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1813930
1. The possibility that the cholinergic afferent system terminating in the vermal cortex of the cerebellar anterior lobe acts on the target neurons by utilizing nicotinic receptors has been investigated in decerebrate cats by testing the effects of local microinjection of cholinergic nicotinic agonists and antagonists on posture as well as on the dynamic characteristics of the vestibulospinal (VS) reflexes. 2. Unilateral injection into the vermal cortex of the culmen of nicotine (0.25 microliter at the concentration of 0.05-0.5 microgram/microliter saline) decreased the extensor tonus in the ipsilateral forelimb, while the extensor tonus in the contralateral forelimb increased. The some agent significantly increased the gain of the first harmonic component of the EMG responses of the ipsilateral and more prominently also of the contralateral triceps brachii to animal tilt. However, the phase angle of the responses remained bilaterally unmodified. The effects described above were first observed 5-10 min after the injection, reached the peak after 40-60 min and persisted for at least 2-3 h before disappearing. 3. The effective area was located between the second and the fourth folium of the cerebellar vermis rostral to the fissura prima, at the laterality of 1.4-1.8 mm. This area, which upon cathodal stimulation suppressed the spontaneous EMG activity of the ipsilateral triceps brachii, actually corresponds to the zone B of the cerebellar cortex which exerts a direct inhibitory influence on the lateral vestibular nucleus. Moreover, the effects were dose-dependent. 4. Microinjection of nicotinic antagonists of both the ganglionic type (hexamethonium, 0.25 microliter at 4 micrograms/microliters saline) and the neuromuscular type (d-tubocurarine, 0.25 microliter at 7 micrograms/microliters saline) produced a postural asymmetry opposite in sign to that elicited by nicotine. The same agents also decreased the response gain of the triceps brachii of both sides to animal tilt recorded either under normal conditions or after previous injections of nicotine. 5. The experiments indicate that the cholinergic system is involved in the control of posture as well as in the gain regulation of the VS reflexes. Previous histochemical studies had shown that the cholinergic fibers terminate not only on Purkinje (P)-cells, but also and more prominently as mossy fibers ending on granular cells. This system may thus affect the discharge of P-cells and related inhibitory interneurons not only ipsilaterally but also contralaterally to the side of the injection.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8481082
Reflex responses of masseter muscles to sound
Acoustic stimuli can evoke reflex EMG responses (acoustic jaw reflex) in the masseter muscle. Although these were previously ascribed to activation of cochlear receptors, high intensity sound can also activate vestibular receptors. Since anatomical and physiological studies, both in animals and humans, have shown that masseter muscles are a target for vestibular inputs we have recently reassessed the vestibular contribution to masseter reflexes. We found that high intensity sound evokes two bilateral and symmetrical short-latency responses in active unrectified masseter EMG of healthy subjects: a high threshold, early p11/n15 wave and a lower threshold, later p16/n21 wave. Both of these reflexes are inhibitory but differ in their threshold, latency and appearance in the rectified EMG avera...
Two mouse models, the CochG88E/G88E or "knock-in" and the Coch-/- or "knock-out" (Coch null), have been developed to study the human late-onset, progressive, sensorineural hearing loss and vestibular dysfunction known as DFNA9. This disorder results from missense and in-frame deletion mutations in COCH (coagulation factor C homology), encoding cochlin, the most abundantly detected protein in the inner ear. We have performed hearing and vestibular analyses by auditory brainstem response (ABR) and vestibular evoked potential (VsEP) testing of the Coch-/- and CochG88E/G88E mouse models. Both Coch-/- and CochG88E/G88E mice show substantially elevated ABRs at 21 months of age, but only at the highest frequency tested for the former and all frequencies for the latter. At 21 months, 9 of 11 Coch-...
Vestibular-evoked myogenic potentials in vestibular migraine
Sound-induced vestibular-evoked myogenic potentials (VEMPs) can be used to investigate saccular function, measured from the tonically contracted sternocleidomastoid muscles (SCM) in response to loud sound stimuli. The aim of the present study was to assess VEMPs in patients with vestibular migraine and to determine whether saccular function is affected by the disease. Furthermore, tests such as tilts of subjective visual vertical (SVV) and caloric testing were conducted to test whether deficits in the various tests are associated with each other. The amplitude and latency of VEMPs were measured from the SCM in 63 patients with vestibular migraine (median age 47?years; range 24?70?years) and compared with those of 63 sex- and age-matched healthy controls (median age 46?years; range 17?73?ye...
Subjective head vertical test reveals subtle head tilt in unilateral peripheral vestibular loss
Utricular dysfunction has been indirectly measured with subjective visual horizontal or vertical testing. Video-oculography equipment with integrated head position sensor allows direct evaluation of head tilt. The aim was to assess head tilt after peripheral vestibular lesion by recording tilting of the head after excluding visual cues (static test condition), and after three lateral head tilts to both sides [subjective head vertical (SHV)]. Thirty patients with unilateral, peripheral vestibular loss were measured in the acute state, and 3?months later. Twenty healthy, age- and sex-matched subjects served as controls. Mean static tilt of 2.6???1.1? in patients with acute vestibular loss differed significantly from that of 1.0???0.4? in healthy subjects (p?=?0.004), and from that of 1.1???0...
Fore?aft translation aftereffects
A general theme in sensory perception is that exposure to a stimulus makes it seem more neutral such that perception of subsequent stimuli is shifted in the opposite direction. The visual motion aftereffect (MAE) is an extensively studied example of this. Although similar effects have been described in other sensory systems, it has not previously been described in the vestibular system. Velocity storage has been extensively studied in the vestibular system and suggests a persistence of perception in the direction of the initial movement. The current study sought to determine how motion perception is influenced by prior movement in darkness. Thirteen human subjects (mean age 41, range 21?68) underwent whole-body fore?aft translation. The threshold of vestibular motion discrimination percept...
Developments in autonomic research: a review of the latest literature
Motion sickness is characterized by several autonomic signs: pallor, sweating, loss of appetite, nausea and vomiting. Gastric myoelectrical activity is reduced and gastric emptying delayed, and the high-frequency to low-frequency ratio of heart rate variability increases with motion sickness. Children showing a high incidence of vasovagal syncope during head-up tilt are also more susceptible to motion sickness, arguing strongly for a vestibular contribution to both conditions. Typically, motion sickness is caused by slow oscillatory movements (~0.2?Hz), and is considered by many to be dependent on inputs from the vestibular system. However, given that signs of motion sickness can be induced by moving visual stimuli, changes in inputs from the vestibular system are evidently not required. I...
We present an interesting and relatively uncommon case of vestibular pneumolabyrinth in a young child post-trauma. His initial clinical exam and imaging studies of the head and cervical spine were negative. He subsequently developed nystagmus and a dedicated temporal bone study demonstrated a subtle fracture and vestibular pneumolabyrinth. Temporal bone fractures can be difficult to appreciate, and therefore, associated findings of fluid in the middle ear, stapes dislocation, or vestibular pneumolabyrinth must be carefully evaluated. Temporal bone computed tomography is a high resolution study, utilizing dynamic focal spot mode which leads to increased sampling and resolution, thereby reducing aliasing artifacts but a longer scan time and increased radiation dose. CT head and cervical spin...
Expression of transient receptor potential vanilloid (TRPV) 1, 2, 3, and 4 in mouse inner ear
Conclusion. It is suggested that transient receptor potential vanilloids (TRPVs) may play a functional role in cell physiology and TRPV-4 and -2 may play an important part in fluid homeostasis in the inner ear. Objective. Expression of TRPV-1, -2, -3, and -4 in the normal mouse inner ear was studied. Materials and methods. CBA/J mice were used in this study. The localization of TRPV-1, -2, -3, and -4 in the inner ear, i.e. cochlea, vestibular end organs, and endolymphatic sac, was investigated by immunohistochemistry. Results. TRPV-1, -2, and -3 were co-expressed in hair cells and supporting cells of the organ of Corti, in spiral ganglion cells, sensory cells in vestibular end organs, vestibular ganglion cells, and sensory nerve fibers. TRPV-2 was also detected in the stria vascularis, dar...
A novel treatment for vestibular disorder with FGLM-NH2 plus SSSR
Topical FGLM-NH2 (Phenylalanine-Glycine-Leucine-Methionine-Amide) plus SSSR (Serine-Serine-Serine-Arginine) facilitates recovery from vestibular disorders induced by (+/-)-a-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid (AMPA) in guinea pigs and might offer a treatment strategy for patients with peripheral vestibular disorders. The tetrapeptide FGLM-NH2 derived from substance P (SP) can be used to treat corneal disorders when combined with SSSR, which is a tetrapeptide derived from insulin-like growth factor-1 (IGF-1). We examined the influence of FGLM-NH2 plus SSSR when locally applied to the unilateral inner ear of guinea pigs with vestibular disorder induced by AMPA. A total of 18 Hartley white guinea pigs were assigned to groups receiving either FGLM-NH2 plus SSSR, artificial per...
Context: This article is a revue of bibliographique synthesis. Study's aim: Determine the effects of different type of vestibular rehabilitation on symptoms and the life's quality of a patient after a surgical ablation of an acoustic neuroma. Method and equipment: The research of articles was carried out in the months of October, November and December 2011 using the database PubMed. The keywords used were acoustic, neuroma rehabilitation physiotherapy, syndrom vestibular. On all results, 41 articles were retained. Results: Overall there isn't or few significant differences between patients following a vestibular re-education after a surgical ablation of an acoustic neuroma, but studys aren't unanimous. Some studies show some improvement on specific populations, like an improvement of postu...
Superficial neurofibromas in the setting of schwannomatosis: nosologic implications
First described in the past decade, schwannomatosis is a syndrome distinct from neurofibromatosis 2 (NF2). It is characterized by the development of multiple schwannomas, sparing the vestibular division of cranial nerve VIII, and may also predispose to develop meningiomas. We report two female patients, a 27 and a 44?years old who developed multiple peripheral schwannomas, but without involvement of the vestibular nerves, satisfying clinical criteria for schwannomatosis. Lack of vestibular nerve involvement was confirmed with MRI using an internal auditory canal protocol with 3?mm thick slices in both patients after age 30. Both patients developed a small neurofibroma in axillary subcutaneous tissues and a diffuse cutaneous neurofibroma of the left buttock, respectively. This report highli...
Head acceleration following linear translations in the freely-standing cat.
The aim of this study was to determine whether vestibular information related to head acceleration is available for triggering postural responses to perturbations of stance in the freely-standing cat. Linear accelerations of the head were recorded during postural responses evoked by linear translations of the support surface. A consistent initial peak of acceleration was observed at an average latency of 22 ms and magnitude of 0.03 g (g is acceleration due to gravity, 9.8 m/s/s). The acceleration peak preceded the first evoked EMG activity by an average of 24 ms. It was concluded that stimulation of the vestibular apparatus was both adequate and early enough for the vestibular system to have triggered the automatic postural response. PMID:1756820
Optical nerve stimulation for a vestibular prosthesis
Infrared Nerve Stimulation (INS) offers several advantages over electrical stimulation, including more precise spatial selectivity and improved surgical access. In this study, INS and electrical stimulation were compared in their ability to activate the vestibular branch of the VIIIth nerve, as a potential way to treat balance disorders. The superior and lateral canals of the vestibular system of Guinea pigs were identified and approached with the aid of precise 3-D reconstructions. A monopolar platinum stimulating electrode was positioned near the ampullae of the canals, and biphasic current pulses were used to stimulate vestibular evoked potentials and eye movements. Thresholds and input/output functions were measured for various stimulus conditions. A short pulsed diode laser (Capella, Lockheed Martin-Aculight, Inc., Bothell WA) was placed in the same anatomical position and various stimulus conditions were evaluated in their ability to evoke similar potentials and eye movements.
Respiratory vulnerability to vehicle buffeting
Objective Buffeting in a jerky ride in a bus or ambulance normally provokes a sustained tachypnoea driven by vibration and sensory mechanisms including vestibular signals. Tachypnoea reinforces the torso against mechanical shocks but results in overbreathing, causing a mild fall in CO2. However, normal CO2 is rapidly restored by a reduction in depth of breathing. We test the hypothesis that vulnerable subjects, exemplified by elderly individuals and patients with vestibular disorders, may fail to adapt to buffeting. Methods Respiratory and cardiovascular functions were recorded from five elderly subjects, two patients with bilateral loss of vestibular function and five patients with ?BPPV,? while being exposed to 15-min buffeting in a flight simulator which simulated transport in an ambula...
Dynamic transformation of vestibular signals for orientation
The same pattern of vestibular afferent feedback may signify a loss of balance or a change in body orientation, depending upon the initial head posture. To resolve this ambiguity and generate an appropriate motor response, the CNS must transform vestibular information from a head-centred reference frame into relevant motor coordinates. But what if the reference frame is continuously moving? Here, we ask if this neural transformation process is continuously updated during a voluntary change in head posture. Galvanic vestibular stimulation (GVS) was used to induce a sensation of head roll motion in blindfolded subjects marching on the spot. When head orientation was fixed, this caused unconscious turning behaviour that was maximal during neck flexion, minimal with the head level and reversed...
Meniere's disease and middle ear pressure - vestibular function after transtympanic tube placement
Conclusion: Selected patients with Meniere's disease (MD) show an improvement of disability from vertigo after transtympanic ventilation tube insertion, although an effect on vestibular function is not seen if ipsilateral middle ear pressure lower than -50 daPa is used as a selection criterion. Objectives: Transtympanic ventilation tube insertion as a treatment option for MD has been reported but its results have been controversial. So far, no investigations on vestibular function in patients with MD after tube insertion have been carried out. Subjects and methods: Twenty-two patients with unilateral MD who were intractable to medical treatment and who had an ipsilateral middle ear pressure lower than -50 daPa received a transtympanic ventilation tube. Vestibular evoked myogenic potentials...
The vestibular system is the sensory organ responsible for perceiving head rotational movements and maintaining postural balance of human body. The objectives of this study are to propose an innovative computational technique capable of automatically segmenting the vestibular system and to analyze its geometrical features from high resolution T2-weighted MR images. In this study, the proposed technique was used to test the hypothesis that the morphoanatomy of vestibular system in adolescent idiopathic scoliosis (AIS) patients is different from healthy control subjects. The findings could contribute significantly to the understanding of the etiopathogenesis of AIS. The segmentation pipeline consisted of extraction of region of interest, image pre-processing, K-means clustering, and surface ...
The ocular vestibular-evoked myogenic potentials (oVEMPs) in response to air-conducted sound (ACS) and bone-conducted vibration (BCV) have recently been used to assess otolith-ocular pathways in humans. Although the oVEMPs to BCV are considered to reflect the function of the utricle and superior vestibular pathway, the pathway of the oVEMPs to ACS remains controversial. In this study, we compared the effect of different head positions in the roll plane on oVEMPs in response to BCV and ACS in 20 normal subjects. Head tilt in the roll plane significantly increased the asymmetry ratio of oVEMPs to BCV (p?p?>?0.6). These results suggest that oVEMPs to BCV reflect the activity of a different population of vestibular afferents to those which are active during oVEMPs to ACS.
Abstract in portuguese OBJETIVO: Avaliar o equilíbrio corporal e quantificar possíveis alterações na posturografia estática do Balance Rehabilitation Unit (BRU TM) em pacientes com disfunção vestibular. MÉTODOS: Estudo retrospectivo, com prontuários de 100 pacientes com topodiagnóstico de disfunção vestibular periférica ou central e 100 indivíduos hígidos compondo o Grupo Controle, de ambos os gêneros, entre 7 a 86 anos. Para a posturografia foi utilizado o equipamento Balance R (more) ehabilitation Unit (BRU TM), da Medicaa®. Foram analisados os parâmetros limite de estabilidade, área de elipse e velocidade de oscilação em dez condições sensoriais. RESULTADOS: A média dos valores do limite de estabilidade, da área de elipse e da velocidade de oscilação do Grupo Experimental foi significativa em relação ao Grupo Controle em todas as condições. A média dos parâmetros do gênero feminino do Grupo Experimental foi significativa em relação ao do Grupo Controle em todas as condições avaliadas. Os pacientes com disfunção vestibular central obtiveram maiores valores que os pacientes com disfunção vestibular periférica nas variáveis área de elipse e velocidade de oscilação, porém menor valor da área do limite de estabilidade. CONCLUSÃO: A posturografia com estímulos de realidade virtual foi um método de avaliação eficaz para detectar alterações relacionadas às variáveis limite de estabilidade, área de elipse e velocidade de oscilação, uma vez que o Grupo Controle obteve melhor desempenho, tanto entre os grupos quanto entre os gêneros. Entre as disfunções vestibulares, os indivíduos com acometimento periférico obtiveram melhor desempenho do que os indivíduos com disfunção vestibular central em todas as variáveis analisadas na posturografia. Abstract in english PURPOSE: To assess body balance and to quantify possible alterations over the static posturography of the Balance Rehabilitation Unit (BRU TM) in patients with vestibular dysfunction. METHODS: Retrospective study, with files of 100 patients with topographic diagnosis of peripheral or central vestibular dysfunction and 100 healthy individuals that composed the control group, of both genders, with ages varying between 7 and 86 years. For the posturography, the Balance Rehab (more) ilitation Unit (BRU TM), of Medicaa® was used. The following parameters were analyzed: stability limits, elliptical area, and speed of oscillation in ten sensory conditions. RESULTS: Mean values ??of the stability limit, the elliptical area and the speed of oscillation in the experimental group was significant when compared to the control group in all conditions. The mean parameters of the female experimental group were significant when compared to the control group in all conditions. Patients with central vestibular dysfunction obtained higher values than patients with peripheral vestibular dysfunction in the variables elliptical area and speed of oscillation, however with lower value of the area of the stability limit. CONCLUSION: Posturography with virtual reality stimuli was an effective assessment method for detecting alterations related to the variables stability limits, elliptical area, and speed of oscillation, since the control group performed better, both between groups and between genders. Among the vestibular dysfunctions, individuals with peripheral condition performed better than those with central vestibular dysfunction in all the variables analyzed on posturography.
