Sample records for vestibular ocular reflex

  1. Vestibular-ocular accommodation reflex in man (United States)

    Clark, B.; Randle, R. J.; Stewart, J. D.


    Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present paper studies a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 sec of rotating. Accommodation was recorded continuously on an infrared optometer for 110 sec under two conditions: while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

  2. The vestibular implant: Frequency-dependency of the electrically evoked Vestibulo-Ocular Reflex in humans

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    Raymond eVan De Berg


    Full Text Available The Vestibulo-Ocular Reflex (VOR shows frequency-dependent behavior. This study investigated whether the characteristics of the electrically evoked VOR (eVOR elicited by a vestibular implant, showed the same frequency-dependency.Twelve vestibular electrodes implanted in 7 patients with bilateral vestibular hypofunction were tested. Stimuli consisted of amplitude-modulated electrical stimulation with a sinusoidal profile at frequencies of 0.5Hz, 1Hz, and 2Hz. The main characteristics of the eVOR were evaluated and compared to the natural VOR characteristics measured in a group of age-matched healthy volunteers who were subjected to horizontal whole body rotations with equivalent sinusoidal velocity profiles at the same frequencies.A strong and significant effect of frequency was observed in the total peak eye velocity of the eVOR. This effect was similar to that observed in the natural VOR. Other characteristics of the (eVOR (angle, habituation-index, and asymmetry showed no significant frequency-dependent effect. In conclusion, this study demonstrates that, at least at the specific (limited frequency range tested, responses elicited by a vestibular implant closely mimic the frequency-dependency of the normal vestibular system.

  3. Beyond the Vestibulo-Ocular Reflex: Vestibular Input is Processed Centrally to Achieve Visual Stability

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    Edwin S. Dalmaijer


    Full Text Available The current study presents a re-analysis of data from Zink et al. (1998, Electroencephalography and Clinical Neurophysiology, 107, who administered galvanic vestibular stimulation through unipolar direct current. They placed electrodes on each mastoid and applied either right or left anodal stimulation. Ocular torsion and visual tilt were measured under different stimulation intensities. New modelling introduced here demonstrates that directly proportional linear models fit reasonably well with the relationship between vestibular input and visual tilt, but not to that between vestibular input and ocular torsion. Instead, an exponential model characterised by a decreasing slope and an asymptote fitted best. These results demonstrate that in the results presented by Zink et al. (1998, ocular torsion could not completely account for visual tilt. This suggests that vestibular input is processed centrally to stabilise vision when ocular torsion is insufficient. Potential mechanisms and seemingly conflicting literature are discussed.

  4. Directional plasticity rapidly improves 3D vestibulo-ocular reflex alignment in monkeys using a multichannel vestibular prosthesis. (United States)

    Dai, Chenkai; Fridman, Gene Y; Chiang, Bryce; Rahman, Mehdi A; Ahn, Joong Ho; Davidovics, Natan S; Della Santina, Charles C


    Bilateral loss of vestibular sensation can be disabling. We have shown that a multichannel vestibular prosthesis (MVP) can partly restore vestibular sensation as evidenced by improvements in the 3-dimensional angular vestibulo-ocular reflex (3D VOR). However, a key challenge is to minimize misalignment between the axes of eye and head rotation, which is apparently caused by current spread beyond each electrode's targeted nerve branch. We recently reported that rodents wearing a MVP markedly improve 3D VOR alignment during the first week after MVP activation, probably through the same central nervous system adaptive mechanisms that mediate cross-axis adaptation over time in normal individuals wearing prisms that cause visual scene movement about an axis different than the axis of head rotation. We hypothesized that rhesus monkeys would exhibit similar improvements with continuous prosthetic stimulation over time. We created bilateral vestibular deficiency in four rhesus monkeys via intratympanic injection of gentamicin. A MVP was mounted to the cranium, and eye movements in response to whole-body passive rotation in darkness were measured repeatedly over 1 week of continuous head motion-modulated prosthetic electrical stimulation. 3D VOR responses to whole-body rotations about each semicircular canal axis were measured on days 1, 3, and 7 of chronic stimulation. Horizontal VOR gain during 1 Hz, 50 °/s peak whole-body rotations before the prosthesis was turned on was prosthetic stimulation under normal diurnal lighting. Similar improvements were noted for all animals, all three axes of rotation tested, for all sinusoidal frequencies tested (0.05-5 Hz), and for high-acceleration transient rotations. VOR asymmetry changes did not reach statistical significance, although they did trend toward slight improvement over time. Prior studies had already shown that directional plasticity reduces misalignment when a subject with normal labyrinths views abnormal visual scene

  5. Cross-axis adaptation improves 3D vestibulo-ocular reflex alignment during chronic stimulation via a head-mounted multichannel vestibular prosthesis (United States)

    Dai, Chenkai; Fridman, Gene Y.; Chiang, Bryce; Davidovics, Natan; Melvin, Thuy-Anh; Cullen, Kathleen E.; Della Santina, Charles C.


    By sensing three-dimensional (3D) head rotation and electrically stimulating the three ampullary branches of a vestibular nerve to encode head angular velocity, a multichannel vestibular prosthesis (MVP) can restore vestibular sensation to individuals disabled by loss of vestibular hair cell function. However, current spread to afferent fibers innervating non-targeted canals and otolith endorgans can distort the vestibular nerve activation pattern, causing misalignment between the perceived and actual axis of head rotation. We hypothesized that over time, central neural mechanisms can adapt to correct this misalignment. To test this, we rendered five chinchillas vestibular-deficient via bilateral gentamicin treatment and unilaterally implanted them with a head mounted MVP. Comparison of 3D angular vestibulo-ocular reflex (aVOR) responses during 2 Hz, 50°/s peak horizontal sinusoidal head rotations in darkness on the first, third and seventh days of continual MVP use revealed that eye responses about the intended axis remained stable (at about 70% of the normal gain) while misalignment improved significantly by the end of one week of prosthetic stimulation. A comparable time course of improvement was also observed for head rotations about the other two semicircular canal axes and at every stimulus frequency examined (0.2–5 Hz). In addition, the extent of disconjugacy between the two eyes progressively improved during the same time window. These results indicate that the central nervous system rapidly adapts to multichannel prosthetic vestibular stimulation to markedly improve 3D aVOR alignment within the first week after activation. Similar adaptive improvements are likely to occur in other species, including humans. PMID:21374081

  6. Vestibulo-ocular reflex and the head impulse test

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    Eliana T. Maranhão


    Full Text Available The authors highlights the importance of the vestibulo-ocular reflex examination through the head impulse test as a diagnostic method for vestibular dysfunction as well as, and primarily, a bedside semiotic resource capable of differentiating between acute peripheral vestibulopathy and a cerebellar or brainstem infarction in emergency rooms.

  7. Plasticity of the human otolith-ocular reflex (United States)

    Wall, C. 3rd; Smith, T. R.; Furman, J. M.


    The eye movement response to earth vertical axis rotation in the dark, a semicircular canal stimulus, can be altered by prior exposure to combined visual-vestibular stimuli. Such plasticity of the vestibulo-ocular reflex has not been described for earth horizontal axis rotation, a dynamic otolith stimulus. Twenty normal human subjects underwent one of two types of adaptation paradigms designed either to attenuate or enhance the gain of the semicircular canal-ocular reflex prior to undergoing otolith-ocular reflex testing with horizontal axis rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about a vertical axis with a 0.2 Hz optokinetic stripe pattern that was deliberately mismatched in peak velocity. Pre- and post-adaptation horizontal axis rotations were at 60 degrees/s in the dark and produced a modulation in the slow component velocity of nystagmus having a frequency of 0.17 Hz due to putative stimulation of the otolith organs. Results showed that the magnitude of this modulation component response was altered in a manner similar to the alteration in semicircular canal-ocular responses. These results suggest that physiologic alteration of the vestibulo-ocular reflex using deliberately mismatched visual and semicircular canal stimuli induces changes in both canal-ocular and otolith-ocular responses. We postulate, therefore, that central nervous system pathways responsible for controlling the gains of canal-ocular and otolith-ocular reflexes are shared.

  8. Model simulation studies to clarify the effect on saccadic eye movements of initial condition velocities set by the Vestibular Ocular Reflex (VOR) (United States)

    Nam, M. H.; Winters, J. M.; Stark, L.


    Voluntary active head rotations produced vestibulo-ocular reflex eye movements (VOR) with the subject viewing a fixation target. When this target jumped, the size of the refixation saccades were a function of the ongoing initial velocity of the eye. Saccades made against the VOR were larger in magnitude. Simulation of a reciprocally innervated model eye movement provided results comparable to the experimental data. Most of the experimental effect appeared to be due to linear summation for saccades of 5 and 10 degree magnitude. For small saccades of 2.5 degrees, peripheral nonlinear interaction of state variables in the neuromuscular plant also played a role as proven by comparable behavior in the simulated model with known controller signals.

  9. Ontogeny of mouse vestibulo-ocular reflex following genetic or environmental alteration of gravity sensing.

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    Mathieu Beraneck

    Full Text Available The vestibular organs consist of complementary sensors: the semicircular canals detect rotations while the otoliths detect linear accelerations, including the constant pull of gravity. Several fundamental questions remain on how the vestibular system would develop and/or adapt to prolonged changes in gravity such as during long-term space journey. How do vestibular reflexes develop if the appropriate assembly of otoliths and semi-circular canals is perturbed? The aim of present work was to evaluate the role of gravity sensing during ontogeny of the vestibular system. In otoconia-deficient mice (ied, gravity cannot be sensed and therefore maculo-ocular reflexes (MOR were absent. While canals-related reflexes were present, the ied deficit also led to the abnormal spatial tuning of the horizontal angular canal-related VOR. To identify putative otolith-related critical periods, normal C57Bl/6J mice were subjected to 2G hypergravity by chronic centrifugation during different periods of development or adulthood (Adult-HG and compared to non-centrifuged (control C57Bl/6J mice. Mice exposed to hypergravity during development had completely normal vestibulo-ocular reflexes 6 months after end of centrifugation. Adult-HG mice all displayed major abnormalities in maculo-ocular reflexe one month after return to normal gravity. During the next 5 months, adaptation to normal gravity occurred in half of the individuals. In summary, genetic suppression of gravity sensing indicated that otolith-related signals might be necessary to ensure proper functioning of canal-related vestibular reflexes. On the other hand, exposure to hypergravity during development was not sufficient to modify durably motor behaviour. Hence, 2G centrifugation during development revealed no otolith-specific critical period.

  10. Ocular vestibular evoked myogenic potential elicited from binaural air-conducted stimulations: clinical feasibility in patients with peripheral vestibular dysfunction. (United States)

    Iwasaki, Shinichi; Egami, Naoya; Inoue, Aki; Kinoshita, Makoto; Fujimoto, Chisato; Murofushi, Toshihisa; Yamasoba, Tatsuya


    Ocular vestibular evoked myogenic potentials (oVEMPs) to binaural air-conducted stimulation (ACS) may provide a convenient way of assessing the crossed vestibulo-ocular reflex in patients with vestibular dysfunction as well as in healthy subjects. To investigate the clinical feasibility of using oVEMPs in response to binaural ACS to assess normal subjects and patients with vestibular dysfunction. The study investigated 24 normal subjects (14 men and 10 women, aged from 23 to 60 years) and 14 patients with unilateral peripheral vestibular dysfunction. Each subject underwent oVEMP testing in response to monaural ACS and binaural ACS (500 Hz tone burst, 135 dBSPL). In normal subjects, bilateral oVEMPs were elicited in 75% of subjects in response to monaural ACS and in 91% in response to binaural ACS. Asymmetry ratios (ARs) of the responses to binaural ACS were significantly smaller than those of the responses to monaural ACS (p binaural ACS. Approximately 30% of patients showed reduced ARs to binaural ACS relative to monaural ACS, primarily due to contamination by uncrossed responses elicited in healthy ears.

  11. A Brief Vestibular/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussions (United States)

    Mucha, Anne; Collins, Michael W.; Elbin, R.J.; Furman, Joseph M.; Troutman-Enseki, Cara; DeWolf, Ryan M.; Marchetti, Greg; Kontos, Anthony P.


    Background Vestibular and ocular motor impairments and symptoms have been documented in patients with sport-related concussions. However, there is no current brief clinical screen to assess and monitor these issues. Purpose To describe and provide initial data for the internal consistency and validity of a brief clinical screening tool for vestibular and ocular motor impairments and symptoms after sport-related concussions. Study Design Cross-sectional study; Level of evidence, 2. Methods Sixty-four patients, aged 13.9 ± 2.5 years and seen approximately 5.5 ± 4.0 days after a sport-related concussion, and 78 controls were administered the Vestibular/Ocular Motor Screening (VOMS) assessment, which included 5 domains: (1) smooth pursuit, (2) horizontal and vertical saccades, (3) near point of convergence (NPC) distance, (4) horizontal vestibular ocular reflex (VOR), and (5) visual motion sensitivity (VMS). Participants were also administered the Post-Concussion Symptom Scale (PCSS). Results Sixty-one percent of patients reported symptom provocation after at least 1 VOMS item. All VOMS items were positively correlated to the PCSS total symptom score. The VOR (odds ratio [OR], 3.89; P concussed group. An NPC distance ≥5 cm and any VOMS item symptom score ≥2 resulted in an increase in the probability of correctly identifying concussed patients of 38% and 50%, respectively. Receiver operating characteristic curves supported a model including the VOR, VMS, NPC distance, and ln(age) that resulted in a high predicted probability (area under the curve = 0.89) for identifying concussed patients. Conclusion The VOMS demonstrated internal consistency as well as sensitivity in identifying patients with concussions. The current findings provide preliminary support for the utility of the VOMS as a brief vestibular/ocular motor screen after sport-related concussions. The VOMS may augment current assessment tools and may serve as a single component of a comprehensive approach

  12. Effect of transcranial direct current stimulation on vestibular-ocular and vestibulo-perceptual thresholds. (United States)

    Kyriakareli, Artemis; Cousins, Sian; Pettorossi, Vito E; Bronstein, Adolfo M


    Transcranial direct current stimulation (tDCS) was used in 17 normal individuals to modulate vestibulo-ocular reflex (VOR) and self-motion perception rotational thresholds. The electrodes were applied over the temporoparietal junction bilaterally. Both vestibular nystagmic and perceptual thresholds were increased during as well as after tDCS stimulation. Body rotation was labeled as ipsilateral or contralateral to the anode side, but no difference was observed depending on the direction of rotation or hemisphere polarity. Threshold increase during tDCS was greater for VOR than for motion perception. 'Sham' stimulation had no effect on thresholds. We conclude that tDCS produces an immediate and sustained depression of cortical regions controlling VOR and movement perception. Temporoparietal areas appear to be involved in vestibular threshold modulation but the differential effects observed between VOR and perception suggest a partial dissociation between cortical processing of reflexive and perceptual responses.

  13. Bone conducted vibration activates the vestibulo-ocular reflex in the guinea pig. (United States)

    Vulovic, Vedran; Curthoys, Ian S


    The aim of the study was: (a) to test whether short duration (6 ms) 500 Hz bone-conducted vibration (BCV) of the skull in alert head free guinea pigs would elicit eye movements; (b) to test whether these eye movements were vestibular in origin; and (c) to determine whether they corresponded to human eye movements to such stimuli. In this way we sought to establish the guinea pig as an acceptable model for testing the mechanism of the effect BCV on the vestibulo-ocular reflex. Consistent short-latency stimulus-locked responses to BCV were observed. The magnitude of eye displacement was directly related to stimulus intensity as recorded by accelerometers cemented onto the animal's skull. The strongest and most consistent response component was intorsion of both eyes. In lateral-eyed animals intorsion is produced by the combined contraction of the inferior rectus and superior oblique muscles. In humans the same pair of muscles acts to cause depression of the eye. To test whether the movements were vestibular we selectively ablated the vestibular endorgans: 3 of the 8 animals underwent a bilateral intratympanic injection of gentamicin, an ototoxic aminoglycoside antibiotic, to ablate their vestibular receptors. After ablation there was an overall reduction in the magnitude of eye displacement, as well as a reduction in the effectiveness of the BCV stimulus to elicit eye movements. The animals' hearing, as measured by the threshold for auditory brainstem responses, remained unchanged after gentamicin, confirming that the cochlea was not affected. The reduced magnitude of responses after vestibular receptor ablation demonstrates that the eye-movement responses to BCV are probably caused by the stimulation of vestibular receptors, which in turn activate the vestibulo-ocular reflex. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Enhancement of Otolith Specific Ocular Responses Using Vestibular Stochastic Resonance (United States)

    Fiedler, Matthew; De Dios, Yiri E.; Esteves, Julie; Galvan, Raquel; Wood, Scott; Bloomberg, Jacob; Mulavara, Ajitkumar


    Introduction: Astronauts experience disturbances in sensorimotor function after spaceflight during the initial introduction to a gravitational environment, especially after long-duration missions. Our goal is to develop a countermeasure based on vestibular stochastic resonance (SR) that could improve central interpretation of vestibular input and mitigate these risks. SR is a mechanism by which noise can assist and enhance the response of neural systems to relevant, imperceptible sensory signals. We have previously shown that imperceptible electrical stimulation of the vestibular system enhances balance performance while standing on an unstable surface. Methods: Eye movement data were collected from 10 subjects during variable radius centrifugation (VRC). Subjects performed 11 trials of VRC that provided equivalent tilt stimuli from otolith and other graviceptor input without the normal concordant canal cues. Bipolar stochastic electrical stimulation, in the range of 0-1500 microamperes, was applied to the vestibular system using a constant current stimulator through electrodes placed over the mastoid process behind the ears. In the VRC paradigm, subjects were accelerated to 216 deg./s. After the subjects no longer sensed rotation, the chair oscillated along a track at 0.1 Hz to provide tilt stimuli of 10 deg. Eye movements were recorded for 6 cycles while subjects fixated on a target in darkness. Ocular counter roll (OCR) movement was calculated from the eye movement data during periods of chair oscillations. Results: Preliminary analysis of the data revealed that 9 of 10 subjects showed an average increase of 28% in the magnitude of OCR responses to the equivalent tilt stimuli while experiencing vestibular SR. The signal amplitude at which performance was maximized was in the range of 100-900 microamperes. Discussion: These results indicate that stochastic electrical stimulation of the vestibular system can improve otolith specific responses. This will have a

  15. Ocular Motor Function in Patients with Bilateral Vestibular Weakness

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    Seyyed Amir Hossein Ghazizadeh Hashemi


    Full Text Available Introduction: Patients with bilateral weakness (BW have many difficulties in gaze stability that interfere with their normal function. The aim of this study was to evaluate ocular motor functions in patients with BW to better understand the problem of gaze instability in these patients.   Materials and Methods: Patients were referred from the Otolaryngology Department for Vestibular Assessment to our clinic between November 2014 and March 2015. We assessed ocular motor function (gaze, saccade, and smooth pursuit in patients over the age of 18 years with BW, as verified by a caloric test.   Results: Seventy-eight patients completed all the tests. The mean age of patients was 51.9 (±15.9 years, and 47 (60% were female. Abnormal results were found in five (6.4%, 32 (41%, and seven (9% patients with respect to gaze, smooth pursuit, and saccade, respectively. There were positive but relatively weak relationships between age and ocular motor results.   Conclusion:  Patients with BW suffer from dizziness and unsteadiness. These patients have abnormal function in ocular motor (especially smooth pursuit tests. The ocular motor dysfunction is responsible for gaze instability in static positions such as standing.

  16. Potencial evocado miogênico vestibular ocular: revisão de literatura


    Silva,Tatiana Rocha; Resende,Luciana Macedo de; Santos,Marco Aurélio Rocha


    RESUMO Objetivo Identificar e sistematizar os principais estudos sobre o potencial evocado miogênico vestibular ocular e suas aplicações no diagnóstico das diversas doenças vestibulares. Estratégia de pesquisa Foram localizados artigos que descrevem a utilização do potencial evocado miogênico vestibular ocular na avaliação de doenças vestibulares nas bases PubMed, Web of Science, MEDLINE, Scopus, LILACS e SciELO. Critérios de seleção Foram incluídos estudos originais, com resumo disponí...

  17. Role of the cerebellum and the vestibular apparatus in regulation of orthostatic reflexes in the cat (United States)

    Doba, N.; Reis, D. J.


    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.

  18. Research progress of the relationship between abnormal vestibular reflexes and adolescent idiopathic scoliosis

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    Yi-Lin Yang


    Full Text Available Adolescent idiopathic scoliosis (AIS is an agnogenic structural scoliosis occurring in adolescence, and the main diagnostic criteria is coronal Cobb angle >10°in total spine X-ray. Studies have shown that AIS may be associated with abnormal postural reflexes, vestibular system is an important component of postural reflexes and its mechanism in the occurrence and development of scoliosis has received wide attention in recent years. In the study, the research progress on the role of abnormal vestibular reflexes in the pathogenesis of AIS was mainly introduced to help the clinicians better understand the pathogenesis of AIS and provide new ideas for AIS study.

  19. Combined ocular and cervical vestibular evoked myogenic potential in individuals with vestibular hyporeflexia and in patients with Ménière's disease. (United States)

    Silva, Tatiana Rocha; de Resende, Luciana Macedo; Santos, Marco Aurélio Rocha

    The vestibular evoked myogenic potential is a potential of mean latency that measures the muscle response to auditory stimulation. This potential can be generated from the contraction of the sternocleidomastoid muscle and also from the contraction of extraocular muscles in response to high-intensity sounds. This study presents a combined or simultaneous technique of cervical and ocular vestibular evoked myogenic potential in individuals with changes in the vestibular system, for use in otoneurologic diagnosis. To characterize the records and analyze the results of combined cervical and ocular VEMP in individuals with vestibular hyporeflexia and in those with Ménière's disease. The study included 120 subjects: 30 subjects with vestibular hyporeflexia, 30 with Ménière's disease, and 60 individuals with normal hearing. Data collection was performed by simultaneously recording the cervical and ocular vestibular evoked myogenic potential. There were differences between the study groups (individuals with vestibular hyporeflexia and individuals with Ménière's disease) and the control group for most of wave parameters in combined cervical and ocular vestibular evoked myogenic potential. For cervical vestibular evoked myogenic potential, it was observed that the prolongation of latency of the P13 and N23 waves was the most frequent finding in the group with vestibular hyporeflexia and in the group with Ménière's disease. For ocular vestibular evoked myogenic potential, prolonged latency of N10 and P15 waves was the most frequent finding in the study groups. Combined cervical and ocular vestibular evoked myogenic potential presented relevant results for individuals with vestibular hyporeflexia and for those with Ménière's disease. There were differences between the study groups and the control group for most of the wave parameters in combined cervical and ocular vestibular evoked myogenic potential. Copyright © 2016 Associação Brasileira de Otorrinolaringologia

  20. Behavioral analysis of signals that guide learned changes in the amplitude and dynamics of the vestibulo-ocular reflex (United States)

    Raymond, J. L.; Lisberger, S. G.


    We characterized the dependence of motor learning in the monkey vestibulo-ocular reflex (VOR) on the duration, frequency, and relative timing of the visual and vestibular stimuli used to induce learning. The amplitude of the VOR was decreased or increased through training with paired head and visual stimulus motion in the same or opposite directions, respectively. For training stimuli that consisted of simultaneous pulses of head and target velocity 80-1000 msec in duration, brief stimuli caused small changes in the amplitude of the VOR, whereas long stimuli caused larger changes in amplitude as well as changes in the dynamics of the reflex. When the relative timing of the visual and vestibular stimuli was varied, brief image motion paired with the beginning of a longer vestibular stimulus caused changes in the amplitude of the reflex alone, but the same image motion paired with a later time in the vestibular stimulus caused changes in the dynamics as well as the amplitude of the VOR. For training stimuli that consisted of sinusoidal head and visual stimulus motion, low-frequency training stimuli induced frequency-selective changes in the VOR, as reported previously, whereas high-frequency training stimuli induced changes in the amplitude of the VOR that were more similar across test frequency. The results suggest that there are at least two distinguishable components of motor learning in the VOR. One component is induced by short-duration or high-frequency stimuli and involves changes in only the amplitude of the reflex. A second component is induced by long-duration or low-frequency stimuli and involves changes in the amplitude and dynamics of the VOR.

  1. Adaptation of the vertical vestibulo-ocular reflex in cats during low-frequency vertical rotation. (United States)

    Fushiki, Hiroaki; Maruyama, Motoyoshi; Shojaku, Hideo


    We examined plastic changes in the vestibulo-ocular reflex (VOR) during low-frequency vertical head rotation, a condition under which otolith inputs from the vestibular system are essential for VOR generation. For adaptive conditioning of the vertical VOR, 0.02Hz sinusoidal pitch rotation for one hour about the earth's horizontal axis was synchronized with out-of-phase vertical visual stimulation from a random dot pattern. A vertical VOR was well evoked when the upright animal rotated around the earth-horizontal axis (EHA) at low frequency due to the changing gravity stimulus and dynamic stimulation of the otoliths. After adaptive conditioning, the amplitude of the vertical VOR increased by an average of 32.1%. Our observations showing plasticity in the otolithic contribution to the VOR may provide a new strategy for visual-vestibular mismatch training in patients with otolithic disorders. This low-frequency vertical head rotation protocol also provides a model for investigating the mechanisms underlying the adaptation of VORs mediated by otolith activation. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Rapid motor learning in the translational vestibulo-ocular reflex (United States)

    Zhou, Wu; Weldon, Patrick; Tang, Bingfeng; King, W. M.; Shelhamer, M. J. (Principal Investigator)


    Motor learning was induced in the translational vestibulo-ocular reflex (TVOR) when monkeys were repeatedly subjected to a brief (0.5 sec) head translation while they tried to maintain binocular fixation on a visual target for juice rewards. If the target was world-fixed, the initial eye speed of the TVOR gradually increased; if the target was head-fixed, the initial eye speed of the TVOR gradually decreased. The rate of learning acquisition was very rapid, with a time constant of approximately 100 trials, which was equivalent to or=1 d without any reinforcement, indicating induction of long-term synaptic plasticity. Although the learning generalized to targets with different viewing distances and to head translations with different accelerations, it was highly specific for the particular combination of head motion and evoked eye movement associated with the training. For example, it was specific to the modality of the stimulus (translation vs rotation) and the direction of the evoked eye movement in the training. Furthermore, when one eye was aligned with the heading direction so that it remained motionless during training, learning was not expressed in this eye, but only in the other nonaligned eye. These specificities show that the learning sites are neither in the sensory nor the motor limb of the reflex but in the sensory-motor transformation stage of the reflex. The dependence of the learning on both head motion and evoked eye movement suggests that Hebbian learning may be one of the underlying cellular mechanisms.

  3. Peaks and troughs of three-dimensional vestibulo-ocular reflex in humans

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    Goumans, J.; Houben, M.M.J.; Dits, J.; Steen, J. van der


    The three-dimensional vestibulo-ocular reflex (3D VOR) ideally generates compensatory ocular rotations not only with a magnitude equal and opposite to the head rotation but also about an axis that is collinear with the head rotation axis. Vestibulo-ocular responses only partially fulfill this ideal

  4. Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) with chronic cough and preserved muscle stretch reflexes: evidence for selective sparing of afferent Ia fibres. (United States)

    Infante, Jon; García, Antonio; Serrano-Cárdenas, Karla M; González-Aguado, Rocío; Gazulla, José; de Lucas, Enrique M; Berciano, José


    The aim of this study was to describe five patients with cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS) with chronic cough and preserved limb muscle stretch reflexes. All five patients were in the seventh decade of age, their gait imbalance having been initiated in the fifth decade. In four patients cough antedated gait imbalance between 15 and 29 years; cough was spasmodic and triggered by variable factors. Established clinical picture included severe hypopallesthesia predominating in the lower limbs with postural imbalance, and variable degree of cerebellar axial and appendicular ataxia, dysarthria and horizontal gaze-evoked nystagmus. Upper- and lower-limb tendon jerks were preserved, whereas jaw jerk was absent. Vestibular function testing showed bilateral impairment of the vestibulo-ocular reflex. Nerve conduction studies demonstrated normal motor conduction parameters and absence or severe attenuation of sensory nerve action potentials. Somatosensory evoked potentials were absent or severely attenuated. Biceps and femoral T-reflex recordings were normal, while masseter reflex was absent or attenuated. Sympathetic skin responses were normal. Cranial MRI showed vermian and hemispheric cerebellar atrophy predominating in lobules VI, VII and VIIa. We conclude that spasmodic cough may be an integral part of the clinical picture in CANVAS, antedating the appearance of imbalance in several decades and that sparing of muscle spindle afferents (Ia fibres) is probably the pathophysiological basis of normoreflexia.

  5. Temporal dynamics of ocular position dependence of the initial human vestibulo-ocular reflex. (United States)

    Crane, Benjamin T; Tian, Junru; Demer, Joseph L


    While an ideal vestibulo-ocular reflex (VOR) generates ocular rotations compensatory for head motion, during visually guided movements, Listing's Law (LL) constrains the eye to rotational axes lying in Listing's Plane (LP). The present study was conducted to explore the recent proposal that the VOR's rotational axis is not collinear with the head's, but rather follows a time-dependent strategy intermediate between LL and an ideal VOR. Binocular LPs were defined during visual fixation in eight normal humans. The VOR was evoked by a highly repeatable transient whole-body yaw rotation in darkness at a peak acceleration of 2800 deg/s2. Immediately before rotation, subjects regarded targets 15 or 500 cm distant located at eye level, 20 degrees up, or 20 degrees down. Eye and head responses were compared with LL predictions in the position and velocity domains. LP orientation varied both among subjects and between individual subject's eyes, and rotated temporally with convergence by 5 +/- 5 degrees (+/-SEM). In the position domain, the eye compensated for head displacement even when the head rotated out of LP. Even within the first 20 ms from onset of head rotation, the ocular velocity axis tilted relative to the head axis by 30% +/- 8% of vertical gaze position. Saccades increased this tilt. Regardless of vertical gaze position, the ocular rotation axis tilted backward 4 degrees farther in abduction than in adduction. There was also a binocular vertical eye velocity transient and lateral tilt of the ocular axis. These disconjugate, short-latency axis perturbations appear intrinsic to the VOR and may have neural or mechanical origins.

  6. Contribution of the maculo-ocular reflex to gaze stability in the rabbit. (United States)

    Pettorossi, V E; Errico, P; Santarelli, R M


    The contribution of the maculo-ocular reflex to gaze stability was studied in 10 pigmented rabbits by rolling the animals at various angles of sagittal inclination of the rotation and/or longitudinal animal axes. At low frequencies (0.005-0.01 Hz) of sinusoidal stimulation the vestibulo-ocular reflex (VOR) was due to macular activation, while at intermediate and high frequencies it was mainly due to ampullar activation. The following results were obtained: 1) maculo-ocular reflex gain decreased as a function of the cosine of the angle between the rotation axis and the earth's horizontal plane. No change in gain was observed when longitudinal animal axis alone was inclined. 2) At 0 degrees of rotation axis and with the animal's longitudinal axis inclination also set at 0 degrees, the maculo-ocular reflex was oriented about 20 degrees forward and upward with respect to the earth's vertical axis. This orientation remained constant with sagittal inclinations of the rotation and/or longitudinal animal axes ranging from approximately 5 degrees upward to 30 degrees downward. When the longitudinal animal axis was inclined beyond these limits, the eye trajectory tended to follow the axis inclination. In the upside down position, the maculo-ocular reflex was anticompensatory, oblique and fixed with respect to orbital coordinates. 3) Ampullo-ocular reflex gain did not change with inclinations of the rotation and/or longitudinal animal axes. The ocular responses were consistently oriented to the stimulus plane. At intermediate frequencies the eye movement trajectory was elliptic because of directional differences between the ampullo- and maculo-ocular reflexes.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Potencial evocado miogênico vestibular ocular e cervical simultâneo em indivíduos normais


    Silva,Tatiana Rocha; Resende,Luciana Macedo de; Santos,Marco Aurélio Rocha


    RESUMO Objetivo: Caracterizar o registro e analisar os resultados do potencial evocado miogênico vestibular cervical e ocular combinado em indivíduos sem queixas auditivas e vestibulares. Métodos: Participaram da pesquisa 30 indivíduos sem queixa auditiva e com audição dentro dos padrões de normalidade. A coleta de dados foi realizada por meio do potencial evocado miogênico vestibular cervical e ocular registrados simultaneamente. Resultados: Houve diferença entre as orelhas direita e esq...

  8. Cervical and ocular vestibular evoked potentials in Machado-Joseph disease: Functional involvement of otolith pathways. (United States)

    Ribeiro, Rodrigo Souza; Pereira, Melissa Marques; Pedroso, José Luiz; Braga-Neto, Pedro; Barsottini, Orlando Graziani Povoas; Manzano, Gilberto Mastrocola


    Machado-Joseph disease is defined as an autosomal dominant ataxic disorder caused by degeneration of the cerebellum and its connections and is associated with a broad range of clinical symptoms. The involvement of the vestibular system is responsible for several symptoms and signs observed in the individuals affected by the disease. We measured cervical and ocular vestibular evoked myogenic potentials in a sample of Machado-Joseph disease patients in order to assess functional pathways involved. Bilateral measures of cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP) were obtained from 14 symptomatic patients with genetically proven Machado-Joseph disease and compared with those from a control group of 20 healthy subjects. Thirteen (93%) patients showed at least one abnormal test result; oVEMP and cVEMP responses were absent in 17/28 (61%) and 11/28 (39%) measures, respectively; and prolonged latency of cVEMP was found in 3/28 (11%) measures. Of the 13 patients with abnormal responses, 9/13 (69%) patients showed discordant abnormal responses: four with absent oVEMP and present cVEMP, two with absent cVEMP and present oVEMP, and three showed unilateral prolonged cVEMP latencies. Both otolith-related vestibulocollic and vestibulo-ocular pathways are severely affected in Machado-Joseph disease patients evaluated by VEMPs. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Vestibular control of sympathetic activity. An otolith-sympathetic reflex in humans. (United States)

    Kaufmann, H; Biaggioni, I; Voustianiouk, A; Diedrich, A; Costa, F; Clarke, R; Gizzi, M; Raphan, T; Cohen, B


    It has been proposed that a vestibular reflex originating in the otolith organs and other body graviceptors modulates sympathetic activity during changes in posture with regard to gravity. To test this hypothesis, we selectively stimulated otolith and body graviceptors sinusoidally along different head axes in the coronal plane with off-vertical axis rotation (OVAR) and recorded sympathetic efferent activity in the peroneal nerve (muscle sympathetic nerve activity, MSNA), blood pressure, heart rate, and respiratory rate. All parameters were entrained during OVAR at the frequency of rotation, with MSNA increasing in nose-up positions during forward linear acceleration and decreasing when nose-down. MSNA was correlated closely with blood pressure when subjects were within +/-90 degrees of nose-down positions with a delay of 1.4 s, the normal latency of baroreflex-driven changes in MSNA. Thus, in the nose-down position, MSNA was probably driven by baroreflex afferents. In contrast, when subjects were within +/-45 degrees of the nose-up position, i.e., when positive linear acceleration was maximal along the naso-ocipital axis, MSNA was closely related to gravitational acceleration at a latency of 0.4 s. This delay is too short for MSNA changes to be mediated by the baroreflex, but it is compatible with the delay of a response originating in the vestibular system. We postulate that a vestibulosympathetic reflex, probably originating mainly in the otolith organs, contributes to blood pressure maintenance during forward linear acceleration. Because of its short latency, this reflex may be one of the earliest mechanisms to sustain blood pressure upon standing.

  10. Electrical vestibular stimulation after vestibular deafferentation and in vestibular schwannoma.

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    Swee Tin Aw

    Full Text Available BACKGROUND: Vestibular reflexes, evoked by human electrical (galvanic vestibular stimulation (EVS, are utilized to assess vestibular function and investigate its pathways. Our study aimed to investigate the electrically-evoked vestibulo-ocular reflex (eVOR output after bilateral and unilateral vestibular deafferentations to determine the characteristics for interpreting unilateral lesions such as vestibular schwannomas. METHODS: EVOR was recorded with dual-search coils as binocular three-dimensional eye movements evoked by bipolar 100 ms-step at EVS intensities of [0.9, 2.5, 5.0, 7.5, 10.0] mA and unipolar 100 ms-step at 5 mA EVS intensity. Five bilateral vestibular deafferented (BVD, 12 unilateral vestibular deafferented (UVD, four unilateral vestibular schwannoma (UVS patients and 17 healthy subjects were tested with bipolar EVS, and five UVDs with unipolar EVS. RESULTS: After BVD, bipolar EVS elicited no eVOR. After UVD, bipolar EVS of one functioning ear elicited bidirectional, excitatory eVOR to cathodal EVS with 9 ms latency and inhibitory eVOR to anodal EVS, opposite in direction, at half the amplitude with 12 ms latency, exhibiting an excitatory-inhibitory asymmetry. The eVOR patterns from UVS were consistent with responses from UVD confirming the vestibular loss on the lesion side. Unexpectedly, unipolar EVS of the UVD ear, instead of absent response, evoked one-third the bipolar eVOR while unipolar EVS of the functioning ear evoked half the bipolar response. CONCLUSIONS: The bidirectional eVOR evoked by bipolar EVS from UVD with an excitatory-inhibitory asymmetry and the 3 ms latency difference between normal and lesion side may be useful for detecting vestibular lesions such as UVS. We suggest that current spread could account for the small eVOR to 5 mA unipolar EVS of the UVD ear.

  11. Ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo

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    Mozhgan Masoom


    Full Text Available Background and Aim: Since utricle is the main damaged organ in benign paroxysmal positional vertigo (BPPV, ocular vestibular evoked myogenic potential (oVEMP may be an appropriate method to evaluate the utricule dysfunction and the effect of disease recurrence rate on it. This study aimed to record myogenic potential in patients with benign paroxysmal positional vertigo.Methods: In a cross-sectional study, ocular myogenic potential was recorded in 25 healthy subjects and 20 patients with benign paroxysmal positional vertigo using 500 Hz-tone bursts (95 dB nHL.Results: In the affected ear, mean amplitude was lower and mean threshold was higher than those in the unaffected ear and in the normal group (p<0.05. Mean amplitude asymmetry ratio of patients was more than the healthy subjects (p0.05. Frequencies of abnormal responses in the affected ears were higher than in unaffected ears and in the normal group (p<0.05. Furthermore, the patients with recurrent vertigo showed more abnormalities than the patients with non-recurrent (p=0.030.Conclusion: In the recurrent benign paroxysmal positional vertigo, ocular vestibular evoked myogenic potential showed more damage in the utricle, suggesting this response could be used to evaluate the patients with benign paroxysmal positional vertigo.

  12. Systems analysis of the vestibulo-ocular system. [mathematical model of vestibularly driven head and eye movements (United States)

    Schmid, R. M.


    The vestibulo-ocular system is examined from the standpoint of system theory. The evolution of a mathematical model of the vestibulo-ocular system in an attempt to match more and more experimental data is followed step by step. The final model explains many characteristics of the eye movement in vestibularly induced nystagmus. The analysis of the dynamic behavior of the model at the different stages of its development is illustrated in time domain, mainly in a qualitative way.

  13. Vergence increases the gain of the human angular vestibulo-ocular reflex during peripheral hyposensitivity elicited by cold thermal irrigation. (United States)

    Tamás, László T; Lundberg, Yunxia W; Büki, Béla


    When viewing a far target, the gain of the horizontal vestibulo-ocular reflex (VOR) is around 1.0, but when viewing a near target there is an increased response. It has been shown that while this convergence-mediated modulation is unaffected by canal plugging and clinically practical transmastoid galvanic stimulation, it is eliminated by a partial peripheral gentamicin lesion. The aim of this study was to determine if convergence increases the gain during peripheral hyposensitivity elicited by cold thermal irrigation. The high frequency VOR gain was measured using video head impulse testing immediately after the cold caloric stimulus in 9 healthy human subjects with the lateral semicircular canals oriented approximately earth-vertical. Before caloric irrigation, near viewing (15 cm) increased the average VOR gain by 28% (from 1 to 1.28). Cold (24°C) water irrigation of the right ear decreased the gain to 0.66 (far viewing) and 0.82 (near viewing) (22% difference). Although vergence also increased the gain for impulses to the left to the same degree before caloric stimulus, the caloric irrigation itself (applied to the right ear) did not influence the gain for contralateral impulses. In our experiments vergence increased the gain of the human angular VOR during peripheral hyposensitivity elicited by cold thermal irrigation. These results suggest that cold irrigation does not abolish the function of the nonlinear/phasic vestibular afferent pathway.

  14. Prolonged asymmetric vestibular stimulation induces opposite, long-term effects on self-motion perception and ocular responses. (United States)

    Pettorossi, V E; Panichi, R; Botti, F M; Kyriakareli, A; Ferraresi, A; Faralli, M; Schieppati, M; Bronstein, A M


    Self-motion perception and the vestibulo-ocular reflex (VOR) were investigated in healthy subjects during asymmetric whole body yaw plane oscillations while standing on a platform in the dark. Platform oscillation consisted of two half-sinusoidal cycles of the same amplitude (40°) but different duration, featuring a fast (FHC) and a slow half-cycle (SHC). Rotation consisted of four or 20 consecutive cycles to probe adaptation further with the longer duration protocol. Self-motion perception was estimated by subjects tracking with a pointer the remembered position of an earth-fixed visual target. VOR was measured by electro-oculography. The asymmetric stimulation pattern consistently induced a progressive increase of asymmetry in motion perception, whereby the gain of the tracking response gradually increased during FHCs and decreased during SHCs. The effect was observed already during the first few cycles and further increased during 20 cycles, leading to a totally distorted location of the initial straight-ahead. In contrast, after some initial interindividual variability, the gain of the slow phase VOR became symmetric, decreasing for FHCs and increasing for SHCs. These oppositely directed adaptive effects in motion perception and VOR persisted for nearly an hour. Control conditions using prolonged but symmetrical stimuli produced no adaptive effects on either motion perception or VOR. These findings show that prolonged asymmetric activation of the vestibular system leads to opposite patterns of adaptation of self-motion perception and VOR. The results provide strong evidence that semicircular canal inputs are processed centrally by independent mechanisms for perception of body motion and eye movement control. These divergent adaptation mechanisms enhance awareness of movement toward the faster body rotation, while improving the eye stabilizing properties of the VOR.

  15. Vestibular Restoration and Adaptation in Vestibular Neuritis and Ramsay Hunt Syndrome With Vertigo. (United States)

    Martin-Sanz, Eduardo; Rueda, Almudena; Esteban-Sanchez, Jonathan; Yanes, Joaquin; Rey-Martinez, Jorge; Sanz-Fernandez, Ricardo


    To evaluate vestibular restoration and the evolution of the compensatory saccades in acute severe inflammatory vestibular nerve paralysis, including vestibular neuritis and Ramsay Hunt syndrome with vertigo. Prospective. Tertiary referral center. Vestibular neuritis (n = 18) and Ramsay Hunt syndrome patients with vertigo (n = 13) were enrolled. After treatment with oral corticosteroids, patients were followed up for 6 months. Functional recovery of the facial nerve was scored according to the House-Brackman grading system. Caloric and video head impulse tests were performed in every patient at the time of enrolment. Subsequently, successive video head impulse test (vHIT) exploration was performed at the 1, 3, and 6-month follow-up. Eighteen patients with vestibular neuritis and 13 with Ramsay Hunt syndrome and associated vertigo were included. Vestibular function was significantly worse in patients with Ramsay Hunt syndrome than in those with vestibular neuritis. Similar compensatory saccades velocity and latency values were observed in both groups, in both the caloric and initial vHIT tests. Successive vHIT results showed a significantly higher vestibulo-ocular reflex gain recovery in vestibular neuritis patients than in Ramsay Hunt syndrome patients. A significantly faster reduction in the latency, velocity, and organization of the compensatory saccades was observed in neuritis than in Ramsay Hunt syndrome patients. In addition to the recovery of the vestibulo-ocular reflex, the reduction of latency, velocity and the organization of compensatory saccades play a role in vestibular compensation.

  16. The combination of vestibular impairment and congenital sensorineural hearing loss predisposes patients to ocular anomalies, including Usher syndrome. (United States)

    Kletke, S; Batmanabane, V; Dai, T; Vincent, A; Li, S; Gordon, K A; Papsin, B C; Cushing, S L; Héon, E


    The co-occurrence of hearing impairment and visual dysfunction is devastating. Most deaf-blind etiologies are genetically determined, the commonest being Usher syndrome (USH). While studies of the congenitally deaf population reveal a variable degree of visual problems, there are no effective ophthalmic screening guidelines. We hypothesized that children with congenital sensorineural hearing loss (SNHL) and vestibular impairment were at an increased risk of having USH. A retrospective chart review of 33 cochlear implants recipients for severe to profound SNHL and measured vestibular dysfunction was performed to determine the ocular phenotype. All the cases had undergone ocular examination and electroretinogram (ERG). Patients with an abnormal ERG underwent genetic testing for USH. We found an underlying ocular abnormality in 81.81% (27/33) of cases; of which 75% had refractive errors, and 50% of those patients showed visual improvement with refractive correction. A total of 14 cases (42.42%; 14/33) had generalized rod-cone dysfunction on ERG suggestive of Usher syndrome type 1, confirmed by mutational analysis. This work shows that adding vestibular impairment as a criterion for requesting an eye exam and adding the ERG to detect USH increases the chances of detecting ocular anomalies, when compared with previous literature focusing only on congenital SNHL. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. The Dynamics of Prosthetically Elicited Vestibulo-Ocular Reflex Function Across Frequency and Context in the Rhesus Monkey

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    James O. Phillips


    Full Text Available Electrical vestibular neurostimulation may be a viable tool for modulating vestibular afferent input to restore vestibular function following injury or disease. To do this, such stimulators must provide afferent input that can be readily interpreted by the central nervous system to accurately represent head motion to drive reflexive behavior. Since vestibular afferents have different galvanic sensitivity, and different natural sensitivities to head rotational velocity and acceleration, and electrical stimulation produces aphysiological synchronous activation of multiple afferents, it is difficult to assign a priori an appropriate transformation between head velocity and acceleration and the properties of the electrical stimulus used to drive vestibular reflex function, i.e., biphasic pulse rate or pulse current amplitude. In order to empirically explore the nature of the transformation between vestibular prosthetic stimulation and vestibular reflex behavior, in Rhesus macaque monkeys we parametrically varied the pulse rate and current amplitude of constant rate and current amplitude pulse trains, and the modulation frequency of sinusoidally modulated pulse trains that were pulse frequency modulated (FM or current amplitude modulated (AM. In addition, we examined the effects of differential eye position and head position on the observed eye movement responses. We conclude that there is a strong and idiosyncratic, from canal to canal, effect of modulation frequency on the observed eye velocities that are elicited by stimulation. In addition, there is a strong effect of initial eye position and initial head position on the observed responses. These are superimposed on the relationships between pulse frequency or current amplitude and eye velocity that have been shown previously.

  18. Influence of the extraocular muscle proprioceptors on the orientation of the vestibulo-ocular reflex. (United States)

    Pettorossi, V E; Errico, P; Ferraresi, A; Manni, E


    In the intact brain lamb, unilateral electrolytic lesion of the medial dorso-lateral portion of the semilunar ganglion containing the first order neurons of the eye muscle proprioception induced modifications of the horizontal and vertical vestibulo-ocular reflex (HVOR and VVOR) which consisted in marked alterations of the trajectories of the quick phases, while the slow phases were scarcely affected. Similar results were observed after section of the branches described by Winckler in the retrobulbar region along the extraocular muscle proprioceptive information travels. These findings extend those of previous investigations carried out in decorticate animals.

  19. The horizontal and vertical cervico-ocular reflexes of the rabbit. (United States)

    Barmack, N H; Nastos, M A; Pettorossi, V E


    Horizontal and vertical cervico-ocular reflexes of the rabbit (HCOR, VCOR) were evoked by sinusoidal oscillation of the body about the vertical and longitudinal axes while the head was fixed. These reflexes were studied over a frequency range of 0.005-0.800 Hz and at stimulus amplitudes of +/- 10 degrees. When the body of the rabbit was rotated horizontally clockwise around the fixed head, clockwise conjugate eye movements were evoked. When the body was rotated about the longitudinal axis onto the right side, the right eye rotated down and the left eye rotated up. The mean gain of the HCOR (eye velocity/body velocity) rose from 0.21 and 0.005 Hz to 0.27 at 0.020 Hz and then declined to 0.06 at 0.3Hz. The gain of the VCOR was less than the gain of the HCOR by a factor of 2-3. The HCOR was measured separately and in combination with the horizontal vestibulo-ocular reflex (HVOR). These reflexes combine linearly. The relative movements of the first 3 cervical vertebrae during stimulation of the HCOR and VCOR were measured. For the HCOR, the largest angular displacement (74%) occurs between C1 and C2. For the VCOR, the largest relative angular displacement (45%) occurs between C2 and C3. Step horizontal clockwise rotation of the head and body (HVOR) evoked low velocity counterclockwise eye movements followed by fast clockwise (resetting) eye movements. Step horizontal clockwise rotation of the body about the fixed head (HCOR) evoked low velocity clockwise eye movements which were followed by fast clockwise eye movements. Step horizontal clockwise rotation of the head about the fixed body (HCOR + HVOR) evoked low velocity counterclockwise eye movements which were not interrupted by fast clockwise eye movements. These data provide further evidence for a linear combination of independent HCOR and HVOR signals.

  20. A cerebellar learning model of vestibulo-ocular reflex adaptation in wild-type and mutant mice. (United States)

    Clopath, Claudia; Badura, Aleksandra; De Zeeuw, Chris I; Brunel, Nicolas


    Mechanisms of cerebellar motor learning are still poorly understood. The standard Marr-Albus-Ito theory posits that learning involves plasticity at the parallel fiber to Purkinje cell synapses under control of the climbing fiber input, which provides an error signal as in classical supervised learning paradigms. However, a growing body of evidence challenges this theory, in that additional sites of plasticity appear to contribute to motor adaptation. Here, we consider phase-reversal training of the vestibulo-ocular reflex (VOR), a simple form of motor learning for which a large body of experimental data is available in wild-type and mutant mice, in which the excitability of granule cells or inhibition of Purkinje cells was affected in a cell-specific fashion. We present novel electrophysiological recordings of Purkinje cell activity measured in naive wild-type mice subjected to this VOR adaptation task. We then introduce a minimal model that consists of learning at the parallel fibers to Purkinje cells with the help of the climbing fibers. Although the minimal model reproduces the behavior of the wild-type animals and is analytically tractable, it fails at reproducing the behavior of mutant mice and the electrophysiology data. Therefore, we build a detailed model involving plasticity at the parallel fibers to Purkinje cells' synapse guided by climbing fibers, feedforward inhibition of Purkinje cells, and plasticity at the mossy fiber to vestibular nuclei neuron synapse. The detailed model reproduces both the behavioral and electrophysiological data of both the wild-type and mutant mice and allows for experimentally testable predictions. Copyright © 2014 the authors 0270-6474/14/347203-13$15.00/0.

  1. Vestibular Compensation in Unilateral Patients Often Causes Both Gain and Time Constant Asymmetries in The VOR

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    Mina eRanjbaran


    Full Text Available The vestibulo-ocular reflex (VOR is essential in our daily life to stabilize retinal images during head movements. Balanced vestibular functionality secures optimal reflex performance which can be distorted in case of peripheral vestibular lesions. Luckily, vestibular compensation in different neuronal sites restores VOR function to some extent over time. Studying vestibular compensation gives insight into the possible mechanisms for plasticity in the brain.In this work, novel experimental analysis tools are employed to reevaluate the VOR characteristics following unilateral vestibular lesions and compensation. Our results suggest that following vestibular lesions, asymmetric performance of the VOR is not only limited to its gain. Vestibular compensation also causes asymmetric dynamics, i.e. different time constants for the VOR during leftward or rightward passive head rotation. Potential mechanisms for these experimental observations are provided using simulation studies.

  2. Asymmetric vestibular stimulation reveals persistent disruption of motion perception in unilateral vestibular lesions. (United States)

    Panichi, R; Faralli, M; Bruni, R; Kiriakarely, A; Occhigrossi, C; Ferraresi, A; Bronstein, A M; Pettorossi, V E


    Self-motion perception was studied in patients with unilateral vestibular lesions (UVL) due to acute vestibular neuritis at 1 wk and 4, 8, and 12 mo after the acute episode. We assessed vestibularly mediated self-motion perception by measuring the error in reproducing the position of a remembered visual target at the end of four cycles of asymmetric whole-body rotation. The oscillatory stimulus consists of a slow (0.09 Hz) and a fast (0.38 Hz) half cycle. A large error was present in UVL patients when the slow half cycle was delivered toward the lesion side, but minimal toward the healthy side. This asymmetry diminished over time, but it remained abnormally large at 12 mo. In contrast, vestibulo-ocular reflex responses showed a large direction-dependent error only initially, then they normalized. Normalization also occurred for conventional reflex vestibular measures (caloric tests, subjective visual vertical, and head shaking nystagmus) and for perceptual function during symmetric rotation. Vestibular-related handicap, measured with the Dizziness Handicap Inventory (DHI) at 12 mo correlated with self-motion perception asymmetry but not with abnormalities in vestibulo-ocular function. We conclude that 1 ) a persistent self-motion perceptual bias is revealed by asymmetric rotation in UVLs despite vestibulo-ocular function becoming symmetric over time, 2 ) this dissociation is caused by differential perceptual-reflex adaptation to high- and low-frequency rotations when these are combined as with our asymmetric stimulus, 3 ) the findings imply differential central compensation for vestibuloperceptual and vestibulo-ocular reflex functions, and 4 ) self-motion perception disruption may mediate long-term vestibular-related handicap in UVL patients. NEW & NOTEWORTHY A novel vestibular stimulus, combining asymmetric slow and fast sinusoidal half cycles, revealed persistent vestibuloperceptual dysfunction in unilateral vestibular lesion (UVL) patients. The compensation of


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    Loreta Ungureanu


    Full Text Available Scope of the study: Vestibular pathology is a complex one, requiring a minute clinical evaluation, as well as numerous paraclinical investigations. The present study analyzes the contribution of the modern methods of vestibular and auditive investigation to the diagnosis of dizziness. Materials and method: The results of the investigations performed on 84 patients with peripheric vestibular syndrome, on whom a complete audiological and vestibular assessment had been also made, have been retrospectively analyzed. Results: Anamnestic data and the results of evaluation permitted classification of peripheric vestibular pathology according to topo-lesional and etiological criteria. The most frequently diagnosed diseases were: benign paroxysmal positional vertigo, Ménière syndrome and vestibular neuronitis. Conclusions: Testing of the vestibulo-ocular and vestibulo-spinal reflexes through videonystagmoscopy and, respectively, computerized dynamic posturography, besides tonal vocal audiometry and precocious auditive potentials, is especially important for a positive diagnosis and etiological differentiation of vestibular syndromes.

  4. Cervico-ocular Reflex Is Increased in People With Nonspecific Neck Pain. (United States)

    de Vries, Jurryt; Ischebeck, Britta K; Voogt, Lennard P; Janssen, Malou; Frens, Maarten A; Kleinrensink, Gert-Jan; van der Geest, Jos N


    Neck pain is a widespread complaint. People experiencing neck pain often present an altered timing in contraction of cervical muscles. This altered afferent information elicits the cervico-ocular reflex (COR), which stabilizes the eye in response to trunk-to-head movements. The vestibulo-ocular reflex (VOR) elicited by the vestibulum is thought to be unaffected by afferent information from the cervical spine. The aim of the study was to measure the COR and VOR in people with nonspecific neck pain. This study utilized a cross-sectional design in accordance with the STROBE statement. An infrared eye-tracking device was used to record the COR and the VOR while the participant was sitting on a rotating chair in darkness. Eye velocity was calculated by taking the derivative of the horizontal eye position. Parametric statistics were performed. The mean COR gain in the control group (n=30) was 0.26 (SD=0.15) compared with 0.38 (SD=0.16) in the nonspecific neck pain group (n=37). Analyses of covariance were performed to analyze differences in COR and VOR gains, with age and sex as covariates. Analyses of covariance showed a significantly increased COR in participants with neck pain. The VOR between the control group, with a mean VOR of 0.67 (SD=0.17), and the nonspecific neck pain group, with a mean VOR of 0.66 (SD=0.22), was not significantly different. Measuring eye movements while the participant is sitting on a rotating chair in complete darkness is technically complicated. This study suggests that people with nonspecific neck pain have an increased COR. The COR is an objective, nonvoluntary eye reflex and an unaltered VOR. This study shows that an increased COR is not restricted to patients with traumatic neck pain. © 2016 American Physical Therapy Association.

  5. Vestibular perception following acute unilateral vestibular lesions.

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    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  6. Vestibulo-ocular reflexes in rabbits: reduction by intravenous injection of diazepam. (United States)

    Barmack, N H; Pettorossi, V E


    We have studied the influence of intravenously administered diazepam on the horizontal (HVOR) and vertical (VVOR) vestibulo-ocular reflexes of the rabbit. The HVOR and VVOR were evoked by sinusoidal oscillation of rabbits on a rate table (0.01 to 0.8 Hz, +/- 10 degrees), and eye movements were measured with an infrared light-projection technique. The gains of the HVOR and VVOR (evoked eye velocity/head velocity) were reduced by diazepam injections of 5 microgram/kg. The dose required to produce a 50% reduction in HVOR gain was 500 microgram/kg. The time required to reduce the HVOR gain to 50% of its maximal reduction at dose of 400 microgram/kg (0.4 Hz +/- 10 degrees) was 60 s. These data suggest that diazepam might be effective as an anti-motion-sickness agent.

  7. Visuo-Vestibular Interactions (United States)


    Session TA3 includes short reports covering: (1) Vestibulo-Oculomotor Interaction in Long-Term Microgravity; (2) Effects of Weightlessness on the Spatial Orientation of Visually Induced Eye Movements; (3) Adaptive Modification of the Three-Dimensional Vestibulo-Ocular Reflex during Prolonged Microgravity; (4) The Dynamic Change of Brain Potential Related to Selective Attention to Visual Signals from Left and Right Visual Fields; (5) Locomotor Errors Caused by Vestibular Suppression; and (6) A Novel, Image-Based Technique for Three-Dimensional Eye Measurement.

  8. Assessment of otolith function using cervical and ocular vestibular evoked myogenic potentials in individuals with motion sickness. (United States)

    Singh, Niraj Kumar; Pandey, Preeti; Mahesh, Soumya


    The involvement of otolith organs in motion sickness has long been debated; however, equivocal findings exist in literature. The present study thus aimed at evaluating the otolith functioning in individuals with motion sickness. Cervical and ocular vestibular evoked myogenic potentials were recorded from 30 individuals with motion sickness, 30 professional drivers and 30 healthy individuals. The results revealed no significant difference in latencies and amplitudes between the groups (p>0.05). Nonetheless, thresholds were significantly elevated and inter-aural asymmetry ratio significantly higher in motion sickness susceptible group (p otolithic function seem the likely reasons behind motion sickness susceptibility.

  9. Evidence for cognitive vestibular integration impairment in idiopathic scoliosis patients

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    Mercier Pierre


    Full Text Available Abstract Background Adolescent idiopathic scoliosis is characterized by a three-dimensional deviation of the vertebral column and its etiopathogenesis is unknown. Various factors cause idiopathic scoliosis, and among these a prominent role has been attributed to the vestibular system. While the deficits in sensorimotor transformations have been documented in idiopathic scoliosis patients, little attention has been devoted to their capacity to integrate vestibular information for cognitive processing for space perception. Seated idiopathic scoliosis patients and control subjects experienced rotations of different directions and amplitudes in the dark and produced saccades that would reproduce their perceived spatial characteristics of the rotations (vestibular condition. We also controlled for possible alteration of the oculomotor and vestibular systems by measuring the subject's accuracy in producing saccades towards memorized peripheral targets in absence of body rotation and the gain of their vestibulo-ocular reflex. Results Compared to healthy controls, the idiopathic scoliosis patients underestimated the amplitude of their rotations. Moreover, the results revealed that idiopathic scoliosis patients produced accurate saccades to memorized peripheral targets in absence of body rotation and that their vestibulo-ocular reflex gain did not differ from that of control participants. Conclusion Overall, results of the present study demonstrate that idiopathic scoliosis patients have an alteration in cognitive integration of vestibular signals. It is possible that severe spine deformity developed partly due to impaired vestibular information travelling from the cerebellum to the vestibular cortical network or alteration in the cortical mechanisms processing the vestibular signals.

  10. Ocular vestibular evoked myogenic potentials to vertex low frequency vibration as a diagnostic test for superior canal dehiscence. (United States)

    Verrecchia, Luca; Westin, Magnus; Duan, Maoli; Brantberg, Krister


    To explore ocular vestibular evoked myogenic potentials (oVEMP) to low-frequency vertex vibration (125 Hz) as a diagnostic test for superior canal dehiscence (SCD) syndrome. The oVEMP using 125 Hz single cycle bone-conducted vertex vibration were tested in 15 patients with unilateral superior canal dehiscence (SCD) syndrome, 15 healthy controls and in 20 patients with unilateral vestibular loss due to vestibular neuritis. Amplitude, amplitude asymmetry ratio, latency and interaural latency difference were parameters of interest. The oVEMP amplitude was significantly larger in SCD patients when affected sides (53 μVolts) were compared to non-affected (17.2 μVolts) or compared to healthy controls (13.6 μVolts). Amplitude larger than 33.8 μVolts separates effectively the SCD ears from the healthy ones with sensitivity of 87% and specificity of 93%. The other three parameters showed an overlap between affected SCD ears and non-affected as well as between SCD ears and those in the two control groups. oVEMP amplitude distinguishes SCD ears from healthy ones using low-frequency vibration stimuli at vertex. Amplitude analysis of oVEMP evoked by low-frequency vertex bone vibration stimulation is an additional indicator of SCD syndrome and might serve for diagnosing SCD patients with coexistent conductive middle ear problems. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Reliability and Normative Reference Values for the Vestibular/Ocular Motor Screening (VOMS) Tool in Youth Athletes. (United States)

    Moran, Ryan N; Covassin, Tracey; Elbin, R J; Gould, Dan; Nogle, Sally


    The Vestibular/Ocular Motor Screening (VOMS) measure is a newly developed vestibular and ocular motor symptom provocation screening tool for sport-related concussions. Baseline data, psychometric properties, and reliability of the VOMS are needed to further understand the applications of this tool, especially in the youth population, where research is scarce. To establish normative data and document the internal consistency and false-positive rate of the VOMS in a sample of nonconcussed youth athletes. Cross-sectional study; Level of evidence, 3. A total of 423 youth athletes (male = 278, female = 145) between the ages of 8 and 14 years completed baseline VOMS screening before the start of their respective sport seasons. Internal consistency was measured with Cronbach α and inter-item correlations. Approximately 60% of youth athletes reported no symptom provocation on baseline VOMS assessment, with 9% to 13% scoring over the cutoff levels (score of ≥2 for any individual VOMS symptom, near point convergence distance of ≥5 cm). The VOMS displayed a high internal consistency (Cronbach α = .97) at baseline among youth athletes. The current findings provide preliminary support for the implementation of VOMS baseline assessment into clinical practice, due to a high internal consistency, strong relationships between VOMS items, and a low false-positive rate at baseline in youth athletes.