Abstract in portuguese INTRODUÇÃO: Os sistemas auditivo e vestibular estão localizados no mesmo receptor periférico, porém adentram ao SNC e percorrem caminhos distintos, estabelecendo uma série de conexões e abrangendo uma vasta região do encéfalo. Mesmo percorrendo caminhos diferentes, algumas alterações podem comprometer ambos os sistemas. Testes como os Potenciais Evocados Auditivos podem auxiliar no diagnóstico com alterações vestibulares. OBJETIVO: Caracterizar os resultados (more) dos Potenciais Evocados Auditivos de indivíduos com queixa de tontura ou vertigem com Síndromes Vestibulares Periféricas e com indivíduos normais, com a mesma queixa. MÉTODO: Foram realizados os Potenciais Evocados Auditivos de curta, média e longa latência, sendo um estudo prospectivo transversal. CONCLUSÃO: Indivíduos com queixa de tontura ou vertigem podem apresentar alterações no PEATE, PEAML e P300. Abstract in english INTRODUCTION: The auditory and vestibular systems are located in the same peripheral receptor, however they enter the CNS and go through different ways, thus creating a number of connections and reaching a wide area of the encephalon. Despite going through different ways, some changes can impair both systems. Such tests as Auditory Evoked Potentials can help find a diagnosis when vestibular alterations are seen. OBJECTIVE: describe the Auditory Evoked Potential results in (more) individuals complaining about dizziness or vertigo with Peripheral Vestibular Disorders and in normal individuals having the same complaint. METHODS: Short, middle and long latency Auditory Evoked Potentials were performed as a transversal prospective study. CONCLUSION: individuals complaining about dizziness or vertigo can show some changes in BAEP (Brainstem Auditory Evoked Potential), MLAEP (Medium Latency Auditory Evoked Potential) and P300.
Exposure to the microgravity conditions of space flight induces adaptive modification in the control of vestibular-mediated reflexive head movement during locomotion after space flight. Space flight causes astronauts to be exposed to somatosensory adaptation in both the vestibular and body load-sensing (BLS) systems. The goal of these studies was to examine the contributions of vestibular and BLS-mediated somatosensory influences on head movement control during locomotion after long-duration space flight. Subjects were asked to walk on a treadmill driven at 1.8 m/s while performing a visual acuity task. Data were collected using the same testing protocol from three independent subject groups; 1) normal subjects before and after exposure to 30 minutes of 40% bodyweight unloaded treadmill walking, 2) bilateral labyrinthine deficient (LD) patients and 3) astronauts who performed the protocol before and after long duration space flight. Motion data from head and trunk segmental motion data were obtained to calculate the angular head pitch (HP) movements during walking trials while subjects performed the visual task, to estimate the contributions of vestibular reflexive mechanisms in HP movements. Results showed that exposure to unloaded locomotion caused a significant increase in HP movements, whereas in the LD patients the HP movements were significantly decreased. Astronaut subjects results showed a heterogeneous response of both increases and decreases in the amplitude of HP movement. We infer that BLS-mediated somatosensory input centrally modulates vestibular input and can adaptively modify head-movement control during locomotion. Thus, space flight may cause a central adaptation mediated by the converging vestibular and body load-sensing somatosensory systems.
OBJECTIVES: Visulization of endolymphatic hydrops has been reported using magnetic resonance imaging (MRI) in patients with Meniere's disease. However, the relationship between the endolymphatic hydrops visualized by MRI and audio-vestibular functional tests have not been sufficiently investigated, such as pure tone audiometry (PTA), electrocochleography (EcoG), and vestibular evoked myogenic potential (VEMP). METHODS: Here we attempted to visualize endolymphatic hydrops in patients with Meniere's disease using 3Tesla (3T)-MRI following intratympanic gadolinium-diethylene-triamnie petaaetic acidbis (Gd-DTPA) injection and correlated the presence of hydrops with auditory testing. Following intratympanic Gd-DTPA contrast injections in 26 patients diagnosed as having definite Meniere's disease, 3D-fluid-attenuated inversion recovery (3D-FLAIR) sequence imagings were performed. The PTA, EcoG, and VEMP testing was done bilaterally. Patients had typical results of auditory testing for Meniere's disease. RESULTS: The 3D-FLAIR MRI clearly demonstrated endolymphatic hydrops with signal voids in the cochlea (81%) and saccule (69%) in the definite Meniere's disease group. Auditory tests verified that the visualized cochlear hydrops (basal turn) was correlated with a high tone hearing threshold in PTA and an abnormal EcoG. Though the absence of VEMP did not correlate with vestibular hydrops on MRI, large vestibular hydrops were detected by imaging. This study demonstrates that endolymphatic hydrops could be visualized by 3D-FLAIR MRI in Meniere's disease patients. CONCLUSION: Cochlea hydrops and vestibular (saccular) hydrops are readily visualized using these techniques. Hydrops, as visualized on MRI, may be a reliable means to diagnosis Meniere's disease; this is supported by appropriate correlations with auditory vestibular functional testing. PMID:22867525
The vestibular system is the sensory organ responsible for perceiving head rotational movements and maintaining postural balance of human body. The objectives of this study are to propose an innovative computational technique capable of automatically segmenting the vestibular system and to analyze its geometrical features from high resolution T2-weighted MR images. In this study, the proposed technique was used to test the hypothesis that the morphoanatomy of vestibular system in adolescent idiopathic scoliosis (AIS) patients is different from healthy control subjects. The findings could contribute significantly to the understanding of the etiopathogenesis of AIS. The segmentation pipeline consisted of extraction of region of interest, image pre-processing, K-means clustering, and surface smoothing. The geometry of this high-genus labyrinth structure was analyzed through automatic partition into genus-0 units and approximation using the best-fit circle and plane for each unit. The metrics of the best-fit planes and circles were taken as shape measures. The proposed technique was applied on a cohort of 20 right-thoracic AIS patients (mean age 14.7 years old) and 20 age-matched healthy girls. The intermediate results were validated by subjective scoring. The result showed that the distance between centers of lateral and superior canals and the angle with vertex at the center of posterior canal were significantly smaller in AIS than in healthy controls in the left-side vestibular system with p=0.0264 and p=0.0200 respectively, but not in the right-side counterparts. The detected morphoanatomical changes are likely to be associated with subclinical postural, vestibular and proprioceptive dysfunctions reported frequently in AIS. This study has demonstrated that the proposed method could be applied in MRI-based morphoanatomy studies of vestibular system clinically. PMID:20382235
Abstract in portuguese TEMA: o Potencial Evocado Miogênico Vestibular (Vemp) é formado por respostas miogênicas ativadas por estimulação sonora de alta intensidade. Essas respostas são registradas por eletromiografia de superfície sobre a musculatura cervical na presença de contração muscular, ativando a mácula, o nervo vestibular inferior e as vias vestíbulo-espinhais descendentes. OBJETIVO: descrever as respostas evocadas do Vemp em uma população normal. MÉTODO: selecionaram-se (more) 30 sujeitos adultos, sendo 13 homens e 17 mulheres, sem queixas otoneurológicas. Utilizou-se 200 estímulos tone burst com freqüência de 1Hz e intensidade de 118dB Na, filtro passa-banda de 10Hz a 1500Hz. Os traçados obtidos foram analisados em relação ao primeiro potencial bifásico composto por P13 e N23. RESULTADOS: não houve diferença estatisticamente significativa entre o lado da estimulação em relação a latência e amplitude, porém foi encontrada diferença estatisticamente significativa em relação à amplitude do potencial entre os sexos. CONCLUSÃO: Vemp demonstrou ser uma ferramenta confiável na avaliação da função vestibular. Abstract in english BACKGROUND: the Vestibular Evoked Myogenic Potential (Vemp) is formed by myogenic neurophysiologic responses activated by high-intensity sound stimulation. The response is registered through surface electromyography of the cervical muscles during muscle contraction. The acoustic stimuli activate the saccular macula, the vestibular inferior nerve and the pathways related to the vestibule-spinal descendant nerves. AIM: to describe Vemp parameters in a normal population. MET (more) HODS: thirty adults, 13 men and 17 women with no otoneurological complaints were selected. The stimuli were 200 tone burst, with a frequency of 1Hz and intensity of 118 dB Na, band-pass filter ranging from 10Hz to 1500Hz. The first potential biphasic P13-N23 wave was analyzed. RESULTS: no significant difference was observed between the sides of stimulation in terms of latency and amplitude. However, a statistically significant difference was found for amplitude between genders. CONCLUSION: Vemp demonstrated to be a reliable instrument in the clinical assessment of the vestibular function.
Perception of smooth and perturbed vection in short-duration microgravity
Successful adaptation to the microgravity environment of space and readaptation to gravity on earth requires recalibration of visual and vestibular signals. Recently, we have shown that adding simulated viewpoint oscillation to visual self-motion displays produces more compelling vection (despite the expected increase in visual-vestibular conflict experienced by stationary observers). Currently, it is unclear what role adaptation to gravity might play in this oscillation-based vection advantage. The vection elicited by optic flow displays simulating either smooth forward motion or forward motion perturbed by viewpoint oscillation was assessed before, during and after microgravity exposure in parabolic flight. During normal 1-g conditions subjects experienced significantly stronger vection ...
Abstract in portuguese Nos dentes multirradiculares, é comum se observar uma alta taxa de exposição radicular e, conseqüentemente, a exposição da região de furca. Nos molares superiores, esse fato pode afetar as três furcas existentes (vestibular, mesial e distal), ocasionando sérias dificuldades. Nesta pesquisa, foram estabelecidas medidas de distâncias da abertura da furca vestibular em relação às faces mesial (F1M) e distal (F1D) das raízes mésio-vestibular e disto-vestibular; (more) da furca mesial em relação às faces vestibular (F2V) e palatina (F2P) das raízes mésio-vestibular e palatina e da furca distal em relação às faces vestibular (F3V) e palatina (F3P) das raízes disto-vestibular e palatina, respectivamente. Foram utilizados 100 primeiros molares superiores, separados respectivamente em 50 do lado direito e 50 do lado esquerdo. Medidas de referência e demarcações foram realizadas nas furcas e também nas superfícies radiculares adjacentes. Concluímos que essas mensurações são importantes porque contribuem eficientemente para o diagnóstico, a prevenção e o tratamento de problemas periodontais. Abstract in english A high rate of root exposure and consequently the exposure of the furcation area is usually observed in multirooted teeth. In maxillary molar teeth, this fact may endanger the three existent furcations (buccal, mesial and distal), causing serious problems. In this research, distance measures from the buccal furcation to the mesial (F1M) and distal (F1D) surfaces of the mesio-buccal and disto-buccal roots; from the mesial furcation to the buccal (F2B) and palatal (F2P) sur (more) faces of the mesio-buccal and palatal roots and from the distal furcation to the buccal (F3B) and palatal (F3P) surfaces of the disto-buccal and palatal roots, respectively were established. One hundred maxillary first molar teeth were used, 50 of the right and 50 of the left side. Reference marks and demarcations were determined on the furcations and also on the root surfaces involved in the measures. We concluded that these measurements are important because they may effectivelly contribute to diagnosis, prevention and treatment of periodontal problems.
Progress in neuro-otology research in the last year
Herein, we summarize articles in the field of neuro-otology published in the Journal of Neurology over the last year. Topics included acute and chronic vertigo as well as auditory and ocular motor disorders. Characteristic lesion locations in Pusher syndrome are reported and the usefulness of bedside ocular motor tests in vertebrobasilar stroke is revisited. Probing the vestibular system and its value in predicting the outcome in vegetative state is discussed. Several articles address new diagnostic and therapeutic approaches in different disorders associated with chronic vestibular, auditory or gait deficits. In a series of case reports, we focus on different eye movement disorders in the vertical plane, which are often difficult to assess.
State reversals of optically induced tilt and torsional eye movements
Alternations of the state of apparent self-motion during observation of a large visual display rotating about the line of sight are associated with alternations in the magnitude of induced tilt and torsional eye rotation. In one experiment, shifts in visually induced tilt during these state alternations are found to be in the opposite direction to corresponding shifts in induced ocular torsion. In a second experiment, the reversals of self-motion perception are shown to be an intravisual phenomenon, independent of competing inputs provided by the vestibular system. These results emphasize the importance of distinguishing between visual and vestibular processes in tilt perception and ocular rotation during human orientation to gravitational vertical.
Aseptic Meningoencephalitis Presenting with Bilateral Vestibular Ataxia: a Case Report
Bilateral vestibular dysfunction is a rare condition, of which peripheral disorders are most common, whereas central disorders are extremely rare. A 35-year-old woman developed fever, headache, dizziness, convulsion, and disturbance of consciousness at the same time. MRI findings were normal. Based on the neurological findings and laboratory abnormalities, she was diagnosed as having aseptic meningoencephalitis. Steroid pulse therapy successfully ameliorated her encephalitis sign. However, isolated bilateral vestibular ataxia and dizziness, together with severe decrease of Caloric nystagmus, became apparent and lasted for the following 3 months, without cerebellar/brainstem involvement.
Postoperative imaging of vestibular schwannomas.
Symptomatic vestibular schwannomas can be treated with resection (translabyrinthine, retrosigmoid [suboccipital], or middle cranial fossa approaches) or stereotactic radiosurgery. When appropriate, auditory brainstem stimulators can also be implanted in patients with current or impending hearing loss due to bilateral vestibular schwannomas. Imaging plays a prominent role in determining management following these procedures. In this article, the expected postoperative imaging appearances are depicted. The radiological features of complications are also reviewed, including recurrent tumor, fat graft necrosis, CSF leakage, infection, hydrocephalus, cerebral infarction, venous sinus thrombosis, hemorrhage, and temporal lobe and cerebellar contusions. PMID:22937852
Role of the cerebellum and the vestibular apparatus in regulation of orthostatic reflexes in the cat
The contribution of the fastigial nucleus and the vestibular nerves (eighth cranial nerves) to the orthostatic reflexes in anesthetized, paralyzed cats was studied. Bilateral lesions of the rostral fastigial nucleus resulted in impairment of the reflex changes in blood pressure, femoral arterial flow, and resistance evoked by head-up tilting to 30 deg or 60 deg. The rostral fastigial nucleus, which might be triggered by the vestibular apparatus, appears to participate in concert with the baroreceptors in the initiation and possibly the maintenance of the orthostatic reflexes.
The dolphin brain-A challenge for synthetic neurobiology
Toothed whales (odontocetes) are a promising paradigm for neurobiology and evolutionary biology. The ecophysiological implications and structural adaptations of their brain seem to reflect the necessity of effective underwater hearing for echolocation (sonar), navigation, and communication. However, not all components of the auditory system are equally well developed. Other sensory systems are more or less strongly reduced such as the olfactory system and, as an exception among vertebrates, the vestibular system (the semicircular canals and vestibular nuclei). Additional outstanding features are: (1) the hypertrophy of the neocortex, pons, cerebellum (particularly the paraflocculus), the elliptic nucleus, the facial motor nucleus and the medial accessory inferior olive and (2) the reductio...
The value of MR imaging by post-contrast T1-weighted 3D spoiled gradient-echo (3D SPGR) is well established for the detection of small vestibular schwannomas in the cerebellopontine angle region. We describe a case in which a flow ghost artifact in the slice-encoding direction mimicked a vestibular schwannoma and heavily T2-weighted MR cisternography and multiplanar reconstruction images helped us to reach the correct diagnosis. In addition, we conducted a volunteer study to demonstrate that changing the k-space trajectory can reduce this artifact in post-contrast 3D SPGR images.
Experimental study on computed tomography of the vestibular aqueduct
Investigations of the vestibular aqueduct by computed tomography were performed in dry temporal bones and patients with unilateral sensorineural hearing loss. Using an accessory table for a wider aperture of the whole body scanner (CT/T-8800), it was possible to position patient's head for a direct sagittal plane of the temporal region on CT scans. The scans were employed with a 1.5-mm-thick slice with 1.5-mm slice space. In this study, it was proven that this method displayed the vestibular aqueduct as clearly in patients as in dry temporal bones. However, one of the disadvantages of this technique was uncomfortable positioning for some patients.
Cochlin expression in vestibular endorgans obtained from patients with Meniere?s disease
The distribution of cochlin and its associated basement membrane proteins (collagen IV, collagen II, laminin-?2, and nidogen-1) were evaluated in the vestibular endorgans of subjects with Meniere?s disease and compared with normal specimens. Cochlin mRNA expression in vestibular endorgans from Meniere?s disease specimens was also investigated. Specimens were obtained from patients who had Meniere?s disease and who were undergoing ablative labyrinthectomy. Control specimens were obtained both from autopsy specimens with documented normal audiovestibular function and from patients undergoing labyrinthectomy for acoustic neuroma excision. In the normal control specimens, cochlin immunoreactivity was found evenly distributed in the stroma of the cristae ampullaris and maculae of the utricle. I...
Neurohumoral reactions to long-term vestibular stimulation in man.
The main purposes of present work were: 1) to examine neurohumoral reactions to long-term vestibular stimulation provocative for MS symptoms in man; 2) to compare the peculiarities of neuroendocrine reactions to short-term and to long-term vestibular stimulation; 3) to analyze the received results from the position of neuroendocrine adaptive reactions biological conformity to natural laws, and its physiological importance for human organisms; 4) to make some prognostic points of neurohumoral reaction changes on health and capacity for work in subjects influenced by professional conditions, provocative for MS manifestation development. PMID:11538529
The reproductive system of female Rhipicephalus sanguineus consists of a single ovary, paired oviducts fusing into a single common oviduct, connecting tube, the vagina that in turn divides into cervical and vestibular regions, a wide receptaculum seminis and tubular accessory glands that open into the vagina between the cervical and vestibular regions. The histological structure of each part of the female reproductive system is described. The fine structure of the ovary, connecting tube and accessory glands is also provided in this study. PMID:12557929
Corticosteroid Therapy for Hearing and Balance Disorders
Abstract This review addresses the current status of steroid therapies for hearing and vestibular disorders and how certain misconceptions may be undermining the efficacy in restoring normal ear function, both experimentally and clinically. Specific misconceptions addressed are that steroid therapy is not effective, steroid-responsive hearing loss proves an underlying inflammatory problem in the ear, and steroids only have application to the hearing disorders listed below. Glucocorticoid therapy for hearing and balance disorders has been employed for over 60 years. It is recommended in cases of sudden hearing loss, Menire's disease, immune-mediated hearing loss, and any vestibular dysfunction suspected of having an inflammatory etiology. The predominant steroids employed today are dexameth...
An assessment of the vestibulo-ocular reflex (VOR) in persons with Down syndrome
Down syndrome (DS), the most common genetically defined cause of intellectual disability, is the phenotypic consequence of a supernumerary chromosome 21. Persons with DS commonly display deficits in visuomotor integration, motor coordination, and balance. Despite the key roles of the optokinetic and vestibular systems in these submodalities of motor function, a systematic investigation into the optokinetic nystagmus (OKN) and vestibulo-ocular reflex (VOR) in persons with DS was lacking in the literature. Accordingly, this study generated quantitative data on oculomotor function in persons with DS under vestibular stimulation (an accompanying work describes results on the analysis of optokinetic function in the same cohort of participants). Experiments involved 32 participants with DS (14?3...
Abstract in portuguese A associação de distúrbios da audição e equilíbrio com enxaqueca é reconhecida desde a Grécia antiga quando Aretaeus da Capadócia em 131 a.C., fez uma descrição precisa e com detalhes desta ocorrência durante uma crise de enxaqueca. Uma revisão ampla das manifestações otoneurológicas da enxaqueca é apresentada, usando as mais recentes publicações com respeito à epidemiologia, apresentação clínica, fisiopatologia, métodos diagnósticos e manejo dest (more) a síndrome. OBJETIVO: Descrever a entidade clínica "Enxaqueca associada a Disfunção Auditivo-vestibular" no intuito de ajudar médicos otorrinolaringologistas e neurologistas no diagnóstico e no manejo clínico dessa doença. COMENTÁRIOS FINAIS: Uma forte associação existe entre sintomas otoneurológicos e enxaqueca, sendo a enxaqueca associada a disfunção auditivo-vestibular a causa mais comum de vertigem episódica espontânea (não-posicional). Os sintomas podem variar bastante entre pacientes tornando um desafio diagnóstico para o otorrinolaringologista. Esta entidade geralmente se apresenta com ataques de vertigem espontâneos ou posicionais, durando de segundos a dias com sintomas de enxaqueca associados. Uma melhor elucidação da ligação entre os mecanismos vestibulares centrais e os mecanismos da enxaqueca em si, além da descoberta de defeitos em canais iônicos em algumas causas de enxaqueca, ataxia e vertigem, podem levar a um entendimento maior da fisiopatologia da enxaqueca associada a disfunção auditivo-vestibular. Abstract in english The association between hearing and balance disorders with migraine is known since the times of the ancient Greeks, when Aretaeus from Cappadocia in 131 B.C, made an accurate and detailed description of this occurrence during a migraine episode. We present a broad review of migraine neurotological manifestations, using the most recent publications associated with epidemiology, clinical presentation, pathophysiology, diagnostic methods and treatment for this syndrome. AIM: (more) to describe the clinical entity: "Migraine associated with auditory-vestibular dysfunction" in order to help otorhinolaryngologists and neurologists in the diagnosis and management of such disorder. FINAL REMARKS: There is a strong association between neurotological symptoms and migraine, and the auditory-vestibular dysfunction-associated migraine is the most common cause of spontaneous episodic vertigo (non-positional). Symptoms may vary broadly among patients, making it a diagnostic challenge to the otorhinolaryngologist. This entity usually presents with positional or spontaneous vertigo spells, lasting for seconds or days, associated with migraine symptoms. A better understanding of the relationship between central vestibular mechanisms and migraine mechanisms, besides the discovery of ionic channel disorders in some cases of migraine, ataxia and vertigo, may lead to a better understanding of migraine pathophysiology associated with audio-vestibular disorder.
Long-term neuronal behavior caused by two synaptic modification mechanisms
We report the first results of simulating the coupling of neuronal, astrocyte, and cerebrovascular activity. It is suggested that the dynamics of the system is different from systems that only include neurons. In the neuron-vascular coupling, distribution of synapse strengths affects neuronal behavior and thus balance of the blood flow; oscillations are induced in the neuron-to-astrocyte coupling.
Abstract in portuguese INTRODUÇÃO: além da espessura da cortical óssea e da largura dos espaços inter-radiculares, a densidade óssea é fator primordial para a eficiência dos mini-implantes usados como recurso de ancoragem. OBJETIVO: nesse estudo, pretendeu-se avaliar a densidade óssea alveolar e basal maxilar e mandibular, em unidades Hounsfield (HU). MÉTODOS: em onze arquivos de imagens tomográficas computadorizadas Cone-Beam, de indivíduos adultos, foram obtidas 660 medidas das de (more) nsidades ósseas alveolar (corticais vestibular e lingual), do osso medular e basal (maxilar e mandibular). Os valores foram obtidos através do software Mimics 10.01 (Materialise, Bélgica). RESULTADOS: maxila - a densidade da cortical vestibular na faixa de osso alveolar variou de 438 a 948HU, e a lingual de 680 a 950HU; já o osso medular variou de 207 a 488HU; a densidade da cortical vestibular na faixa de osso basal apresentou uma variação de 672 a 1380HU e o osso medular de 186 a 420HU. Mandíbula - a variação do osso na cortical vestibular na faixa de osso alveolar foi de 782 a 1610HU, na cortical lingual alveolar de 610 a 1301HU, e na medular de 224 a 538; a densidade na área basal foi de 1145 a 1363HU na cortical vestibular, e de 184 a 485HU na medular. CONCLUSÕES: a maior densidade óssea na maxila foi observada entre pré-molares na cortical alveolar vestibular. A tuberosidade maxilar foi a região com menor densidade óssea. A densidade óssea na mandíbula foi maior do que na maxila, e observou-se um acréscimo progressivo de anterior para posterior e de alveolar para basal Abstract in english INTRODUCTION: The cortical thickness, the interradicular spaces width and bone density are the key factors for the efficiency of mini-implants as anchorage resources. OBJECTIVES: The objective was to assess the alveolar and basal bone density in maxilla and mandible in Hounsfield units (HU). METHODS: From eleven files of adults computed tomography images were obtained 660 measurements of bone density: alveolar (buccal and lingual cortical), medullary bone and basal (maxil (more) la and mandible). Values were obtained through the Mimics software version 10.01 (Materialize, Belgium). RESULTS: Maxilla - the density of cortical vestibular alveolar ranged from 438 to 948 HU, and the lingual from 680 to 950 HU, and the bone marrow ranged from 207 to 488 HU. The basal bone in vestibular showed a variation from 672 to 1380 HU and bone marrow from 186 to 402 HU. In the mandible - a variation in alveolar bone in the cortical vestibular was 782 to 1610 HU, in the cortical lingual alveolar from 610 to 1301 HU, and bone marrow from 224 to 538 HU. The density in the basal area was from 1145 to 1363 HU in the cortical vestibular and 184 to 485 HU in the spinal cord. CONCLUSIONS: The greater values in bone density in the maxilla were observed in the area between the pre-molars in the alveolar vestibular cortical. The maxillary tuberosity is the region with lower bone density. The bone density in the mandible was higher than in the maxilla and there was a progressive increase from anterior to posterior and from alveolar to basal bone
Mutations in COCH (coagulation factor C homology) are etiologic for the late-onset, progressive, sensorineural hearing loss and vestibular dysfunction known as DFNA9. We introduced the G88E mutation by gene targeting into the mouse and have created a CochG88E/G88E mouse model for the study of DFNA9 ...
Vestibular diagnostics and therapy ist the mirror of technological, scientific and socio-economics trends as are other fields of clinical medicine. These trends have led to a substantial diversification of the field of neurotology. The improvements in diagnostics have been characterized by the introduction of new receptor testing tools (e.g., VEMPs), progress in imaging (e.g., the endolymphatic hydrops) and in the description of central-vestibular neuroplasticity. The etiopathology of vestibular disorders has been updated by geneticists (e.g., the description of the COCH gene mutations), the detection of structural abnormalities (e.g., dehiscence syndromes) and related disorders (e.g. migraine-associated vertigo). The therapeutic options were extended by re-evaluation of techniques known a long time ago (e.g., saccus exposure), the development of new approaches (e.g., dehiscence repair) and the introduction of new drug therapy concepts (e.g., local drug delivery). Implantable, neuroprosthetic solutions have not yet reached experimental safety and validity and are still far away. However, externally worn neuroprosthetic solution were introduced in the rehab of vestibular disorders (e.g., VertiGuard system). These and related trends point into a medical future which is characterized by presbyvertigo as classical sign of the demographic changes ahead, by shortage of financial resources and a medico-legally over-regulated, even hostile environment for physicians in clinical medicine. PMID:17562902
Perspectives in vestibular diagnostics and therapy.
Vestibular diagnostics and therapy ist the mirror of technological, scientific and socio-economics trends as are other fields of clinical medicine. These trends have led to a substantial diversification of the field of neurotology.The improvements in diagnostics have been characterized by the introduction of new receptor testing tools (e.g., VEMPs), progress in imaging (e.g., the endolymphatic hydrops) and in the description of central-vestibular neuroplasticity. The etiopathology of vestibular disorders has been updated by geneticists (e.g., the description of the COCH gene mutations), the detection of structural abnormalities (e.g., dehiscence syndromes) and related disorders (e.g. migraine-associated vertigo). The therapeutic options were extended by re-evaluation of techniques known a long time ago (e.g., saccus exposure), the development of new approaches (e.g., dehiscence repair) and the introduction of new drug therapy concepts (e.g., local drug delivery). Implantable, neuroprosthetic solutions have not yet reached experimental safety and validity and are still far away. However, externally worn neuroprosthetic solution were introduced in the rehab of vestibular disorders (e.g., VertiGuard system).These and related trends point into a medical future which is characterized by presbyvertigo as classical sign of the demographic changes ahead, by shortage of financial resources and a medico-legally over-regulated, even hostile environment for physicians in clinical medicine. PMID:22558055
Five missense mutations in the FCH/LCCL domain of the COCH gene, encoding the protein cochlin, are pathogenic for the autosomal dominant hearing loss and vestibular dysfunction disorder, DFNA9. To date, the function of cochlin and the mechanism of pathogenesis of the mutations are unknown. We have...
Extralabyrinthine Manifestations of DFNA9
DFNA9 is an autosomal dominant cause of non-syndromic adult-onset sensorineural hearing loss with associated variable vestibular dysfunction caused by mutations in the COCH gene. DFNA9 has previously been characterized by the presence of unique histopathologic features limited to the cochlear and ve...
Recommended research on artificial gravity - NASA Technical ...
In addition, bed rest does not produce the full range of vestibular disorders characteristic of .... advantages as a model system for countermeasure development. Rats ..... monitoring what a group of people normally eats. ... pre- bed rest ambulatory control period or throughout in the case of synchronous controls, age diet and ...
The aim of this study is to evaluate the internal consistency, test-retest reliability, construct validity, and sensitivity to change of the Activities-specific Balance Confidence Scale (ABC) in people with peripheral vestibular disorder. Thirty-three patients with unilateral peripheral vestibular disease were included in the study. Patients were also evaluated with the Visual Analog Scale, the Romberg test (eyes open, closed), the tandem Romberg test (eyes open, closed), standing on foam (eyes open, closed), static posturography, Five Times Sit to Stand test, Timed Up to Go test, gait speed, Dynamic Gait Index, Functional Gait Assessment, and Dizziness Handicap Inventory. To assess sensitivity to change, 27 patients were involved in a 4-week customized vestibular rehabilitation program and then reassessed at the end of 4 weeks. The individual item intraclass correlation coefficient ranged from 0.67 to 0.92 and Cronbach ranged from 0.67 to 0.93. The Cronbach value for whole scale was determined as 0.95. Although the Dizziness Handicap Inventory showed significant correlation with the Turkish ABC Scale (r = 0.51-0.54, P less than 0.05), no such a correlation was observed between the Turkish ABC Scale and the other parameters assessed (P greater than 0.05). Both Turkish ABC Scale and the other parameters assessed showed significant improvement after 4-week customized exercise program (P less than 0.05). The Turkish ABC Scale is a culturally relevant, reliable, and sensitive to change tool for measuring self-perceived balance confidence in unilateral peripheral vestibular disease.
Vestibulo-Cardiorespiratory Responses at the Onset of Chair Rotation in Endurance Runners
Stimulation of the vestibular system has been reported to elicit ventilatory and circulatory changes in humans. The purpose of this study was to clarify the characteristics of vestibular-mediated ventilatory and circulatory responses in male endurance runners at the onset of passive chair rotation, which selectively stimulates the semicircular canals. Fourteen runners and 14 male untrained subjects participated. The vestibular stimulus test, which consists of 180° chair rotations (left or right half-turns on an earth-vertical axis) for a duration of 2 s, was carried out on each subject. Inspiratory minute ventilation, tidal volume, respiratory frequency, heart rate, and blood pressure were measured by breath-by-breath and beat-to-beat techniques before, during, and after the chair rotation for a total of 60 s. It was found in this study that (i) the relative change of minute ventilation response in the endurance runners was significantly (P < 0.05) greater than in the untrained subjects during and after the rotation, and that (ii) no significant group differences were observed in heart rate and mean blood pressure responses during and after the rotation. In conclusion, vestibular-mediated ventilatory response, but not circulatory response, at the onset of the chair rotation in the endurance runners was significantly greater than that in the untrained subjects. The results from the present study suggest that an increase in vestibulo-ventilatory response would be attributed to an adaptation to long-term endurance training.
Three patients with spasmodic torticollis following VIII nerve lesions (VIII-ST) underwent quantitative assessment of their sternomastoid EMG during vestibular (otolith and semicircular canal) stimulation. The results were compared with a normal control group and with six patients with idiopathic sp...
Assessment and treatment of dizzy patients in primary health care.
Dizziness is a common reason for visits to primary health care, especially among elderly patients. From a physiotherapeutic perspective, this thesis aims to study the assessment and treatment of dizzy patients in primary health care. Interventions in papers I, III and IV comprised a vestibular rehab...
The Effects of Space Flight on the Human Vestibular System
How does the human body maintain a sense of body position and balance ... Might a better understanding of this microgravity-induced vestibular function .... Photo of Astronaut James P. Bagian sitting in a Barany Chair while wearing an accelerometer .... Newton's Laws of Motion – Hand the volunteer an electric leaf blower.