  12. Progress Toward Development of a Multichannel Vestibular Prosthesis for Treatment of Bilateral Vestibular Deficiency (United States)



    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

  13. Progress toward development of a multichannel vestibular prosthesis for treatment of bilateral vestibular deficiency. (United States)

    Fridman, Gene Y; Della Santina, Charles C


    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

  14. Development of Vestibular Stochastic Resonance as a Sensorimotor Countermeasure: Improving Otolith Ocular and Motor Task Responses (United States)

    Mulavara, Ajitkumar; Fiedler, Matthew; DeDios,Yiri E.; Galvan, Raquel; Bloomberg, Jacob; Wood, Scott


    Astronauts experience disturbances in sensorimotor function after spaceflight during the initial introduction to a gravitational environment, especially after long-duration missions. Stochastic resonance (SR) is a mechanism by which noise can assist and enhance the response of neural systems to relevant, imperceptible sensory signals. We have previously shown that imperceptible electrical stimulation of the vestibular system enhances balance performance while standing on an unstable surface. The goal of our present study is to develop a countermeasure based on vestibular SR that could improve central interpretation of vestibular input and improve motor task responses to mitigate associated risks.

  15. Response of pontomedullary reticulospinal neurons to vestibular stimuli in vertical planes. Role in vertical vestibulospinal reflexes of the decerebrate cat (United States)

    Bolton, P. S.; Goto, T.; Schor, R. H.; Wilson, V. J.; Yamagata, Y.; Yates, B. J.


    1. To investigate the neural substrate of vestibulospinal reflexes in decerebrate cats, we studied the responses of pontomedullary reticulospinal neurons to natural stimulation of the labyrinth in vertical planes. Our principal aim was to determine whether reticulospinal neurons that terminate in, or are likely to give off collaterals to, the upper cervical segments had properties similar to those of the vestibulocollic reflex (VCR). 2. Antidromic stimulation was used to determine whether the neurons projected to the neck, lower cervical, thoracic, or lumbar levels. Dynamics of the responses of spontaneously firing neurons were studied with sinusoidal stimuli delivered at 0.05-1 Hz and aligned to the plane of body rotation, that produced maximal modulation of the neuron (response vector orientation). Each neuron was assigned a vestibular input classification of otolith, vertical canal, otolith + canal, or spatial-temporal convergence (STC). 3. We found, in agreement with previous studies, that the largest fraction of pontomedullary reticulospinal neurons projected to the lumbar cord, and that only a small number ended in the neck segments. Neurons projecting to all levels of the spinal cord had similar responses to labyrinth stimulation. 4. Reticulospinal neurons that received only vertical canal inputs were rare (1 of 67 units). Most reticulospinal neurons (48%) received predominant otolith inputs, 18% received otolith + canal input, and only 9% had STC behavior. These data are in sharp contrast to the results of our previous studies of vestibulospinal neurons. A considerable portion of vestibulospinal neurons receives vertical canal input (38%), fewer receive predominantly otolith input (22%), whereas the proportion that have otolith + canal input or STC behavior is similar to our present reticulospinal data. 5. The response vector orientations of our reticulospinal neurons, particularly those with canal inputs (canal, otolith + canal, STC) were predominantly in

  16. Prediction of Vestibular Imbalance in Acute Peripheral Vestibulopathy by Measuring Horizontal Ocular Deviation on Magnetic Resonance Imaging. (United States)

    Yang, Yeon-Jun; Kim, Kun Woo; Choi, Ji Eun; Lee, Min Young; Yoo, Dong Soo; Jung, Jae Yun


    The aim of the study is to evaluate whether horizontal ocular deviation (OD) from MR imaging in the emergency room (ER) reflects vestibular imbalance, by comparing the horizontal OD in patients with acute vestibulopathy to controls. Retrospective review. A total of 69 patients with acute unilateral peripheral vestibulopathy and 30 healthy subjects were included. Horizontal OD was quantified by using the axial T2-weighted fast-spin echo (FSE) images of the brain at 1.5 T. In the study group, the results of VFTs (videonystagmography [VNG], caloric test, rotary chair test, and cervical vestibular evoked myogenic potentials [cVEMP]) were also reviewed. The averaged angle of right and left horizontal ODs was compared between patients with acute unilateral vestibulopathy and healthy controls. Also, the correlation between horizontal OD and results of VFTs was analyzed in the study group. The averaged angle of horizontal OD in study group (23.7° ± 11.6°) was significantly greater than that of control group (4.27° ± 3.7°) (p < 0.05). Horizontal OD significantly correlated with slow phase velocity of spontaneous nystagmus (SN), the value of caloric paresis (CP) on caloric testing, rotary chair gain, asymmetry ratio of rotary chair test and interaural difference (IAD) of cVEMP, regardless of time intervals between magnetic resonance imaging (MRI) and VFTs. Horizontal OD significantly correlated with parameters of VFT which reflect the vestibular imbalance. Therefore, horizontal OD can be used as an indicator of unilateral peripheral vestibular weakness.

  17. Non-linear interaction of angular and translational vestibulo-ocular reflex during eccentric rotation in the monkey

    Czech Academy of Sciences Publication Activity Database

    Fuhry, L.; Nedvídek, Jan; Haburcakova, C.; Büttner, U.


    Roč. 143, č. 3 (2002), s. 303-317 ISSN 0014-4819 R&D Projects: GA ČR GA309/97/0556 Grant - others:DFG(DE) FU 291/2-1 Institutional research plan: CEZ:AV0Z5011922 Keywords : otolith * vestibulo-ocular reflex * macaque monkey Subject RIV: FH - Neurology Impact factor: 2.300, year: 2002

  18. Vestibulo-Ocular Reflex Abnormalities in Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Tayyebe Fallahnezhad


    Full Text Available Introduction: Benign paroxysmal positional vertigo (BPPV, involving the semicircular canals, is one of the most common diseases of the inner ear. The video head impulse test (vHIT is a new test that examines the function of the canals. This study aimed to investigate the vestibulo-ocular reflex (VOR gain, gain asymmetry and saccades after stimulating all six canals in patients definitively diagnosed with posterior semicircular canal BPPV (PSC-BPPV.   Materials and Methods: Twenty-nine unilateral PSC-BPPV patients with normal oculographic and caloric results were enrolled in this study. vHIT was performed on six canals, and VOR gain, gain asymmetry and saccades were measured.   Results: Sixteen (55.17% patients had abnormal posterior canal VOR gains in the ipsilesional ear. VOR gains in both horizontal canals were within normal limits. Superior canal VOR gains were mostly lower than normal and were not correlated to PSC abnormalities (P>0.05. No corrective saccades could be observed.   Conclusion: VOR gain in the direction of the posterior semicircular canal may be reduced in PSC-BPPV patients. Evaluation of PSC-VOR parameters could be beneficial, although superior canal measurements should be interpreted with caution.

  19. Vestibulo-ocular reflex gain values in the suppression head impulse test of healthy subjects. (United States)

    Rey-Martinez, Jorge; Thomas-Arrizabalaga, Izaskun; Espinosa-Sanchez, Juan Manuel; Batuecas-Caletrio, Angel; Trinidad-Ruiz, Gabriel; Matiño-Soler, Eusebi; Perez-Fernandez, Nicolas


    To assess whether there are differences in vestibulo-ocular reflex (VOR) gain for suppression head impulse (SHIMP) and head impulse (HIMP) video head impulse test paradigms, and if so, what are their causes. Prospective multicenter observational double-blind nonrandomized clinical study was performed by collecting 80 healthy subjects from four reference hospitals. SHIMP data was postprocessed to eliminate impulses in which early SHIMP saccades were detected. Differences between HIMP and SHIMP VOR gain values were statistically evaluated. Head impulse maximum velocity, gender, age, direction of impulse, and hospital center were considered as possible influential factors. A small significant statistical difference between HIMP and SHIMP VOR gain values was found on repeated measures analysis of variance (-0.05 ± 0.006, P gain values and did not find influence between gain values differences and maximum head impulse velocity. Both HIMP and SHIMP VOR gain values were significant lower (-0.09, P gain values not adequately explained by known gain modification factors. The persistence of this slight but significant difference indicates that there are more factors causing lower SHIMP VOR gain values. This difference must to be considered in further studies as well as in the clinical SHIMP testing protocols. We hypothesized that VOR phasic response inhibition could be the underlying cause of this difference. IIb. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Are Covert Saccade Functionally Relevant in Vestibular Hypofunction? (United States)

    Hermann, R; Pelisson, D; Dumas, O; Urquizar, Ch; Truy, E; Tilikete, C


    The vestibulo-ocular reflex maintains gaze stabilization during angular or linear head accelerations, allowing adequate dynamic visual acuity. In case of bilateral vestibular hypofunction, patients use saccades to compensate for the reduced vestibulo-ocular reflex function, with covert saccades occurring even during the head displacement. In this study, we questioned whether covert saccades help maintain dynamic visual acuity, and evaluated which characteristic of these saccades are the most relevant to improve visual function. We prospectively included 18 patients with chronic bilateral vestibular hypofunction. Subjects underwent evaluation of dynamic visual acuity in the horizontal plane as well as video recording of their head and eye positions during horizontal head impulse tests in both directions (36 ears tested). Frequency, latency, consistency of covert saccade initiation, and gain of covert saccades as well as residual vestibulo-ocular reflex gain were calculated. We found no correlation between residual vestibulo-ocular reflex gain and dynamic visual acuity. Dynamic visual acuity performance was however positively correlated with the frequency and gain of covert saccades and negatively correlated with covert saccade latency. There was no correlation between consistency of covert saccade initiation and dynamic visual acuity. Even though gaze stabilization in space during covert saccades might be of very short duration, these refixation saccades seem to improve vision in patients with bilateral vestibular hypofunction during angular head impulses. These findings emphasize the need for specific rehabilitation technics that favor the triggering of covert saccades. The physiological origin of covert saccades is discussed.

  1. Three-dimensional analysis of otolith-ocular reflex during eccentric rotation in humans. (United States)

    Takimoto, Yasumitsu; Imai, Takao; Okumura, Tomoko; Takeda, Noriaki; Inohara, Hidenori


    When a participant is rotated while displaced from the axis of rotation (eccentric rotation, ER), both rotational stimulation and linear acceleration are applied to the participant. As linear acceleration stimulates the otolith, the vestibulo-ocular reflex (VOR) caused by the otolith (linear VOR; lVOR) would be induced during ER. Ten participants were rotated sinusoidally at a maximum angular velocity of 50°/s and at frequencies of 0.1, 0.3, 0.5, and 0.7Hz. The radius of rotation during ER was 90cm. The participants sat on a chair at three different positions: on the axis (center rotation, CR), at 90cm backward from the axis (nose-in ER, NI-ER) and at 90cm forward from the axis (nose-out ER, NO-ER). Their eye movements during rotation were recorded and analyzed three-dimensionally. The VOR gain during NI-ER was lower at 0.5 and 0.7Hz, and that during NO-ER was higher at 0.3, 0.5, and 0.7Hz than during CR. These results indicate that lVOR actually worked at 0.5 and 0.7Hz during ER and that the enhancement and decline of the VOR gain relative to the VOR gain during CR was seen in humans. Thus, we suggest that otolith function can be assessed via rotational testing of NI-ER and NO-ER. Copyright © 2016 Elsevier Ireland Ltd and Japan Neuroscience Society. All rights reserved.

  2. A Study of Relationship between the Acoustic Sensitivity of Vestibular System and the Ability to Trigger Sound-Evoked Muscle Reflex of the Middle Ear in Adults with Normal Hearing

    Directory of Open Access Journals (Sweden)

    S.F. Emami


    Full Text Available Introduction & Objective: The vestibular system is sound sensitive and the sensitivity is related to the saccule. The vestibular afferents are projected to the middle ear muscles (such as the stapedius. The goal of this research was studying the relationship between the vestibular hearing and the sound-evoked muscle reflex of the middle ear to 500 HZ. Materials & Methods: This study was a cross sectional-comparison done in audiology department of Sheikholreis C‍‍linic (Hamadan, Iran. The study groups consisted of thirty healthy people and thirty patients with benign paroxysmal positional vertigo. Inclusion criteria of the present study were to have normal hearing on pure tone audiometry, acoustic reflex, and speech discrimination scores. Based on ipsilateral acoustic reflex test at 500HZ, they were divided to normal and abnormal groups. Then they were evaluated by cervical vestibular evoked myogenic potentials (cVEMPs and finally classified in three groups (N Normal ear , (CVUA Contra lateral vertiginous ear with unaffected saccular sensitivity to sound,(IVA Ipsilateral vertiginous ear with affected saccular sensitivity to sound. Results: Thirty affected ears (IVA with decreased vestibular excitability as detected by ab-normal cVEMPs, revealed abnormal findings of acoustic reflex at 500HZ. Whereas, both un-affected (CVUA and normal ears (N had normal results. Multiple comparisons of mean values of cVEMPs (p13,n23 and acoustic reflex at500HZ among the three groups were sig-nificant. The correlation between acoustic reflex at 500HZ and p13 latencies was significant. The n23 latencies showed significant correlation with acoustic reflex at 500HZ. Conclusion: The vestibular sensitivity to sound retains the ability to trigger sound-evoked re-flex of the middle ear at 500 HZ. (Sci J Hamadan Univ Med Sci 2014; 21 (2:99-104

  3. Practice guideline: Cervical and ocular vestibular evoked myogenic potential testing: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. (United States)

    Fife, Terry D; Colebatch, James G; Kerber, Kevin A; Brantberg, Krister; Strupp, Michael; Lee, Hyung; Walker, Mark F; Ashman, Eric; Fletcher, Jeffrey; Callaghan, Brian; Gloss, David S


    To systematically review the evidence and make recommendations with regard to diagnostic utility of cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP, respectively). Four questions were asked: Does cVEMP accurately identify superior canal dehiscence syndrome (SCDS)? Does oVEMP accurately identify SCDS? For suspected vestibular symptoms, does cVEMP/oVEMP accurately identify vestibular dysfunction related to the saccule/utricle? For vestibular symptoms, does cVEMP/oVEMP accurately and substantively aid diagnosis of any specific vestibular disorder besides SCDS? The guideline panel identified and classified relevant published studies (January 1980-December 2016) according to the 2004 American Academy of Neurology process. Level C positive: Clinicians may use cVEMP stimulus threshold values to distinguish SCDS from controls (2 Class III studies) (sensitivity 86%-91%, specificity 90%-96%). Corrected cVEMP amplitude may be used to distinguish SCDS from controls (2 Class III studies) (sensitivity 100%, specificity 93%). Clinicians may use oVEMP amplitude to distinguish SCDS from normal controls (3 Class III studies) (sensitivity 77%-100%, specificity 98%-100%). oVEMP threshold may be used to aid in distinguishing SCDS from controls (3 Class III studies) (sensitivity 70%-100%, specificity 77%-100%). Level U: Evidence is insufficient to determine whether cVEMP and oVEMP can accurately identify vestibular function specifically related to the saccule/utricle, or whether cVEMP or oVEMP is useful in diagnosing vestibular neuritis or Ménière disease. Level C negative: It has not been demonstrated that cVEMP substantively aids in diagnosing benign paroxysmal positional vertigo, or that cVEMP or oVEMP aids in diagnosing/managing vestibular migraine. © 2017 American Academy of Neurology.

  4. Modification of Otolith-Ocular Reflexes, Motion Perception and Manual Control During Variable Radius Centrifugation Following Space Flight (United States)

    Wood, Scott J.; Clarke, A. H.; Rupert, A. H.; Harm, D. L.; Clement, G. R.


    Two joint ESA-NASA studies are examining changes in otolith-ocular reflexes and motion perception following short duration space flights, and the operational implications of post-flight tilt-translation ambiguity for manual control performance. Vibrotactile feedback of tilt orientation is also being evaluated as a countermeasure to improve performance during a closed-loop nulling task. Data is currently being collected on astronaut subjects during 3 preflight sessions and during the first 8 days after Shuttle landings. Variable radius centrifugation is utilized to elicit otolith reflexes in the lateral plane without concordant roll canal cues. Unilateral centrifugation (400 deg/s, 3.5 cm radius) stimulates one otolith positioned off-axis while the opposite side is centered over the axis of rotation. During this paradigm, roll-tilt perception is measured using a subjective visual vertical task and ocular counter-rolling is obtained using binocular video-oculography. During a second paradigm (216 deg/s, less than 20 cm radius), the effects of stimulus frequency (0.15 - 0.6 Hz) are examined on eye movements and motion perception. A closed-loop nulling task is also performed with and without vibrotactile display feedback of chair radial position. Data collection is currently ongoing. Results to date suggest there is a trend for perceived tilt and translation amplitudes to be increased at the low and medium frequencies on landing day compared to pre-flight. Manual control performance is improved with vibrotactile feedback. One result of this study will be to characterize the variability (gain, asymmetry) in both otolith-ocular responses and motion perception during variable radius centrifugation, and measure the time course of post-flight recovery. This study will also address how adaptive changes in otolith-mediated reflexes correspond to one's ability to perform closed-loop nulling tasks following G-transitions, and whether manual control performance can be improved

  5. A reevaluation of the vestibulo-ocular reflex: new ideas of its purpose, properties, neural substrate, and disorders (United States)

    Leigh, R. J.; Brandt, T.


    Conventional views of the vestibulo-ocular reflex (VOR) have emphasized testing with caloric stimuli and by passively rotating patients at low frequencies in a chair. The properties of the VOR tested under these conditions differ from the performance of this reflex during the natural function for which it evolved--locomotion. Only the VOR (and not visually mediated eye movements) can cope with the high-frequency angular and linear perturbations of the head that occur during locomotion; this is achieved by generating eye movements at short latency (disorders that disrupt the VOR cause not just only nystagmus, but also instability of posture (eg, increased fore-aft sway in patients with downbeat nystagmus) and disturbance of spatial orientation (eg, tilt of the subjective visual vertical in Wallenberg's syndrome).

  6. Adaptation of the vestibulo-ocular reflex for forward-eyed foveate vision (United States)

    Migliaccio, Americo A; Minor, Lloyd B; Santina, Charles C Della


    To maintain visual fixation on a distant target during head rotation, the angular vestibulo-ocular reflex (aVOR) should rotate the eyes at the same speed as the head and in exactly the opposite direction. However, in primates for which the 3-dimensional (3D) aVOR has been extensively characterised (humans and squirrel monkeys (Saimiri sciureus)), the aVOR response to roll head rotation about the naso-occipital axis is lower than that elicited by yaw and pitch, causing errors in aVOR magnitude and direction that vary with the axis of head rotation. In other words, primates keep the central part of the retinal image on the fovea (where photoreceptor density and visual acuity are greatest) but fail to keep that image from twisting about the eyes' resting optic axes. We tested the hypothesis that aVOR direction dependence is an adaptation related to primates' frontal-eyed, foveate status through comparison with the aVOR of a lateral-eyed, afoveate mammal (Chinchilla lanigera). As chinchillas' eyes are afoveate and never align with each other, we predicted that the chinchilla aVOR would be relatively low in gain and isotropic (equal in gain for every head rotation axis). In 11 normal chinchillas, we recorded binocular 3D eye movements in darkness during static tilts, 20–100 deg s−1 whole-body sinusoidal rotations (0.5–15 Hz), and 3000 deg s−2 acceleration steps. Although the chinchilla 3D aVOR gain changed with both frequency and peak velocity over the range we examined, we consistently found that it was more nearly isotropic than the primate aVOR. Our results suggest that primates' anisotropic aVOR represents an adaptation to their forward-eyed, foveate status. In primates, yaw and pitch aVOR must be compensatory to stabilise images on both foveae, whereas roll aVOR can be under-compensatory because the brain tolerates torsion of binocular images that remain on the foveae. In contrast, the lateral-eyed chinchilla faces different adaptive demands and thus

  7. Migraine patients consistently show abnormal vestibular bedside tests

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    Eliana Teixeira Maranhão


    Full Text Available Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs.Objective To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls.Method Cross-sectional study including sixty individuals – thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls.Results Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity.Conclusion Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  8. Migraine patients consistently show abnormal vestibular bedside tests. (United States)

    Maranhão, Eliana Teixeira; Maranhão-Filho, Péricles; Luiz, Ronir Raggio; Vincent, Maurice Borges


    Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs. To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR) responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls. Cross-sectional study including sixty individuals - thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls. Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity). Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  9. Pitfalls and Rewards for Implementing Ocular Motor Testing in Acute Vestibular Syndrome: A Pilot Project. (United States)

    Dumitrascu, Oana M; Torbati, Sam; Tighiouart, Mourad; Newman-Toker, David E; Song, Shlee S


    Isolated acute vestibular syndrome (iAVS) presentations to the emergency department (ED) pose management challenges, given the concerns for posterior circulation strokes. False-negative brain imaging may erroneously reassure clinicians, whereas HINTS-plus examination outperforms imaging to screen for strokes in iAVS. We studied the feasibility of implementing HINTS-plus testing in the ED, aiming to reduce neuroimaging in patients with iAVS. We launched an institutional Quality Improvement initiative, using DMAIC methodology. The outcome measures [proportion of iAVS subjects who had HINTS-plus examinations and underwent neuroimaging by computed tomography/magnetic resonance imaging (CT/MRI)] were compared before and after the established intervention. The intervention consisted of formal training for neurologists and emergency physicians on how to perform, document, and interpret HINTS-plus and implementation of novel iAVS management algorithm. Neuroimaging was not recommended if HINTS-plus suggested peripheral vestibular etiology. If a central process was suspected, brain MRI/MR angiogram was performed. Head CT was reserved only for thrombolytic time-window cases. In the first 2 months postimplementation, HINTS-plus testing performance by neurologists increased from 0% to 80% (P=0.007), and by ED providers from 0% to 9.09% (P=0.367). Head CT scans were reduced from 18.5% to 6.25%. Brain MRI use was reduced from 51.8% to 31.2%. About 60% of the iAVS subjects were discharged from the ED; none were readmitted or had another ED presentation in the ensuing 30 days. Implementation of HINTS-plus evaluation in the ED is valuable and feasible for neurologists, but challenging for emergency physicians. Future studies should determine the "dose-response" curve of educational interventions.

  10. Comparison of bone-conducted vibration for eliciting ocular vestibular-evoked myogenic potentials: forehead versus mastoid tapping. (United States)

    Tseng, Chia-Chen; Wang, Shou-Jen; Young, Yi-Ho


    This study compared bone-conducted vibration (BCV) stimuli at forehead (Fz) and mastoid sites for eliciting ocular vestibular-evoked myogenic potentials (oVEMPs). Prospective study. University hospital. Twenty healthy subjects underwent oVEMP testing via BCV stimuli at Fz and mastoid sites. Another 50 patients with unilateral Meniere's disease also underwent oVEMP testing. All healthy subjects showed clear oVEMPs via BCV stimulation regardless of the tapping sites. The right oVEMPs stimulated by tapping at the right mastoid had earlier nI and pI latencies and a larger nI-pI amplitude compared with those stimulated by tapping at the Fz and left mastoid. Similar trends were also observed in left oVEMPs. However, the asymmetry ratio did not differ significantly between the ipsilateral mastoid and Fz sites. Clinically, tapping at the Fz revealed absent oVEMPs in 28% of Meniere's ears, which decreased to 16% when tapping at the ipsilesional (hydropic) mastoid site, exhibiting a significant difference. Tapping at the ipsilateral mastoid site elicits earlier oVEMP latencies and larger oVEMP amplitudes when compared with tapping at the Fz site. Thus, tapping at the Fz site is suggested to screen for the otolithic function, whereas tapping at the ipsilesional mastoid site is suitable for evaluating residual otolithic function.

  11. The efficiency of simultaneous binaural ocular vestibular evoked myogenic potentials: a comparative study with monaural acoustic stimulation in healthy subjects. (United States)

    Kim, Min-Beom; Ban, Jae Ho


    To evaluate the test-retest reliability and convenience of simultaneous binaural acoustic-evoked ocular vestibular evoked myogenic potentials (oVEMP). Thirteen healthy subjects with no history of ear diseases participated in this study. All subjects underwent oVEMP test with both separated monaural acoustic stimulation and simultaneous binaural acoustic stimulation. For evaluating test-retest reliability, three repetitive sessions were performed in each ear for calculating the intraclass correlation coefficient (ICC) for both monaural and binaural tests. We analyzed data from the biphasic n1-p1 complex, such as latency of peak, inter-peak amplitude, and asymmetric ratio of amplitude in both ears. Finally, we checked the total time required to complete each test for evaluating test convenience. No significant difference was observed in amplitude and asymmetric ratio in comparison between monaural and binaural oVEMP. However, latency was slightly delayed in binaural oVEMP. In test-retest reliability analysis, binaural oVEMP showed excellent ICC values ranging from 0.68 to 0.98 in latency, asymmetric ratio, and inter-peak amplitude. Additionally, the test time was shorter in binaural than monaural oVEMP. oVEMP elicited from binaural acoustic stimulation yields similar satisfactory results as monaural stimulation. Further, excellent test-retest reliability and shorter test time were achieved in binaural than in monaural oVEMP.

  12. Vestibular signals in primate cortex for self-motion perception. (United States)

    Gu, Yong


    The vestibular peripheral organs in our inner ears detect transient motion of the head in everyday life. This information is sent to the central nervous system for automatic processes such as vestibulo-ocular reflexes, balance and postural control, and higher cognitive functions including perception of self-motion and spatial orientation. Recent neurophysiological studies have discovered a prominent vestibular network in the primate cerebral cortex. Many of the areas involved are multisensory: their neurons are modulated by both vestibular signals and visual optic flow, potentially facilitating more robust heading estimation through cue integration. Combining psychophysics, computation, physiological recording and causal manipulation techniques, recent work has addressed both the encoding and decoding of vestibular signals for self-motion perception. Copyright © 2018. Published by Elsevier Ltd.

  13. Vestibular dysfunction in Turner syndrome: a case report. (United States)

    Baxter, Michael; Agrawal, Yuri


    Turner syndrome is a well-known cause of sensorineural hearing loss, and the lack of estrogen has been implicated in cochlear dysfunction. It has never been associated with vestibular dysfunction. We report a case of a patient with Turner syndrome who was found to have bilateral vestibular dysfunction based on video-oculography (VOG) testing. A single patient with a history of Turner syndrome who was found to have significant bilateral vestibular dysfunction. After noticing a deficit in the vestibulo-ocular reflexes on qualitative horizontal head impulse examination, the patient underwent VOG testing. VOG testing quantatively measures angular vestibulo-ocular reflex (AVOR) gain in the horizontal semicircular canal plane. AVOR gain represents the eye movement response to a head movement; in normal individuals the eye movement is fully compensatory and gain values are close to unity. VOG results showed AVOR gains of 0.29 and 0.36 on the right and left sides, respectively. We have presented a case of a woman with Turner syndrome with asymptomatic vestibular dysfunction demonstrated with VOG testing. Although there is a documented relationship between Turner syndrome and sensorineural hearing loss, there are no previous studies or case reports linking Turner syndrome and vestibular dysfunction. Additional research and added vigilance in monitoring Turner syndrome patients may be warranted.

  14. Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control. (United States)

    Low Choy, Nancy L; Lucey, Mary-Therese M; Lewandowski, Susan L; Panizza, Benedict J


    To investigate balance, community mobility, gaze instability, and dizziness handicap and assess falls risk in people who are conservatively managed with small vestibular schwannoma (VS). Cross-sectional study with controls. The study involved 18 people (mean age 58.7 ± 12.2 years) diagnosed with VS (<12 mm) and 22 age-matched controls (mean age 56.9 ± 8.0 years). Measures included standing on firm and foam surfaces with feet apart, then together with eyes open and closed, Timed Up and Go (TUG) test and dual TUG test, Dynamic Gait Index, 6-Minute Walk Test, Halmagyi Impulse Test, Dynamic Visual Acuity Test, and the Dizziness Handicap Inventory. The clinical group failed more trials standing feet together on foam with eyes closed (P < .05); had inferior mobility and walked more slowly with divided attention (P < .05); had more difficulty walking with head movement, negotiating obstacles, and using stairs (P < .01); and walked shorter distances (P < .001) than controls. Reduced gaze stability (P < .01) and higher total (P = .007) and subcategory dizziness handicap scores (P < .05) were revealed compared to age-matched controls. Although outcomes for the clinical group are inferior to the control group across all measures and the dizziness impact is higher, the results fall in the low-risk category for falls. Preliminary data (level 4 evidence) support using a suite of clinical measures to monitor people with VS during conservative management. 4 Laryngoscope, 127:1147-1152, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Contribution of the otoliths to the human torsional vestibulo-ocular reflex

    NARCIS (Netherlands)

    Groen, Eric; Bos, Jelte E.; De Graaf, Bernd


    The dynamic contribution of the otolith organs to the human ocular torsion response was examined during passive sinusoidal body roll about an earth-horizontal axis (varying otolith inputs) and about an earth-vertical axis (invariant otolith inputs). Torsional eye movements were registered in 5

  16. Contribution of the otholiths to the human torsional vestibulo-ocular reflex

    NARCIS (Netherlands)

    Groen, E.L.; Bos, J.E.; Graaf, J.E. de


    The dynamic contribution of the otoliths to the human ocular torsion response was examined during passive sinusoidal body roll about an earth-horizontal axis (varying otolith input) and about an earth-vertical axis (unvarying otolith input). At a fixed amplitude of 25°, the stimulus frequency was

  17. Acute inhibition of estradiol synthesis impacts vestibulo-ocular reflex adaptation and cerebellar long-term potentiation in male rats. (United States)

    Dieni, Cristina V; Ferraresi, Aldo; Sullivan, Jacqueline A; Grassi, Sivarosa; Pettorossi, Vito E; Panichi, Roberto


    The vestibulo-ocular reflex (VOR) adaptation is an ideal model for investigating how the neurosteroid 17 beta-estradiol (E2) contributes to the modification of behavior by regulating synaptic activities. We hypothesized that E2 impacts VOR adaptation by affecting cerebellar synaptic plasticity at the parallel fiber-Purkinje cell (PF) synapse. To verify this hypothesis, we investigated the acute effect of blocking E2 synthesis on gain increases and decreases in adaptation of the VOR in male rats using an oral dose (2.5 mg/kg) of the aromatase inhibitor letrozole. We also assessed the effect of letrozole on synaptic plasticity at the PF synapse in vitro, using cerebellar slices from male rats. We found that letrozole acutely impaired both gain increases and decreases adaptation of the VOR without altering basal ocular-motor performance. Moreover, letrozole prevented long-term potentiation at the PF synapse (PF-LTP) without affecting long-term depression (PF-LTD). Thus, in male rats neurosteroid E2 has a relevant impact on VOR adaptation and affects exclusively PF-LTP. These findings suggest that E2 might regulate changes in VOR adaptation by acting locally on cerebellar and extra-cerebellar synaptic plasticity sites.

  18. Enhancing vestibular function in the elderly with imperceptible electrical stimulation. (United States)

    Serrador, Jorge M; Deegan, Brian M; Geraghty, Maria C; Wood, Scott J


    Age-related loss of vestibular function can result in decrements in gaze stabilization and increased fall risk in the elderly. This study was designed to see if low levels of electrical stochastic noise applied transcutaneously to the vestibular system can improve a gaze stabilization reflex in young and elderly subject groups. Ocular counter-rolling (OCR) using a video-based technique was obtained in 16 subjects during low frequency passive roll tilts. Consistent with previous studies, there was a significant reduction in OCR gains in the elderly compared to the young group. Imperceptible stochastic noise significantly increased OCR in the elderly (Mean 23%, CI: 17-35%). Increases in OCR gain were greatest for those with lowest baseline gain and were negligible in those with normal gain. Since stimulation was effective at low levels undetectable to subjects, stochastic noise may provide a new treatment alternative to enhance vestibular function, specifically otolith-ocular reflexes, in the elderly or patient populations with reduced otolith-ocular function.