Vestibular schwannomas show a large variation in growth rate, making prediction and anticipation of tumor growth difficult. More accurate prediction of clinical behavior requires better understanding of tumor biological factors influencing tumor progression. Biological processes like intratumoral hemorrhage, cell proliferation, microvessel density, and inflammation were analyzed in order to determine their role in vestibular schwannoma development. Tumor specimens of 67 patients surgically treated for a histologically proven unilateral vestibular schwannoma were studied. Preoperative magnetic resonance imaging (MRI) scans were used to determine tumor size and to classify tumors as homogeneous, inhomogeneous, and cystic. Immunohistochemical studies evaluated cell proliferation (histone H3 and Ki-67), microvessel density (CD31), and inflammation (CD45 and CD68). Intratumoral hemorrhage was assessed by hemosiderin deposition. The expression patterns of these markers were compared with tumor size, tumor growth index, MRI appearance, patients' age, and duration of symptoms. No relation between cell proliferation and clinical signs of tumor volume increase or MRI appearance was found. Intratumoral hemosiderin, microvessel density, and inflammation were significantly positively correlated with tumor size and the tumor growth index. Cystic and inhomogeneous tumors showed significantly more hemosiderin deposition than homogeneous tumors. The microvessel density was significantly higher in tumors with a high number of CD68-positive cells. The volume increase of vestibular schwannomas is not based on cell proliferation alone. Factors like intratumoral bleeding, (neo)vascularization, and intensity of the inflammatory reaction also influence tumor volume. PMID:22555941
Meniere’s disease is nearly invariably associated with endolymphatic hydrops (the net accumulation of water in the inner ear endolymphatic space). Vestibular maculae utriculi were acquired from patients undergoing surgery for Meniere’s disease and acoustic neuroma and from autopsy (subjects with nor...
The endolymphatic sac (ES) is an inner ear organ that is connected to the cochleo-vestibular system through the endolymphatic duct. The luminal fluid of the ES contains a much higher concentration of proteins than any other compartment of the inner ear. This high protein concentration likely contrib...
Neurofibromatosis type 2 (NF2) is an autosomal dominant disorder with the clinical hallmark of bilateral vestibular schwannomas (VS). Patients affected by a severe NF2 phenotype also presents with peripheral schwannomas, meningiomas and ependymomas. The closely related disorder schwannomatosis also ...
Frequent NF2 gene transcript mutations in sporadic meningiomas and vestibular schwannomas
The gene for the hereditary disorder neurofibromatosis type 2 (NF2), which predisposes for benign CNS tumors such as vestibular schwannomas and meningiomas, has been assigned to chromosome 22 and recently has been isolated. Mutations in the NF2 gene were found in both sporadic meningiomas and vestibular schwannomas. However, so far only 6 of the 16 exons of the gene have been analyzed. In order to extend the analysis of an involvement of the NF2 gene in the sporadic counterparts of these NF2-related tumors, the authors have used reverse transcriptase-PCR amplification followed by SSCP and DNA sequence analysis to screen for mutations in the coding region of the NF2 gene. Analysis of the NF2 gene transcript in 53 unrelated patients with meningiomas and vestibular schwannomas revealed mutations in 32% of the sporadic meningiomas (n = 44), in 50% of the sporadic vestibular schwannomas (n = 4), in 100% of the tumors found in NF2 patients (n = 2), and in one of three tumors from multiple-meningioma patients. Of the 18 tumors in which a mutation in the NF2 gene transcript was observed and the copy number of chromosome 22 could be established, 14 also showed loss of (parts of) chromosome 22. This suggests that in sporadic meningiomas and NF2-associated tumors the NF2 gene functions as a recessive tumor-suppressor gene. The mutations detected resulted mostly in frameshifts, predicting truncations starting within the N-terminal half of the putative protein. 23 refs., 2 figs. 3 tabs.
Frequent NF2 Gene Transcript Mutations in Sporadic Meningiomas and Vestibular Schwannomas
The gene for the hereditary disorder neurofibromatosis type 2 (NF2), which predisposes for benign CNS tumors such as vestibular schwannomas and meningiomas, has been assigned to chromosome 22 and recently has been isolated. Mutations in the NF2 gene were found in both sporadic meningiomas and vestib...
Blood samples from 125 unrelated families with classical type 2 neurofibromatosis (NF2) with bilateral vestibular schwannomas have been analysed for mutations in the NF2 gene. A further 17 families fulfilling modified criteria for NF2 have also been analysed. Causative mutations have been identified...
Patients who present with unilateral vestibular schwannomas either at a young age or with additional features of type 2 neurofibromatosis (NF2) are at risk of developing bilateral disease and transmitting a risk of neurogenic tumours to their offspring. We have identified 15 patients from a series o...
Neurofibromatosis type 2 (NF2): A clinical and molecular review
Neurofibromatosis type 2 (NF2) is a tumour-prone disorder characterised by the development of multiple schwannomas and meningiomas. Prevalence (initially estimated at 1: 200,000) is around 1 in 60,000. Affected individuals inevitably develop schwannomas, typically affecting both vestibular nerves an...
The paper describes the results of combined utilization of magnetic field (MF), sinusoidal modulated current (SMC) and galvanic current (GC) generated by a specially devised unit "Sedaton". This multimodality physiotherapy was tested in chronic experiments on 25 cats with experimental vascular and vestibular dysfunction. MF in combination with SMC displayed greater efficacy than in monotherapy. Positive physiological reactions were more pronounced. PMID:8171842
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Adaptive changes during space flight in how the brain integrates vestibular cues with other sensory information can lead to impaired movement coordination, vertigo, spatial disorientation and perceptual illusions following Gtransitions. These studies are designed to examine both the physiological basis and operational implications for disorientation and tilt-translation disturbances following short duration space flights.
Multimodal Fusion in Self-Motion Perception using Wavelets and Quaternions
In this new model of self-motion perception we focused on two main questions that are central in this field. The first one is how this central nervous system (CNS) merges information coming from different sensory modalities (as vision, touch, vestibular system,...). Another important question is how...
AEROSPACE MEDICINE AND BIOLOGY A CONTINUING ...
Results of a physico-mathematical analysis of the vestibular tions of the ... 57-62. 19 refs. In Russian. with 23 human subjects show that the breathing of a 100% oxygen ... and the acid-alkali equilibrium of blood in subjects with different motor activity stresses ...... exhalation volumes during asana /yoga tissues gymnastics/ ...
Introduction. The purpose of the present study is to investigate the effect of electrical-acoustic stimulation on vestibular function in CI patients by using the EquiTest and to help answer the question of whether electrically stimulating the inner ear using a cochlear implant influences the balance system in any way. Material and Methods. A test population (n = 50) was selected at random from among the cochlear implant recipients. Dynamic posturography (using the EquiTest) was performed with the device switched off an switched on. Results. In summary, it can be said that an activated cochlear implant affects the function of the vestibular system and may, to an extent, even lead to a stabilization of balance function under the static conditions of dynamic posturography, but nevertheless also to a significant destabilization. Significant improvements in vestibular function were seen mainly in equilibrium scores under conditions 4 and 5, the composite equilibrium score, and the vestibular components as revealed by sensory analysis. Conclusions. Only under the static conditions are significantly poorer scores achieved when stimulation is applied. It may be that the explanation for any symptoms of dizziness lies precisely in the fact that they occur in supposedly noncritical situations, since, when the cochlear implant makes increased demands on the balance system, induced disturbances can be centrally suppressed. PMID:20671908
Immunology and mathematics: crossing the divide
Introduction. The purpose of the present study is to investigate the effect of electrical-acoustic stimulation on vestibular function in CI patients by using the EquiTest and to help answer the question of whether electrically stimulating the inner ear using a cochlear implant influences the balance system in any way. Material and Methods. A test population (n = 50) was selected at random from among the cochlear implant recipients. Dynamic posturography (using the EquiTest) was performed with the device switched off an switched on. Results. In summary, it can be said that an activated cochlear implant affects the function of the vestibular system and may, to an extent, even lead to a stabilization of balance function under the static conditions of dynamic posturography, but nevertheless also to a significant destabilization. Significant improvements in vestibular function were seen mainly in equilibrium scores under conditions 4 and 5, the composite equilibrium score, and the vestibular components as revealed by sensory analysis. Conclusions. Only under the static conditions are significantly poorer scores achieved when stimulation is applied. It may be that the explanation for any symptoms of dizziness lies precisely in the fact that they occur in supposedly noncritical situations, since, when the cochlear implant makes increased demands on the balance system, induced disturbances can be centrally suppressed. PMID:15819694
THE ULTRASTRUCTURE OF THE KINOCILIUM OF THE SENSORY CELLS IN THE INNER EAR AND LATERAL LINE ORGANS
The bundle of sensory hairs protruding from the top of each receptor cell in the vestibular and lateral line organs in the teleost fish (burbot) Lota vulgaris is composed of a number of stereocilia and one kinocilium located in the periphery of the bundle. The ultrastructure of the kinocilium and i...
Only a handful of cases of de-novo malignancies of the vestibulocochlear nerve have been reported. Even rarer is the malignant transformation of a previously histologically diagnosed benign vestibular schwannoma. We present the case of a young adult who had combined operative/Gamma knife treatment f...
Differential expression of LIM domain-only (LMO) genes in the developing mouse inner ear.
The vertebrate inner ear, a complex sensory organ with vestibular and auditory functions, is derived from a single ectoderm structure called the otic placode. Currently, the molecular mechanisms governing the differentiation and specification of the otic epithelium are poorly understood. We present here a detailed expression study of LMO1-4 in the developing mouse inner ear using a combination of in situ hybridization and immunohistochemistry. LMO1 is specifically expressed in the vestibular and cochlear hair cells as well as the vestibular ganglia of the developing inner ear. LMO2 expression is detected in the periotic mesenchyme of the developing mouse cochlea from E12.5 to E14.5. The expression of LMO3 expression is first observed in the cochlea at E13.5 and becomes confined to the lesser epithelial ridge (LER) from E14.5 to E17.5. LMO3 is also expressed in some of the vestibular ganglion cells. LMO4 is initially expressed in the dorsolateral portion of the otic vesicle and its expression persists in the semicircular canals, macula, crista, and the spiral ganglia throughout embryogenesis. Thus, the regionalized expression patterns of LMO1-4 are closely associated with the morphogenesis of the inner ear. PMID:16597514
Functional expression of TRPA1 cation channels in vestibular type II hair cells
Although the expression of TRPA1 proteins has been demonstrated in hair cells of the inner ear, the role of this Ca2+-permeable cation channel is unclear because TRPA1 knock-out mice have normal transduction currents in hair cells and do not show hearing impairment or vestibular problems. To test wh...
Genetic Heterogeneity of Usher Syndrome: Analysis of 151 Families with Usher Type I
Usher syndrome type I is an autosomal recessive disorder marked by hearing loss, vestibular areflexia, and retinitis pigmentosa. Six Usher I genetic subtypes at loci USH1A–USH1F have been reported. The MYO7A gene is responsible for USH1B, the most common subtype. In our analysis, 151 families with U...
Perspectives in vestibular diagnostics and therapy
Vestibular diagnostics and therapy ist the mirror of technological, scientific and socio-economics trends as are other fields of clinical medicine. These trends have led to a substantial diversification of the field of neurotology.The improvements in diagnostics have been characterized by the introd...
Mathematical requirements of visual-vestibular integration.
This article addresses the intersection between perceptual estimates of head motion based on purely vestibular and purely visual sensation, by considering how nonvisual (e.g. vestibular and proprioceptive) sensory signals for head and eye motion can be combined with visual signals available from a single landmark to generate a complete perception of self-motion. In order to do this, mathematical dimensions of sensory signals and perceptual parameterizations of self-motion are evaluated, and equations for the sensory-to-perceptual transition are derived. With constant velocity translation and vision of a single point, it is shown that visual sensation allows only for the externalization, to the frame of reference given by the landmark, of an inertial self-motion estimate from nonvisual signals. However, it is also shown that, with nonzero translational acceleration, use of simple visual signals provides a biologically plausible strategy for integration of inertial acceleration sensation, to recover translational velocity. A dimension argument proves similar results for horizontal flow of any number of discrete visible points. The results provide insight into the convergence of visual and vestibular sensory signals for self-motion and indicate perceptual algorithms by which primitive visual and vestibular signals may be integrated for self-motion perception. PMID:22134859
Recovery of the High-Acceleration Vestibulo-ocular Reflex After Vestibular Neuritis
Vestibular neuritis (VN) usually leads to a sudden gain asymmetry of the high-acceleration horizontal vestibulo-ocular reflex (VOR). We asked whether this asymmetry decreases over time indicating peripheral recovery and/or central compensation. The horizontal VOR during rapid rotational head impulse...
STS-40 Payload Specialist Hughes-Fulford inserts contact lens into her eye
STS-40 Payload Specialist Millie Hughes-Fulford inserts a contact lens into her eye while on the middeck of Columbia, Orbiter Vehicle (OV) 102. Hughes-Fulford is preparing for Experiment No. 072, Vestibular Experiments in Spacelab. The rotating dome associated with one of this experiment's procedures requires the contact lenses to record eye movements.
Opaque Contact Lens For Tracking Motion Of Eye
Opaque contact lens facilitates measurements of movements of eye; particularly, torsional movements. Lens, marked with pair of indices at diameter of 0.5 mm, provides stable, high-contrast reference for measurements of angular position and velocity of eye by use of video-image-analysis techniques. Intended for use in experiments on response of eye to vestibular balance mechanism.
Neurofibromatosis type 2 (NF2) is an autosomal dominant syndrome with a prevalence of approximately 1 in 30,000. NF 2 is characterized by bilateral vestibular schwannomas, as well as meningiomas, ependymomas and gliomas. Currently, surgical resection and radiotherapy represent the mainstay of treatment, although new studies suggest a role for certain chemotherapeutic agents. Intravenous administration of Bevacizumab (Avastin, Genetech Pharmaceuticals) has been shown to be active in the treatment of vestibular schwannomas. The IV route of administration, however, carries a risk of known systemic side-effects such as bowel perforation, wound dehiscence and pulmonary embolism. In addition, the percentage of drug that reaches the tumor site may be restricted by the blood tumor barrier. This report describes the super-selective intra-arterial infusion of Bevacizumab following blood brain barrier disruption for the treatment of vestibular schwannomas in three patients with Neurofibromatosis type 2. It represents the first time such a technique has been performed for this disease. Additionally, this method of drug delivery may have important implications in the treatment of patients with vestibular schwannomas associated with Neurofibromatosis type 2. PMID:22681725
Olfactory Schwannoma-Case Report-
Intracranial schwannomas preferentially arise from the vestibular branch of the eighth nerve, and rarely from the trigeminal nerve, facial nerve, and lower cranial nerves. Anterior cranial fossa schwannomas are extremely uncommon and few details about them have been reported. The patient was a 39-ye...
Peripheral Calcifying Odontogenic Cyst: A Case Report and Review of the Literature
The peripheral calcifying odontogenic cyst (PCOC) accounts for less than 25% of the cases of calcifying odontogenic cysts and most commonly appears as a nodule on the gingiva. This paper aims to present both a case report of a PCOC located in the left vestibular maxilla as well as a review of the En...
The Jugular Dural Fold—A Helpful Skull Base Landmark to the Cranial Nerves
During a retrosigmoid (or combined retrolabyrinthine-retrosigmoid) approach to the posterior fossa for vestibular neurectomy or removal of small acoustic neuromas, a white dural fold is a consistent landmark to cranial nerves VII through XII. This fold of dura appears as a white linear structure ext...
Influence of Bilateral Vestibular Loss on Spinal Stabilization in Humans
The control of upper body (UB) orientation relative to the pelvis in the frontal plane was characterized in bilateral vestibular loss subjects (BVLs) and compared with healthy control subjects (Cs). UB responses to external perturbations were evoked using continuous pelvis tilts (eyes open and eyes ...
Postural Compensation for Unilateral Vestibular Loss
Postural control of upright stance was investigated in well-compensated, unilateral vestibular loss (UVL) subjects compared to age-matched control subjects. The goal was to determine how sensory weighting for postural control in UVL subjects differed from control subjects, and how sensory weighting ...
there was no residual damage to the vestibular system, and he was certified for flight in a relatively .... complete intake and output of everything we ate, everything we drank, everything we ... You're not going to feed them both 2,400 calories a day for what amounts to three .... We weren't just guinea pigs; we were also co- ...
Scar formation in the vestibular sensory epithelium after aminoglycoside toxicity.