  19. Quantification of vestibular-induced eye movements in zebrafish larvae

    Directory of Open Access Journals (Sweden)

    Mo Weike


    Full Text Available Abstract Background Vestibular reflexes coordinate movements or sensory input with changes in body or head position. Vestibular-evoked responses that involve the extraocular muscles include the vestibulo-ocular reflex (VOR, a compensatory eye movement to stabilize retinal images. Although an angular VOR attributable to semicircular canal stimulation was reported to be absent in free-swimming zebrafish larvae, recent studies reveal that vestibular-induced eye movements can be evoked in zebrafish larvae by both static tilts and dynamic rotations that tilt the head with respect to gravity. Results We have determined herein the basis of sensitivity of the larval eye movements with respect to vestibular stimulus, developmental stage, and sensory receptors of the inner ear. For our experiments, video recordings of larvae rotated sinusoidally at 0.25 Hz were analyzed to quantitate eye movements under infrared illumination. We observed a robust response that appeared as early as 72 hours post fertilization (hpf, which increased in amplitude over time. Unlike rotation about an earth horizontal axis, rotation about an earth vertical axis at 0.25 Hz did not evoke eye movements. Moreover, vestibular-induced responses were absent in mutant cdh23 larvae and larvae lacking anterior otoliths. Conclusions Our results provide evidence for a functional vestibulo-oculomotor circuit in 72 hpf zebrafish larvae that relies upon sensory input from anterior/utricular otolith organs.

  20. Baseline vestibular and auditory findings in a trial of post-concussive syndrome (United States)

    Meehan, Anna; Searing, Elizabeth; Weaver, Lindell; Lewandowski, Andrew


    Previous studies have reported high rates of auditory and vestibular-balance deficits immediately following head injury. This study uses a comprehensive battery of assessments to characterize auditory and vestibular function in 71 U.S. military service members with chronic symptoms following mild traumatic brain injury that did not resolve with traditional interventions. The majority of the study population reported hearing loss (70%) and recent vestibular symptoms (83%). Central auditory deficits were most prevalent, with 58% of participants failing the SCAN3:A screening test and 45% showing abnormal responses on auditory steady-state response testing presented at a suprathreshold intensity. Only 17% of the participants had abnormal hearing (⟩25 dB hearing loss) based on the pure-tone average. Objective vestibular testing supported significant deficits in this population, regardless of whether the participant self-reported active symptoms. Composite score on the Sensory Organization Test was lower than expected from normative data (mean 69.6 ±vestibular tests, vestibulo-ocular reflex, central auditory dysfunction, mild traumatic brain injury, post-concussive symptoms, hearing15.6). High abnormality rates were found in funduscopy torsion (58%), oculomotor assessments (49%), ocular and cervical vestibular evoked myogenic potentials (46% and 33%, respectively), and monothermal calorics (40%). It is recommended that a full peripheral and central auditory, oculomotor, and vestibular-balance evaluation be completed on military service members who have sustained head trauma.

  1. Effect of spaceflight on the spatial orientation of the vestibulo-ocular reflex during eccentric roll rotation: A case report. (United States)

    Reschke, Millard F; Wood, Scott J; Clément, Gilles


    Ground-based studies have reported shifts of the vestibulo-ocular reflex (VOR) slow phase velocity (SPV) axis toward the resultant gravito-inertial force vector. The VOR was examined during eccentric roll rotation before, during and after an 8-day orbital mission. On orbit this vector is aligned with the head z-axis. Our hypothesis was that eccentric roll rotation on orbit would generate horizontal eye movements. Two subjects were rotated in a semi-supine position with the head nasal-occipital axis parallel to the axis of rotation and 0.5 m off-center. The chair accelerated at 120 deg/s2 to 120 deg/s, rotated at constant velocity for one minute, and then decelerated to a stop in similar fashion. On Earth, the stimulation primarily generated torsional VOR. During spaceflight, in one subject torsional VOR became horizontal VOR, and then decayed very slowly. In the other subject, torsional VOR was reduced on orbit relative to pre- and post-flight, but the SPV axis did not rotate. We attribute the shift from torsional to horizontal VOR on orbit to a spatial orientation of velocity storage toward alignment with the gravito-inertial force vector, and the inter-individual difference to cognitive factors related to the subjective straight-ahead.

  2. Habituation to novel visual vestibular environments with special reference to space flight (United States)

    Young, L. R.; Kenyon, R. V.; Oman, C. M.


    The etiology of space motion sickness and the underlying physiological mechanisms associated with spatial orientation in a space environment were investigated. Human psychophysical experiments were used as the basis for the research concerning the interaction of visual and vestibular cues in the development of motion sickness. Particular emphasis is placed on the conflict theory in terms of explaining these interactions. Research on the plasticity of the vestibulo-ocular reflex is discussed.

  3. Central adaptation to repeated galvanic vestibular stimulation: implications for pre-flight astronaut training.

    Directory of Open Access Journals (Sweden)

    Valentina Dilda

    Full Text Available Healthy subjects (N = 10 were exposed to 10-min cumulative pseudorandom bilateral bipolar Galvanic vestibular stimulation (GVS on a weekly basis for 12 weeks (120 min total exposure. During each trial subjects performed computerized dynamic posturography and eye movements were measured using digital video-oculography. Follow up tests were conducted 6 weeks and 6 months after the 12-week adaptation period. Postural performance was significantly impaired during GVS at first exposure, but recovered to baseline over a period of 7-8 weeks (70-80 min GVS exposure. This postural recovery was maintained 6 months after adaptation. In contrast, the roll vestibulo-ocular reflex response to GVS was not attenuated by repeated exposure. This suggests that GVS adaptation did not occur at the vestibular end-organs or involve changes in low-level (brainstem-mediated vestibulo-ocular or vestibulo-spinal reflexes. Faced with unreliable vestibular input, the cerebellum reweighted sensory input to emphasize veridical extra-vestibular information, such as somatosensation, vision and visceral stretch receptors, to regain postural function. After a period of recovery subjects exhibited dual adaption and the ability to rapidly switch between the perturbed (GVS and natural vestibular state for up to 6 months.

  4. Central adaptation to repeated galvanic vestibular stimulation: implications for pre-flight astronaut training. (United States)

    Dilda, Valentina; Morris, Tiffany R; Yungher, Don A; MacDougall, Hamish G; Moore, Steven T


    Healthy subjects (N = 10) were exposed to 10-min cumulative pseudorandom bilateral bipolar Galvanic vestibular stimulation (GVS) on a weekly basis for 12 weeks (120 min total exposure). During each trial subjects performed computerized dynamic posturography and eye movements were measured using digital video-oculography. Follow up tests were conducted 6 weeks and 6 months after the 12-week adaptation period. Postural performance was significantly impaired during GVS at first exposure, but recovered to baseline over a period of 7-8 weeks (70-80 min GVS exposure). This postural recovery was maintained 6 months after adaptation. In contrast, the roll vestibulo-ocular reflex response to GVS was not attenuated by repeated exposure. This suggests that GVS adaptation did not occur at the vestibular end-organs or involve changes in low-level (brainstem-mediated) vestibulo-ocular or vestibulo-spinal reflexes. Faced with unreliable vestibular input, the cerebellum reweighted sensory input to emphasize veridical extra-vestibular information, such as somatosensation, vision and visceral stretch receptors, to regain postural function. After a period of recovery subjects exhibited dual adaption and the ability to rapidly switch between the perturbed (GVS) and natural vestibular state for up to 6 months.

  5. Dizziness and Imbalance in the Elderly: Age-related Decline in the Vestibular System (United States)

    Iwasaki, Shinichi; Yamasoba, Tatsuya


    Dizziness and imbalance are amongst the most common complaints in older people, and are a growing public health concern since they put older people at a significantly higher risk of falling. Although the causes of dizziness in older people are multifactorial, peripheral vestibular dysfunction is one of the most frequent causes. Benign paroxysmal positional vertigo is the most frequent form of vestibular dysfunction in the elderly, followed by Meniere’s disease. Every factor associated with the maintenance of postural stability deteriorates during aging. Age-related deterioration of peripheral vestibular function has been demonstrated through quantitative measurements of the vestibulo-ocular reflex with rotational testing and of the vestibulo-collic reflex with testing of vestibular evoked myogenic potentials. Age-related decline of vestibular function has been shown to correlate with the age-related decrease in the number of vestibular hair cells and neurons. The mechanism of age-related cellular loss in the vestibular endorgan is unclear, but it is thought that genetic predisposition and cumulative effect of oxidative stress may both play an important role. Since the causes of dizziness in older people are multi-factorial, management of this disease should be customized according to the etiologies of each individual. Vestibular rehabilitation is found to be effective in treating both unilateral and bilateral vestibular dysfunction. Various prosthetic devices have also been developed to improve postural balance in older people. Although there have been no medical treatments improving age-related vestibular dysfunction, new medical treatments such as mitochondrial antioxidants or caloric restriction, which have been effective in preventing age-related hearing loss, should be ienvestigated in the future. PMID:25657851

  6. Ocular vestibular evoked myogenic potentials in response to air-conducted 500 Hz short tones: Effect of stimulation procedure (monaural or binaural), age and gender. (United States)

    Versino, Maurizio; Colnaghi, Silvia; Ranzani, Marina; Alloni, Roberto; Bolis, Carlotta; Sacco, Simone; Moglia, Arrigo; Callieco, Roberto


    The ocular vestibular myogenic potentials (oVEMP) can be elicited by monaural air-conducted sound stimulation, and are usually recorded from the contralateral eye. In clinical setting a binaural stimulation would save time and require less effort from the subjects. We evaluated the differences between monaural and binaural stimulation, and the possible effect of age and gender on oVEMP parameters. Air-conducted oVEMP were recorded by binaural and by monaural stimulation in a group of 54 normal subjects, aged from 12 to 83 years, and in 50 vestibular patients. From each side, we measured the latency of the N1 component, and the peak-to-peak N1-P1 amplitude. For both parameters we also computed the asymmetry ratio. In normal subjects binaural stimulation produced slightly larger responses than monaural stimulation; detectability, latency and amplitude ratio were the same for the two techniques. We found no differences related to gender, and the age-induced amplitude decline was likely to be negligible.oVEMP recorded not in an acute phase of their disorder, proved to be abnormal in about 20% of the patients, and the normal or abnormal findings obtained either with monaural or with binaural stimulation were always concordant. The oVEMP obtained after binaural and monaural stimulation are very similar, and they are largely independent from age and gender.

  7. Vestibulo-ocular reflex of the squirrel monkey during eccentric rotation with centripetal acceleration along the naso-occipital axis (United States)

    Merfeld, D. M.; Paloski, W. H. (Principal Investigator)


    The vestibulo-ocular reflexes (VOR) are determined not only by angular acceleration, but also by the presence of gravity and linear acceleration. This phenomenon was studied by measuring three-dimensional nystagmic eye movements, with implanted search coils, in four male squirrel monkeys. Monkeys were rotated in the dark at 200 degrees/s, centrally or 79 cm off-axis, with the axis of rotation always aligned with gravity and the spinal axis of the upright monkeys. The monkey's position relative to the centripetal acceleration (facing center or back to center) had a dramatic influence on the VOR. These studies show that a torsional response was always elicited that acted to shift the axis of eye rotation toward alignment with gravito-inertial force. On the other hand, a slow phase downward vertical response usually existed, which shifted the axis of eye rotation away from the gravito-inertial force. These findings were consistent across all monkeys. In another set of tests, the same monkeys were rapidly tilted about their interaural (pitch) axis. Tilt orientations of 45 degrees and 90 degrees were maintained for 1 min. Other than a compensatory angular VOR during the rotation, no consistent eye velocity response was ever observed during or following the tilt. The absence of any response following tilt proves that the observed torsional and vertical responses were not a positional nystagmus. Model simulations qualitatively predict all components of these eccentric rotation and tilt responses. These simulations support the conclusion that the VOR during eccentric rotation may consist of two components: a linear VOR and a rotational VOR. The model predicts a slow phase downward, vertical, linear VOR during eccentric rotation even though there was never a change in the force aligned with monkey's spinal (Z) axis. The model also predicts the torsional components of the response that shift the rotation axis of the angular VOR toward alignment with gravito-inertial force.

  8. ZAG-Otolith: Modification of Otolith-Ocular Reflexes, Motion Perception and Manual Control during Variable Radius Centrifugation Following Space Flight (United States)

    Wood, S. J.; Clarke, A. H.; Rupert, A. H.; Harm, D. L.; Clement, G. R.


    Two joint ESA-NASA studies are examining changes in otolith-ocular reflexes and motion perception following short duration space flights, and the operational implications of post-flight tilt-translation ambiguity for manual control performance. Vibrotactile feedback of tilt orientation is also being evaluated as a countermeasure to improve performance during a closed-loop nulling task. METHODS. Data is currently being collected on astronaut subjects during 3 preflight sessions and during the first 8 days after Shuttle landings. Variable radius centrifugation is utilized to elicit otolith reflexes in the lateral plane without concordant roll canal cues. Unilateral centrifugation (400 deg/s, 3.5 cm radius) stimulates one otolith positioned off-axis while the opposite side is centered over the axis of rotation. During this paradigm, roll-tilt perception is measured using a subjective visual vertical task and ocular counter-rolling is obtained using binocular video-oculography. During a second paradigm (216 deg/s, otolith-mediated reflexes correspond to one's ability to perform closed-loop nulling tasks following G-transitions, and whether manual control performance can be improved with vibrotactile feedback of orientation.

  9. Three-dimensional head-mounted gaming task procedure maximizes effects of vestibular rehabilitation in unilateral vestibular hypofunction: a randomized controlled pilot trial. (United States)

    Micarelli, Alessandro; Viziano, Andrea; Augimeri, Ivan; Micarelli, Domenico; Alessandrini, Marco


    Considering the emerging advantages related to virtual reality implementation in clinical rehabilitation, the aim of the present study was to discover possible (i) improvements achievable in unilateral vestibular hypofunction patients using a self-assessed head-mounted device (HMD)-based gaming procedure when combined with a classical vestibular rehabilitation protocol (HMD group) as compared with a group undergoing only vestibular rehabilitation and (ii) HMD procedure-related side effects. Therefore, 24 vestibular rehabilitation and 23-matched HMD unilateral vestibular hypofunction individuals simultaneously underwent a 4-week rehabilitation protocol. Both otoneurological measures (vestibulo-ocular reflex gain and postural arrangement by studying both posturography parameters and spectral values of body oscillation) and performance and self-report measures (Italian Dizziness Handicap Inventory; Activities-specific Balance Confidence scale; Zung Instrument for Anxiety Disorders, Dynamic Gait Index; and Simulator Sickness Questionnaire) were analyzed by means of a between-group/within-subject analysis of variance model. A significant post-treatment between-effect was found, and the HMD group demonstrated an overall improvement in vestibulo-ocular reflex gain on the lesional side, in posturography parameters, in low-frequency spectral domain, as well as in Italian Dizziness Handicap Inventory and Activities-specific Balance Confidence scale scores. Meanwhile, Simulator Sickness Questionnaire scores demonstrated a significant reduction in symptoms related to experimental home-based gaming tasks during the HMD procedure. Our findings revealed the possible advantages of HMD implementation in vestibular rehabilitation, suggesting it as an innovative, self-assessed, low-cost, and compliant tool useful in maximizing vestibular rehabilitation outcomes.

  10. The Relationship between Vestibular Function and Topographical Memory in Older Adults

    Directory of Open Access Journals (Sweden)

    Fred Henry Previc


    Full Text Available Research during the past two decades has demonstrated an important role of the vestibular system in topographical orientation and memory and the network of neural structures associated with them. Almost all of the supporting data have come from animal or human clinical studies, however. The purpose of the present study was to investigate the link between vestibular function and topographical memory in normal elderly humans. Twenty-five participants aged 70 to 85 years who scored from mildly impaired to normal on the Montreal Cognitive Assessment received three topographical memory tests: the Camden Topographical Recognition Memory Test (CTMRT, a computerized topographical mental rotation test (TMRT, and a virtual pond maze (VPM. They also received six vestibular or oculomotor tests: optokinetic nystagmus (OKN, visual pursuit (VP, actively generated vestibulo-ocular reflex (VOR, the sensory orientation test (SOT for posture, and two measures of rotational memory (error in degrees, or RMº, and correct directional recognition, or RM→. The only significant bivariate correlations were among the three vestibular measures primarily assessing horizontal canal function (VOR, RMº, and RM→. A multiple regression analysis showed significant relationships between vestibular and demographic predictors and both the TMRT (R=.78 and VPM (R=.66 measures. The significant relationship between the vestibular and topographical memory measures supports the theory that vestibular loss may contribute to topographical memory impairment in the elderly.

  11. Differences between otolith- and semicircular canal-activated neural circuitry in the vestibular system. (United States)

    Uchino, Yoshio; Kushiro, Keisuke


    In the last two decades, we have focused on establishing a reliable technique for focal stimulation of vestibular receptors to evaluate neural connectivity. Here, we summarize the vestibular-related neuronal circuits for the vestibulo-ocular reflex, vestibulocollic reflex, and vestibulospinal reflex arcs. The focal stimulating technique also uncovered some hidden neural mechanisms. In the otolith system, we identified two hidden neural mechanisms that enhance otolith receptor sensitivity. The first is commissural inhibition, which boosts sensitivity by incorporating inputs from bilateral otolith receptors, the existence of which was in contradiction to the classical understanding of the otolith system but was observed in the utricular system. The second mechanism, cross-striolar inhibition, intensifies the sensitivity of inputs from both sides of receptive cells across the striola in a single otolith sensor. This was an entirely novel finding and is typically observed in the saccular system. We discuss the possible functional meaning of commissural and cross-striolar inhibition. Finally, our focal stimulating technique was applied to elucidate the different constructions of axonal projections from each vestibular receptor to the spinal cord. We also discuss the possible function of the unique neural connectivity observed in each vestibular receptor system. Copyright © 2011 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.

  12. Effect of Elevated Intracranial Pressure on Amplitudes and Frequency Tuning of Ocular Vestibular Evoked Myogenic Potentials Elicited by Bone-Conducted Vibration. (United States)

    Gürkov, Robert; Speierer, Guillaume; Wittwer, Luis; Kalla, Roger

    Recently, it could be demonstrated that an increased intracranial pressure causes a modulation of the air conducted sound evoked ocular vestibular evoked myogenic potential (oVEMP). The mechanism for this modulation is not resolved and may depend on a change of either receptor excitability or sound energy transmission. oVEMPs were elicited in 18 healthy subjects with a minishaker delivering 500 and 1000 Hz tone bursts, in supine and tilted positions. The study could confirm the frequency tuning of oVEMP. However, at neither stimulus frequency could a modulating effect of increased intracranial pressure be observed. These data suggest that the observed modulation of the oVEMP response by an increased intracranial pressure is primarily due to the effect of an increased intralabyrinthine pressure onto the stiffness of the inner ear contents and the middle ear-inner ear junction. Future studies on the effect of intracranial pressure on oVEMP should use air-conducted sound and not bone-conducted vibration.

  13. Effects of Vestibular Loss on Orthostatic Responses to Tilts in the Pitch Plane (United States)

    Wood, Scott J.; Serrador, Jorge M.; Black, F. Owen; Rupert,Angus H.; Schlegel, Todd T.


    The purpose of this study was to determine the extent to which vestibular loss might impair orthostatic responses to passive tilts in the pitch plane in human subjects. Data were obtained from six subjects having chronic bilateral vestibular loss and six healthy individuals matched for age, gender, and body mass index. Vestibular loss was assessed with a comprehensive battery including dynamic posturography, vestibulo-ocular and optokinetic reflexes, vestibular evoked myogenic potentials, and ocular counterrolling. Head up tilt tests were conducted using a motorized two-axis table that allowed subjects to be tilted in the pitch plane from either a supine or prone body orientation at a slow rate (8 deg/s). The sessions consisted of three tilts, each consisting of20 min rest in a horizontal position, tilt to 80 deg upright for 10 min, and then return to the horizontal position for 5 min. The tilts were performed in darkness (supine and prone) or in light (supine only). Background music was used to mask auditory orientation cues. Autonomic measurements included beat-to-beat recordings of blood pressure (Finapres), heart rate (ECG), cerebral blood flow velocity in the middle cerebral artery (transcranial Doppler), end tidal CO2, respiratory rate and volume (Respritrace), and stroke volume (impedance cardiography). For both patients and control subjects, cerebral blood flow appeared to exhibit the most rapid adjustment following transient changes in posture. Outside of a greater cerebral hypoperfusion in patients during the later stages of tilt, responses did not differ dramatically between the vestibular loss and control subjects, or between tilts performed in light and dark room conditions. Thus, with the 'exception of cerebrovascular regulation, we conclude that orthostatic responses during slow postural tilts are not substantially impaired in humans following chronic loss of vestibular function, a result that might reflect compensation by nonvisual graviceptor

  14. Self-motion perception and vestibulo-ocular reflex during whole body yaw rotation in standing subjects: the role of head position and neck proprioception. (United States)

    Panichi, Roberto; Botti, Fabio Massimo; Ferraresi, Aldo; Faralli, Mario; Kyriakareli, Artemis; Schieppati, Marco; Pettorossi, Vito Enrico


    Self-motion perception and vestibulo-ocular reflex (VOR) were studied during whole body yaw rotation in the dark at different static head positions. Rotations consisted of four cycles of symmetric sinusoidal and asymmetric oscillations. Self-motion perception was evaluated by measuring the ability of subjects to manually track a static remembered target. VOR was recorded separately and the slow phase eye position (SPEP) was computed. Three different head static yaw deviations (active and passive) relative to the trunk (0°, 45° to right and 45° to left) were examined. Active head deviations had a significant effect during asymmetric oscillation: the movement perception was enhanced when the head was kept turned toward the side of body rotation and decreased in the opposite direction. Conversely, passive head deviations had no effect on movement perception. Further, vibration (100 Hz) of the neck muscles splenius capitis and sternocleidomastoideus remarkably influenced perceived rotation during asymmetric oscillation. On the other hand, SPEP of VOR was modulated by active head deviation, but was not influenced by neck muscle vibration. Through its effects on motion perception and reflex gain, head position improved gaze stability and enhanced self-motion perception in the direction of the head deviation. Copyright © 2010 Elsevier B.V. All rights reserved.

  15. Functional Imaging of Human Vestibular Cortex Activity Elicited by Skull Tap and Auditory Tone Burst (United States)

    Noohi, F.; Kinnaird, C.; Wood, S.; Bloomberg, J.; Mulavara, A.; Seidler, R.


    The current study characterizes brain activation in response to two modes of vestibular stimulation: skull tap and auditory tone burst. The auditory tone burst has been used in previous studies to elicit either the vestibulo-spinal reflex (saccular-mediated colic Vestibular Evoked Myogenic Potentials (cVEMP)), or the ocular muscle response (utricle-mediated ocular VEMP (oVEMP)). Some researchers have reported that air-conducted skull tap elicits both saccular and utricle-mediated VEMPs, while being faster and less irritating for the subjects. However, it is not clear whether the skull tap and auditory tone burst elicit the same pattern of cortical activity. Both forms of stimulation target the otolith response, which provides a measurement of vestibular function independent from semicircular canals. This is of high importance for studying otolith-specific deficits, including gait and balance problems that astronauts experience upon returning to earth. Previous imaging studies have documented activity in the anterior and posterior insula, superior temporal gyrus, inferior parietal lobule, inferior frontal gyrus, and the anterior cingulate cortex in response to different modes of vestibular stimulation. Here we hypothesized that skull taps elicit similar patterns of cortical activity as the auditory tone bursts, and previous vestibular imaging studies. Subjects wore bilateral MR compatible skull tappers and headphones inside the 3T GE scanner, while lying in the supine position, with eyes closed. Subjects received both forms of the stimulation in a counterbalanced fashion. Pneumatically powered skull tappers were placed bilaterally on the cheekbones. The vibration of the cheekbone was transmitted to the vestibular system, resulting in the vestibular cortical response. Auditory tone bursts were also delivered for comparison. To validate our stimulation method, we measured the ocular VEMP outside of the scanner. This measurement showed that both skull tap and auditory

  16. Changes in resting-state fMRI in vestibular neuritis. (United States)

    Helmchen, Christoph; Ye, Zheng; Sprenger, Andreas; Münte, Thomas F


    Vestibular neuritis (VN) is a sudden peripheral unilateral vestibular failure with often persistent head movement-related dizziness and unsteadiness. Compensation of asymmetrical activity in the primary peripheral vestibular afferents is accomplished by restoration of impaired brainstem vestibulo-ocular and vestibulo-spinal reflexes, but presumably also by changing cortical vestibular tone imbalance subserving, e.g., spatial perception and orientation. The aim of this study was to elucidate (i) whether there are changes of cerebral resting-state networks with respect to functional interregional connectivity (resting-state activity) in VN patients and (ii) whether these are related to neurophysiological, perceptual and functional parameters of vestibular-induced disability. Using independent component analysis (ICA), we compared resting-state networks between 20 patients with unilateral VN and 20 age- and gender-matched healthy control subjects. Patients were examined in the acute VN stage and after 3 months. A neural network (component 50) comprising the parietal lobe, medial aspect of the superior parietal lobule, posterior cingulate cortex, middle frontal gyrus, middle temporal gyrus, parahippocampal gyrus, anterior cingulate cortex, insular cortex, caudate nucleus, thalamus and midbrain was modulated between acute VN patients and healthy controls and in patients over time. Within this network, acute VN patients showed decreased resting-state activity (ICA) in the contralateral intraparietal sulcus (IPS), in close vicinity to the supramarginal gyrus (SMG), which increased after 3 months. Resting-state activity in IPS tended to increase over 3 months in VN patients who improved with respect to functional parameters of vestibular-induced disability (VADL). Resting-state activity in the IPS was not related to perceptual (subjective visual vertical) or neurophysiological parameters of vestibular-induced disability (e.g., gain of vestibulo-ocular reflex, caloric

  17. Streptomycin action to the mammalian inner ear vestibular organs: comparison between pigmented guinea pigs and rats. (United States)

    Meza, Graciela; Aguilar-Maldonado, Beatriz


    Streptomycin is the antibiotic of choice to treat tuberculosis and other infectious diseases but it causes vestibular malfunction and hipoacusia. Rodents are usually employed as models of drug action to the inner ear and results are extrapolated to what happens in humans. In rats, streptomycin destroys macular sensory cells and does not affect cochlear ones, whereas in guinea pigs the contrary is true. Action on the vestibular cristae cells involved in vestibulo-ocular reflex integrity is less clear. Thus, we compared this response in both pigmented guinea pigs (Cavia cobaya) and rats (Rattus norvegicus) after parallel streptomycin chronic treatment. In guinea pigs, the reflex was obliterated along treatment time; in rats this behavior was not observed, suggesting that the end organ target was diverse. In recent studies, streptidine, a streptomycin derivative found in the blood of humans and rats treated with streptomycin, was the actual ototoxic agent. The putative streptomycin vestibular organ target observed in humans corresponds with the guinea pig observations. Results observed in rats are controversial: streptidine did not cause any damage either to vestibular cristae nor auditory cells. We hypothesize differential drug metabolism and distribution and conclude that results in laboratory animals may not always be applicable in the human situation.

  18. Vestibular migraine

    DEFF Research Database (Denmark)

    Lempert, Thomas; Olesen, Jes; Furman, Joseph


    This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...... in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms...

  19. Association between vestibulo-ocular reflex suppression, balance, gait, and fall risk in ageing and neurodegenerative disease: protocol of a one-year prospective follow-up study. (United States)

    Srulijes, Karin; Mack, David J; Klenk, Jochen; Schwickert, Lars; Ihlen, Espen A F; Schwenk, Michael; Lindemann, Ulrich; Meyer, Miriam; Srijana, K C; Hobert, Markus A; Brockmann, Kathrin; Wurster, Isabel; Pomper, Jörn K; Synofzik, Matthis; Schneider, Erich; Ilg, Uwe; Berg, Daniela; Maetzler, Walter; Becker, Clemens


    Falls frequency increases with age and particularly in neurogeriatric cohorts. The interplay between eye movements and locomotion may contribute substantially to the occurrence of falls, but is hardly investigated. This paper provides an overview of current approaches to simultaneously measure eye and body movements, particularly for analyzing the association of vestibulo-ocular reflex (VOR) suppression, postural deficits and falls in neurogeriatric risk cohorts. Moreover, VOR suppression is measured during head-fixed target presentation and during gaze shifting while postural control is challenged. Using these approaches, we aim at identifying quantitative parameters of eye-head-coordination during postural balance and gait, as indicators of fall risk. Patients with Progressive Supranuclear Palsy (PSP) or Parkinson's disease (PD), age- and sex-matched healthy older adults, and a cohort of young healthy adults will be recruited. Baseline assessment will include a detailed clinical assessment, covering medical history, neurological examination, disease specific clinical rating scales, falls-related self-efficacy, activities of daily living, neuro-psychological screening, assessment of mobility function and a questionnaire for retrospective falls. Moreover, participants will simultaneously perform eye and head movements (fixating a head-fixed target vs. shifting gaze to light emitting diodes in order to quantify vestibulo-ocular reflex suppression ability) under different conditions (sitting, standing, or walking). An eye/head tracker synchronized with a 3-D motion analysis system will be used to quantify parameters related to eye-head-coordination, postural balance, and gait. Established outcome parameters related to VOR suppression ability (e.g., gain, saccadic reaction time, frequency of saccades) and motor related fall risk (e.g., step-time variability, postural sway) will be calculated. Falls will be assessed prospectively over 12 months via protocols and

  20. Interactions of cervico-ocular and vestibulo-ocular fast-phase signals in the control of eye position in rabbits. (United States)

    Barmack, N H; Errico, P; Ferraresi, A; Pettorossi, V E


    1. Eye movements in unanaesthetized rabbits were studied during horizontal neck-proprioceptive stimulation (movement of the body with respect to the fixed head), when this stimulation was given alone and when it was given simultaneously with vestibular stimulation (rotation of the head-body). The effect of neck-proprioceptive stimulation on modifying the anticompensatory fast-phase eye movements (AFPs) evoked by vestibular stimulation was studied with a 'conditioning-test' protocol; the 'conditioning' stimulus was a neck-proprioceptive signal evoked by a step-like change in body position with respect to the head and the 'test' stimulus was a vestibular signal evoked by a step rotation of the head-body. 2. The influence of eye position and direction of slow eye movements on the occurrence of compensatory fast-phase eye movements (CFPs) evoked by neck-proprioceptive stimulation was also examined. 3. The anticompensatory fast phase (AFP) evoked by vestibular stimulation was attenuated by a preceding neck-proprioceptive stimulus which when delivered alone evoked compensatory slow-phase eye movements (CSP) in the same direction as the CSP evoked by vestibular stimulation. Conversely, the vestibularly evoked AFP was potentiated by a neck-proprioceptive stimulus which evoked CSPs opposite to that of vestibularly evoked CSPs. 4. Eccentric initial eye positions increased the probability of occurrence of midline-directed compensatory fast-phase eye movements (CFPs) evoked by appropriate neck-proprioceptive stimulation. 5. The gain of the horizontal cervico-ocular reflex (GHCOR) was measured from the combined changes in eye position resulting from AFPs and CSPs. GHCOR was potentiated during simultaneous vestibular stimulation. This enhancement of GHCOR occurred at neck-proprioceptive stimulus frequencies which, in the absence of conjoint vestibular stimulation, do not evoke CSPs. PMID:2795479

  1. Tuning and sensitivity of the human vestibular system to low-frequency vibration. (United States)

    Todd, Neil P McAngus; Rosengren, Sally M; Colebatch, James G


    Mechanoreceptive hair-cells of the vertebrate inner ear have a remarkable sensitivity to displacement, whether excited by sound, whole-body acceleration or substrate-borne vibration. In response to seismic or substrate-borne vibration, thresholds for vestibular afferent fibre activation have been reported in anamniotes (fish and frogs) in the range -120 to -90 dB re 1g. In this article, we demonstrate for the first time that the human vestibular system is also extremely sensitive to low-frequency and infrasound vibrations by making use of a new technique for measuring vestibular activation, via the vestibulo-ocular reflex (VOR). We found a highly tuned response to whole-head vibration in the transmastoid plane with a best frequency of about 100 Hz. At the best frequency we obtained VOR responses at intensities of less than -70 dB re 1g, which was 15 dB lower than the threshold of hearing for bone-conducted sound in humans at this frequency. Given the likely synaptic attenuation of the VOR pathway, human receptor sensitivity is probably an order of magnitude lower, thus approaching the seismic sensitivity of the frog ear. These results extend our knowledge of vibration-sensitivity of vestibular afferents but also are remarkable as they indicate that the seismic sensitivity of the human vestibular system exceeds that of the cochlea for low-frequencies.

  2. Common Vestibular Disorders

    Directory of Open Access Journals (Sweden)

    Dimitrios G. Balatsouras


    Full Text Available The three most common vestibular diseases, benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD and vestibular neuritis (VN, are presented in this paper. BPPV, which is the most common peripheral vestibular disorder, can be defined as transient vertigo induced by a rapid head position change, associated with a characteristic paroxysmal positional nystagmus. Canalolithiasis of the posterior semicircular canal is considered the most convincing theory of its pathogenesis and the development of appropriate therapeutic maneuvers resulted in its effective treatment. However, involvement of the horizontal or the anterior canal has been found in a significant rate and the recognition and treatment of these variants completed the clinical picture of the disease. MD is a chronic condition characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Presence of endolymphatic hydrops on postmortem examination is its pathologic correlate. MD continues to be a diagnostic and therapeutic challenge. Patients with the disease range from minimally symptomatic, highly functional individuals to severely affected, disabled patients. Current management strategies are designed to control the acute and recurrent vestibulopathy but offer minimal remedy for the progressive cochlear dysfunction. VN is the most common cause of acute spontaneous vertigo, attributed to acute unilateral loss of vestibular function. Key signs and symptoms are an acute onset of spinning vertigo, postural imbalance and nausea as well as a horizontal rotatory nystagmus beating towards the non-affected side, a pathological headimpulse test and no evidence for central vestibular or ocular motor dysfunction. Vestibular neuritis preferentially involves the superior vestibular labyrinth and its afferents. Symptomatic medication is indicated only during the acute phase to relieve the vertigo and nausea

  3. Saccadic entropy of head impulses in acute unilateral vestibular loss. (United States)

    Hsieh, Li-Chun; Lin, Hung-Ching; Lee, Guo-She


    To evaluate the complexity of vestibular-ocular reflex (VOR) in patients with acute unilateral vestibular loss (AUVL) via entropy analysis of head impulses. Horizontal head impulse test (HIT) with high-velocity alternating directions was used to evaluate 12 participants with AUVL and 16 healthy volunteers. Wireless electro-oculography and electronic gyrometry were used to acquire eye positional signals and head velocity signals. The eye velocity signals were then obtained through differentiation, band-pass filtering. The approximate entropy of eye velocity to head velocity (R ApEn ) was used to evaluate chaos property. VOR gain, gain asymmetry ratio, and R ApEn asymmetry ratio were also used to compare the groups. For the lesion-side HIT of the patient group, the mean VOR gain was significantly lower and the mean R ApEn was significantly greater compared with both nonlesion-side HIT and healthy controls (p Entropy and gain analysis of HIT using wireless electro-oculography system could be used to detect the VOR dysfunctions of AUVL and may become effective methods for evaluating vestibular disorders. Copyright © 2017. Published by Elsevier B.V.

  4. Vision and Vestibular System Dysfunction Predicts Prolonged Concussion Recovery in Children. (United States)

    Master, Christina L; Master, Stephen R; Wiebe, Douglas J; Storey, Eileen P; Lockyer, Julia E; Podolak, Olivia E; Grady, Matthew F


    Up to one-third of children with concussion have prolonged symptoms lasting beyond 4 weeks. Vision and vestibular dysfunction is common after concussion. It is unknown whether such dysfunction predicts prolonged recovery. We sought to determine which vision or vestibular problems predict prolonged recovery in children. A retrospective cohort of pediatric patients with concussion. A subspecialty pediatric concussion program. Four hundred thirty-two patient records were abstracted. Presence of vision or vestibular dysfunction upon presentation to the subspecialty concussion program. The main outcome of interest was time to clinical recovery, defined by discharge from clinical follow-up, including resolution of acute symptoms, resumption of normal physical and cognitive activity, and normalization of physical examination findings to functional levels. Study subjects were 5 to 18 years (median = 14). A total of 378 of 432 subjects (88%) presented with vision or vestibular problems. A history of motion sickness was associated with vestibular dysfunction. Younger age, public insurance, and presence of headache were associated with later presentation for subspecialty concussion care. Vision and vestibular problems were associated within distinct clusters. Provocable symptoms with vestibulo-ocular reflex (VOR) and smooth pursuits and abnormal balance and accommodative amplitude (AA) predicted prolonged recovery time. Vision and vestibular problems predict prolonged concussion recovery in children. A history of motion sickness may be an important premorbid factor. Public insurance status may represent problems with disparities in access to concussion care. Vision assessments in concussion must include smooth pursuits, saccades, near point of convergence (NPC), and accommodative amplitude (AA). A comprehensive, multidomain assessment is essential to predict prolonged recovery time and enable active intervention with specific school accommodations and targeted rehabilitation.

  5. Presbyequilibrium in the oldest old, a combination of vestibular, oculomotor and postural deficits. (United States)

    Tuunainen, Eeva; Poe, Dennis; Jäntti, Pirkko; Varpa, Kirsi; Rasku, Jyrki; Toppila, Esko; Pyykkö, Ilmari


    Dizziness, impaired balance and fear of falling are common complaints in the elderly. We evaluated the association of vestibular symptoms with vestibular findings in the elderly by posturography and video-oculography (VOG). We studied 38 oldest old subjects (≥ 85 yrs, mean age 89) living in a residential home. Vestibular symptoms were taken with a structured questionnaire, the Mini Mental State Examination (MMSE) was scored and any falls were recorded over a period of 12 months. Posturography was measured with a force platform and eye movements were measured by video-oculography. In the majority of the elderly, vestibular abnormalities were found, such as reduced vestibulo-ocular reflex gain 6/38, spontaneous nystagmus 5/38, gaze deviation nystagmus 5/38, head shaking nystagmus 9/38, pathologic head thrust test 10/38, and positional nystagmus 17/38. Posturography demonstrated two major findings: the body support area was limited and the use of vision for postural control was reduced. In principal component analysis of the vertigo, four major factors described elements of failure in the vestibular and other systems important to maintenance of balance: episodic vertigo, postural instability, multisystem failure (frail) and presyncopal imbalance. These four factors were associated in different degrees to vestibular abnormalities and falls. During the follow-up period, in 19 elderly (19/38), one or more falls were recorded. Progressive loss of balance in the aged, or "presbyequilibrium," is a complex and incompletely understood process involving vestibular, oculomotor, visual acuity, proprioception, motor, organ system and metabolic weaknesses and disorders. These factors provide a potential basis for streamlining diagnostic evaluations and aiding in planning for effective therapy. In oldest old, these problems are magnified, increasing the need for additional expertise in their care, which may be met by training specialized healthcare staff.

  6. The otolithic contribution to vertical ocular stability in the cat. (United States)

    Pettorossi, V E; Draicchio, F; Ferraresi, A; Bruni, R


    In cats, horizontal (HVOR) and vertical (VVOR) vestibulo-ocular reflexes were studied alone and combined with optokinetic stimulation. The upright VVOR (VVOR O degree) only showed higher gain and smaller phase lead compared to those of HVOR at frequencies below 0.05 Hz. The addition of optokinetic stimulation to the vestibular stimulation increased the gain of the horizontal and vertical ocular responses close to 1. VVOR was also studied in side down position (VVOR 90 degrees). In VVOR 90 degrees the ocular responses were asymmetric. The downward directed eye responses of VVOR 90 degrees showed lower gain and greater phase lead compared to those of VVOR 0 degree for the whole range of tested frequencies (0.01-0.4 Hz), while the upward eye responses only showed a lower gain at the lower range of frequencies tested. In the light the gain of VVOR 90 degrees increased, but the gain of downward directed eye responses was consistently lower than 1 at lower frequencies. The higher gain of the VVOR 0 degree compared to the VVOR 90 degrees and HVOR was attributed to the maculo-ocular reflex (MOR) evoked by the gravity modulation of the otolithic receptors, when the animals were oscillated in the pitch plane. The MOR was isolated from the VVOR 0 degree by plugging all semicircular canals. At very low frequencies the gain of the MOR was 0.3-0.35 and the phase was close to 0 degree. This reflex showed a progressive gain decrease and phase lag by increasing the stimulation frequencies. This suggests a low pass filtering process of the otolithic signal. Furthermore in plugged animals the asymmetry of the vertical optokinetic responses was reduced by adding the MOR. The quick phases (QPs) of the vestibular responses were also different depending upon the stimulation plane. The QPs of VVOR 0 degree were smaller and more delayed than those of HVOR and VVOR 90 degrees. In conclusion the main effects observed during otolithic coactivation in the VVOR 0 of the cat are: 1) the

  7. Head movements evoked in alert rhesus monkey by vestibular prosthesis stimulation: implications for postural and gaze stabilization.

    Directory of Open Access Journals (Sweden)

    Diana E Mitchell

    Full Text Available The vestibular system detects motion of the head in space and in turn generates reflexes that are vital for our daily activities. The eye movements produced by the vestibulo-ocular reflex (VOR play an essential role in stabilizing the visual axis (gaze, while vestibulo-spinal reflexes ensure the maintenance of head and body posture. The neuronal pathways from the vestibular periphery to the cervical spinal cord potentially serve a dual role, since they function to stabilize the head relative to inertial space and could thus contribute to gaze (eye-in-head + head-in-space and posture stabilization. To date, however, the functional significance of vestibular-neck pathways in alert primates remains a matter of debate. Here we used a vestibular prosthesis to 1 quantify vestibularly-driven head movements in primates, and 2 assess whether these evoked head movements make a significant contribution to gaze as well as postural stabilization. We stimulated electrodes implanted in the horizontal semicircular canal of alert rhesus monkeys, and measured the head and eye movements evoked during a 100 ms time period for which the contribution of longer latency voluntary inputs to the neck would be minimal. Our results show that prosthetic stimulation evoked significant head movements with latencies consistent with known vestibulo-spinal pathways. Furthermore, while the evoked head movements were substantially smaller than the coincidently evoked eye movements, they made a significant contribution to gaze stabilization, complementing the VOR to ensure that the appropriate gaze response is achieved. We speculate that analogous compensatory head movements will be evoked when implanted prosthetic devices are transitioned to human patients.

  8. Personality Changes in Patients with Vestibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Paul eSmith


    Full Text Available The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly reliant on visual information to determine self-motion. Since the vestibular system first evolved in invertebrate species in order to detect gravitational vertical, it is likely that the central nervous system has developed a special dependence upon vestibular input. In addition to the deficits in eye movement and postural reflexes that occur following vestibular dysfunction, there is convincing evidence that vestibular loss also causes cognitive and emotional disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and cortex play in the sense of spatial orientation. Beyond this, however, patients with vestibular disorders have been reported to experience other personality changes that suggest that vestibular sensation is implicated in the sense of self. These are depersonalisation and derealisation symptoms such as feeling ‘spaced out’, ‘body feeling strange’ and ‘not feeling in control of self’. We suggest in this review that these symptoms suggest that the vestibular system may make a unique contribution to the concept of self through the information regarding self-motion and self-location that it transmits, albeit indirectly, to areas of the brain such as the temporo-parietal junction.

  9. Significant vestibular system impairment is common in a cohort of elderly patients referred for assessment of falls risk. (United States)

    Jacobson, Gary P; McCaslin, Devin L; Grantham, Sarah L; Piker, Erin G


    Falls in elderly patients are associated with morbidity, mortality, and cost to the healthcare system. The development of falls risk assessment programs have represented a method of responding to what is known about injurious falls. The multidimensional assessments involve the comparison against normative data of a patient's performance on metrics known to influence the likelihood of future falls. The factors assessed usually include falls and medication history, measures of mentation, depression, orthostatic hypotension, simple or choice reaction time, gait stability, postural stability, and the integrity of the patient's vision, somesthetic, and vestibular senses. This investigation was conducted to measure the proportion of patients referred for falls risk assessment who have evidence of vestibular system impairment. Qualitative, retrospective review of data collected from 2003 to 2007. The cohort was 185 consecutive patients referred for multidimensional assessments of falls risk. Patients underwent quantitative assessments of peripheral and central vestibular system function consisting of electro- or videonystagmography (i.e., ENG/VNG), and sinusoidal harmonic acceleration testing. Results of these tests were compared to normative data. We found that 73% of the sample who underwent vestibular system assessment had quantitative evidence of either peripheral or central vestibular system impairment. Our results suggest that quantitative assessments of the vestibulo-ocular reflex should be conducted on patients who are evaluated for falls risk. These examinations should include at least caloric testing and, where available, rotational testing.

  10. Age-Related Neurochemical Changes in the Vestibular Nuclei. (United States)

    Smith, Paul F


    There is evidence that the normal aging process is associated with impaired vestibulo-ocular reflexes (VOR) and vestibulo-spinal reflexes, causing reduced visual acuity and postural instability. Nonetheless, the available evidence is not entirely consistent, especially with respect to the VOR. Some recent studies have reported that VOR gain can be intact even above 80 years of age. Similarly, although there is evidence for age-related hair cell loss and neuronal loss in Scarpa's ganglion and the vestibular nucleus complex (VNC), it is not entirely consistent. Whatever structural and functional changes occur in the VNC as a result of aging, either to cause vestibular impairment or to compensate for it, neurochemical changes must underlie them. However, the neurochemical changes that occur in the VNC with aging are poorly understood because the available literature is very limited. This review summarizes and critically evaluates the available evidence relating to the noradrenaline, serotonin, dopamine, glutamate, GABA, glycine, and nitric oxide neurotransmitter systems in the aging VNC. It is concluded that, at present, it is difficult, if not impossible, to relate the neurochemical changes observed to the function of specific VNC neurons and whether the observed changes are the cause of a functional deficit in the VNC or an effect of it. A better understanding of the neurochemical changes that occur during aging may be important for the development of potential drug treatments for age-related vestibular disorders. However, this will require the use of more sophisticated methodology such as in vivo microdialysis with single neuron recording and perhaps new technologies such as optogenetics.

  11. Vergence-mediated changes in the axis of eye rotation during the human vestibulo-ocular reflex can occur independent of eye position. (United States)

    Migliaccio, Americo A; Cremer, Phillip D; Aw, Swee T; Halmagyi, G Michael; Curthoys, Ian S; Minor, Lloyd B; Todd, Michael J


    The aim of this study was to determine whether vergence-mediated changes in the axis of eye rotation in the human vestibulo-ocular reflex (VOR) would obey Listing's Law (normally associated with saccadic eye movements) independent of the initial eye position. We devised a paradigm for disassociating the saccadic velocity axis from eye position by presenting near and far targets that were centered with respect to one eye. We measured binocular 3-dimensional eye movements using search coils in ten normal subjects and 3-dimensional linear head acceleration using Optotrak in seven normal subjects. The stimuli consisted of passive, unpredictable, pitch head rotations with peak acceleration of approximately 2000 degrees /s(2 )and amplitude of approximately 20 degrees. During the pitch head rotation, each subject fixated straight ahead with one eye, whereas the other eye was adducted 4 degrees during far viewing (94 cm) and 25 degrees during near viewing (15 cm). Our data showed expected compensatory pitch rotations in both eyes, and a vergence-mediated horizontal rotation only in the adducting eye. In addition, during near viewing we observed torsional eye rotations not only in the adducting eye but also in the eye looking straight ahead. In the straight-ahead eye, the change in torsional eye velocity between near and far viewing, which began approximately 40 ms after the start of head rotation, was 10+/-6 degrees /s (mean +/- SD). This change in torsional eye velocity resulted in a 2.4+/-1.5 degrees axis tilt toward Listing's plane in that eye. In the adducting eye, the change in torsional eye velocity between near and far viewing was 16+/-6 degrees /s (mean +/- SD) and resulted in a 4.1+/-1.4 degrees axis tilt. The torsional eye velocities were conjugate and both eyes partially obeyed Listing's Law. The axis of eye rotation tilted in the direction of the line of sight by approximately one-third of the angle between the line of sight and a line orthogonal to Listing

  12. Sensitivity and specificity of the amer dizziness diagnostic scale (adds) for patients with vestibular disorders. (United States)

    Al Saif, Amer; Alsenany, Samira


    [Purpose] To investigate the sensitivity and specificity of a newly developed diagnostic tool, the Amer Dizziness Diagnostic Scale (ADDS), to evaluate and differentially diagnose vestibular disorder and to identify the strengths and weaknesses of the scale and its usefulness in clinical practice. [Subjects and Methods] Two hundred subjects of both genders (72 males, 128 females) aged between 18 to 60 (49.5±7.8) who had a history of vertigo and/or dizziness symptoms for this previous two weeks or less were recruited for the study. All subjects were referred by otolaryngologists, neurologists or family physicians in and around Jeddah, Kingdom of Saudi Arabia. On the first clinic visit, all the patients were evaluated once using the ADDS, following which they underwent routine testing of clinical signs and symptoms, audiometry, and a neurological examination, coupled with tests of Vestibulo-Ocular Reflex function, which often serves as the "gold standard" for determining the probability of a vestibular deficit. [Results] The results show that the ADDS strongly correlated with "true-positive" and "true-negative" responses for determining the probability of a vestibular disorder (r =0.95). A stepwise linear regression was conducted and the results indicate that the ADDS was a significant predictor of "true-positive" and "true-negative" responses in vestibular disorders (R(2) =0.90). Approximately 90% of the variability in the vestibular gold standard test was explained by its relationship to the ADDS. Moreover, the ADDS was found to have a sensitivity of 96% and a specificity of 96%. [Conclusion] This study showed that the Amer Dizziness Diagnostic Scale has high sensitivity and specificity and that it can be used as a method of differential diagnosis for patients with vestibular disorders.

  13. Effect of betel nut chewing on the otolithic reflex system. (United States)

    Lin, Chuan-Yi; Young, Yi-Ho


    This study investigated the effect of betel nut chewing on the otolithic reflex system. Seventeen healthy volunteers without any experience of chewing betel nut (fresh chewers) and 17 habitual chewers underwent vital sign measurements, ocular vestibular-evoked myogenic potential (oVEMP), and cervical VEMP (cVEMP) tests prior to the study. Each subject then chewed two pieces of betel nut for 2min (dosing). The same paradigm was repeated immediately, 10min, and 20min after chewing. On a different day, 10 fresh chewers masticated chewing gum as control. Fresh chewers exhibited significantly decreased response rates of oVEMP (53%) and cVEMP (71%) after dosing compared with those from the predosing period. These abnormal VEMPs returned to normal 20min after dosing. In contrast, 100% response rates of oVEMP and cVEMP were observed before and after masticating chewing gum. In habitual chewers, the response rates of oVEMP and cVEMP were 32% and 29%, respectively, 20min after dosing. Chewing betel nuts induced a transient loss of the otolithic reflexes in fresh chewers but may cause permanent loss in habitual chewers. Chewing betel nuts can cause a loss of otholitic reflex function. This creates a risk for disturbed balance and malfunction, for instance, during driving. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Dynamic characteristics of otolith ocular response during counter rotation about dual yaw axes in mice. (United States)

    Shimizu, N; Wood, S; Kushiro, K; Yanai, S; Perachio, A; Makishima, T


    The central vestibular system plays an important role in higher neural functions such as self-motion perception and spatial orientation. Its ability to store head angular velocity is called velocity storage mechanism (VSM), which has been thoroughly investigated across a wide range of species. However, little is known about the mouse VSM, because the mouse lacks typical ocular responses such as optokinetic after nystagmus or a dominant time constant of vestibulo-ocular reflex for which the VSM is critical. Experiments were conducted to examine the otolith-driven eye movements related to the VSM and verify its characteristics in mice. We used a novel approach to generate a similar rotating vector as a traditional off-vertical axis rotation (OVAR) but with a larger resultant gravito-inertial force (>1g) by using counter rotation centrifugation. Similar to results previously described in other animals during OVAR, two components of eye movements were induced, i.e. a sinusoidal modulatory eye movement (modulation component) on which a unidirectional nystagmus (bias component) was superimposed. Each response is considered to derive from different mechanisms; modulations arise predominantly through linear vestibulo-ocular reflex, whereas for the bias, the VSM is responsible. Data indicate that the mouse also has a well-developed vestibular system through otoliths inputs, showing its highly conserved nature across mammalian species. On the other hand, to reach a plateau state of bias, a higher frequency rotation or a larger gravito-inertial force was considered to be necessary than other larger animals. Compared with modulation, the bias had a more variable profile, suggesting an inherent complexity of higher-order neural processes in the brain. Our data provide the basis for further study of the central vestibular system in mice, however, the underlying individual variability should be taken into consideration. Copyright © 2014 IBRO. Published by Elsevier Ltd. All

  15. Reflex control of the spine and posture: a review of the literature from a chiropractic perspective

    Directory of Open Access Journals (Sweden)

    Schlappi Mark


    Full Text Available Abstract Objective This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. Background Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. Method We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or

  16. [Infrared videonystagmography in vestibular diagnosis]. (United States)

    Frisina, A; Piazza, F; Quaranta, N


    Vestibular examination relied upon electronystagmography (ENG) for more than 50 years. This method is based on recording of nystagmus (Ny) without any possibility to see the ocular movements directly. More recently, infrared videonystagmography (VNG) entered the diagnostic protocol of vestibular disorders. VNG permits to record and visualize Ny, both in the darkness and with open eyes. Aim of the present study was to verify the possible advantages of VNG versus ENG for functional evaluation of the vestibular system in patients suffering from otoneurological disorders. To that purpose, VNG and ENG tracings were recorded in 12 patients. The preliminary results show that there are not significant differences in quantitative evaluation of Ny between the two methods. Anyhow, VNG has some technical and clinical advantages that make it the method of choice.

  17. Traumatic brain injury and vestibulo-ocular function: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Wallace B


    Full Text Available Bridgett Wallace,1–4 Jonathan Lifshitz4–8 1360 Balance and Hearing, Department of Physical Therapy, Austin, TX, 2Concussion Health, Department of Clinical Education, Austin, TX, 3Conquering Concussions, Scottsdale, AZ, 4Barrow Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ, 5Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, 6The CACTIS Foundation, Scottsdale, 7Phoenix VA Healthcare System, Phoenix, AZ, 8Department of Psychology, Arizona State University, Tempe, AZ, USA Abstract: Normal function of the vestibulo-ocular reflex (VOR coordinates eye movement with head movement, in order to provide clear vision during motion and maintain balance. VOR is generated within the semicircular canals of the inner ear to elicit compensatory eye movements, which maintain stability of images on the fovea during brief, rapid head motion, otherwise known as gaze stability. Normal VOR function is necessary in carrying out activities of daily living (eg, walking and riding in a car and is of particular importance in higher demand activities (eg, sports-related activities. Disruption or damage in the VOR can result in symptoms such as movement-related dizziness, blurry vision, difficulty maintaining balance with head movements, and even nausea. Dizziness is one of the most common symptoms following traumatic brain injury (TBI and is considered a risk factor for a prolonged recovery. Assessment of the vestibular system is of particular importance following TBI, in conjunction with oculomotor control, due to the intrinsic neural circuitry that exists between the ocular and vestibular systems. The purpose of this article is to review the physiology of the VOR and the visual-vestibular symptoms associated with TBI and to discuss assessment and treatment guidelines for TBI. Current challenges and future prospects will also be addressed. Keywords: traumatic brain injury, concussion, vestibular, ocular

  18. Age-Related Neurochemical Changes in the Vestibular Nuclei

    Directory of Open Access Journals (Sweden)

    Paul eSmith


    Full Text Available There is evidence that the normal aging process is associated with impaired vestibulo-ocular (VOR and vestibulo-spinal reflexes, causing reduced visual acuity and postural instability. Nonetheless, the available evidence is not entirely consistent, especially with respect to the VOR. Some recent studies have reported that VOR gain can be intact even above 80 years of age. Similarly, although there is evidence for age-related hair cell loss and neuronal loss in Scarpa’s ganglion and the vestibular nucleus complex (VNC, it is not entirely consistent. Whatever structural and functional changes occur in the VNC as a result of aging, either to cause vestibular impairment or to compensate for it, neurochemical changes must underlie them. However, the neurochemical changes that occur in the VNC with aging are poorly understood because the available literature is very limited. This review summarises and critically evaluates the available evidence relating to the noradrenaline, serotonin, dopamine, glutamate, GABA, glycine, and nitric oxide neurotransmitter systems in the aging VNC. It is concluded that, at present, it is difficult, if not impossible, to relate the neurochemical changes observed to the function of specific VNC neurons and whether the observed changes are the cause of a functional deficit in the VNC or an effect of it. A better understanding of the neurochemical changes that occur during aging may be important for the development of potential drug treatments for age-related vestibular disorders. However, this will require the use of more sophisticated methodology such as in vivo microdialysis with single neuron recording and perhaps new technologies such as optogenetics.

  19. A new dynamic visual acuity test to assess peripheral vestibular function. (United States)

    Vital, Domenic; Hegemann, Stefan C A; Straumann, Dominik; Bergamin, Oliver; Bockisch, Christopher J; Angehrn, Dominik; Schmitt, Kai-Uwe; Probst, Rudolf


    To evaluate a novel test for dynamic visual acuity (DVA) that uses an adaptive algorithm for changing the size of Landolt rings presented during active or passive head impulses, and to compare the results with search-coil head impulse testing. Prospective study in healthy individuals and patients with peripheral vestibular deficits. Tertiary academic center. One hundred neuro-otologically healthy individuals (age range, 19-80 years) and 15 patients with bilateral (n = 5) or unilateral (n = 10) peripheral vestibular loss (age range, 27-72 years). Testing of static visual acuity (SVA), DVA during active and passive horizontal head rotations (optotype presentation at head velocities >100 degrees/s and >150 degrees/s), and quantitative horizontal head impulse testing with scleral search coils. Difference between SVA and DVA, that is, visual acuity loss (VA loss), gain of the high-acceleration vestibulo-ocular reflex. Passive head impulses and higher velocities were more effective than active impulses and lower velocities. Using passive head impulses and velocities higher than 150 degrees/s, the DVA test discriminated significantly (P test sensitivity was 100%, specificity was 94%, and accuracy was 95%, with search-coil head impulse testing used as a reference. In healthy individuals, VA loss increased significantly with age (P testing with Landolt rings that are adaptively changed in size enables detection of peripheral vestibular dysfunction in a fast and simple way.

  20. Velocity storage contribution to vestibular self-motion perception in healthy human subjects. (United States)

    Bertolini, G; Ramat, S; Laurens, J; Bockisch, C J; Marti, S; Straumann, D; Palla, A


    Self-motion perception after a sudden stop from a sustained rotation in darkness lasts approximately as long as reflexive eye movements. We hypothesized that, after an angular velocity step, self-motion perception and reflexive eye movements are driven by the same vestibular pathways. In 16 healthy subjects (25-71 years of age), perceived rotational velocity (PRV) and the vestibulo-ocular reflex (rVOR) after sudden decelerations (90°/s(2)) from constant-velocity (90°/s) earth-vertical axis rotations were simultaneously measured (PRV reported by hand-lever turning; rVOR recorded by search coils). Subjects were upright (yaw) or 90° left-ear-down (pitch). After both yaw and pitch decelerations, PRV rose rapidly and showed a plateau before decaying. In contrast, slow-phase eye velocity (SPV) decayed immediately after the initial increase. SPV and PRV were fitted with the sum of two exponentials: one time constant accounting for the semicircular canal (SCC) dynamics and one time constant accounting for a central process, known as velocity storage mechanism (VSM). Parameters were constrained by requiring equal SCC time constant and VSM time constant for SPV and PRV. The gains weighting the two exponential functions were free to change. SPV were accurately fitted (variance-accounted-for: 0.85 ± 0.10) and PRV (variance-accounted-for: 0.86 ± 0.07), showing that SPV and PRV curve differences can be explained by a greater relative weight of VSM in PRV compared with SPV (twofold for yaw, threefold for pitch). These results support our hypothesis that self-motion perception after angular velocity steps is be driven by the same central vestibular processes as reflexive eye movements and that no additional mechanisms are required to explain the perceptual dynamics.

  1. Human otolith-ocular reflexes during off-vertical axis rotation: effect of frequency on tilt-translation ambiguity and motion sickness (United States)

    Wood, Scott J.; Paloski, W. H. (Principal Investigator)


    The purpose of this study was to examine how the modulation of tilt and translation otolith-ocular responses during constant velocity off-vertical axis rotation varies as a function of stimulus frequency. Eighteen human subjects were rotated in darkness about their longitudinal axis 30 degrees off-vertical at stimulus frequencies between 0.05 and 0.8 Hz. The modulation of torsion decreased while the modulation of horizontal slow phase velocity (SPV) increased with increasing frequency. It is inferred that the ambiguity of otolith afferent information is greatest in the frequency region where tilt (torsion) and translational (horizontal SPV) otolith-ocular responses crossover. It is postulated that the previously demonstrated peak in motion sickness susceptibility during linear accelerations around 0.3 Hz is the result of frequency segregation of ambiguous otolith information being inadequate to distinguish between tilt and translation.

  2. Otolithic and extraocular muscle proprioceptive influences on the spatial organization of the vestibulo- and cervico-ocular quick phases. (United States)

    Pettorossi, V E; Manni, E; Errico, P; Ferraresi, A; Bortolami, R


    The cervico-ocular reflex (COR) was studied alone or in combination with the vestibulo-ocular reflex (VOR) in the rabbit. Step stimulations of the body with respect to the fixed head induced small slow compensatory responses followed by large compensatory quick phases (QP). These responses remained aligned with the horizon at different head pitch angles. The QP reorientation in space was due to the gravity influence on the otolithic receptors. The vestibular induced QPs exhibit a similar pattern. Because of this reorientation, the reduction of the amplitude of the vestibular induced QPs, due to the addition of the COR, was maintained even at different static head positions. The electrolytic lesion of the ophthalmic branch of the trigeminal nerve deeply affected the space orientation of the COR. In particular, the cervically induced compensatory QPs of the eye ipsilateral to the lesion showed a remarkable variability of their trajectories and they lost space reorientation. These findings suggest that the coordinate system controlling the QPs is influenced by signals originating from both head position in space and eye position in the orbit.