Hair cell degeneration and the repair process due to differing types of trauma have been studied extensively in the organ of Corti. It has been determined that, during scar formation, after differing types of trauma to the auditory sensory system, the reticular lamina is maintained with adherens junctions and tight junctions. We investigated the repair process within the vestibular epithelium. Hair cell degeneration was induced by the unilateral application of streptomycin to the inner ears of guinea pigs. Whole mount preparations of all five vestibular organs were processed and examined by fluorescence, light and electron microscopy. Scar formation was seen as early as 4 days post-treatment with streptomycin and was noted to coincide with hair cell degeneration. Neighboring supporting cells swelled and filled the space beneath the degenerating hair cell. Between three and five supporting cells participate in the reparative process. The distribution of cytokeratin is also altered during scar formation. The area once occupied by the hair cell becomes filled with cytokeratin-rich processes of supporting cells. It appears that differing numbers of supporting cells are involved in the reparative process within the vestibular sensory epithelium as compared to the auditory system. The reticular lamina remains intact at all times. This may possibly prevent mixing of fluids between different compartments in the inner ear and dysfunction of the vestibular sensory organs.
Vestibular schwannomas: microsurgery after partial removal and stereoradiosurgery
The aim of this work is a comparison of results in two groups: primary radical removal of vestibular schwannoma (VS) and secondary radical removal following unsuccessful partial surgery and/or gamma knife stereoradiosurgery (GKS) and assessing the favorable one. Between 1997 and 2004, 106 patients w...
Patients with autoimmune inner ear disease develop rapidly progressive sensorineural hearing loss over a period of several weeks or months, often accompanied by vestibular loss. This disease can occur as a distinct clinical entity or in association with an underlying autoimmune disorder. Treatment c...
Around three years ago, in the special issue on augmented and virtual reality in rehabilitation, the topics of simulator sickness was briefly discussed in relation to vestibular rehabilitation. Simulator sickness with virtual reality applications have also been referred to as visually induced motion...
Immersive Virtual Environment for Visuo-Vestibular Therapy: Preliminary Results
The sense of equilibrium aggregates several interacting cues. On patients with vestibular loss, vision plays a major role. In this study, the goal is to propose a new immersive therapy based on 3D opto-kinetic stimulation. We propose to demonstrate that 3D monoscopic optical flows are an efficient t...
Coexpression of GABA BR1 and GABA BR2 receptor subunits in the rat vestibular nucleus
The expression patterns of the two subunits of the metabotropic GABA B receptor, GABA BR1 and GABA BR2, vary among various neural regions and their relative expression in the rat central vestibular system remains unknown. To identify the expression patterns of these two subunits of the metabotropic ...
Firing Patterns of Rat Vestibulospinal Neurons during Quadrupedal Standing on a Pitching Platform
The neuronal activity of vestibulospinal neurons projecting to the lumbar enlargement was recorded in conscious rats standing with four limbs on a pitching platform. The neurons were classified into 3 groups: up-neurons firing maximally in the head-up phase (2/8), down-neurons with maximal firing in the head-down phase (2/8), and nonmodulated neurons (4/8). The 3 groups may play differential roles in stance control.
Abstract in portuguese A betaistina é um medicamento utilizado no tratamento de distúrbios da função vestibular, que também tem sido utilizado para tratar o zumbido. OBJETIVO: Avaliar o efeito da betaistina sobre o zumbido de pacientes com distúrbios vestibulares. MATERIAL E MÉTODO: Foram coletados dados retrospectivos de pacientes com vestibulopatia e zumbido. Os pacientes incluídos receberam 48 mg/dia de betaistina ao dia e os resultados clínicos foram comparados com os de um grupo c (more) ontrole, que incluiu indivíduos impossibilitados de receber betaistina devido à gastrite, úlceras, gravidez, asma ou hipersensibilidade ao medicamento. Os pacientes realizaram controle de fatores agravantes e exercícios de reabilitação vestibular, como tratamento de base para a vestibulopatia. A intensidade, frequência e duração do zumbido foram avaliadas no primeiro dia e após 120 dias de tratamento. A melhora clínica foi definida pela redução total ou parcial do zumbido após o tratamento. RESULTADOS: Observou-se melhora clínica do zumbido em 80/262 (30,5%) dos pacientes tratados com a betaistina e em 43/252 (17,1%) pacientes do grupo controle. A betaistina melhorou significativamente (p Abstract in english Betahistine is a medicine used to treat vestibular disorders that has also been used to treat tinnitus. AIM: To assess the effects of betahistine on tinnitus in patients with vestibular disorders. MATERIAL AND METHOD: Retrospective data were collected from patient records for individuals presenting with vestibular dysfunction and tinnitus. Patients included had received betahistine 48 mg/day and clinical outcomes were compared with a control group comprising individuals w (more) ho were unable to receive betahistine due to gastritis, ulcers, pregnancy, asthma or hypersensitivity to the drug. Patients underwent control of any aggravating factors and also standard vestibular exercises as a basis for treatment. The intensity, frequency and duration of tinnitus were assessed on the first day of dosing and after 120 days of treatment. Clinical improvement was defined as a total or partial reduction of tinnitus after treatment. RESULTS: Clinical improvement was observed in 80/262 (30. 5%) of patients treated with betahistine and 43/252 (17. 1%) of control patients. Betahistine significantly (p
Abstract Neuromodulation is a fundamental process in the brain that regulates synaptic transmission, neuronal network activity and behavior. Emerging evidence demonstrates that astrocytes, a major population of glial cells in the brain, play previously unrecognized functions in neuronal modulation. Astrocytes can detect the level of neuronal activity and release chemical transmitters to influence neuronal function. For example, recent findings show that astrocytes play crucial roles in the control of Hebbian plasticity, the regulation of neuronal excitability and the induction of homeostatic plasticity. This review discusses the importance of astrocyte-to-neuron signaling in different aspects of neuronal function from the activity of single synapses to that of neuronal networks.
Abstract in portuguese TEMA: impacto da tontura na qualidade de vida (QV) em idosos vestibulopatas crônicos. OBJETIVO: avaliar a associação entre o impacto da tontura na QV de idosos com disfunção vestibular crônica e variáveis demográficas e clínicas. MÉTODO: estudo prospectivo em que 120 idosos com disfunção vestibular crônica submeteram-se à versão brasileira do Dizziness Handicap Inventory (DHI). Foram utilizados os testes de Mann-Whitney, Kruskal-Wallis e Coeficiente de Corr (more) elação de Spearman para verificar a associação de QV e as variáveis demográficas e clínicas. RESULTADOS: ocorreram associações significantes entre a presença de tontura rotatória e não rotatória com o escore total do DHI (p = 0,010) e subescala física (p = 0,049) e funcional (p = 0,009); entre quedas recorrentes com o DHI total (p = 0,004) e subescalas física (p = 0,045), funcional (p = 0,010) e emocional (p = 0,011). Correlações significantes foram encontradas entre incapacidade funcional e o DHI total (? = + 0,557; p Abstract in english BACKGROUND: dizziness impact on the quality of life (QoL) of elderly patients with chronic vestibular dysfunction. AIM: to evaluate the association between the impact of dizziness on the QoL of elderly patients with chronic vestibular dysfunction and demographic and clinical variables. METHOD: a prospective study. A hundred and twenty elderly patients with chronic vestibular dysfunction underwent the Brazilian version of the Dizziness Handicap Inventory (DHI). In order to (more) verify the association between the QoL and the demographic and clinical variables, the following testes were used: Mann-Whitney, Kruskal-Wallis and Spearman's correlation coefficient. RESULTS: there were significant associations between the presence of rotating and non-rotating dizziness with the total score of the DHI (p = 0.010) and physical (p = 0.049) and functional (p = 0.009) subscales; between recurrent falls with total DHI (p = 0.004) and physical (p = 0.045), functional (p = 0.010) and emotional (p = 0.011) subscales. Significant correlations were found between functional incapacity and total DHI (r = + 0,557; p
Abstract in portuguese As doenças vestibulares são frequentes na população idosa, resultando, principalmente, em tontura e desequilíbrio corporal, sintomas que podem prejudicar as atividades de vida diária. OBJETIVO: Estudar a correlação entre equilíbrio corporal e a capacidade funcional e a comparação entre risco de queda, ocorrência de queda e a capacidade funcional de idosos com disfunções vestibulares crônicas. MATERIAL E MÉTODO: Forma de estudo transversal, clínico e exper (more) imental com 50 idosos, de 60 a 86 anos, com vestibulopatias periféricas crônicas. Estes idosos foram submetidos à avaliação do equilíbrio por meio do Dynamic Gait Index (DGI) e à avaliação da capacidade funcional, por meio da Medida de Independência Funcional (MIF). Os dados obtidos foram submetidos ao teste de correlação de Spearman e aos de comparação de Mann-Whitney e Kruskal-Wallis, sendo considerado ?=5% (0,05). RESULTADOS: Verificou-se correlação positiva entre o escore total do DGI e todas as pontuações da MIF, especialmente a MIF total (r=0,447; p Abstract in english Vestibular disorders are common among the elderly, mainly resulting in dizziness and imbalance - symptoms which can impact daily routine activities. AIM: To study the correlation between body balance and functional capacity and a comparison of risk of falls, actual falls and the functional capacity of the elderly with chronic vestibular dysfunctions. MATERIALS AND METHODS: A cross-sectional, clinical and experimental study with 50 senior citizens - 60 to 86 years, with ch (more) ronic peripheral vestibular dysfunction. These participants underwent body balance assessment by the Dynamic Gait Index (DGI) and functional capacity assessment by the Functional Independence Measure (FIM). The data was tested using the Spearman correlation and comparison tests, Mann-Whitney and Kruskal- Wallis, being ?=5% (0.05). RESULTS: There was a significant correlation between the total DGI score and all FIM scores, especially the total score (r=0.447; p
Abstract in portuguese OBJETIVO: Identificar os fatores relacionados aos sintomas depressivos de idosos com disfunção vestibular crônica. MÉTODO: Estudo transversal, em que 120 idosos com disfunção vestibular crônica submeteram-se ao questionário Geriatric Depression Scale. Realizou-se análise de regressão linear multivariada (p(more) 1. O modelo preditivo para piora dos sintomas depressivos foi composto por gênero feminino, distúrbios de memória e da concentração, insônia, hipoacusia, visão péssima, não utilização de dispositivo de auxílio à marcha e maior impacto da tontura no aspecto emocional. CONCLUSÃO: O maior número de sintomas depressivos de idosos vestibulopatas crônicos está relacionado à presença de distúrbios de memória e da concentração, insônia, hipoacusia, visão péssima, maior impacto da tontura no aspecto emocional, gênero feminino e não utilização de dispositivo de auxílio à marcha. Abstract in english OBJECTIVE: To identify factors relating to depressive symptoms among elderly people with chronic vestibular dysfunction. METHOD: This was a cross-sectional study in which 120 elderly people with chronic vestibular dysfunction answered the Geriatric Depression Scale questionnaire. Multivariate linear regression analysis was performed (p(more) 55.8%) scored above the cutoff of 11 points. The predictive model for worsening of depressive symptoms was composed of female gender, memory and concentration disorders, insomnia, hearing disorders, poor sight, nonuse of walking aids and greater emotional impact of dizziness. CONCLUSION: Greater numbers of depressive symptoms among elderly people with chronic vestibular disease were related to the presence of memory and concentration disorders, insomnia, hearing disorders, very poor sight, greater emotional impact of dizziness, female gender and nonuse of walking aids.
Clear vision of objects that move in depth toward or away from an observer requires vergence eye movements. The vergence system must interact with the vestibular system to maintain the object images on the foveae of both eyes during head movement. Previous studies have shown that training with sinusoidal vergence-vestibular interaction improves the frequency response of vergence eye movements during pitch rotation: vergence eye velocity gains increase and phase-lags decrease. To further understand the changes in eye movement responses in this adaptation, we examined latencies of vergence eye movements before and after vergence-vestibular training. Two head-stabilized Japanese monkeys were rewarded for tracking a target spot moving in depth that required vergence eye movements of 10 degrees/s. This target motion was synchronized with pitch rotation at 20 degrees/s. Both target and chair moved in a trapezoidal waveform interspersed with random inter-trial intervals. Before training, pitch rotation in complete darkness without a target did not induce vergence eye movements. Mean latencies of convergence and divergence eye movements induced by vergence target motion alone were 182 and 169 ms, respectively. After training, mean latencies of convergence and divergence eye movements to a target synchronized with pitch rotation shortened to 65 and 53 ms, and vergence eye velocity gains (relative to vergence target velocity) at the normal latencies were 0.68 and 1.53, respectively. Pitch rotation alone without a target induced vergence eye movements with similar latencies after training. These results indicate that vestibular information can be used effectively to initiate vergence eye movements following vergence-vestibular training. PMID:15252701
Abstract in portuguese A vertigem posicional paroxística benigna (VPPB) corresponde a uma das vestibulopatias mais comuns e a rotação cefálica ativa um dos métodos mais modernos de avaliação da função vestibular. OBJETIVO: O objetivo desta pesquisa foi verificar se a prova de rotação cefálica ativa pode revelar sinais de disfunção do reflexo vestíbulo-ocular horizontal e/ou vertical em pacientes vertiginosos com hipótese diagnóstica de VPPB. DESENHO DO ESTUDO: Estudo de série (more) retrospectivo. MATERIAL E MÉTODO: Uma avaliação otoneurológica incluindo a eletronistagmografia computadorizada e a prova de rotação cefálica ativa, no plano horizontal e vertical foi conduzida em 100 pacientes com hipótese diagnóstica de VPPB. Resultados: Alterações isoladas ou associadas de ganho, fase e assimetria do reflexo vestíbulo-ocular horizontal e/ou vertical, foram os achados indicativos de comprometimento vestibular em 77,0% dos casos de VPPB. CONCLUSÃO: A prova de rotação cefálica ativa permitiu evidenciar distúrbios do reflexo vestíbulo-ocular horizontal e/ou vertical em relevante proporção dos pacientes com VPPB. Abstract in english Benign Positional Paroxysmal Vertigo (BPPV) is one of the most common vestibular diseases and the active head rotation test one of the most modern methods of vestibular function assessment. AIM: this study aims to verify if the active head rotation test may reveal signs of horizontal and/or vertical vestibulo-ocular reflex dysfunction in vertigo patients suspected for BPPV. STUDY DESIGN: retrospective series study. MATERIALS AND METHOD: Neurotological evaluation including (more) computerized electronystagmography and active head rotation on the horizontal and vertical axes were conducted in 100 patients suspected for BPPV patients. Results: Isolated or associated abnormalities of the horizontal and/or vertical vestibulo-ocular reflex gain, phase and symmetry were indicative of vestibular involvement and found in 77.0% of the BPPV patients. CONCLUSION: the active head rotation test revealed horizontal and/or vertical vestibulo-ocular reflex dysfunctions in a relevant number of BPPV patients.
Vestibular dysfunction in humans is associated with anxiety and cognitive disorders. However, various animal studies of the effects of vestibular loss have yielded conflicting results, from reduced anxiety to increased anxiety, depending on the particular model of vestibular dysfunction and the anxiety test used. In this study we revisited the question of whether rats with surgical bilateral vestibular deafferentation (BVD) exhibit changes in anxiety-related behaviour by testing them in the open field maze (OFM), elevated plus maze (EPM) and elevated T maze (ETM) in the presence of a non-sedating anxiolytic drug, buspirone, or an anxiogenic drug, FG-7142. We also tested the animals in a spatial T maze (STM) in order to evaluate their cognitive function under the same set of conditions. We found that BVD animals exhibited increased locomotor activity (P?0.003), reduced supported and unsupported rearing (P?0.02 and P?0.000, respectively) and reduced thigmotaxis (P?0.000) in the OFM, which for the most part the drugs did not modify. By contrast, there were no significant differences between BVD and sham control animals in the EPM and the BVD animals exhibited a marginally longer escape latency in the ETM (P?0.03), with no change in avoidance latency. In the STM, the BVD animals demonstrated a large and significant decrease in accuracy compared to the sham control animals (P?0.000), which was not affected by drug treatment. These results have replicated previous findings regarding increased locomotor activity, reduced rearing and thigmotaxis in the OFM, and impaired performance in the STM. However, they failed to replicate some previous results obtained using the EPM and ETM. Overall, they do not support the hypothesis that BVD animals exhibit increased anxiety-like behaviour and suggest that the cognitive deficits may be independent of the emotional effects of vestibular loss. PMID:22824589
Gamma Knife Radiosurgery for Benign Tumors With Symptoms From Brainstem Compression
Purpose: This study evaluated the role of radiosurgery in the management of symptomatic patients with brainstem compression from benign basal tumors. Methods and Materials: Over a 17-year, period 246 patients (202 vestibular schwannomas and 44 meningiomas) with brainstem compression from benign skull-base tumors were managed with Gamma Knife radiosurgery. Median tumor volumes were 3.9 cm{sup 3} (range, 0.8-39.0 mL) and 6.6 mL (range, 1.6-25.1 mL) for vestibular schwannomas and meningiomas, respectively. For both tumors, a median marginal dose of 13 Gy was prescribed. Median follow-up of patients was 65 months for vestibular schwannomas and 60 months for meningiomas. Patients were categorized into four groups on the basis of the tumor-brainstem relationship on neuroimaging. Results: Preservation of function was stratified according to grade of brainstem compression. We analyzed the effect of radiosurgery on symptoms of brainstem compression. The tumor control rate was 100 % for meningioma and 97% for vestibular schwannomas (although 5% required an additional procedure such as a ventriculoperitoneal shunt). In patients with vestibular schwannoma, serviceable hearing was preserved in 72.0%. Balance improved in 31.9%, remained unchanged in 56.5%, and deteriorated in 11.6% of patients who had imbalance at presentation. Balance improved significantly in patients who had less tumor compression (p = 0.0357) after radiosurgery. Symptoms improved in 43.2% of patients with meningioma. Conclusion: Radiosurgery is a minimally invasive option for patients with benign basal tumors that indent or distort the brainstem. A high tumor growth control rate and satisfactory rate of neurological preservation and symptom control can be obtained with radiosurgery.
The aim of this study was to evaluate the changes caused by different sterilization or disinfection methods on the vestibular surface of four commercially made preformed crowns using stereomicroscopy and scanning electron microscopy (SEM). Preformed crowns (NuSmile Primary Anterior Crown (NSC), Kinder Krowns (KK), Pedo Pearls (PP) and polycarbonate crowns (PC)) were sterilized and/or disinfected by one of the following techniques: no sterilization or disinfection (G1 control group); steam autoclaving at 134 degrees C (30 psi) for 4 min (G2); steam autoclaving at 134 degrees C (30 psi) for 12 min (G3); steam autoclaving at 121 degrees C (15 psi) for 30 min (G4); and ultrasonication in a bath containing 4% Lysetol AF for 5 min at room temperature (chemical disinfection) (G5). Scanning electron micrographs of the crowns were taken before and after their sterilization or disinfection. The changes on the vestibular surface were then scored for the presence or absence of crazing, contour alteration, fracturing, and vestibular surface changes. The data were analyzed statistically using the chi-square test. No changes were observed before and after sterilization or disinfection in the stereomicroscopic evaluation of the vestibular surface of the crowns. However, all methods in which steam autoclaving was used to sterilize the crowns caused significant (P < 0.05) crazing and contour alterations of the vestibular surface of the crowns when they were examined by SEM. Chemical disinfection using an aldehyde-free disinfectant is the preferred method of disinfection for crowns that have been used previously in other dental patients. PMID:19008625
Coupling of Semiconductor Nanowires with Neurons and Their Interfacial Structure
We report on the compatibility of various nanowires with hippocampal neurons and the structural study of the neuron–nanowire interface. Si, Ge, SiGe, and GaN nanowires are compatible with hippocampal neurons due to their native oxide, but ZnO nanowires are toxic to neuron due to a release of Zn ion....
Dorsal root ganglia (DRG) neurons include multiple types of sensory neurons with well-appreciated anatomical and physiological distinctions. In this issue of Neuron, Chen et al. adds to our molecular understanding of these differences by reporting that DRG11, a paired homeodomain transcription factor, is specifically required for the proper development of pain-sensing nociceptive neurons. PMID:11498043
A current-mode conductance-based silicon neuron for address-event neuromorphic systems
Silicon neuron circuits emulate the electrophysiological behavior of real neurons. Many circuits can be integrated on a single very large scale integration (VLSI) device, and form large networks of spiking neurons. Connectivity among neurons can be achieved by using time multiplexing and fast asynch...
During normal development in the cat Layer VI cortical neurons, including pyramidal cells, fusiform neurons, inverted pyramidal cells and bipolar neurons located in the gyral regions retain the vertical orientation characteristic of earlier developmental stages. However, Layer VI pyramidal neurons a...
N-cadherin regulates radial glial fiber-dependent migration of cortical locomoting neurons
During cerebral cortical development, post-mitotic neurons exhibit a multi-step migration. The locomotion mode covers most of the neuronal migration path. Although for many decades, locomoting neurons have been known to migrate along radial glial fibers, how the cortical locomoting neurons attach to...
Synaptic transmission between a graded potential neuron and a spiking neuron was investigated in vivo using sensory stimulation instead of artificial excitation of the presynaptic neuron. During visual motion stimulation, individual presynaptic and postsynaptic neurons in the brain of the fly were e...
Spatio-temporal light shaping in 3D real-time
Combining our GPC-technology with temporal focusing, we can precisely stimulate single neuronal processes, neurons or groups of neurons, despite the highly complex neuronal structures. Our recent results published in Nature Methods will be outlined and the exciting perspectives it provides for the emerging fields of neurophotonics and optogenetics.
The transcription of neuron-specific genes must be repressed in nonneuronal cells. REST/NRSF is a transcription factor that restricts the expression of many neuronal genes through interaction with the neuron-restrictive silencer element at the promoter level. PAHX-AP1 is a neuronal gene that is deve...
Advances in genomic study of cortical projection neurons
The mammalian neocortex gives rise to perception and initiates voluntary motor responses. The cortical laminae are comprised of six distinct cellular layers of local circuit neurons and projection neurons. To explore molecular identities of the distinct cortical projection neurons, discovery-orientated genomic approaches have been adopted. Microarray analysis of dissected cortical tissues has been applied to identify cortical layer markers. Early neuronal cells were sorted by FACS from GFPlabeled embryonic brains for gene expression profiling. Laser capture microdissection of retrograde-labeled projection neurons, when coupled with optimal RNA amplification technology, has become a valuable strategy for neuronal isolation and gene expression analysis in differentiated neurons. RNA sequenci...
Searching for optimal stimuli: ascending a neuron's response function.
Many methods used to analyze neuronal response assume that neuronal activity has a fundamentally linear relationship to the stimulus. However, some neurons are strongly sensitive to multiple directions in stimulus space and have a highly nonlinear response. It can be difficult to find optimal stimuli for these neurons. We demonstrate how successive linear approximations of neuronal response can effectively carry out gradient ascent and move through stimulus space towards local maxima of the response. We demonstrate search results for a simple model neuron and two models of a highly selective neuron. PMID:22580579
Searching for optimal stimuli: ascending a neuron?s response function
Many methods used to analyze neuronal response assume that neuronal activity has a fundamentally linear relationship to the stimulus. However, some neurons are strongly sensitive to multiple directions in stimulus space and have a highly nonlinear response. It can be difficult to find optimal stimuli for these neurons. We demonstrate how successive linear approximations of neuronal response can effectively carry out gradient ascent and move through stimulus space towards local maxima of the response. We demonstrate search results for a simple model neuron and two models of a highly selective neuron.
Automated identification of neurons and their locations
Individual locations of many neuronal cell bodies (>10^4) are needed to enable statistically significant measurements of spatial organization within the brain such as nearest-neighbor and microcolumnarity measurements. In this paper, we introduce an Automated Neuron Recognition Algorithm (ANRA) which obtains the (x,y) location of individual neurons within digitized images of Nissl-stained, 30 micron thick, frozen sections of the cerebral cortex of the Rhesus monkey. Identification of neurons within such Nissl-stained sections is inherently difficult due to the variability in neuron staining, the overlap of neurons, the presence of partial or damaged neurons at tissue surfaces, and the presence of non-neuron objects, such as glial cells, blood vessels, and random artifacts. To overcome these challenges and identify neurons, ANRA applies a combination of image segmentation and machine learning. The steps involve active contour segmentation to find outlines of potential neuron cell bodies followed by artificial ...
Abstract in portuguese Em pacientes com Síndrome da Imunodeficiência Adquirida há uma diminuição das células envolvidas na resposta imune, o que influencia na população celular dos folículos linfóides encontrados nas pregas vestibulares, favorecendo o aparecimento de infecções nas vias aéreas destes pacientes. Estas infecções são a principal causa de mortalidade e morbidade nestes pacientes. OBJETIVO: Caracterizar a população de células nos folículos linfóides localizados n (more) as pregas vestibulares de adultos autopsiados com Síndrome da Imunodeficiência Adquirida, com e sem infecções respiratórias associadas. MATERIAIS E MÉTODOS: Foi realizado um estudo retrospectivo transversal em 64 laringes de adultos coletadas na rotina das autopsias. Para a imunohistoquímica foram utilizados os anticorpos: Anti-B cells, Anti-CD3, Anti-CD68 e Anti-follicular dendritic cells. RESULTADOS: 46 (71,87%) dos pacientes estudados tinham diagnóstico de Síndrome da Imunodeficiência Adquirida. Nestes pacientes, a celularidade dos folículos linfóides foi estatisticamente menor em relação ao grupo controle em todos os fenótipos estudados. Nos pacientes imunodeprimidos com infecção respiratória associada, o número de células estava diminuído, sendo significante no caso dos linfócitos T (p=0,024). CONCLUSÃO: Em nosso estudo demonstramos que os folículos linfóides das pregas vestibulares são afetados pela infecção viral e representam com fidedignidade o estado imunológico de imunodepressão destes pacientes. Abstract in english Immune response cells are decreased in patients with the Acquired Immunodeficiency Syndrome. This alters the cell population in vestibular fold lymphoid follicles, leading to respiratory infections in these patients. Such infections are the main cause of mortality and morbidity in these patients. AIM: to characterize lymphoid follicle cell populations in the vestibular folds of adults with the Acquired Immunodeficiency Syndrome and associated or not respiratory infection. (more) MATERIALS AND METHODS: A retrospective study was made of 64 adult larynges harvested during routine autopsies. Anti-B cell, Anti-CD3, Anti-CD68 and Anti-follicular dendritic cell antibodies were used for immunological testing. RESULTS: 46 (71.87%) of the sample patients had the Acquired Immunodeficiency Syndrome. In these patients, lymphoid follicle cellularity was lower compared to the control group. The cell number was decreased in patients with the Acquired Immunodefficiency Syndrome and associated respiratory tract infection. CONCLUSION: We demonstrated in this study that vestibular fold lymphoid follicles were affected by viral infections, and may be considered as a reliable marker of immunodepression in these patients.
Abstract in spanish Objetivo: Analizar los resultados iniciales de un estudio prospectivo en pacientes con schwanomas vestibulares tratados con radiocirugía en la Pontificia Universidad Católica de Chile. Material y método: Se presentan 17 pacientes portadores de schwanomas vestibulares esporádicos tratados con radiocirugía y seguidos entre 6 y 26 meses. El tratamiento fue realizado con acelerador lineal Varían clinac21 EX, con equipamiento Varían-Zmed. La dosis marginal administrada (more) al tumor fue de 12 a 12,5 Gray El seguimiento a 6, 12 y 24 meses consta de resonancia magnética, audiometríay evaluación clínica. Resultados: La dosis marginal de irradiación usada fue entre 12y 12,5 Gray normalizada a la isodosis 70% u 80%. En todos los pacientes se documentó disminución de la captación de contraste del tumor y en 16 (94%) se observaron áreas de necrosis centro tumoral. No hubo mortalidad, la preservación de audición útil fue 62,5% actuaría! a 2 años. No ha existido deterioro de la función de los nervios facial ni trigémino. Todos los pacientes que previamente estaban trabajando retornaron a sus labores en promedio 11,5 días luego del tratamiento. Conclusiones: Los resultados iniciales de esta serieison comparables a los resultados publicados en la literatura y refuerzan el demostrado rol de la radiocirugía en el tratamiento de los schwanomas vestibulares. Abstract in english Objective: To analyze the preliminary experience of radiosurgery for Vestibular Schwannomas at the Pontificia Universidad Católica de Chile. Material and methods: Thefirst 17 patients with sporadic Vestibular Schwannomas treated by radiosurgery at our institution are reponed. The marginal dose used was 12 to 12.5 Gy. prescribed at the 70 or 80 isodose Une. Patients were controlled at 6, 12 and 24 months with magnetic resonance, audiometric study and clinical examination. (more) Results: In all of the 17 patients treated a decrease tumor enhancement on MR was demonstrated. In 16 patients (94%) a pattern of central tumor necrosis was observed during the firsyear Actuaría! useful hearing was maintained in 62.5% at 2 year after treatment. Facial nerve function was maintained in all of the 15 patients with normal function at treatment (100%). Trigémina! function was maintained in all of the 14 patients (100%) with previous normal trigeminal function. The mean time to return to work or normal activities was 11.5 days after treatment Conclusions: These preliminary results are comparable with results published in the literature and reinforce the demónstrate role oí radiosurgery in the management oí vestibular schwannomas.
Microglial Cx3cr1 knockout prevents neuron loss in a mouse model of Alzheimer's disease
Microglia, the immune cells of the brain, can have a beneficial effect in Alzheimer's disease by phagocytosing amyloid-?. Two-photon in vivo imaging of neuron loss in the intact brain of living Alzheimer's disease mice revealed an involvement of microglia in neuron elimination, indicated by locally increased number and migration velocity of microglia around lost neurons. Knockout of the microglial chemokine receptor Cx3cr1, which is critical in neuron-microglia communication, prevented neuron loss.
Sinusoidal galvanic vestibular stimulation (sGVS) induces a vasovagal response in the rat
Blood pressure (BP) and heart rate (HR) were studied in isoflurane-anesthetized Long-Evans rats during sinusoidal galvanic vestibular stimulation (sGVS) and sinusoidal oscillation in pitch to characterize vestibular influences on autonomic control of BP and HR. sGVS was delivered binaurally via Ag/AgCl needle electrodes inserted over the mastoids at stimulus frequencies 0.008?0.4?Hz. Two processes affecting BP and HR were induced by sGVS: 1) a transient drop in BP (?15?20?mmHg) and HR (?3 beat*s?1), followed by a slow recovery over 1?6?min; and 2) inhibitory modulations in BP (?4.5?mmHg/g) and HR (?0.15 beats*s?1/g) twice in each stimulus cycle. The BP and HR modulations were approximately in-phase with each other and were best evoked by low stimulus frequencies. A wavelet analysis indicat...
The neurofibromatoses. Part 2: NF2 and schwannomatosis.
The neurofibromatoses, including neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2), and schwannomatosis, comprise a group of genetically distinct disorders of the nervous system that are unified by the predisposition to nerve sheath tumors. All 3 types of NF have tumor manifestations (consistent with tumor-suppressor status) and nontumor manifestations. In the second part of this 2-part series, the manifestations of NF2 and schwannomatosis are reviewed. NF2 is characterized by bilateral vestibular schwannomas, meningiomas, ependymomas, cataracts, and epiretinal membranes. The combination of complete hearing loss from vestibular schwannomas and blindness from bifacial weakness is a devastating potential outcome of NF2. Schwannomatosis is characterized by multiple nonvestibular, nonintradermal schwannomas and chronic pain. Recently, germline alterations in the SMARCB1/INI1 gene have been implicated in both familial and sporadic forms of this disorder. Neurologists play an important role in the diagnosis and management of the neurofibromatoses. PMID:19898272
11b-hydroxysteroid dehydrogenase (11b-HSD) is an enzyme complex responsible for the conversion of hormonally active cortisol to inactive cortisone, and two isoforms of the enzyme (11b-HSD1 and 11b-HSD2) have been cloned and characterized. An immunohistochemical study was performed to determine the precise distribution of glucocorticoid receptors (GRs) and the isoforms of 11b-HSD in the rat (postnatal day 1, 4, 10, and adult). Immunoreactivity of GRs was detected in the stria vascularis (SV), the outer hair cells (OHCs), the inner hair cells (IHCs), the spiral ligament (SLig), the spiral limbus (SLib), the spiral ganglion cells (SGCs), Reissner’s membrane (RM), the cochlear nerve (CN), the vestibular hair cells (VHCs), the dark cells (DCs), and the vestibular nerve (VN) in the rats. ...
Mutations in COCH (coagulation factor C homology) are etiologic for the late-onset, progressive, sensorineural hearing loss and vestibular dysfunction known as DFNA9. We introduced the G88E mutation by gene targeting into the mouse and have created a CochG88E/G88E mouse model for the study of DFNA9 pathogenesis and cochlin function. Vestibular-evoked potential (VsEP) thresholds of CochG88E/G88E mice were elevated at all ages tested compared with wild-type littermates. At the oldest ages, two out of eight CochG88E/G88E mice had no measurable VsEP. Auditory brainstem response (ABR) thresholds of CochG88E/G88E mice were substantially elevated at 21 months but not at younger ages tested. At 21 months, four of eight CochG88E/G88E mice had absent ABRs at all frequencies tested and two of three C...
Extralabyrinthine Manifestations of DFNA9
DFNA9 is an autosomal dominant cause of non-syndromic adult-onset sensorineural hearing loss with associated variable vestibular dysfunction caused by mutations in the COCH gene. DFNA9 has previously been characterized by the presence of unique histopathologic features limited to the cochlear and vestibular labyrinth. This report describes newly discovered extralabyrinthine findings within the middle ear in DFNA9 and discusses their implications. The histopathologic anatomy of extralabyrinthine structures was reviewed in 12 temporal bones from seven individuals with DFNA9 and compared with age-matched controls. All temporal bones with DFNA9 had abnormal deposits within the tympanic membrane, incudomalleal joint, and incudostapedial joint. Hematoxylin and eosin stain and Movat?s pentachrome...