  3. Altered resting-state functional connectivity in patients with chronic bilateral vestibular failure. (United States)

    Göttlich, Martin; Jandl, Nico M; Wojak, Jann F; Sprenger, Andreas; von der Gablentz, Janina; Münte, Thomas F; Krämer, Ulrike M; Helmchen, Christoph


    Patients with bilateral vestibular failure (BVF) suffer from gait unsteadiness, oscillopsia and impaired spatial orientation. Brain imaging studies applying caloric irrigation to patients with BVF have shown altered neural activity of cortical visual-vestibular interaction: decreased bilateral neural activity in the posterior insula and parietal operculum and decreased deactivations in the visual cortex. It is unknown how this affects functional connectivity in the resting brain and how changes in connectivity are related to vestibular impairment. We applied a novel data driven approach based on graph theory to investigate altered whole-brain resting-state functional connectivity in BVF patients (n= 22) compared to age- and gender-matched healthy controls (n= 25) using resting-state fMRI. Changes in functional connectivity were related to subjective (vestibular scores) and objective functional parameters of vestibular impairment, specifically, the adaptive changes during active (self-guided) and passive (investigator driven) head impulse test (HIT) which reflects the integrity of the vestibulo-ocular reflex (VOR). BVF patients showed lower bilateral connectivity in the posterior insula and parietal operculum but higher connectivity in the posterior cerebellum compared to controls. Seed-based analysis revealed stronger connectivity from the right posterior insula to the precuneus, anterior insula, anterior cingulate cortex and the middle frontal gyrus. Excitingly, functional connectivity in the supramarginal gyrus (SMG) of the inferior parietal lobe and posterior cerebellum correlated with the increase of VOR gain during active as compared to passive HIT, i.e., the larger the adaptive VOR changes the larger was the increase in regional functional connectivity. Using whole brain resting-state connectivity analysis in BVF patients we show that enduring bilateral deficient or missing vestibular input leads to changes in resting-state connectivity of the brain. These

  4. Vestibular-related frontal cortical areas and their roles in smooth-pursuit eye movements: representation of neck velocity, neck-vestibular interactions and memory-based smooth-pursuit

    Directory of Open Access Journals (Sweden)

    Kikuro eFukushima


    Full Text Available Smooth-pursuit eye movements are voluntary responses to small slow-moving objects in the fronto-parallel plane. They evolved in primates, who possess high-acuity foveae, to ensure clear vision about the moving target. The primate frontal cortex contains two smooth-pursuit related areas; the caudal part of the frontal eye fields (FEF and the supplementary eye fields (SEF. Both areas receive vestibular inputs. We review functional differences between the two areas in smooth-pursuit. Most FEF pursuit neurons signal pursuit parameters such as eye velocity and gaze-velocity, and are involved in cancelling the vestibulo-ocular reflex by linear addition of vestibular and smooth-pursuit responses. In contrast, gaze-velocity signals are rarely represented in the SEF. Most FEF pursuit neurons receive neck velocity inputs, while discharge modulation during pursuit and trunk-on-head rotation adds linearly. Linear addition also occurs between neck velocity responses and vestibular responses during head-on-trunk rotation in a task-dependent manner. During cross-axis pursuit-vestibular interactions, vestibular signals effectively initiate predictive pursuit eye movements. Most FEF pursuit neurons discharge during the interaction training after the onset of pursuit eye velocity, making their involvement unlikely in the initial stages of generating predictive pursuit. Comparison of representative signals in the two areas and the results of chemical inactivation during a memory-based smooth-pursuit task indicate they have different roles; the SEF plans smooth-pursuit including working memory of motion-direction, whereas the caudal FEF generates motor commands for pursuit eye movements. Patients with idiopathic Parkinson’s disease were asked to perform this task, since impaired smooth-pursuit and visual working memory deficit during cognitive tasks have been reported in most patients. Preliminary results suggested specific roles of the basal ganglia in memory

  5. Patients with vestibular loss, tullio phenomenon, and pressure-induced nystagmus: vestibular atelectasis? (United States)

    Wenzel, Angela; Ward, Bryan K; Schubert, Michael C; Kheradmand, Amir; Zee, David S; Mantokoudis, Georgios; Carey, John Patrick


    To propose an etiology for a syndrome of bilateral vestibular hypofunction and sound and/or pressure-evoked eye movements with normal hearing thresholds. Retrospective case series. Tertiary care referral center. Four patients with bilateral vestibular hypofunction, sound and/or pressure-evoked nystagmus and normal hearing thresholds were identified over a 3-year period. No evidence of other known vestibular disorders was identified. None of these patients presented with a history of exposure to toxins, radiation, aminoglycosides or chemotherapy; head trauma; or a family history of inherited vestibular loss. All patients underwent high-resolution CT scan of the temporal bones to evaluate for labyrinthine dehiscence. Additionally, all individuals underwent audiometric testing to ANSI standards, vestibular-evoked myogenic potentials (VEMP) testing using either click stimulus cervical VEMPs (cVEMPs), or tone burst ocular VEMPs (oVEMPs). Bithermal caloric stimulation was used to measure horizontal semicircular canal function, with either videonystagmography (VNG) or electronystagmography (ENG) to record eye movements. Individual responses of each of the 6 semicircular canals (SCC) to rapid head rotations were tested with the bedside head impulse test. We identified 4 patients with a combination of bilateral vestibular hypofunction and sound and/or pressure-induced eye movements, normal-hearing thresholds and no evidence for any other vestibular disorder. We suggest that this unique combination of symptoms should be considered as the clinical presentation of vestibular atelectasis, which has been previously described histologically as collapse of the endolymph-containing portions of the labyrinth.

  6. The role of vestibular and support-tactile-proprioceptive inputs in visual-manual tracking (United States)

    Kornilova, Ludmila; Naumov, Ivan; Glukhikh, Dmitriy; Khabarova, Ekaterina; Pavlova, Aleksandra; Ekimovskiy, Georgiy; Sagalovitch, Viktor; Smirnov, Yuriy; Kozlovskaya, Inesa

    Sensorimotor disorders in weightlessness are caused by changes of functioning of gravity-dependent systems, first of all - vestibular and support. The question arises, what’s the role and the specific contribution of the support afferentation in the development of observed disorders. To determine the role and effects of vestibular, support, tactile and proprioceptive afferentation on characteristics of visual-manual tracking (VMT) we conducted a comparative analysis of the data obtained after prolonged spaceflight and in a model of weightlessness - horizontal “dry” immersion. Altogether we examined 16 Russian cosmonauts before and after prolonged spaceflights (129-215 days) and 30 subjects who stayed in immersion bath for 5-7 days to evaluate the state of the vestibular function (VF) using videooculography and characteristics of the visual-manual tracking (VMT) using electrooculography & joystick with biological visual feedback. Evaluation of the VF has shown that both after immersion and after prolonged spaceflight there were significant decrease of the static torsional otolith-cervical-ocular reflex (OCOR) and simultaneous significant increase of the dynamic vestibular-cervical-ocular reactions (VCOR) with a revealed negative correlation between parameters of the otoliths and canals reactions, as well as significant changes in accuracy of perception of the subjective visual vertical which correlated with changes in OCOR. Analyze of the VMT has shown that significant disorders of the visual tracking (VT) occurred from the beginning of the immersion up to 3-4 day after while in cosmonauts similar but much more pronounced oculomotor disorders and significant changes from the baseline were observed up to R+9 day postflight. Significant changes of the manual tracking (MT) were revealed only for gain and occurred on 1 and 3 days in immersion while after spaceflight such changes were observed up to R+5 day postflight. We found correlation between characteristics

  7. Ocular Hypertension (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Leer en Español: ¿Qué es la hipertensión ocular? ...

  8. Isometric and Dynamic Control of Neck Muscles : Reflexive contributions and muscle synergies

    NARCIS (Netherlands)

    De Bruijn, E.


    It is well established that the central nervous system (CNS) stabilizes the head using reflexive feedback and cocontraction. The major reflexive pathways in the neck are through muscle spindles generating the cervicocollic reflex (CCR) and through the vestibular organ generating the vestibulocollic

  9. Biobehavioural analysis of the vestibular system and posture control in patients with cervicogenic dizziness. A cross-sectional study. (United States)

    Grande-Alonso, M; Moral Saiz, B; Mínguez Zuazo, A; Lerma Lara, S; La Touche, R


    Cervicogenic dizziness is a musculoskeletal disorder mainly characterised by dizziness and disequilibrium associated with neck pain. The pathophysiology is unclear and the neurophysiological basis remains to be ascertained. The aim of this study is to compare the vestibulo-ocular reflex and postural control between patients with cervicogenic dizziness and asymptomatic subjects, and to assess the association between debilitating dizziness and other psychosocial variables. A total of 20 patients and 22 asymptomatic subjects were selected. Vestibulo-ocular reflex was assessed by performing the head impulse test. Computerised dynamic posturography was used to evaluate the postural control by means of the sensory organisation test. In addition, subjects self-reported their degree of disability due to dizziness, cervical disability, kinesiophobia, and state of anxiety and depression. There were no differences in the vestibulo-ocular reflex (P>.05). However, we found differences with a medium-to-large effect size (d>0.60) in variables related to proprioception and visual information integration; the former variable set was related to disability due to dizziness. Disability due to dizziness presents strong-to-moderate associations with cervical disability, kinesiophobia, and anxiety. Our data rule out changes in the vestibular system in cervicogenic dizziness, but they do point to proprioceptive impairment. According to our results, the association between dizziness-related disability and other psychosocial factors in cervicogenic dizziness is very relevant for clinical medicine and for future research projects. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Peripheral Vestibular System Disease in Vestibular Schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Hansen, Søren; Caye-Thomasen, Per


    density of the peripheral vestibular nerve branches, and atrophy of the neuroepithelium of the vestibular end organs. In cases with small tumors, peripheral disease occurred only in the tissue structures innervated by the specific nerve from which the tumor originated. CONCLUSION: Vestibular schwannomas...... are associated with distinctive disease of the peripheral vestibular tissue structures, suggesting anterograde degeneration and that dizziness in these patients may be caused by deficient peripheral vestibular nerve fibers, neurons, and end organs. In smaller tumors, a highly localized disease occurs, which...

  11. Modification of Otolith Reflex Asymmetries Following Space Flight (United States)

    Clarke, Andrew H.; Schoenfeld, Uwe; Wood, Scott J.


    We hypothesize that changes in otolith-mediated reflexes adapted for microgravity contribute to perceptual, gaze and postural disturbances upon return to Earth s gravity. Our goal was to determine pre- versus post-fight differences in unilateral otolith reflexes that reflect these adaptive changes. This study represents the first comprehensive examination of unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times pre-flight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation (UC, +/- 3.5cm at 400deg/s), utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and by video-oculographic measurement of the otolith-mediated ocular counter-roll (OOR). Unilateral saccular reflexes were recorded by measurement of collic Vestibular Evoked Myogenic Potential (cVEMP). Although data from a few subjects were not obtained early post-flight, a general increase in asymmetry of otolith responses was observed on landing day relative to pre-flight baseline, with a subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in the asymmetry measures appeared strongest for SVV, in a consistent direction for OOR, and in an opposite direction for cVEMP. These results are consistent with our hypothesis that space flight results in adaptive changes in central nervous system processing of otolith input. Adaptation to microgravity may reveal asymmetries in otolith function upon to return to Earth that were not detected prior to the flight due to compensatory mechanisms.

  12. Preservation of vestibular function after scala vestibuli cochlear implantation. (United States)

    Suzuki, Mitsuya; Goto, Takio; Kashio, Akinori; Yasui, Takuya; Sakamoto, Takashi; Ito, Ken; Yamasoba, Tatsuya


    A 58-year-old man, in whom the cochlear implant (CI) had been inserted into the left ear, had right middle-ear cancer. The CI was removed immediately before receiving subtotal removal of right temporal bone. Four months later, the CI was again inserted in his left cochlea. Because of obliterated scala tympani, the 22 active electrodes of the CI were placed into the scala vestibuli. After the surgery, the patient complained that he experienced rotary vertigo and "jumbling of vertical direction" of objects on walking. Using rotation test, we evaluated vestibular function of remaining left ear. Numerous horizontal nystagmus beats were induced during earth-vertical axis rotation, whereas vertical downbeat nystagmus was scarcely induced during off-vertical axis rotation. The horizontal vestibulo-ocular reflex (VOR) was almost normally induced by sinusoidal stimulation at 0.8Hz. These data suggest that the scala vestibuli insertion of CI would be not so invasive against the lateral semicircular canal. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. A vestibular sensation: probabilistic approaches to spatial perception. (United States)

    Angelaki, Dora E; Klier, Eliana M; Snyder, Lawrence H


    The vestibular system helps maintain equilibrium and clear vision through reflexes, but it also contributes to spatial perception. In recent years, research in the vestibular field has expanded to higher-level processing involving the cortex. Vestibular contributions to spatial cognition have been difficult to study because the circuits involved are inherently multisensory. Computational methods and the application of Bayes theorem are used to form hypotheses about how information from different sensory modalities is combined together with expectations based on past experience in order to obtain optimal estimates of cognitive variables like current spatial orientation. To test these hypotheses, neuronal populations are being recorded during active tasks in which subjects make decisions based on vestibular and visual or somatosensory information. This review highlights what is currently known about the role of vestibular information in these processes, the computations necessary to obtain the appropriate signals, and the benefits that have emerged thus far.

  14. Interaction of visual and vestibular stimulation on spatial coordinates for eye movements in rabbits. (United States)

    Pettorossi, V E; Errico, P; Ferraresi, A; Minciotti, M; Barmack, N H


    Researchers investigated how vestibular and optokinetic signals alter the spatial transformation of the coordinate system that governs the spatial orientation of reflexive eye movements. Also examined were the effects of sensory stimulation when vestibular and optokinetic signals act synergistically and when the two signals are in conflict.

  15. Cross-Modal Calibration of Vestibular Afference for Human Balance.

    Directory of Open Access Journals (Sweden)

    Martin E Héroux

    Full Text Available To determine how the vestibular sense controls balance, we used instantaneous head angular velocity to drive a galvanic vestibular stimulus so that afference would signal that head movement was faster or slower than actual. In effect, this changed vestibular afferent gain. This increased sway 4-fold when subjects (N = 8 stood without vision. However, after a 240 s conditioning period with stable balance achieved through reliable visual or somatosensory cues, sway returned to normal. An equivalent galvanic stimulus unrelated to sway (not driven by head motion was equally destabilising but in this situation the conditioning period of stable balance did not reduce sway. Reflex muscle responses evoked by an independent, higher bandwidth vestibular stimulus were initially reduced in amplitude by the galvanic stimulus but returned to normal levels after the conditioning period, contrary to predictions that they would decrease after adaptation to increased sensory gain and increase after adaptation to decreased sensory gain. We conclude that an erroneous vestibular signal of head motion during standing has profound effects on balance control. If it is unrelated to current head motion, the CNS has no immediate mechanism of ignoring the vestibular signal to reduce its influence on destabilising balance. This result is inconsistent with sensory reweighting based on disturbances. The increase in sway with increased sensory gain is also inconsistent with a simple feedback model of vestibular reflex action. Thus, we propose that recalibration of a forward sensory model best explains the reinterpretation of an altered reafferent signal of head motion during stable balance.

  16. Decreased otolith-mediated vestibular response in 25 astronauts induced by long-duration spaceflight. (United States)

    Hallgren, Emma; Kornilova, Ludmila; Fransen, Erik; Glukhikh, Dmitrii; Moore, Steven T; Clément, Gilles; Van Ombergen, Angelique; MacDougall, Hamish; Naumov, Ivan; Wuyts, Floris L


    The information coming from the vestibular otolith organs is important for the brain when reflexively making appropriate visual and spinal corrections to maintain balance. Symptoms related to failed balance control and navigation are commonly observed in astronauts returning from space. To investigate the effect of microgravity exposure on the otoliths, we studied the otolith-mediated responses elicited by centrifugation in a group of 25 astronauts before and after 6 mo of spaceflight. Ocular counterrolling (OCR) is an otolith-driven reflex that is sensitive to head tilt with regard to gravity and tilts of the gravito-inertial acceleration vector during centrifugation. When comparing pre- and postflight OCR, we found a statistically significant decrease of the OCR response upon return. Nine days after return, the OCR was back at preflight level, indicating a full recovery. Our large study sample allows for more general physiological conclusions about the effect of prolonged microgravity on the otolith system. A deconditioned otolith system is thought to be the cause of several of the negative effects seen in returning astronauts, such as spatial disorientation and orthostatic intolerance. This knowledge should be taken into account for future long-term space missions. Copyright © 2016 the American Physiological Society.

  17. Neurophysiology of vestibular rehabilitation. (United States)

    Hain, Timothy C


    The vestibular system is a sophisticated human control system. Accurate processing of sensory input about rapid head and postural motion is critical. Not surprisingly, the body uses multiple, partially redundant sensory inputs and motor outputs, combined with a very competent central repair capability. The system as a whole can adapt to substantial peripheral vestibular dysfunction. The Achilles' heel of the vestibular system is a relative inability to repair central vestibular dysfunction.

  18. Neurophysiology of vestibular rehabilitation


    Hain Timothy, C.


    The vestibular system is a sophisticated human control system. Accurate processing of sensory input about rapid head and postural motion is critical. Not surprisingly, the body uses multiple, partially redundant sensory inputs and motor outputs, combined with a very competent central repair capability. The system as a whole can adapt to substantial peripheral vestibular dysfunction. The Achilles' heel of the vestibular system is a relative inability to repair central vestibular dysfunction.

  19. Vestibular involvement in adults with HIV/AIDS. (United States)

    Heinze, Barbara M; Vinck, Bart M; Hofmeyr, Louis M; Swanepoel, De Wet


    HIV/AIDS is responsible for widespread clinical manifestations involving the head, and neck. The prevalence and nature of vestibular involvement is still largely unknown. This study, aimed to describe and compare the occurrence and nature of vestibular involvement among a group of, adults infected with HIV compared to a control group. It also aimed to compare the vestibular function, of symptomatic and asymptomatic HIV positive adults who receive antiretroviral (ARV) therapies to, subjects not receiving ARV. A cross-sectional study was conducted on 53 adults (29 male, 24 female, aged 23-49 years, mean=38.5, SD=4.4) infected with HIV, compared to a control group of 38 HIV negative adults (18, male, 20 female, aged 20-49 years, mean=36.9, SD=8.2). A structured interview probed the subjective, perception of vestibular symptoms. Medical records were reviewed for CD4+ cell counts and the use of, ARV medication. An otologic assessment and a comprehensive vestibular assessment (bedside, assessments, vestibular evoked myogenic potentials, ocular motor and positional tests and bithermal, caloric irrigation) were conducted. Vestibular involvement occurred in 79.2% of subjects with HIV in all categories of disease, progression, compared to 18.4% in those without HIV. Vestibular involvement increased from 18.9% in CDC category 1 to 30.2% in category 2. Vestibular involvement was 30.1% in category 3. There were, vestibular involvement in 35.9% of symptomatic HIV positive subjects, and 41.5% in asymptomatic, HIV positive subjects. There was no significant difference in the occurrence of vestibular involvement, in subjects receiving ARV therapies compared to those not receiving ARV therapies (p=.914; chi-square, test). The odds ratio indicates that individuals with HIV have a 16.61 times higher risk of developing, vestibular involvement during their lifetime of living with the disease and that it may occur despite, being asymptomatic. Vestibular involvement was significantly more

  20. Improving Sensorimotor Function and Adaptation using Stochastic Vestibular Stimulation (United States)

    Galvan, R. C.; Bloomberg, J. J.; Mulavara, A. P.; Clark, T. K.; Merfeld, D. M.; Oman, C. M.


    disturbances. Subjects will adapt to wearing minifying glasses, resulting in decreased vestibular ocular reflex (VOR) gain. The VOR gain will then be intermittently measured while the subject readapts to normal vision, with and without optimal SVS. We expect that optimal SVS will cause a steepening of the adaptation curve. The third experiment will test the use of optimal SVS in an operationally relevant aerospace task, using the tilt translation sled at NASA Johnson Space Center, a test platform capable of recreating the tilt-gain and tilt-translation illusions associated with landing of a spacecraft post-space flight. In this experiment, a perception based manual control measure will be used to compare performance with and without optimal SVS. We expect performance to improve in this task when optimal SVS is applied. The ultimate goal of this work is to systematically investigate and further understand the potential benefits of stochastic vestibular stimulation in the context of human space flight so that it may be used in the future as a component of a comprehensive countermeasure plan for adaptation to G-transitions.

  1. Reflexives and reflexive constructions in Afrikaans

    African Journals Online (AJOL)

    Kate H

    2. Reflexives. Afrikaans items belonging to the traditional lexical category of reflexives (or reflexive ... reflexive and non-reflexive pronouns are syntactically derived from the same lexical root pronoun √PRON. The ...... 32 The matrix verbs in (33) and (34) both concern a future activity of an entity: belowe (“promise”) in the (a).

  2. Histamine Excites Rat Superior Vestibular Nuclear Neurons via Postsynaptic H1 and H2 Receptors in vitro

    Directory of Open Access Journals (Sweden)

    Qian-Xing Zhuang


    Full Text Available The superior vestibular nucleus (SVN, which holds a key position in vestibulo-ocular reflexes and nystagmus, receives direct hypothalamic histaminergic innervations. By using rat brainstem slice preparations and extracellular unitary recordings, we investigated the effect of histamine on SVN neurons and the underlying receptor mechanisms. Bath application of histamine evoked an excitatory response of the SVN neurons, which was not blocked by the low-Ca2+/high-Mg2+ medium, indicating a direct postsynaptic effect of the amine. Selective histamine H1 receptor agonist 2-pyridylethylamine and H2 receptor agonist dimaprit, rather than VUF8430, a selective H4 receptor agonist, mimicked the excitation of histamine on SVN neurons. In addition, selective H1 receptor antagonist mepyramine and H2 receptor antagonist ranitidine, but not JNJ7777120, a selective H4 receptor antagonist, partially blocked the excitatory response of SVN neurons to histamine. Moreover, mepyramine together with ranitidine nearly totally blocked the histamine-induced excitation. Immunostainings further showed that histamine H1 and H2 instead of H4 receptors existed in the SVN. These results demonstrate that histamine excites the SVN neurons via postsynaptic histamine H1 and H2 receptors, and suggest that the central histaminergic innervation from the hypothalamus may actively bias the SVN neuronal activity and subsequently modulate the SVN-mediated vestibular functions and gaze control.

  3. [Vestibular testing abnormalities in individuals with motion sickness]. (United States)

    Ma, Yan; Ou, Yongkang; Chen, Ling; Zheng, Yiqing


    To evaluate the vestibular function of motion sickness. VNG, which tests the vestibular function of horizontal semicircular canal, and CPT, which tests vestibulospinal reflex and judge proprioceptive, visual and vestibular status, were performed in 30 motion sickness patients and 20 healthy volunteers (control group). Graybiel score was recorded at the same time. Two groups' Graybiel score (12.67 +/- 11.78 vs 2.10 +/- 6.23; rank test P<0.05), caloric test labyrinth value [(19.02 +/- 8.59) degrees/s vs (13.58 +/- 5.25) degrees/s; t test P<0.05], caloric test labyrinth value of three patients in motion sickness group exceeded 75 degrees/s. In computerized posturography testing (CPT), motion sickness patients were central type (66.7%) and disperse type (23.3%); all of control group were central type. There was statistical significance in two groups' CTP area, and motion sickness group was obviously higher than control group. While stimulating vestibulum in CPT, there was abnormality (35%-50%) in motion sickness group and none in control group. Generally evaluating CPT, there was only 2 proprioceptive hypofunction, 3 visual hypofunction, and no vestibular hypofunction, but none hypofunction in control group. Motion sickness patients have high vestibular susceptible, some with vestibular hyperfunction. In posturography, a large number of motion sickness patients are central type but no vestibular hypofunction, but it is hard to keep balance when stimulating vestibulum.

  4. Ocular Melanoma (United States)

    ... is Ocular Melanoma? Leer en Español: ¿Qué es el melanoma ocular? Written By: Daniel Porter Reviewed By: Robert H Janigian Jr MD Sep. 01, 2017 Ocular melanoma (melanoma in or around the eye) is a type of cancer that develops in the cells that produce pigment. ...

  5. [Vestibular compensation studies]. [Vestibular Compensation and Morphological Studies (United States)

    Perachio, Adrian A. (Principal Investigator)


    The following topics are reported: neurophysiological studies on MVN neurons during vestibular compensation; effects of spinal cord lesions on VNC neurons during compensation; a closed-loop vestibular compensation model for horizontally canal-related MVN neurons; spatiotemporal convergence in VNC neurons; contributions of irregularly firing vestibular afferents to linear and angular VOR's; application to flight studies; metabolic measures in vestibular neurons; immediate early gene expression following vestibular stimulation; morphological studies on primary afferents, central vestibular pathways, vestibular efferent projection to the vestibular end organs, and three-dimensional morphometry and imaging.

  6. A Cross-sectional Survey and Cross-sectional Clinical Trial to Determine the Prevalence and Management of Eye Movement Disorders and Vestibular Dysfunction in Post-Stroke Patients in the Sub-Acute Phase: Protocol. (United States)

    van Wyk, Andoret; Eksteen, Carina A; Becker, Piet J; Heinze, Barbara M


    Visual impairment, specifically eye movement disorders and vestibular dysfunction may have a negative influence on the functional recovery in post-stroke patients. This type of sensory dysfunction may further be associated with poor functional outcome in patients' post-stroke. In phase 1, a cross-sectional survey ( n  = 100) will be conducted to determine the prevalence of eye movement disorders and vestibular dysfunction in patients who sustained a stroke. A cross-sectional clinical trial ( n  = 60) will be conducted during phase 2 of the study to determine the effect of the combination of vestibular rehabilitation therapy (VRT) and visual scanning exercises (VSE) (experimental group) integrated with task-specific activities compared with the effect of task-specific activities as an intervention (control group) on patients who present with eye movement impairment and central vestibular dysfunction post-stroke. An audiologist will assess (a) visual acuity (static and dynamic), (b) nystagmus, (c) saccadic eye movements, (d) smooth pursuit eye movements, (e) vestibulo-ocular reflex, and (f) saccular, utricular, and vestibular nerve function. An independent physiotherapist will assess (1) cognitive function, (2) residual oculomotor visual performance, (3) visual-perceptual system, (4) functional balance, (5) gait, (6) functional ability, (7) presence of anxiety and/or depression, and (8) level of participation in physical activity. Ethics approval has been obtained from the Ethics Committee of the Faculty of Health Sciences at the University of Pretoria (UP) (374/2015). The study will be submitted as fulfillment for the PhD degree at UP. Dissemination will include submission to peer-reviewed professional journals and presentation at congresses. Training of rehabilitation team members on the integration of VSE and VRT into task-specific activities in rehabilitation will be done if the outcome of the experimental group's functional performance is clinically and


    Directory of Open Access Journals (Sweden)

    Yougan Saman


    Full Text Available ABSTRACTEvidence is emerging of a significant clinical and neuro-anatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety and there is a relationship between increased state anxiety and worsening balance function. Aims1.To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit.2.To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. MethodsTwo separate cohorts Vestibular Schwannoma (VS patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials and caloric responses and questionnaire assessment (Vertigo handicap Questionnaire, Vertigo Symptom Scale, State Trait Anxiety InventoryFifteen post resection Vestibular schwannoma patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1. Forty-five patients with VS in-situ and with preserved vestibular function formed the cohort for Experiment 2 (Aim 2. Experiment 1: VS subjects (N=15 with a complete post-resection unilateral vestibular deafferentation completed a State anxiety questionnaire before caloric assessment and again afterwards with the point of maximal vertigo as the reference (Aim 1. Experiment 2: State anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of presenting with balance symptoms (Group 1 N=26 and without balance symptoms (Group 2 N=11 (Aim 2. The presence of balance symptoms was defined as having a positive score on the VSS-VER.ResultsIn experiment 1, a significant difference (p<0.01 was found when comparing

  8. New insights into pathophysiology of vestibular migraine

    Directory of Open Access Journals (Sweden)

    Juan Manuel Espinosa-Sanchez


    Full Text Available Vestibular migraine (VM is a common disorder in which genetic, epigenetic and environmental factors probably contribute to its development. The pathophysiology of VM is unknown; nevertheless in the last few years, several studies are contributing to understand the neurophysiological pathways involved in VM. The current hypotheses are mostly based on the knowledge of migraine itself. The evidence of trigeminal innervation of the labyrinth vessels and the localization of vasoactive neuropeptides in the perivascular afferent terminals of these trigeminal fibers support the involvement of the trigemino-vascular system. The neurogenic inflammation triggered by activation of the trigeminal-vestibulocochlear reflex, with the subsequent inner ear plasma protein extravasation and the release of inflammatory mediators, can contribute to a sustained activation and sensitization of the trigeminal primary afferent neurons explaining VM symptoms. The reciprocal connections between brainstem vestibular nuclei and the structures that modulate trigeminal nociceptive inputs (rostral ventromedial medulla, ventrolateral periaqueductal grey, locus coeruleus and nucleus raphe magnus are critical to understand the pathophysiology of VM. Although cortical spreading depression can affect cortical areas involved in processing vestibular information, functional neuroimaging techniques suggest a dysmodulation in the multimodal sensory integration and processing of vestibular and nociceptive information, resulting from a vestibulo-thalamo-cortical dysfunction, as the pathogenic mechanism underlying VM. The elevated prevalence of VM suggests that multiple functional variants may confer a genetic susceptibility leading to a dysregulation of excitatory-inhibitory balance in brain structures involved in the processing of sensory information, vestibular inputs and pain. The interactions among several functional and structural neural networks could explain the pathogenic

  9. Shoulder reflexes

    DEFF Research Database (Denmark)

    Diederichsen, L.; Krogsgaard, M.; Voigt, Michael


    long latency (300 ms) excitatory reflex has been found when nerves in the capsule were stimulated electrically during shoulder surgery. In addition, when the anterior-inferior capsule was excited in conscious humans with modest amplitude electrical stimuli during muscle activity, a strong inhibition...... activity around the shoulder. This has implications for rehabilitation and shoulder surgery.......Dynamic shoulder stability is dependent on muscular coordination and sensory inputs. In the shoulder, mechanoreceptors are found in the coracoacromial ligament, the rotator cuff tendons, the musculotendinous junctions of the rotator cuff and in the capsule. The number of receptors in the capsule...

  10. Otolith and canal reflexes in human standing (United States)

    Cathers, Ian; Day, Brian L; Fitzpatrick, Richard C


    We used galvanic vestibular stimulation (GVS) to identify human balance reflexes of the semicircular canals and otolith organs. The experiment used a model of vestibular signals arising from GVS modulation of the net signal from vestibular afferents. With the head upright, the model predicts that the GVS-evoked canal signal indicates lateral head rotation while the otolith signal indicates lateral tilt or acceleration. Both signify body sway transverse to the head. With the head bent forward, the model predicts that the canal signal indicates body spin about a vertical axis but the otolith signal still signifies lateral body motion. Thus, we compared electromyograms (EMG) in the leg muscles and body sway evoked by GVS when subjects stood with the head upright or bent forward. With the head upright, GVS evoked a large sway in the direction of the anodal electrode. This response was abolished with the head bent forward leaving only small, oppositely directed, transient responses at the start and end of the stimulus. With the head upright, GVS evoked short-latency (60–70 ms), followed by medium-latency (120 ms) EMG responses, of opposite polarity. Bending the head forward abolished the medium-latency but preserved the short-latency response. This is compatible with GVS evoking separate otolithic and canal reflexes, indicating that balance is controlled by independent canal and otolith reflexes, probably through different pathways. We propose that the short-latency reflex and small transient sway are driven by the otolith organs and the medium-latency response and the large sway are driven by the semicircular canals. PMID:15618274

  11. Vestibular myogenic and acoustical brainstem evoked potentials in neurological practice

    Directory of Open Access Journals (Sweden)

    O. S. Korepina


    Full Text Available Along with the inspection of acoustical cortex and brainstem EP in neurologic, otoneurologic and audiologic practice recently start to use so-called vestibular evoked myogenic potentials (VEMP. It is shown, that at ear stimulation by a loud sound and record of sterno-cleidomastoid contraction is possible to estimate function of the inferior vestibular nerve and vestibulospinal pathways, a sacculo-cervical reflex. In article some methodical and clinical questions of application of these kinds are presented. Combine research acoustic brainstem EP and VEMP allows to confirm effectively lesions of acoustical and vestibular ways at brainstem. The conclusion becomes, that this kind of inspection is important for revealing demielinisation and defeats in vestibulospinal tract, that quite often happens at MS, and at estimation of efficiency of treatment

  12. Angiogenesis in vestibular schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Werther, Kim; Nalla, Amarnadh


    Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) are potent mediators of tumor angiogenesis. It has been demonstrated that vestibular schwannoma VEGF expression correlates with tumor growth pattern, whereas knowledge on the expression of MMPs is lacking. This study...