Abstract The acquisition of special skills can induce plastic changes in the human hippocampus, a finding demonstrated in expert navigators (Maguire et al. (2000) Proc Natl Acad Sci USA 97:4,398-403). Conversely, patients with acquired chronic bilateral vestibular loss develop atrophy of the hippocampus, which is associated with impaired spatial memory (Brandt et al. (2005) Brain 128:2,732-741). This suggests that spatial memory relies on vestibular input. In this study 21 professional dancers and slackliners were examined to assess whether balance training with extensive vestibulo-visual stimulation is associated with altered hippocampal formation volumes or spatial memory. Gray matter voxel-based morphometry showed smaller volumes in the anterior hippocampal formation and in parts of the...
Objective.We compared vibration-induced ocular vestibular evoked myogenic potentials (OVEMPs) with the visual vertical during whole-body roll tilt and eccentric rotation in healthy subjects and patients with unilateral vestibular loss, to determine which test was most sensitive in discriminating impaired utricle function.Methods. OVEMPs and the visual vertical were measured in 11 patients and 11 healthy subjects. Visual vertical was measured during roll tilts between ?9.6? and 9.6?, and during rotation at 400?/s with the head upright and the vertical rotation axis located between ?3.5 cm from the head center.Results. OVEMPs in patients were strikingly asymmetric, whereas they were approximately symmetric in healthy subjects. Patients showed impaired visual vertical gain during eccentric ro...
Conclusion. Chronic subjective dizziness (CSD) is frequent and affects twice as many women as men. Anxiety is a strong predisposing factor. The pathophysiologic concept of this disorder assumes that balance function and emotion share common neurologic pathways, which might explain that the balance disorder can provoke fear and vice versa, giving rise to a problem in perception of space and motion. In anxious patients this can turn into a space and motion phobia, with avoidance behaviour. Objective. CSD is a diagnosis based on the hypothesis of an interaction between the vestibular system and the psychiatric sphere. Patients complain of chronic imbalance, worsened by visual motion stimulation, and frequently suffer from anxiety. Vestibular examination reveals no anomalies. We evaluated the ...
Visual-manual tracking and vestibular function during a seven-day dry immersion
A seven-day dry immersion experiment provided the opportunity to study the effects of decreased proprioceptive tactile and support afferentations on the vestibular function and visual-manual tracking. Before and after immersion, six subjects participated in a video oculographic evaluation of the static torsion otolith-cervicoocular reflex (OCOR) in response to head tilt by 30? in the frontal plane and dynamic vestibular-cervicoocular reactions to head longitudinal rotations at 0.125 Hz. In addition, the hand-eye motor coordination of tracking a jerky (sinusoidal) or smooth (linear) movement of point targets along the horizontal or vertical lines was evaluated on the basis of the data of electrooculography and records of manipulations with the joystick during immersion. A computerized test ...
Incidence of airsickness among military parachutists.
This study describes the incidence of airsickness among military parachutists and analyzes the factors involved in its occurrence. Each of 45 healthy male subjects (28 students and 17 advanced parachutists) was studied. Each student participated in five parachute-jump exercises (one daily) and each advanced parachutist participated in one exercise only (proficiency). A questionnaire used for the diagnostic evaluation of motion sickness symptoms was completed by the subjects after each training exercise. A positive diagnosis of airsickness was established for 64% of the students on their first jump and for 35% of the advanced paratroopers on their proficiency jump. By the fifth jump, only 25% of the students experienced airsickness. This suggests that some students developed tolerance to airsickness after five consecutive exposures to inflight vestibular stimulation. Airsickness among student and advanced paratroopers occurred during the transport flight. This can be attributed to vestibular stimulation resulting from the aircraft maneuvers and inflight air turbulence. PMID:2775137
Spatial Reorientation of Sensorimotor Balance Control in Altered Gravity
Sensorimotor coordination of body segments following space flight are more pronounced after landing when the head is actively tilted with respect to the trunk. This suggests that central vestibular processing shifts from a gravitational frame of reference to a head frame of reference in microgravity. A major effect of such changes is a significant postural instability documented by standard head-erect Sensory Organization Tests. Decrements in functional performance may still be underestimated when head and gravity reference frames remained aligned. The purpose of this study was to examine adaptive changes in spatial processing for balance control following space flight by incorporating static and dynamic tilts that dissociate head and gravity reference frames. A second aim of this study was to examine the feasibility of altering the re-adaptation process following space flight by providing discordant visual-vestibular-somatosensory stimuli using short-radius pitch centrifugation.
Perception of the Postural Vertical and Falls in Older People
Abstract Background: Research on the relationship between vestibular function and falls in older people is sparse. The perception of the postural vertical (PPV) provides an indicator measure of vestibular (otolith) function in the absence of visual input and diminished somatosensory feedback. Objective: This study examined whether impaired PPV is associated with falls in this group. Methods: One hundred and ninety-five people aged 70 plus years stood blindfolded on a motorised platform that could be tilted in the roll plane and attempted to adjust it so that their bodies were aligned to the vertical. Somatosensory feedback was minimised as the base and vertical support surfaces on the tilting platform were covered in thick soft foam rubber. PPV error from true vertical and PPV variability ...
Abstract in portuguese Este artigo refere-se ao enjoo de movimento. Após uma breve descrição da anatomia do aparelho vestibular referimos as teorias acerca da génese do enjoo de movimento. Incidimos particular atenção na teoria do conflito de pistas (Reason & Brand, 1975), na teoria da instabilidade postural (Stoffregen & Riccio, 1991), e na teoria do veneno (Treisman, 1977). Por fim, comentamos as diversas possibilidades de previsão de sintomas e o seu tratamento. Abstract in english This article is about motion sickness. After a brief description of the anatomy of the vestibular apparatus we review the theories about the genesis of motion sickness. We will centre our attention on the cue conflict theory (Reason & Brand, 1975), on the postural instability approach (Stoffregen & Riccio, 1991), and on the poison theory (Treisman, 1977). At last we will discuss the symptoms prevision and its treatment.
Does betahistine treatment have additional benefits to vestibular rehabilitation?
The aim of this study was to investigate the effect of high-dose betahistine treatment added to vestibular rehabilitation (VR) on the disability, balance and postural stability in patients with unilateral vestibular disorder. The VR group (group 1, n?=?24) and the VR?+?betahistine group (group 2, n?=?23) were analyzed retrospectively. All patients were evaluated before and after an 8-week customized VR in terms of disability (Dizziness Handicap Inventory, DHI), dynamic balance [Dynamic Gait Index (DGI)] and postural stability (static posturography). In group 1 and group 2, differences between DHI, DGI and falling index score on static posturography before and after the exercise program were significant (p?p?0.05). Both VR and betahistine?+?VR have a positive effect on disability and bala...
It is all me: the effect of viewpoint on visual?vestibular recalibration
Participants performed a visual?vestibular motor recalibration task in virtual reality. The task consisted of keeping the extended arm and hand stable in space during a whole-body rotation induced by a robotic wheelchair. Performance was first quantified in a pre-test in which no visual feedback was available during the rotation. During the subsequent adaptation phase, optical flow resulting from body rotation was provided. This visual feedback was manipulated to create the illusion of a smaller rotational movement than actually occurred, hereby altering the visual?vestibular mapping. The effects of the adaptation phase on hand stabilization performance were measured during a post-test that was identical to the pre-test. Three different groups of subjects were exposed to different perspect...
Vertigo, was provoked and right torsional up-beat nystagmus was observed in a 47-year-old patient when she was placed into the right Hallpike-Dix test position using infrared goggle technology. The clinical diagnosis was benign paroxysmal positional vertigo (BPPV), specifically right posterior canalithiasis, resulting from a mild traumatic brain injury (TBI) suffered approximately six-months earlier. Previous medical consultations did not include vestibular system examination, and Meclizine was prescribed to suppress her chief complaint of vertigo. Ultimately, the patient was successfully managed by performing two canalith repositioning maneuvers during a single clinical session. The patient reported 100% resolution of symptoms upon reexamination the following day, and the Hallpike-Dix test was negative. Continued symptom resolution was subjectively reported 10 days postintervention via telephone consultation. This case report supports previous publications concerning the presence of BPPV following TBI and the need for inclusion of vestibular system examination during medical consultation. PMID:19826635
Abstract in portuguese Nos modelos DEA com Ganhos de Soma Zero (DEA-GSZ) a restrição dos modelos DEA clássicos de total liberdade de produção ou de uso dos recursos é substituída pela restrição de soma total constante de inputs ou outputs. Neste artigo são apresentados o modelo DEA-GSZ com retornos constantes de escala (DEA-GSZ CCR) e um estudo de caso sobre a realocação do número de aprovados em um concurso vestibular. Abstract in english When using Zero Sum Gains DEA models (ZSG-DEA), classical DEA models restriction of total freedom of production or resources use is replaced by the constant sum of inputs or outputs restriction. In this paper we develop ZSG-DEA models with constant returns to scale (ZSG-DEA CCR) and employ it in the reallocation of the quantity of approved students in the "vestibular".
Localization of prostanoid receptors in the mouse inner ear
Abstract Conclusion: EP4, EP2, and IP prostanoid receptors exert an otoprotective function and FP may be important for fluid homeostasis in the inner ear. Objective: To investigate the expression of prostanoid receptors in the normal mouse inner ear. Methods: CBA/J mice were used in this study. The localization of prostanoid receptors, i.e. DP, EP1, EP2, EP3, EP4, FP, IP, and TP, in the inner ear, i.e. the cochlea, vestibular end organs, endolymphatic sac, was studied by immunohistochemical techniques. Results: The EP4, IP, and FP prostanoid receptors were found to be abundantly distributed in many inner ear structures, i.e. stria vascularis, inner and outer hair cells, spiral ganglion cells, vestibular sensory and ganglion cells, and the endolymphatic sac. EP2 and EP3 are also localized i...
Localization of aquaporins 1, 2, and 3 and vasopressin type 2 receptor in the mouse inner ear
Abstract Conclusion: It is suggested that aquaporins (AQPs) 1, 2, and 3, and vasopressin type 2 receptors (V2Rs) in the fluid transporting cells, such as stria vascularis, vestibular dark and transitional cells, and endolymphatic sac epithelial cells, have an important role in fluid transport in the inner ear, while those in the sensory and ganglion cells may play a functional role in the sensory cell transduction system. Objective: To analyze expression of AQP1, AQP2, and AQP3 as well as V2Rs in the normal mouse inner ear. Methods: CBA/J mice were used in this study. Localization of AQP1, AQP2, AQP3, and V2Rs in the inner ear, i.e. cochlea, vestibular end organs, and endolymphatic sac, was investigated by immunohistochemistry. Results: The results show that AQP1, AQP2, AQP3, and V2Rs are ...
Objective There exist 3 communication routes between the intracranial space and the inner ear, the vestibular aqueduct, the cochlear aqueduct, and the internal auditory canal. They possess a key role in inner ear pressure regulation and fluid homeostasis and are related to inner ear diseases. Review Methods Relevant literature was reviewed, and the current knowledge of the anatomy, physiologic importance, and relations to inner ear diseases were described. Pathologic communication routes such as semicircular canal dehiscence syndrome were highlighted as well. Conclusion Abnormalities in all 3 communication routes may predispose or be the cause of distinct inner ear pathologic condition and involved in other cochlear and vestibular syndromes, in which their role is not completely clear. The...
Conclusions: TRPML3 may play distinct roles in the inner ear, such as stereociliar organization, sensory cell transduction, and inner ear fluid homeostasis, and TRPP3 may be important for fluid homeostasis in the inner ear. Objective: To study the expression of TRPML1-3 and TRPP2, 3, and 5 in the mouse inner ear. Materials and methods: Localization of TRPML1-3 and TRPP2, 3, and 5 in the inner ear of CBA/J mice was investigated by immunohistochemistry. Results: TRPML1-3 immunoreactivity was evident in the stria vascularis, spiral prominence, and spiral ligament. TRPML immunoreactivity was also observed in outer and inner hair cells, supporting cells, and spiral ganglion cells. The vestibular end organs, vestibular sensory cells, dark cells, and ganglion cells all showed immunoreactivity to ...
Enlargement of the vestibular aqueduct (EVA) is one of the most common inner ear malformations associated with sensorineural hearing loss in children. The delayed onset and progressive nature of this phenotype offer a window of opportunity to prevent or retard progression of hearing loss. EVA is not the direct cause of hearing loss in these patients, but rather is a radiologic marker for some underlying pathogenetic defect. Mutations of the SLC26A4 gene are a common cause of EVA. Studies of an Slc26a4 knockout mouse demonstrate that acidification and enlargement of the scala media are early events in the pathogenesis of deafness. The enlargement is driven by fluid secretion in the vestibular labyrinth and a failure of fluid absorption in the embryonic endolymphatic sac. Elucidating the mec...
Effects of MRI contrast agents (Omniscan) on vestibular end organs
Conclusion: These findings indicate that application of 4-16-fold diluted Omniscan could have depressant effects on the frog vestibular end organs. Based on cochlear studies on cytotoxicity using 8-fold diluted Omniscan, 16-fold diluted Omniscan is optimal for the inner ear and its application could be useful for visualization of endolymphatic hydrops as well as the control of vertiginous attacks in Meniere's disease. Objectives: Endolymphatic hydrops could be visualized recently by intratympanic injection of Omniscan diluted 8- or 16-fold with saline using three-dimensional fluid attenuated inversion recovery (3-D FLAIR) MRI. However, the effects of the Omniscan on vestibular end organs are not clearly understood. The purpose of this study was to investigate the effects of Omniscan on ves...
Cochlear implant and inner ear malformation:Proposal for an hyperosmolar therapy at surgery
SummaryThe objective of this retrospective study is to evaluate the efficiency of hyperosmolar therapy for cerebrum spinal fluid (CSF) leakage in cochlear implant (CI) surgery in children with inner ear malformations. Between 1991 and 2006, 490 cochlear implantations were performed in Armand Trousseau Childrens Hospital. Thirty-seven patients (7.5%) had inner ear malformation. They were classified as isolated enlargement of the vestibular aqueduct (EVA) (18 cases), incomplete partition (IP) (11 cases), common cavity (CC) (1 case) and variable canal and vestibular malformations (VSCC) (7 cases). A hyperosmolar protocol was applied during surgery to 13 patients after 2003 (Gp) to be compared to the 24 patients without treatment previously to this date (G0). Mean age at implant CI was 8.1 yea...
Abstract Conclusion: Our results suggest that isolated auditory or vestibular involvement is unlikely and in fact audiovestibular neuropathy can better explain auditory neuropathy. Objective: The purpose of this study was to investigate saccule and related neural pathways in auditory neuropathy patients. Methods: Three males and five females diagnosed with auditory neuropathy were included in this prospective study. Patients' ages ranged from 21 to 45 years with a mean age of 28.6 +- 8.1 years and the history of disease was between 4 and 19 years. A group of 30 normal subjects served as the control group. The main outcome measures were the mean peak latency (in ms) of the two early waves (p13 and n23) of the vestibular evoked myogenic potential (VEMP) test in patients and controls. Results...
Vestibular dysfunction in a Japanese patient with a mutation in the gene OPA1
OPA1 mutations are known to cause autosomal dominant optic atrophy (ADOA), and some types of OPA1 mutations also cause auditory neuropathy. In the present study, we evaluated the vestibular dysfunction that accompanied auditory neuropathy in a patient with an OPA1 mutation. A caloric test failed to elicit nystagmus or dizziness in either ear. Vestibular evoked myogenic potentials (VEMPs) in the right ear were characterized by a normal biphasic waveform. In contrast, no VEMPs were evoked in the left ear. Model building suggested that the OPA1 mutation, p.R445H, indirectly distorts the catalytic structure of the GTPase reaction center and decreases GTPase activity. The patient complained of instability while walking or moving but thought these symptoms were caused by visual dysfunction. This...
Peripheral Calcifying Odontogenic Cyst: A Case Report and Review of the Literature
The peripheral calcifying odontogenic cyst (PCOC) accounts for less than 25% of the cases of calcifying odontogenic cysts and most commonly appears as a nodule on the gingiva. This paper aims to present both a case report of a PCOC located in the left vestibular maxilla as well as a review of the English-language literature. An 11-year-old female patient presented a swelling in the vestibular region of teeth 12 and 13. Periapical and panoramic radiographs demonstrated irregular calcification. Surgical excision was performed. Microscopic examination showed an odontogenic cystic lesion lined by ameloblastoma-like epithelium, containing numerous ghost cells. Areas of calcification associated with ghost cells could also be observed. The patient was diagnosed with PCOC. The patient has been dis...
The roles of beaconing and dead reckoning in human virtual navigation
Beaconing is a process in which the distance between a visual landmark and current position is reduced in order to return to a location. In contrast, dead reckoning is a process in which vestibular, kinesthetic and/or optic flow cues are utilized to update speed of movement, elapsed time of movement, and direction of movement to return to a location. In the present experiment, human participants engaged in a virtual triangle-completion task devoid of vestibular cues in which they navigated two legs of an outbound path before homing (returning to the origin). However, our task was modified such that a landmark array was placed at the origin, allowing both beaconing and dead reckoning to be utilized to home. During the second leg of the outbound path, we manipulated aspects of the landmark a...
P. J. Kullar, D. M. Pearson, D. S. Malley, V. P. Collins and K. Ichimura (2010) Neuropathology and Applied Neurobiology36, 505-514CpG island hypermethylation of the neurofibromatosis type 2 (NF2) gene is rare in sporadic vestibular schwannomas Aims: Loss of both wild-type copies of the neurofibromatosis type 2 (NF2) gene is found in both sporadic and neurofibromatosis type 2-associated vestibular schwannomas (VS). Previous studies have identified a subset of VS with no loss or mutation of NF2. We hypothesized that methylation of NF2 resulting in gene silencing may play a role in such tumours. Methods: Forty sporadic VS were analysed by array comparative genomic hybridization using 1 Mb whole genome and chromosome 22 tile path arrays. The NF2 genes were sequenced and methylation of NF2 exam...
Clinical and Audio Vestibular Profile of Meniere?s Disease in a Tertiary Care Centre in India
The aims of this study are to determine the frequency of patients presenting with Meniere?s Disease(MD) in an Indian setting, using the American Academy of Otolaryngology-Head and Neck Surgery (AAO) diagnostic criteria, and to describe the clinical and audio vestibular profiles of these patients. The study was based on prospective case series design in the settings of a tertiary referral hospital. The study included all consecutive patients aged between 5 and 75 years presenting with the history of hearing loss, vertigo, tinnitus and or aural fullness as participants, satisfying inclusion and exclusion criteria for MD (AAO 1995) recruited over a 12 month period. Main outcome measures comprised the evaluation of epidemiological profile, clinical features, and results of audio vestibular inv...
Mathematical requirements of visual?vestibular integration
This article addresses the intersection between perceptual estimates of head motion based on purely vestibular and purely visual sensation, by considering how nonvisual (e.g. vestibular and proprioceptive) sensory signals for head and eye motion can be combined with visual signals available from a single landmark to generate a complete perception of self-motion. In order to do this, mathematical dimensions of sensory signals and perceptual parameterizations of self-motion are evaluated, and equations for the sensory-to-perceptual transition are derived. With constant velocity translation and vision of a single point, it is shown that visual sensation allows only for the externalization, to the frame of reference given by the landmark, of an inertial self-motion estimate from nonvisual sign...
Morphometric Nerve Fiber Analysis and Aging Process of the Human Vestibular Nerve
Myelinated and unmyelinated nerve fibers of the human vestibular nerve were analyzed with the use of a new staining method that makes it possible to discriminate various structures of the nervous tissue. An image-analyzing digitizer, a microscope with a drawing tube and a personal computer for storing data and performing statistical analyses were employed in this study. We measured the axonal numbers and transverse areas of myelinated vestibular nerve fibers in 20 cadavers, and of unmyelinated fibers in 14 cadavers. The average number of myelinated axons and unmyelinated axons were 20,318 and 2,782, and the average transverse area of their axons were 3.46 and 0.49?m2, respectively. The transverse areas of myelinated axons decreased with age, although the numbers of their axons did not change. However, in the case of unmyelinated axons, both the transverse areas and the numbers did not change.
Abstract Objective: The aim of this study was to investigate the diagnostic capacity of three different rotatory tests, and to investigate the clinical effectiveness of the caloric, rotatory, and vestibular evoked myogenic potential (VEMP) test. Design and study sample: Several rotatory tests-?sinusoidal harmonic acceleration test (SHAT), pseudorandom rotation test (PRRT), velocity step test (VST)-?and a caloric and a VEMP test, were given to 77 patients (mean age 52 years) with a unilateral peripheral vestibular pathology, and 80 control subjects (mean age 48 years). Results: For the rotatory test, the highest diagnostic capacity was obtained with the 0.01 Hz SHAT frequency, followed by 0.1 and 0.05 Hz. A higher diagnostic accuracy was reached for the caloric and VEMP test. The caloric te...
To examine the usefulness of digital tomosynthesis for conducting radiographic diagnosis of the temporal bone, visualization of various aural structures such as the semicircular canals, cochlea, vestibular apparatus, ossicles of the ear and facial nerve canal was examined in 18 volunteers. The visualization of temporal bone specimens by digital tomosynthesis and CT images (slice thickness: 1.5 mm) was compared. The results showed that this system (Digital Tomosynthesis) produced clear images of bony labyrinthine structures such as the semicircular canals, cochlea, and vestibular apparatus. Visualization of the ossicles was also clear, and their continuity could be comprehended better than on CT images. This system also provided good visualization of the labyrinthine and tympanic parts of the facial nerve canal, although CT images had greater sharpness. Visualization of the lower half of the mastoid part was poor with this system. (author).
Herpes Virus and Meniere's Disease
Abstract Objective: The main goal of this study was to examine the vestibular ganglia from patients with intractable classic Meniere's disease (MD) for the presence or absence of DNA from three neurotropic viruses herpes simplex virus 1 and 2 (HSV1, HSV2) and varicella zoster virus (VZV) and to investigate the hypothesis that MD is associated with virus reactivation within Scarpa's ganglion. Study Design: Polymerase chain reaction (PCR) was performed with nested primer sets specific for viral genomic DNA of HSV1, HSV2 and VZV in biopsies of the ganglion scarpae of patients with MD who underwent vestibular neurectomy. Included were patients with MD classified as definite MD according to American Academy of Otolaryngology/Head and Neck Surgery criteria. The ganglion scarpae and ganglion geni...
An in vitro model system to study gene therapy in the human inner ear
The confined fluid-filled labyrinth of the human inner ear presents an opportunity for introduction of gene therapy reagents designed to treat hearing and balance dysfunction. Here we present a novel model system derived from the sensory epithelia of human vestibular organs and show that the tissue can survive up to 5 days in vitro. We generated organotypic cultures from 26 human sensory epithelia excised at the time of labyrinthectomy for intractable Meniere's disease or vestibular schwannoma. We applied multiply deleted adenoviral vectors at titers between 105 and 108 viral particles/ml directly to the cultures for 4–24?h and examined the tissue 12–96?h post-transfection. We noted robust expression of the exogenous transgene, green fluorescent protein (GFP), in ha...
Viral culture and electron microscopy of ganglion cells in Meniere's disease and Bell's palsy.
Specimens of Scarpa's ganglion during vestibular neurectomy were obtained in 6 cases of Meniere's disease and specimens of geniculate ganglion in 2 cases of total facial nerve decompression and studied by tissue culture methods for detection of possible herpes and cytomegalovirus infection. In electron microscopy inclusions in the form of interwoven yarn-like structures, coarse aggregates of chromatin and light nuclear bodies were found in several vestibular ganglion cells. No typical herpes virus virions could be demonstrated. The culture for viruses all proved finally negative. At present there is no proof that viruses are present in Scarpa's or geniculate ganglions but the possibility remains that the inclusion bodies observed might be viruses inactivated inside the ganglion cells. PMID:212928
Abstract Objective: The aim of this study was to disclose possible inner ear abnormalities/pathologies by means of high-resolution computed tomography (HRCT) of the temporal bone (TBHRCT) in children with unilateral hearing loss (UHL). Methods: Retrospective review of audiological evaluation and TBHRCT in 22 children with UHL. Results: Two thirds of the children showed profound hearing loss. Review of HRCT scans identified inner ear malformations/pathologies in 9 (41%) cases and a high jugular bulb (HJB), always dehiscent with the vestibular aqueduct, in another 5 (22%). Inner ear malformations included enlarged vestibular aqueduct, common cavity and cochleovestibular hypoplasia, while labyrinthine ossification was the detected pathology. In 1 child, the common cavity of the right ear was ...
Vestibular and balance findings in nonsymptomatic workers exposed to styrene and dichloromethane
Abstract Objective: The aim of our study was to assess the vestibular and balance system in non-symptomatic workers exposed to styrene and dichloromethane at the workplace. Design: Subjects underwent videonystagmography including saccades, smooth pursuit (SP), optokinetic test (OKN), gaze nystagmus assessment, bithermal caloric test, and static posturography. Study sample: Study groups included 74 workers in plastics manufacturing, aged 40 (SD 8) years, exposed to styrene and dichloromethane, and the reference group of 49 non-exposed subjects, aged 36 (SD 10) years. Results: More than 60% of exposed and non-symptomatic workers revealed abnormal results of vestibular tests. Saccadic latency elongation (p == 0.0098), lower gain in SP (p == 0.0037) and OKN (p == 0.0000) were more common in th...
Brief Report: Further Evidence of Sensory Subtypes in Autism
Distinct sensory processing (SP) subtypes in autism have been reported previously. This study sought to replicate the previous findings in an independent sample of thirty children diagnosed with an Autism Spectrum Disorder. Model-based cluster analysis of parent-reported sensory functioning (measured using the Short Sensory Profile) confirmed the triad of sensory subtypes reported earlier. Subtypes were differentiated from each other based on degree of SP dysfunction, taste/smell sensitivity and vestibular/proprioceptive processing. Further elucidation of two of the subtypes was also achieved in this study. Children with a primary pattern of sensory-based inattention could be further described as sensory seekers or non-seekers. Children with a primary pattern of vestibular/proprioceptive dysfunction were also differentiated on movement and tactile sensitivity.
Nasal vestibular furunculosis is a mucocutaneous disorder commonly seen in the general population. Despite its prevalence in clinical practice, it has been inconsistently described and labeled in the medical literature. We present a case of nasal vestibular furunculosis presenting as recurrent exquisitely tender unilateral erythema and edema of the nasal tip (i.e., the Rudolph sign--as in Rudolph The Red Nosed Reindeer). This symptom complex responded rapidly to topical intranasal mupirocin ointment treatment after having previously failed other treatments including a topical intranasal triple antibiotic ointment and oral doxycycline. This case is instructive as it describes a heretofore under-recognized, but not uncommon, mucocutaneous clinical entity that has been linked to more serious head and neck infections and likely has relevance to the intranasal carriage of Staphylococcus aureus. We review the limited published literature on this mucocutaneous disorder including its nosology and propose future lines of investigation for better defining its clinical significance and pathogenesis. PMID:22483517
The vestibular system of the owl
Five owls were given vestibular examinations, and two of them were sacrificed to provide serial histological sections of the temporal bones. The owls exhibited a curious variability in the postrotatory head nystagmus following abrupt deceleration; sometimes a brisk nystagnus with direction opposite to that appropriate to the stimulus would occur promptly after deceleration. It was found also that owls can exhibit a remarkable head stability during angular movement of the body about any axis passing through the skull. The vestibular apparatus in the owl is larger than in man, and a prominent crista neglecta is present. The tectorial membrane, the cupula, and the otolithic membranes of the utricle, saccule, and lagena are all attached to surfaces in addition to the surfaces hearing hair cells. These attachments are very substantial in the utricular otolithic membrane and in the cupula.
Clinical and Audio Vestibular Profile of Meniere?s Disease in a Tertiary Care Centre in India
The aims of this study are to determine the frequency of patients presenting with Meniere?s Disease(MD) in an Indian setting, using the American Academy of Otolaryngology-Head and Neck Surgery (AAO) diagnostic criteria, and to describe the clinical and audio vestibular profiles of these patients. The study was based on prospective case series design in the settings of a tertiary referral hospital. The study included all consecutive patients aged between 5 and 75?years presenting with the history of hearing loss, vertigo, tinnitus and or aural fullness as participants, satisfying inclusion and exclusion criteria for MD (AAO 1995) recruited over a 12?month period. Main outcome measures comprised the evaluation of epidemiological profile, clinical features, and results of audio vestibular inv...
The expression and function of nicotinic receptor subunits (nAChRs) in the inner ear before the onset of hearing is not well understood. We investigated the mRNA expression of the ?9 and ?10 nAChR subunits in sensory hair cells of the embryonic and postnatal rat inner ear. We mapped their spatial and temporal expression in cochlear and vestibular hair cells using qPCR, [35S] labeled cRNA in situ hybridization, and ?-bungarotoxin (?-Bgt) to label the presumptive membrane-bound receptor on cochlear hair cells. The results suggest that (1) the mRNA expression of the ?9 subunit precedes expression of the ?10 subunit in both cochlear and vestibular hair cells, (2) the mRNA expression of both the ?9 and ?10 subunits occurs earlier in the ve...
Perception of tilt and ocular torsion of vestibular patients during eccentric rotation
Four patients following unilateral vestibular loss and four patients complaining of otolith-dependent vertigo were tested during eccentric yaw rotation generating 1xg centripetal acceleration directed along the interaural axis. Perception of body tilt in roll and in pitch was recorded in darkness using a somatosensory plate that the subjects maintained parallel to the perceived horizon. Ocular torsion was recorded by a video camera. Unilateral vestibular-defective patients underestimated the magnitude of the roll tilt and had a smaller torsion when the centrifugal force was towards the operated ear compared to the intact ear and healthy subjects. Patients with otolithic-dependent vertigo overestimated the magnitude of roll tilt in both directions of eccentric rotation relative to healthy s...
Purpose The aim of this study was to compare the quality and quantity of bone produced by alveolar distraction and interpositional bone grafting. Patients and Methods Twelve patients requiring alveolar reconstruction were randomly divided into 2 groups. Six patients were treated with alveolar distraction osteogenesis, and 6 were treated with the sandwich osteotomy technique and tibial bone grafting. Bone width and vestibular depth were measured before alveolar reconstruction and after reconstruction. Computed tomography bone densitometry was performed to evaluate the densities of the new bones. Results In the alveolar distraction group, the mean alveolar bone width and vestibular depth were 10.6 mm and 7.5 mm, respectively, preoperatively. The postoperative values were 10.1 mm and 9.6 mm, ...
Standing postural stability relies on input from visual, vestibular, proprioceptive and mechanoreceptive sensors. When the information from any of these sensors is unavailable or disrupted, the central nervous system maintains postural stability by relying more on the contribution from the reliable sensors, termed sensory re-weighting. Alcohol intoxication is known to affect the integrity of the vestibular and visual systems. The aim was to assess how mechanoreceptive sensory information contributed to postural stability at 0.00% (i.e. sober), 0.06% and 0.10% blood alcohol concentration (BAC) in 25 healthy subjects (mean age 25.1 years). The subjects were assessed with eyes closed and eyes open under quiet standing and while standing was perturbed by repeated, random-length, vibratory stim...
Primate disconjugate eye movements during the horizontal AVOR in darkness and a plausible mechanism
Disconjugate eye movements during the horizontal angular vestibulo-ocular reflex (AVOR) evoked in response to steps or pulses of head velocity have been previously reported in lateral eyed animals. In this study, we measured binocular responses to sustained sinusoidal and pseudo-random vestibular stimuli in yaw, delivered in darkness, in both human and monkey. The vestibular stimuli used in our experiments had peak velocities in the range of 120?200?/s, frequencies in the range of 0.17?0.5?Hz, and durations between 60 and 75?s. Our results show a large vergence component to the AVOR response that systematically modulated with head velocity. We also examined our results for temporal?nasal preponderance in slow eye velocity. Although each subject showed some degree of directional preference,...
Two studies were done during the period of support covered in this report. One was related to alterations in single unit activity in the vestibular nuclei induced by changes in head position with regard to gravity. The second was a study of effects of gravity on roll eye movements. In addition, we studied habituation and adaptive modification of the vestibulo-ocular reflex and on an analysis of semicircular canal activity and its relation to semicircular canal planes.
Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common peripheral vestibular disorders. Particle repositioning maneuvers are simple and effective treatments for patients with BPPV. This study included 37 consecutive cases of BPPV treated with the particle repositioning maneuver of Epley. 97% of patients improved and the maneuver was well tolerated. We conclude that Epley Maneuver is safe and effective in the treatment of BPPV. PMID:11526863
Visualizing How the Vestibular System Works
In this activity (page 59 of the PDF), learners spin and observe false eyelashes in jars of water (prepared at least 1 day ahead of time) to investigate the effects of different types of motion on the hairs suspended in fluid in the inner ear. The model also demonstrates how the vestibular system maintains or restores equilibrium despite movement. The lesson guide, part of NASA's "The Brain in Space: A Teacher's Guide with Activities for Neuroscience," includes background information, evaluation strategies and handouts.
NCI Funded Research Portfolio - ZIA CP004410 08240 Detail
Neurofibromatosis 2 (NF2) is an autosomal dominant disorder that predisposes to the development of bilateral tumors of the 8th cranial nerve (vestibular schwannomas), schwannomas of other cranial, spinal and peripheral nerves, meningiomas and cataracts. Other tumors such as ependymomas and glioma also occur. The initial goals of the study were to describe the spectrum of clinical features associated with NF2 and to identify the causative gene.