  13. Vestibular function testing.

    LENUS (Irish Health Repository)

    Lang, E E


    Vestibular symptoms of vertigo, dizziness and dysequilibrium are common complaints which can be disabling both physically and psychologically. Routine examination of the ear nose and throat and neurological system are often normal in these patients. An accurate history and thorough clinical examination can provide a diagnosis in the majority of patients. However, in a subgroup of patients, vestibular function testing may be invaluable in arriving at a correct diagnosis and ultimately in the optimal treatment of these patients.

  14. Ocular Sarcoidosis (United States)

    Pasadhika, Sirichai; Rosenbaum, James T


    Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations. PMID:26593141

  15. Traumatismos oculares Ocular traumas

    Directory of Open Access Journals (Sweden)

    Gelen Welch Ruiz


    Full Text Available Se realizó un estudio descriptivo de tipo retrospectivo longitudinal cuyo universo estuvo constituido por 72 ojos de 72 pacientes con traumatismos oculares mecánicos que fueron hospitalizados en el Hospital Militar Central “Dr. Carlos J. Finlay” desde enero de 1999 hasta enero de 2005. Para el análisis estadístico de la información se utilizó el programa automatizado SPSS versión 11.5 en el cual también se conformó la base de datos y se realizaron los cálculos de acuerdo con el tipo de variable analizada. Se utilizaron medidas de resumen, tendencia central y asociación estadística con un nivel de significación de p A retrospective longitudinal and descriptive study was carried out in 72 eyes from 72 patients with mechanical occular traumas, who had been hospitalized in “Dr. Carlos J. Finlay” Military Hospital from December 1999 to January 2005. For the statistical data analysis, an automated program (SPSS 11.5 version was used to create the database and estimations were made according to the variable types. Summary measures, central tendency measures and statistical association with significance level equal to p < 0.05 were employed. Males prevailed (95.8%, the average age was 30.26 years with a minimum rate of 17 years and maximum rate of 82 years. The most frequent mechanisms of trauma were aggressions (23. 6% and injures from secondary projectiles (13.9%. The anterior segment traumas were more frequent (61, 1% than posterior segment traumas (6.94%. Both segments of the eyeball were affected in 39, 1% of eyes which evinced the worst visual acuity. The most common associated injures were hyphema (54, 2% and vitreous hemorrhage (16.6%. Closed trauma (contusions were more common and most of the eyes had better final visual acuity (45, 2% with vision range of 0.6-1.0 and 26.2% with vision range of 0.59-0.1. On the other hand, eyes affected by open trauma (simple wound, contusion-wound, wound with intraocular foreign body and

  16. Deregulated genes in sporadic vestibular schwannomas

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Helweg-Larsen, Rehannah Holga Andrea; Stangerup, Sven-Eric


    In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology.......In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology....

  17. Oculomotor and Vestibular Findings in Gaucher Disease Type 3 and Their Correlation with Neurological Findings

    Directory of Open Access Journals (Sweden)

    Tatiana Bremova-Ertl


    Full Text Available ObjectivesTo evaluate the function of the oculomotor and vestibular systems and to correlate these findings with the clinical status of patients with Gaucher disease type 3 (GD3. The goal of this cross-sectional and longitudinal study was to find oculomotor biomarkers for future clinical trials.MethodsTwenty-six patients with GD3 were assessed for eligibility and 21 were able to perform at least one task. Horizontal and vertical reflexive saccades, smooth pursuit, gaze-holding, optokinetic nystagmus, and horizontal vestibulo-ocular reflex (VOR were examined by video-oculography/video-head impulse test and compared concurrently with 33 healthy controls. The Scale for the Assessment and Rating of Ataxia (SARA, the modified Severity Scoring Tool (mSST, and Grooved Pegboard Test (GPT were administered to assess overall neurological function. Eleven patients were also re-assessed after 1 year.ResultsNine out of 17 patients exhibited gaze-holding deficits. One patient had upbeat nystagmus. Three patients presented with bilateral abducens palsy in combination with central oculomotor disorders, suggesting a bilateral involvement of the abducens nucleus. Horizontal angular VOR gain was reduced in all patients (0.66 ± 0.37 compared with controls (1.1 ± 0.11, p < 0.001. Most strongly correlated with clinical rating scales were peak velocity of downward saccades (SARA: ρ = −0.752, p < 0.0005; mSST: ρ = −0.611, p = 0.003; GPT: ρ = −0.649, p = 0.005 and duration of vertical saccades (SARA: ρ = 0.806, p < 0.001; mSST: ρ = 0.700, p < 0.0005; GPT: ρ = 0.558, p = 0.02 together with the VOR gain (SARA: ρ = −0.63, p = 0.016; mSST: ρ = −0.725, p = 0.003; GPT: ρ = −0.666, p = 0.004. Vertical smooth pursuit gain decreased significantly at follow-up.InterpretationThis study shows neuronal degeneration of the brainstem and cerebellum with combined involvement of

  18. Hereditary familial vestibular degenerative diseases.

    NARCIS (Netherlands)

    Sun, J.; Alphen, A.M. van; Wagenaar, M.; Huygen, P.L.M.; Hoogenraad, C.C.; Hasson, T.; Koekkoek, S.K.; Bohne, B.A.; Zeeuw, C.I. de


    Identification of genes involved in hereditary vestibular disease is growing at a remarkable pace. Mutant mouse technology can be an important tool for understanding the biological mechanism of human vestibular diseases.

  19. Otolith-Canal Convergence In Vestibular Nuclei Neurons (United States)

    Dickman, J. David; Si, Xiao-Hong


    The current final report covers the period from June 1, 1999 to May 31, 2002. The primary objective of the investigation was to determine how information regarding head movements and head position relative to gravity is received and processed by central vestibular nuclei neurons in the brainstem. Specialized receptors in the vestibular labyrinths of the inner ear function to detect angular and linear accelerations of the head, with receptors located in the semicircular canals transducing rotational head movements and receptors located in the otolith organs transducing changes in head position relative to gravity or linear accelerations of the head. The information from these different receptors is then transmitted to central vestibular nuclei neurons which process the input signals, then project the appropriate output information to the eye, head, and body musculature motor neurons to control compensatory reflexes. Although a number of studies have reported on the responsiveness of vestibular nuclei neurons, it has not yet been possible to determine precisely how these cells combine the information from the different angular and linear acceleration receptors into a correct neural output signal. In the present project, rotational and linear motion stimuli were separately delivered while recording responses from vestibular nuclei neurons that were characterized according to direct input from the labyrinth and eye movement sensitivity. Responses from neurons receiving convergent input from the semicircular canals and otolith organs were quantified and compared to non-convergent neurons.

  20. Vestibular Loss in Older Adults Is Associated with Impaired Spatial Navigation: Data from the Triangle Completion Task

    Directory of Open Access Journals (Sweden)

    Yanjun Xie


    Full Text Available BackgroundVestibular inputs have been shown to play a critical role in spatial navigation. In this study, we sought to evaluate whether vestibular loss due to aging contributes to impaired spatial navigation as measured by the triangle completion task (TCT.Materials and methodsWe recruited three types of participants: young controls <55 years of age, older controls ≥55 years of age, and older patients from a Neurotology Clinic with evidence of vestibular physiologic impairment but who did not have any known vestibular disorder. We performed the cervical vestibular-evoked myogenic potential to evaluate saccular function and video head impulse testing to quantify horizontal semicircular canal vestibulo-ocular reflex gain. To assess spatial navigation ability, we administered the TCT, in which participants were conveyed along two segments of a pre-drawn triangular path and instructed to complete the final segment independently. We measured the angle (degrees and distance (centimeters of deviation from the correct trajectory. We evaluated the influence of vestibular inputs on TCT performance.ResultsForty-eight adults participated in the study (mean age: 62.0 years; 52.1% females, including 9 young controls, 15 older controls, and 24 clinic patients. Clinic patients had the greatest distance of deviation (67.7 cm, followed by older controls (45.4 cm, then young controls (27.8 cm; p < 0.01. Similarly, clinic patients had greater rotational angles (22.1° compared to older (13.3° and younger controls (12.4°; p < 0.01. Following multivariate linear regression adjusting for demographic variables, loss of otolith function was associated with an 18.2 cm increase in distance of deviation (95% CI: 15.2–47.4 and a 9.2° increase in rotational angle (95% CI: 3.0–15.5. Abnormal semicircular canal function was associated with a 26.0 cm increase in distance of deviation (95% CI: 0.2–51.8 and a 10.8° increase in rotational angle

  1. Dyscalculia and vestibular function. (United States)

    Smith, P F


    A few studies in humans suggest that changes in stimulation of the balance organs of the inner ear (the 'vestibular system') can disrupt numerical cognition, resulting in 'dyscalculia', the inability to manipulate numbers. Many studies have also demonstrated that patients with vestibular dysfunction exhibit deficits in spatial memory. It is suggested that there may be a connection between spatial memory deficits resulting from vestibular dysfunction and the occurrence of dyscalculia, given the evidence that numerosity is coupled to the processing of spatial information (e.g., the 'spatial numerical association of response codes ('SNARC') effect'). The evidence supporting this hypothesis is summarised and potential experiments to test it are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Vestibular Dysfunction in Patients with Enlarged Vestibular Aqueduct. (United States)

    Zalewski, Chris K; Chien, Wade W; King, Kelly A; Muskett, Julie A; Baron, Rachel E; Butman, John A; Griffith, Andrew J; Brewer, Carmen C


    Enlarged vestibular aqueduct (EVA) is the most common inner ear malformation. While a strong correlative relationship between EVA and hearing loss is well established, its association with vestibular dysfunction is less well understood. In this study, we examine the effects of EVA on the vestibular system in patients with EVA. Prospective, cross-sectional study of a cohort ascertained between 1999 and 2013. National Institutes of Health Clinical Center, a federal biomedical research facility. In total, 106 patients with unilateral or bilateral EVA, defined as a midpoint diameter greater than 1.5 mm, were referred or self-referred to participate in a study of the clinical and molecular aspects of EVA. Clinical history was ascertained with respect to the presence or absence of various vestibular signs and symptoms and history of head trauma. Videonystagmography (VNG), cervical vestibular evoked myogenic potential (cVEMP), and rotational vestibular testing (RVT) were performed to assess the vestibular function. Of the patients with EVA, 45% had vestibular signs and symptoms, and 44% of tested patients had abnormal VNG test results. An increased number of vestibular signs and symptoms was correlated with the presence of bilateral EVA (P = .008) and a history of head injury (P VNG results also correlated with a history of head injury (P = .018). Vestibular dysfunction is common in patients with EVA. However, not all patients with vestibular signs and symptoms have abnormal vestibular test results. Clinicians should be aware of the high prevalence of vestibular dysfunction in patients with EVA. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  3. Ocular Straylight

    Directory of Open Access Journals (Sweden)

    Sigrid Mueller-Schotte OD, MSc


    Full Text Available Intra-ocular straylight can cause decreased visual functioning, and it may cause diminished vision-related quality of life (VRQOL. This cross-sectional population-based study investigates the association between straylight and VRQOL in middle-aged and elderly individuals. Multivariable linear regression analyses were used to assess the association between straylight modeled continuously and cutoff at the recommended fitness-to-drive value, straylight ≥ 1.4 log(s, and VRQOL. The study showed that participants with normal straylight values, straylight ≤ 1.4 log(s, rated their VRQOL slightly better than those with high straylight values (straylight ≥ 1.4 log(s. Furthermore, multivariable regression analysis revealed a borderline statistical significant association ( p = .06 between intra-ocular straylight and self-reported VRQOL in middle-aged and elderly individuals. The association between straylight and self-reported VRQOL was not influenced by the status of the intra-ocular lens (natural vs. artificial intra-ocular lens after cataract extraction or the number of (instrumental activities of daily living that were reported as difficult for the elderly individuals.

  4. Right-sided dominance of the bilateral vestibular system in the upper brainstem and thalamus. (United States)

    Dieterich, Marianne; Kirsch, V; Brandt, T


    MRI diffusion tensor imaging tractography was performed on the bilateral vestibular brainstem pathways, which run from the vestibular nuclei via the paramedian and posterolateral thalamic subnuclei to the parieto-insular vestibular cortex. Twenty-one right-handed healthy subjects participated. Quantitative analysis revealed a rope-ladder-like system of vestibular pathways in the brainstem with crossings at pontine and mesencephalic levels. Three structural types of right-left fiber distributions could be delineated: (1) evenly distributed pathways at the lower pontine level from the vestibular nuclei to the pontine crossing, (2) a moderate, pontomesencephalic right-sided lateralization between the pontine and mesencephalic crossings, and (3) a further increase of the right-sided lateralization above the mesencephalic crossing leading to the thalamic vestibular subnuclei. The increasing lateralization along the brainstem was the result of an asymmetric number of pontine and mesencephalic crossing fibers which was higher for left-to-right crossings. The dominance of the right vestibular meso-diencephalic circuitry in right-handers corresponds to the right-hemispheric dominance of the vestibular cortical network. The structural asymmetry apparent in the upper brainstem might be interpreted in relation to the different functions of the vestibular system depending on their anatomical level: a symmetrical sensorimotor reflex control of eye, head, and body mediated by the lower brainstem; a lateralized right-sided upper brainstem-thalamic function as part of the dominant right-sided cortical/subcortical vestibular system that enables a global percept of body motion and orientation in space.

  5. Vertigo with sudden hearing loss: audio-vestibular characteristics. (United States)

    Pogson, Jacob M; Taylor, Rachael L; Young, Allison S; McGarvie, Leigh A; Flanagan, Sean; Halmagyi, G Michael; Welgampola, Miriam S


    Acute vertigo with sudden sensorineural hearing loss (SSNHL) is a rare clinical emergency. Here, we report the audio-vestibular test profiles of 27 subjects who presented with these symptoms. The vestibular test battery consisted of a three-dimensional video head impulse test (vHIT) of semicircular canal function and recording ocular and cervical vestibular-evoked myogenic potentials (oVEMP, cVEMP) to test otolith dysfunction. Unlike vestibular neuritis, where the horizontal and anterior canals with utricular function are more frequently impaired, 74 % of subjects with vertigo and SSNHL demonstrated impairment of the posterior canal gain (0.45 ± 0.20). Only 41 % showed impairment of the horizontal canal gains (0.78 ± 0.27) and 30 % of the anterior canal gains (0.79 ± 0.26), while 38 % of oVEMPs [asymmetry ratio (AR) = 41.0 ± 41.3 %] and 33 % of cVEMPs (AR = 47.3 ± 41.2 %) were significantly asymmetrical. Twenty-three subjects were diagnosed with labyrinthitis/labyrinthine infarction in the absence of evidence for an underlying pathology. Four subjects had a definitive diagnosis [Ramsay Hunt Syndrome, vestibular schwannoma, anterior inferior cerebellar artery (AICA) infarction, and traction injury]. Ischemia involving the common-cochlear or vestibulo-cochlear branches of the labyrinthine artery could be the simplest explanation for vertigo with SSNHL. Audio-vestibular tests did not provide easy separation between ischaemic and non-ischaemic causes of vertigo with SSNHL.

  6. Drug therapy for peripheral vestibular vertigo

    Directory of Open Access Journals (Sweden)

    L. M. Antonenko


    Full Text Available The choice of effective treatments for vestibular vertigo is one of the important problems, by taking into account the high prevalence of peripheral vestibular diseases. Different drugs, such as vestibular suppressants for the relief of acute vertigo attacks and vestibular compensation stimulants for rehabilitation treatment, are used to treat vestibular vertigo. Drug therapy in combination with vestibular exercises is effective in patients with vestibular neuronitis, Meniere's disease, so is that with therapeutic maneuvers in patients with benign paroxysmal positional vertigo. The high therapeutic efficacy and safety of betahistines permit their extensive use for the treatment of various vestibular disorders.

  7. Influence of gravity on the orientation of vestibular induced quick phases. (United States)

    Pettorossi, V E; Errico, P; Ferraresi, A; Draicchio, F


    In rabbits and cats the orientation of the quick phases (QPs) of the vestibulo-ocular reflex (VOR) was studied varying the head position in space. At different head tilt positions, QPs induced by step vestibular stimulation disaligned with respect to the stimulus toward the orientation of the earth's horizontal axis. The rabbits' QPs were horizontal during yaw stimulation and remained horizontal in a range of head pitch of +/- 90 degrees (reorientation gain = 1). Therefore, the slow compensatory responses (CSPs) progressively disaligned compared with the QPs. QPs induced by roll stimulation also showed horizontal orientation, although these were rare in the upright position and occurred more frequently when the head was pitched. In cats only the yaw-induced QPs were coplanar with the stimulus, while QPs induced by pitching were mostly oblique. It followed that in either yawing or pitching, the QPs had their end point scattered within a horizontally elongated area of the visual field. When tilting cats in the frontal plane, the orientation of QP trajectories changed with respect to the stimulus so that the end point distribution tended to remain aligned toward the horizontal instead of being fixed in the orbit. The reorientation gain decreased from 1 to 0.5 by increasing the head tilt. On the basis of difference regarding eye implantation and motility it was suggested that the effect of gravity on the orientation of QPs could be aimed at maintaining the interocular axis aligned with the horizon in the rabbit and at orientating the visual scanning system in the horizontal plane in the cat.

  8. Decrease of Horizontal Canal Vestibulo-Oculomotor Reflex Gain in the Elderly with Dysequilibrium without Lifetime Vertigo. (United States)

    Teggi, Roberto; Trimarchi, Matteo; Gatti, Omar; Fornasari, Francesco; Bussi, Mario


    Unsteadiness in the elderly is a frequent complaint and a strong predictor of falls and psychological distress. Although there is a general consensus that it is a multifactorial condition, recent studies have focused on the role of aging of the vestibular system as a possible cofactor. The aim of our work was to assess horizontal canal function in the elderly. We evaluated the gain of horizontal vestibulo-ocular reflex (VOR) with a video head impulse test on a sample of 58 subjects aged >70 years without lifetime episodes of vertigo and correlated the value with different clinical conditions (hypertension, diabetes, prior cardiovascular and vascular disorders of the central nervous system, and falls). The mean value of the gain was 0.86 ± 0.12, and people aged between 70 and 80 years presented higher values (0.90 ± 0.1) compared to those >80 years (0.81 ± 0.13; p = 0.025). Previous vascular disorders of the central nervous system were a predictor of decreased VOR gain (p = 0.0003). A nonparametric analysis demonstrated that sex, age, and VOR gain (p ˂ 0.0001) were predictive of falls. Our data support the hypothesis of a decrease of VOR gain in the elderly. The decrease of canal function may therefore play a role in the risk of falls in the elderly. © 2017 S. Karger AG, Basel.

  9. A cross-sectional survey and cross-sectional clinical trial to determine the prevalence and management of eye movement disorders and vestibular dysfunction in post-stroke patients in the sub-acute phase: protocol

    Directory of Open Access Journals (Sweden)

    Andoret Van Wyk


    Full Text Available Introduction: Visual impairment, specifically eye movement disorders and vestibular dysfunction may have a negative influence on the functional recovery in post stroke patients. This type of sensory dysfunction may further be associated with poor functional outcome in patients post stroke.Methods: In phase 1 a cross-sectional survey (n = 100 will be conducted to determine the prevalence of eye movement disorders and vestibular dysfunction in patients that sustained a stroke. A cross-sectional clinical trial (n = 60 will be conducted during phase 2 of the study to determine the effect of the combination of vestibular rehabilitation therapy (VRT and visual scanning exercises (VSE (experimental group integrated with task-specific activities compared to the effect of task-specific activities as an intervention (control group on patients that present with eye movement impairment and central vestibular dysfunction post-stroke. An audiologist will assess; (a visual acuity (static and dynamic; (b nystagmus; (c; saccadic eye movements; (d smooth pursuit eye movements; (e vestibulo-ocular reflex; and (f saccular, utricular and vestibular nerve function. An independent physiotherapist will assess; (1 cognitive function; (2 residual oculomotor visual performance; (3 visual-perceptual system; (4 functional balance; (5 a patient’s ability to modify gait in response to changing task demands; (6 functional ability; and (7 presence of anxiety and/or depression and (8 level of participation in physical activity. Ethics and dissemination: Ethics approval has been obtained from the Ethics Committee of the Faculty of Health Sciences at the University of Pretoria (UP (374/2015. The study will be submitted as fulfilment for the PhD degree at UP. Dissemination will include submission to peer-reviewed professional journals and presentation at congresses. Training of rehabilitation team members on the integration of VSE and VRT into task-specific activities in

  10. Tuberculosis ocular

    Directory of Open Access Journals (Sweden)

    Francisco Infante Barrera


    Full Text Available La evolución etiológica de la medicina la podemos dividir en dos grandes períodos: período de la sífilis y período de la tuberculosis. El período de la sífilis, gracias a las armas de combate de que hoy disponemos, ocupa un lugar secundario. El período de la tuberculosis y que no es sino el paralelo de la vida moderna, ocupa en vigencia el primer lugar. Es el período presente. Hasta hace poco tiempo el médico en general, iniciaba la exploración de su paciente con un interrogatorio, una inspección, un tacto y una serología con una obsesión sifilítica. En la época actual el médico y en especial el oftalmólogo debe tener una obsesión tuberculosa en la investigación etiológica. Cuántas veces en una afección ocular que de una manera lenta pero progresiva produce profundas alteraciones oculares, lleva el sello soterrado de una tuberculosis? Cuántos enfermos de una constitución en apariencia envidiable hacen precisamente por un exceso de sus defensas una alergia tuberculosa? Tan traicionera como la sífilis es la tuberculosis. La sífilis quema sus etapas y estalla con una hemorragia cerebral, una locura, una parálisis general, una ataxia locomotriz progresiva, una goma o una meningitis sifilítica. La tuberculosis hace su presentación con una afección ocular, una goma, una granulia, una artritis, una osteítis, o una meningitis óptico-quiasmática. Siendo esto así, es necesario, en la mayoría de las afecciones oculares, tratar de identificarla por los medios de diagnóstico de que hoy disponemos.

  11. The vestibular implant: Quo vadis?

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    Raymond eVan De Berg


    Full Text Available AbstractObjective: to assess the progress of the development of the vestibular implant and its feasibility short-term. Data sources: a search was performed in Pubmed, Medline and Embase. Key words used were vestibular prosth* and vestibular implant. The only search limit was language: English or Dutch. Additional sources were medical books, conference lectures and our personal experience with per-operative vestibular stimulation in patients selected for cochlear implantation.Study selection: all studies about the vestibular implant and related topics were included and evaluated by two reviewers. No study was excluded since every study investigated different aspects of the vestibular implant. Data extraction and synthesis: data was extracted by the first author from selected reports, supplemented by additional information, medical books conference lectures. Since each study had its own point of interest with its own outcomes, it was not possible to compare data of different studies. Conclusion: to use a basic vestibular implant in humans seems feasible in the very near future. Investigations show that electric stimulation of the canal nerves induces a nystagmus which corresponds to the plane of the canal which is innervated by the stimulated nerve branch. The brain is able to adapt to a higher baseline stimulation, while still reacting on a dynamic component. The best response will be achieved by a combination of the optimal stimulus (stimulus profile, stimulus location, precompensation, complemented by central vestibular adaptation. The degree of response will probably vary between individuals, depending on pathology and their ability to adapt.

  12. True incidence of vestibular schwannoma?

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Tos, Mirko; Thomsen, Jens


    The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging.......The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging....

  13. Functional Plasticity after Unilateral Vestibular Midbrain Infarction in Human Positron Emission Tomography (United States)

    Becker-Bense, Sandra; Buchholz, Hans-Georg; Baier, Bernhard; Schreckenberger, Mathias; Bartenstein, Peter; Zwergal, Andreas; Brandt, Thomas; Dieterich, Marianne


    The aim of the study was to uncover mechanisms of central compensation of vestibular function at brainstem, cerebellar, and cortical levels in patients with acute unilateral midbrain infarctions presenting with an acute vestibular tone imbalance. Eight out of 17 patients with unilateral midbrain infarctions were selected on the basis of signs of a vestibular tone imbalance, e.g., graviceptive (tilts of perceived verticality) and oculomotor dysfunction (skew deviation, ocular torsion) in F18-fluordeoxyglucose (FDG)-PET at two time points: A) in the acute stage, and B) after recovery 6 months later. Lesion-behavior mapping analyses with MRI verified the exact structural lesion sites. Group subtraction analyses and comparisons with healthy controls were performed with Statistic Parametric Mapping for the PET data. A comparison of PET A of acute-stage patients with that of healthy controls showed increases in glucose metabolism in the cerebellum, motion-sensitive visual cortex areas, and inferior temporal lobe, but none in vestibular cortex areas. At the supratentorial level bilateral signal decreases dominated in the thalamus, frontal eye fields, and anterior cingulum. These decreases persisted after clinical recovery in contrast to the increases. The transient activations can be attributed to ocular motor and postural recovery (cerebellum) and sensory substitution of vestibular function for motion perception (visual cortex). The persisting deactivation in the thalamic nuclei and frontal eye fields allows alternative functional interpretations of the thalamic nuclei: either a disconnection of ascending sensory input occurs or there is a functional mismatch between expected and actual vestibular activity. Our data support the view that both thalami operate separately for each hemisphere but receive vestibular input from ipsilateral and contralateral midbrain integration centers. Normally they have gatekeeper functions for multisensory input to the cortex and automatic

  14. Ultrastructure of projections to the oculomotor nucleus and inferior olive from vestibular and cerebellar neurons involved in compensatory eye movements

    NARCIS (Netherlands)

    P.R. Wentzel (Pierre)


    textabstractEarly in the evolution of vertebrates eye movements were strictly primitive reflexes that were predominantly controlled by vestibular and visual sensory stimuli. Later during phylogeny, along with the development of the fovea of the retina, vertebrates acquired the ability to make

  15. Vestibular rehabilitation outcomes in the elderly with chronic vestibular dysfunction. (United States)

    Bayat, Arash; Pourbakht, Akram; Saki, Nader; Zainun, Zuraida; Nikakhlagh, Soheila; Mirmomeni, Golshan


    Chronic vestibular dysfunction is a frustrating problem in the elderly and can have a tremendous impact on their life, but only a few studies are available. Vestibular rehabilitation therapy (VRT) is an important therapeutic option for the neuro-otologist in treating patients with significant balance deficits. The purpose of this study was to assess the effect of vestibular rehabilitation on dizziness in elderly patients with chronic vestibular dysfunction. A total of 33 patients older than 60 years with chronic vestibular dysfunction were studied. Clinical and objective vestibular tests including videonystagmography (VNG) and dizziness handicap inventory (DHI) were carried out at their first visit, 2 weeks, and 8 weeks post-VRT. The VRT exercises were performed according to Cawthorne and Cooksey protocols. Oculomotor assessments were within normal limits in all patients. Nineteen patients (57.57%) showed abnormal canal paralysis on caloric testing which at follow-up sessions; CP values were decreased remarkably after VRT exercises. We found a significant improvement between pre-VRT and post-VRT total DHI scores (P < 0.001). This improvement was most prominent in functional subscore. Our study demonstrated that VRT is an effective therapeutic method for elderly patients with chronic vestibular dysfunction.

  16. Effect of sound stimulion reciprocal interaction of antagonist muscles of lowe extremities in humans under vestibular loadе

    Directory of Open Access Journals (Sweden)

    I. V. Dregval


    Full Text Available Results of the research are evidence of changing muscles reflex activity of human lower extremity under the influence of sound stimulus of various frequency range together with the vestibular burden. The most change of the H-reflex was observed under the sound stimulus of 800 hertz. Not only the proprioceptive but auditory sensory system takes part in the regulation of the brain reflex activity. Existence of different labyrinths actions, according to the situation, on the interneuronic inhibitory ways of the postsynaptic inhibition of the salens muscle’s motoneurons is supposed.

  17. Reflexivity in qualitative research

    DEFF Research Database (Denmark)

    Evans, Adam Brian; Nistrup, Anne; Henderson, Hannah


    There has been something of a “reflexive shift” in sociological research. Sociological researchers are increasingly encouraged to be “present” within their work, and to recognize their own role in structuring the entire research process. One way to achieve this is through engagement in reflexive...... practice, that is, to reflect on our own values, beliefs, and biographies. It can be difficult to know exactly how a researcher should engage in these practices, however. Here, we discuss our reflexive practice in two case studies, both which utilized the same figurational theoretical framework...... Kingdom. Reflexive practice in both studies was affected by researcher biographies and by study design. In Study 1, both researchers were reasonably detached from the study context, the theoretical framework was in place from the very beginning, and reflexive practice was embedded in the study design...

  18. Role of muscle pulleys in producing eye position-dependence in the angular vestibuloocular reflex: a model-based study (United States)

    Thurtell, M. J.; Kunin, M.; Raphan, T.; Wall, C. C. (Principal Investigator)


    It is well established that the head and eye velocity axes do not always align during compensatory vestibular slow phases. It has been shown that the eye velocity axis systematically tilts away from the head velocity axis in a manner that is dependent on eye-in-head position. The mechanisms responsible for producing these axis tilts are unclear. In this model-based study, we aimed to determine whether muscle pulleys could be involved in bringing about these phenomena. The model presented incorporates semicircular canals, central vestibular pathways, and an ocular motor plant with pulleys. The pulleys were modeled so that they brought about a rotation of the torque axes of the extraocular muscles that was a fraction of the angle of eye deviation from primary position. The degree to which the pulleys rotated the torque axes was altered by means of a pulley coefficient. Model input was head velocity and initial eye position data from passive and active yaw head impulses with fixation at 0 degrees, 20 degrees up and 20 degrees down, obtained from a previous experiment. The optimal pulley coefficient required to fit the data was determined by calculating the mean square error between data and model predictions of torsional eye velocity. For active head impulses, the optimal pulley coefficient varied considerably between subjects. The median optimal pulley coefficient was found to be 0.5, the pulley coefficient required for producing saccades that perfectly obey Listing's law when using a two-dimensional saccadic pulse signal. The model predicted the direction of the axis tilts observed in response to passive head impulses from 50 ms after onset. During passive head impulses, the median optimal pulley coefficient was found to be 0.21, when roll gain was fixed at 0.7. The model did not accurately predict the alignment of the eye and head velocity axes that was observed early in the response to passive head impulses. We found that this alignment could be well predicted if

  19. Presbivértigo: ejercicios vestibulares Presbivertigo: vestibular exercises

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    Esther Bernal Valls


    Full Text Available 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.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.

  20. Immunohistochemical characterisation and localisation of cannabinoid CB1 receptor protein in the rat vestibular nucleus complex and the effects of unilateral vestibular deafferentation. (United States)

    Ashton, John C; Zheng, Yiwen; Liu, Ping; Darlington, Cynthia L; Smith, Paul F


    CB1 receptor expression has been reported to be low in the brainstem compared with the forebrain, and low in the vestibular nucleus complex (VNC) compared with other regions in the brainstem. However, a frequent effect of cannabis is dizziness and loss of balance. This may be due to the activation of cannabinoid receptors in the central vestibular pathways. We used immunohistochemistry to study the distribution of CB1 receptor protein in the VNC, and Western blotting to measure CB1 receptor expression in the VNC following unilateral vestibular deafferentation (UVD); the hippocampal CA1, CA2/3 and dentate gyrus (DG) regions were also analysed for comparison. This study confirms a previous electrophysiological demonstration that CB1 receptors exist in significant densities in the VNC and are likely to contribute to the neurochemical control of the vestibular reflexes. Nonetheless, CB1 receptor expression did not change significantly in the VNC during vestibular compensation. In addition, despite some small but significant changes in CB1 receptor expression in the CA2/3 and the DG following UVD, in no case were these differences statistically significant in comparison to both control groups.

  1. Etnography and Reflexivity

    Directory of Open Access Journals (Sweden)

    Mario Cardano


    Full Text Available This essay deals with a relevant and controversial topic – objectivity in ethnographic research. More specifically, I would like to examine how reflexive procedures, more precisely “reflexive account”, can increase the robustness of results gained through an ethnographic research. The essay is organized in five parts. I will start by giving a preliminary definition of the two key concepts which are at the center of the analysis – objectivity and reflexivity. I will then give a brief description of the epistemological framework in which the proposed conceptions of objectivity and reflexivity are located. Thirdly, I move on to consider the epistemic status of ethnographic research, and will emphasize that ethnographies are not just “theory-laden”, as many writers have stated, but also “praxis” or “procedure laden”. In other words, I will stress that it is not only theories which are inevitably embedded in research, influencing how observations can be made; much the same can also be said of the concrete research practices which contribute to determine the experience of the ethnographer and its representation in a text. Fourthly, I will discuss why it is useful to employ reflexive practices, and then immediately afterwards will illustrate the ways in which reflexive descriptions can contribute to greater objectivity of ethnographic accounts. In conclusion, I will discuss a number of objections which have been raised against this use of reflexivity.

  2. On Reflexive Data Models

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, S.


    An information system is reflexive if it stores a description of its current structure in the body of stored information and is acting on the base of this information. A data model is reflexive, if its language is meta-closed and can be used to build such a system. The need for reflexive data models in new areas of information technology applications is argued. An attempt to express basic notions related to information systems is made in the case when the system supports and uses meta-closed representation of the data.

  3. Vestibular-Somatosensory Convergence in Head Movement Control During Locomotion after Long-Duration Space Flight (United States)

    Mulavara, Ajitkumar; Ruttley, Tara; Cohen, Helen; Peters, Brian; Miller, Chris; Brady, Rachel; Merkle, Lauren; Bloomberg, Jacob


    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.

  4. Perspectives on aging vestibular function

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    Eric eAnson


    Full Text Available Much is known about age related anatomical changes in the vestibular system. Knowledge regarding how vestibular anatomical changes impact behavior for older adults continues to grow, in line with advancements in diagnostic testing. However, despite advancements in clinical diagnostics, much remains unknown about the functional impact that an aging vestibular system has on daily life activities like standing and walking. Modern diagnostic tests are very good at characterizing neural activity of the isolated vestibular system, but the tests themselves are artificial and do not reflect the multi-sensory aspects of natural human behavior. Also, the majority of clinical diagnostic tests are passively applied because active behavior can enhance performance. In this perspective paper we review anatomical and behavioral changes associated with an aging vestibular system and highlight several areas where a more functionally relevant perspective can be taken. For postural control, a multi-sensory perturbation approach could be used to bring balance rehabilitation into the arena of precision medicine. For walking and complex gaze stability, this may result in less physiologically specific impairments, but the trade-off would be a greater understanding of how the aging vestibular system truly impacts the daily life of older adults.

  5. Vestibular findings in fibromyalgia patients

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    Zeigelboim, Bianca Simone


    Full Text Available 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 standard 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.

  6. Atypical Manifestation of Vestibular Schwannoma

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    Webster, Guilherme


    Full Text Available Introduction: Vestibular schwannoma (also known as acoustic neuroma is a benign tumor whose cells are derived from Schwann sheaths, which commonly occurs from the vestibular portion of the eighth cranial nerve. Furthermore, vestibular schwannomas account for ∼8% of intracranial tumors in adults and 80 to 90% of tumors of the cerebellopontine angle. Its symptoms are varied, but what stands out most is a unilateral sensorineural hearing loss, with a low index of speech recognition. Objective: Describe an atypical manifestation of vestibular schwannoma. Case Report: The 46-year-old woman had vertigo and binaural hearing loss and fullness, with ear, nose, and throat examination suggestive of cochlear injury. After 6 months, the patient developed worsening of symptoms and onset of right unilateral tinnitus. In further exams the signs of cochlear damage remained, except for the vestibular test (hyporeflexia. Magnetic resonance imaging showed an expansive lesion in the right cerebellopontine angle. Discussion: This report warns about the atypical manifestations of vestibular schwannoma, which must always be remembered in investigating and diagnosing hearing loss.

  7. Vestibular hearing and neural synchronization. (United States)

    Emami, Seyede Faranak; Daneshi, Ahmad


    Objectives. Vestibular hearing as an auditory sensitivity of the saccule in the human ear is revealed by cervical vestibular evoked myogenic potentials (cVEMPs). The range of the vestibular hearing lies in the low frequency. Also, the amplitude of an auditory brainstem response component depends on the amount of synchronized neural activity, and the auditory nerve fibers' responses have the best synchronization with the low frequency. Thus, the aim of this study was to investigate correlation between vestibular hearing using cVEMPs and neural synchronization via slow wave Auditory Brainstem Responses (sABR). Study Design. This case-control survey was consisted of twenty-two dizzy patients, compared to twenty healthy controls. Methods. Intervention comprised of Pure Tone Audiometry (PTA), Impedance acoustic metry (IA), Videonystagmography (VNG), fast wave ABR (fABR), sABR, and cVEMPs. Results. The affected ears of the dizzy patients had the abnormal findings of cVEMPs (insecure vestibular hearing) and the abnormal findings of sABR (decreased neural synchronization). Comparison of the cVEMPs at affected ears versus unaffected ears and the normal persons revealed significant differences (P < 0.05). Conclusion. Safe vestibular hearing was effective in the improvement of the neural synchronization.

  8. [Spasm of the near reflex. Treatment with botulinum toxin]. (United States)

    Merino, P; Rojas, P; Gómez de Liaño, P; Franco Iglesias, G


    A 38-year old female with diplopia and esotropia, with limitation of ocular abduction in both eyes, with full abduction after doll's head rotation also being observed. She was diagnosed with spasm of the near reflex. Treatment with injections of botulinum toxin in both medial rectus has temporally resolved the convergence spasm. Near reflex spasm is characterized as miosis, pseudomyopia, and convergent strabismus that lead to diplopia, blurred vision, headache, and variable, progressive, and intermittent esotropia. As the spasm worsens there will be limited ocular versions and ductions simulating a sixth nerve palsy. Botulinum toxin may be effective in some cases. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Ocularity Feature Contrast Attracts Attention Exogenously

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    Li Zhaoping


    Full Text Available An eye-of-origin singleton, e.g., a bar shown to the left eye among many other bars shown to the right eye, can capture attention and gaze exogenously or reflexively, even when it appears identical to other visual input items in the scene and when the eye-of-origin feature is irrelevant to the observer’s task. Defining saliency as the strength of exogenous attraction to attention, we say that this eye-of-origin singleton, or its visual location, is salient. Defining the ocularity of a visual input item as the relative difference between its left-eye input and its right-eye input, this paper shows the general case that an ocularity singleton is also salient. For example, a binocular input item among monocular input items is salient, so is a left-eye-dominant input item (e.g., a bar with a higher input contrast to the left eye than to the right eye among right-eye-dominant items. Saliency by unique input ocularity is analogous to saliency by unique input colour (e.g., a red item among green ones, as colour is determined by the relative difference(s between visual inputs to different photoreceptor cones. Just as a smaller colour difference between a colour singleton and background items makes this singleton less salient, so does a smaller ocularity difference between an ocularity singleton and background items. While a salient colour difference is highly visible, a salient ocularity difference is often perceptually invisible in some cases and discouraging gaze shifts towards it in other cases, making its behavioural manifestation not as apparent. Saliency by ocularity contrast provides another support to the idea that the primary visual cortex creates a bottom-up saliency map to guide attention exogenously.

  10. Aging of the Human Vestibular System


    Zalewski, Christopher K.


    Aging affects every sensory system in the body, including the vestibular system. Although its impact is often difficult to quantify, the deleterious impact of aging on the vestibular system is serious both medically and economically. The deterioration of the vestibular sensory end organs has been known since the 1970s; however, the measurable impact from these anatomical changes remains elusive. Tests of vestibular function either fall short in their ability to quantify such anatomical deteri...

  11. Abnormal Vestibulo-Ocular Reflexes in Autism: A Potential Endophenotype (United States)


    thus enhancing the normal optokinetic suppression of nystagmus. We propose an extension of the previous interpretation based on a recent theory ...ASD have a tendency to focus on the details or parts of an object, scene or idea rather than the whole or gestalt of it (i.e., they fail to see the...Disorders, 30 (2000), 519-524. [17] E.J. Grinter, M.T. Maybery, E. Pellicano, J.C. Badcock, and D.R Badcock, Perception of shapes targeting local and

  12. Abnormal Vestibulo-Ocular Reflexes in Autism: A Potential Endophenotype (United States)


    Autism. We have not yet submitted an abstract for presentation at a meeting. Milestone #5: Pilot study supports launch of formal research protocol...observations adequately large to justifiably assume that the law of large numbers supports the use of parametric inferential statistics. Accordingly, a ...dysfunction as a factor contributing to potentially abnormal VORs. Oculomotor assessments are useful in the study of neurodevelopmental disorders, as

  13. Potencial evocado miogênico vestibular a baixas frequências de estimulação Vestibular evoked myogenic potentials using low frequency stimuli

    Directory of Open Access Journals (Sweden)

    Aline Cabral de Oliveira


    Full Text Available 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 estimulação. 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 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, 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 <; 0.05. Irrespective of gender, we found latencies of p13-n23 and p13-n23 interpeaks of 13.84 ms (± 1.41, 23.81 ms (±1.99 and 10.62 ms (± 6.56, respectively

  14. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno


    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...... the effect of stereotactic radiotherapy compared to observation, microsurgical resection, any other treatment modality, or a combination of two or more of the above approaches for vestibular schwannoma. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL......; Web of Science; CAB Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the search was 24 July 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs) exploring the efficacy of stereotactic radiotherapy compared with observation alone, microsurgical...

  15. Too Busy for Reflexivity?

    DEFF Research Database (Denmark)

    Ratner, Helene

    What Danish school managers can teach STS researchers about epistemological ideals and pragmatic morals. Reflexivity has an ambivalent status in both anthropology and Science and Technology Studies. On the one hand, the critique of representation at the heart of the reflexivity debates of the 1980s...... highlighted non-symmetric relationships between observer and observed and accused the academic text of enacting a realist genre, concealing the relativism entailed in textual production (Clifford and Marcus 1986, Woolgar 1988, Ashmore 1989). On the other hand, the reflexivity program produced fears...... of a “corrosive relativism in which everything is but a more or less clever expression of opinion” (Geertz 1988:2, 3) and it has suffered the little flattering accusations of piling "layer upon layer of self-consciousness to no avail" (Latour 1988:170) with little “interest [for] … theoretically ambitious...

  16. Reflexivity and social justice

    DEFF Research Database (Denmark)

    Maksimovic, Tijana; Jakobsen, Helle Nordentoft


    Career practitioners’ reflexive understanding of their professional role as change agents in career guidance and counselling practices has a major impact on how social justice can be achieved. This entitles an awareness of the way in which guidance and counselling practices are embedded in the co......Career practitioners’ reflexive understanding of their professional role as change agents in career guidance and counselling practices has a major impact on how social justice can be achieved. This entitles an awareness of the way in which guidance and counselling practices are embedded...

  17. Vestibular migraine: who is the patient? (United States)

    Colombo, Bruno; Teggi, Roberto


    Vestibular migraine has been classified as a specific entity in which vestibular symptomatology is defined as part of the migrainous disorder. New and appropriate diagnostic criteria have been proposed by the Barany and International Headache Societies. The diagnosis of vestibular migraine mainly depends on the patient history. The NIVE project is a prospectic multicentric study on vestibular migraine. The aim of this project is to evaluate demographics, epidemiology, clinical manifestations of migraine and vertigo in a large cohort of Caucasian patients affected by vestibular migraine.

  18. Role of Cerebellum in Motion Perception and Vestibulo-ocular Reflex—Similarities and Disparities (United States)

    Shaikh, Aasef G.; Palla, Antonella; Marti, Sarah; Olasagasti, Itsaso; Optican, Lance M.; Zee, David S.; Straumann, Dominik


    Vestibular velocity storage enhances the efficacy of the angular vestibulo-ocular reflex (VOR) during relatively low-frequency head rotations. This function is modulated by GABA-mediated inhibitory cerebellar projections. Velocity storage also exists in perceptual pathway and has similar functional principles as VOR. However, it is not known whether the neural substrate for perception and VOR overlap. We propose two possibilities. First, there is the same velocity storage for both VOR and perception; second, there are nonoverlapping neural networks: one might be involved in perception and the other for the VOR. We investigated these possibilities by measuring VOR and perceptual responses in healthy human subjects during whole-body, constant-velocity rotation steps about all three dimensions (yaw, pitch, and roll) before and after 10 mg of 4-aminopyridine (4-AP). 4-AP, a selective blocker of inward rectifier potassium conductance, can lead to increased synchronization and precision of Purkinje neuron discharge and possibly enhance the GABAergic action. Hence 4-AP could reduce the decay time constant of the perceived angular velocity and VOR. We found that 4-AP reduced the decay time constant, but the amount of reduction in the two processes, perception and VOR, was not the same, suggesting the possibility of nonoverlapping or partially overlapping neural substrates for VOR and perception. We also noted that, unlike the VOR, the perceived angular velocity gradually built up and plateau prior to decay. Hence, the perception pathway may have additional mechanism that changes the dynamics of perceived angular velocity beyond the velocity storage. 4-AP had no effects on the duration of build-up of perceived angular velocity, suggesting that the higher order processing of perception, beyond the velocity storage, might not occur under the influence of mechanism that could be influenced by 4-AP. PMID:22777507

  19. [Laryngeal adduction reflex]. (United States)

    Ptok, M; Bonenberger, S; Miller, S; Kühn, D; Jungheim, M


    Laryngeal Adductor Reflex Background: A rapid closure of the vocal folds is necessary, whenever foreign materials or food particles penetrate into the larynx. Otherwise a passage of these particles into the trachea or the lower respiratory tract would be imminent. An aspiration could mechanically block the respiratory tract and cause severe dyspnoea or cause aspiration pneumonia. For this systematic review a selective literature research in PubMed and Scopus using the keywords "laryngeal adductor reflex" and "vocal fold closure" has been carried out. Apart from the oesophago-glottal and pharyngo-glottal closure reflexes, the laryngeal adductor reflex (LAR) has been investigated in particular. The LAR qualifies as a reflectory laryngeal adductor mechanism and involves early, presumably di- or oligosynaptic ipsilateral LAR1 as well as late polysynaptic ipsi- and contralateral LAR2 components. In clinical routine diagnostic settings of dysphagia, LAR is only assessed qualitatively and usually triggered by air pulses or tactile stimulation. Dysphagiologists often find that not only the laryngeal sensibility in general is impaired, but especially the protective laryngeal adduction mechanism, which results in a higher risk of aspiration. Thus, it appears mandatory to test the LAR not only qualitatively but also quantitatively. Unfortunately a valid and reliable method that can be employed in clinical practice has not yet been put forward. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Towards a neuromorphic vestibular system. (United States)

    Corradi, Federico; Zambrano, Davide; Raglianti, Marco; Passetti, Giovanni; Laschi, Cecilia; Indiveri, Giacomo


    The vestibular system plays a crucial role in the sense of balance and spatial orientation in mammals. It is a sensory system that detects both rotational and translational motion of the head, via its semicircular canals and otoliths respectively. In this work, we propose a real-time hardware model of an artificial vestibular system, implemented using a custom neuromorphic Very Large Scale Integration (VLSI) multi-neuron chip interfaced to a commercial Inertial Measurement Unit (IMU). The artificial vestibular system is realized with spiking neurons that reproduce the responses of biological hair cells present in the real semicircular canals and otholitic organs. We demonstrate the real-time performance of the hybrid analog-digital system and characterize its response properties, presenting measurements of a successful encoding of angular velocities as well as linear accelerations. As an application, we realized a novel implementation of a recurrent integrator network capable of keeping track of the current angular position. The experimental results provided validate the hardware implementation via comparisons with a detailed computational neuroscience model. In addition to being an ideal tool for developing bio-inspired robotic technologies, this work provides a basis for developing a complete low-power neuromorphic vestibular system which integrates the hardware model of the neural signal processing pathway described with custom bio-mimetic gyroscopic sensors, exploiting neuromorphic principles in both mechanical and electronic aspects.

  1. Perspectival Structure and Vestibular Processing

    DEFF Research Database (Denmark)

    Alsmith, Adrian John Tetteh


    I begin by contrasting a taxonomic approach to the vestibular system with the structural approach I take in the bulk of this commentary. I provide an analysis of perspectival structure. Employing that analysis and following the structural approach, I propose three lines of empirical investigation...


    Chiarella, Giuseppe; Russo, Diego; Monzani, Fabio; Petrolo, Claudio; Fattori, Bruno; Pasqualetti, Giuseppe; Cassandro, Ettore; Costante, Giuseppe


    The aim of this review was to analyze the existing literature concerning the relationship between Hashimoto thyroiditis (HT) and vestibular dysfunction. We used electronic databases (PubMed, EMBASE, Cochrane Library) to search and collect all published articles about the association between HT and vestibular disorders. Several observational and retrospective studies have postulated a relationship between thyroid autoimmunity and vestibular disorders. In most cases, an appropriate control group was lacking, and the impact of thyroid functional status could not precisely be established. In recent years, two well-designed prospective studies have provided convincing evidence that the association is not random. One article reported that patients with Ménière disease (MD) had a significantly higher prevalence of positive anti-thyroid autoantibody as compared to healthy controls. Moreover, more than half of MD patients had either positive anti-thyroid or non-organ-specific autoantibody titers, compared to less than 30% of both patients with unilateral vestibular paresis without cochlear involvement and healthy controls. Another study found that patients with benign paroxysmal positional vertigo (BPPV) had significantly higher serum thyroid-stimulating hormone and antithyroid autoantibody levels than healthy controls. Additionally, almost one-fifth of euthyroid patients with HT had signs of BPPV. The published results indicate that patients with MD or BPPV are potential candidates to also develop HT. Thus, in HT patients, the presence of even slight symptoms or signs potentially related to vestibular lesions should be carefully investigated. AITD = autoimmune thyroid disease; BPPV = benign paroxysmal positional vertigo; EH = endolymphatic hydrops; HT = Hashimoto thyroiditis; L-T 4 = L-thyroxine; MD = Ménière disease; PS = Pendred syndrome; Tg = thyroglobulin; TPO = thyroid peroxidase; TSH = thyroid-stimulating hormone.

  3. Opioid-Induced Nausea Involves a Vestibular Problem Preventable by Head-Rest.

    Directory of Open Access Journals (Sweden)

    Nadine Lehnen

    Full Text Available Opioids are indispensable for pain treatment but may cause serious nausea and vomiting. The mechanism leading to these complications is not clear. We investigated whether an opioid effect on the vestibular system resulting in corrupt head motion sensation is causative and, consequently, whether head-rest prevents nausea.Thirty-six healthy men (26.6 ± 4.3 years received an opioid remifentanil infusion (45 min, 0.15 μg/kg/min. Outcome measures were the vestibulo-ocular reflex (VOR gain determined by video-head-impulse-testing, and nausea. The first experiment (n = 10 assessed outcome measures at rest and after a series of five 1-Hz forward and backward head-trunk movements during one-time remifentanil administration. The second experiment (n = 10 determined outcome measures on two days in a controlled crossover design: (1 without movement and (2 with a series of five 1-Hz forward and backward head-trunk bends 30 min after remifentanil start. Nausea was psychophysically quantified (scale from 0 to 10. The third controlled crossover experiment (n = 16 assessed nausea (1 without movement and (2 with head movement; isolated head movements consisting of the three axes of rotation (pitch, roll, yaw were imposed 20 times at a frequency of 1 Hz in a random, unpredictable order of each of the three axes. All movements were applied manually, passively with amplitudes of about ± 45 degrees.The VOR gain decreased during remifentanil administration (p<0.001, averaging 0.92 ± 0.05 (mean ± standard deviation before, 0.60 ± 0.12 with, and 0.91 ± 0.05 after infusion. The average half-life of VOR recovery was 5.3 ± 2.4 min. 32/36 subjects had no nausea at rest (nausea scale 0.00/0.00 median/interquartile range. Head-trunk and isolated head movement triggered nausea in 64% (p<0.01 with no difference between head-trunk and isolated head movements (nausea scale 4.00/7.25 and 1.00/4.5, respectively.Remifentanil reversibly decreases VOR gain at a half

  4. Cerebellar nodulectomy impairs spatial memory of vestibular and optokinetic stimulation in rabbits. (United States)

    Barmack, N H; Errico, P; Ferraresi, A; Fushiki, H; Pettorossi, V E; Yakhnitsa, V


    Natural vestibular and optokinetic stimulation were used to investigate the possible role of the cerebellar nodulus in the regulation and modification of reflexive eye movements in rabbits. The nodulus and folium 9d of the uvula were destroyed by surgical aspiration. Before and after nodulectomy the vertical and horizontal vestibuloocular reflexes (VVOR, HVOR) were measured during sinusoidal vestibular stimulation about the longitudinal (roll) and vertical (yaw) axes. Although the gain of the HVOR (G(HVOR) = peak eye movement velocity/peak head velocity) was not affected by the nodulectomy, the gain of the VVOR (G(VVOR)) was reduced. The gains of the vertical and horizontal optokinetic reflexes (G(VOKR), G(HOKR)) were measured during monocular, sinusoidal optokinetic stimulation (OKS) about the longitudinal and vertical axes. Following nodulectomy, there was no reduction in G(VOKR) or G(HOKR). Long-term binocular OKS was used to generate optokinetic afternystagmus, OKAN II, that lasts for hours. After OKAN II was induced, rabbits were subjected to static pitch and roll, to determine how the plane and velocity of OKAN II is influenced by a changing vestibular environment. During static pitch, OKAN II slow phase remained aligned with earth-horizontal. This was true for normal and nodulectomized rabbits. During static roll, OKAN II remained aligned with earth-horizontal in normal rabbits. During static roll in nodulectomized rabbits, OKAN II slow phase developed a centripetal vertical drift. We examined the suppression and recovery of G(VVOR) following exposure to conflicting vertical OKS for 10-30 min. This vestibular-optokinetic conflict reduced G(VVOR) in both normal and nodulectomized rabbits. The time course of recovery of G(VVOR) after conflicting OKS was the same before and after nodulectomy. In normal rabbits, the head pitch angle, at which peak OKAN II velocity occurred, corresponded to the head pitch angle maintained during long-term OKS. If the head was

  5. Miopatia ocular descendente

    Directory of Open Access Journals (Sweden)

    Marcos R. G. de Freitas


    Full Text Available Os autores apresentam caso de paciente jovem, do sexo feminino, com afecção muscular primária ocular e faríngea sem caráter familial. Foram feitos estudos eletromiográficos e histopatológicos musculares que confirmam o caráter miogênico do processo. É feita comparação entre a miopatia ocular e a miopatia ocular descendente, acreditando os autores que seriam variantes

  6. Cluster bomb ocular injuries. (United States)

    Mansour, Ahmad M; Hamade, Haya; Ghaddar, Ayman; Mokadem, Ahmad Samih; El Hajj Ali, Mohamad; Awwad, Shady


    To present the visual outcomes and ocular sequelae of victims of cluster bombs. This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon (July 2006). Data were gathered from the reports to the Information Management System for Mine Action. There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% (20/308) of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases (67%) with ocular injury. Ocular findings included corneal or scleral lacerations (16 eyes), corneal foreign bodies (9 eyes), corneal decompensation (2 eyes), ruptured cataract (6 eyes), and intravitreal foreign bodies (10 eyes). The corneas of one patient had extreme attenuation of the endothelium. Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs.

  7. Functional Imaging of Human Vestibular Cortex Activity Elicited by Skull Tap and Auditory Tone Burst (United States)

    Noohi, Fatemeh; Kinnaird, Catherine; Wood, Scott; Bloomberg, Jacob; Mulavara, Ajitkumar; Seidler, Rachael


    our stimulation method, we measured the ocular VEMP outside of the scanner. This measurement showed that both skull tap and auditory tone burst elicited vestibular evoked activation, indicated by eye muscle response. Our preliminary analyses showed that the skull tap elicited activation in medial frontal gyrus, superior temporal gyrus, postcentral gyrus, transverse temporal gyrus, anterior cingulate, and putamen. The auditory tone bursts elicited activation in medial frontal gyrus, superior temporal gyrus, superior frontal gyrus, precentral gyrus, inferior and superior parietal lobules. In line with our hypothesis, skull taps elicited a pattern of cortical activity closely similar to one elicited by auditory tone bursts. Further analysis will determine the extent to which the skull taps can replace the auditory tone stimulation in clinical and basic science vestibular assessments.

  8. Reflex epilepsy: a review

    Directory of Open Access Journals (Sweden)

    Karim Nikkhah


    Full Text Available Interesting phenomena of reflex epileptic syndromes are characterized by epileptic seizures each one induced by specific stimulus with a variety of types. Simple triggers, which lead to seizures within seconds, are of sensory type (most commonly visual, most rarely tactile or proprioceptive stimuli. Complex triggers, which are mostly of cognitive type such as praxis, reading, talking, and music, usually induce the epileptic event within minutes. It should differ from what most epileptic patients report as provocative precipitants for seizures (such as emotional stress, fatigue, fever, sleep deprivation, alcohol, and menstrual cycle. The identification of a specific trigger is not only important for patients or their parents to avoid seizures, but also it might help neurologists to choose the most effective antiepileptic drug for each case. In addition, research in this area may possibly reveal some underlying pathophysiology of epileptic phenomena in the brain.In this review, we briefly introduce reported reflex epileptic seizures, their clinical features and management.

  9. Vestibular-Evoked Myogenic Potentials in Bilateral Vestibulopathy

    Directory of Open Access Journals (Sweden)

    Sally M. Rosengren


    Full Text Available Bilateral vestibulopathy (BVP is a chronic condition in which patients have a reduction or absence of vestibular function in both ears. BVP is characterized by bilateral reduction of horizontal canal responses; however, there is increasing evidence that otolith function can also be affected. Cervical and ocular vestibular-evoked myogenic potentials (cVEMPs/oVEMPs are relatively new tests of otolith function that can be used to test the saccule and utricle of both ears independently. Studies to date show that cVEMPs and oVEMPs are often small or absent in BVP but are in the normal range in a significant proportion of patients. The variability in otolith function is partly due to the heterogeneous nature of BVP but is also due to false negative and positive responses that occur because of the large range of normal VEMP amplitudes. Due to their variability, VEMPs are not part of the diagnosis of BVP; however, they are helpful complementary tests that can provide information about the extent of disease within the labyrinth. This article is a review of the use of VEMPs in BVP, summarizing the available data on VEMP abnormalities in patients and discussing the limitations of VEMPs in diagnosing bilateral loss of otolith function.

  10. Prophylactic treatment of vestibular migraine

    Directory of Open Access Journals (Sweden)

    Márcio Cavalcante Salmito

    Full Text Available Abstract Introduction: Vestibular migraine (VM is now accepted as a common cause of episodic vertigo. Treatment of VM involves two situations: the vestibular symptom attacks and the period between attacks. For the latter, some prophylaxis methods can be used. The current recommendation is to use the same prophylactic drugs used for migraines, including β-blockers, antidepressants and anticonvulsants. The recent diagnostic definition of vestibular migraine makes the number of studies on its treatment scarce. Objective: To evaluate the efficacy of prophylactic treatment used in patients from a VM outpatient clinic. Methods: Review of medical records from patients with VM according to the criteria of the Bárány Society/International Headache Society of 2012 criteria. The drugs used in the treatment and treatment response obtained through the visual analog scale (VAS for dizziness and headache were assessed. The pre and post-treatment VAS scores were compared (the improvement was evaluated together and individually, per drug used. Associations with clinical subgroups of patients were also assessed. Results: Of the 88 assessed records, 47 were eligible. We included patients that met the diagnostic criteria for VM and excluded those whose medical records were illegible and those of patients with other disorders causing dizziness and/or headache that did not meet the 2012 criteria for VM. 80.9% of the patients showed improvement with prophylaxis (p < 0.001. Amitriptyline, Flunarizine, Propranolol and Topiramate improved vestibular symptoms (p < 0.001 and headache (p < 0.015. The four drugs were effective in a statistically significant manner. There was a positive statistical association between the time of vestibular symptoms and clinical improvement. There was no additional benefit in hypertensive patients who used antihypertensive drugs as prophylaxis or depressed patients who used antidepressants in relation to other prophylactic drugs. Drug

  11. Development of a multichannel vestibular prosthesis prototype by modification of a commercially available cochlear implant. (United States)

    Valentin, Nicolas S; Hageman, Kristin N; Dai, Chenkai; Della Santina, Charles C; Fridman, Gene Y


    No adequate treatment exists for individuals who remain disabled by bilateral loss of vestibular (inner ear inertial) sensation despite rehabilitation. We have restored vestibular reflexes using lab-built multichannel vestibular prostheses (MVPs) in animals, but translation to clinical practice may be best accomplished by modification of a commercially available cochlear implant (CI). In this interim report, we describe preliminary efforts toward that goal. We developed software and circuitry to sense head rotation and drive a CI's implanted stimulator (IS) to deliver up to 1 K pulses/s via nine electrodes implanted near vestibular nerve branches. Studies in two rhesus monkeys using the modified CI revealed in vivo performance similar to our existing dedicated MVPs. A key focus of our study was the head-worn unit (HWU), which magnetically couples across the scalp to the IS. The HWU must remain securely fixed to the skull to faithfully sense head motion and maintain continuous stimulation. We measured normal and shear force thresholds at which HWU-IS decoupling occurred as a function of scalp thickness and calculated pressure exerted on the scalp. The HWU remained attached for human scalp thicknesses from 3-7.8 mm for forces experienced during routine daily activities, while pressure on the scalp remained below capillary perfusion pressure.

  12. A study on vestibular-evoked myogenic potentials via galvanic vestibular stimulation in normal people

    Directory of Open Access Journals (Sweden)

    Ying Cheng


    Discussions: Galvanic vestibular stimulation could elicit biphasic EMG responses from SCM via the vestibular nerve but not from the otolith organs. Galvanic stimulation together with air conducted sound (ACS or bone conducted vibration (BCV can elicit VEMPs and may enable the differentiation of retrolabyrinthine lesions from labyrinthine lesions in vestibular system.

  13. [Ocular surface system integrity]. (United States)

    Safonova, T N; Pateyuk, L S


    The interplay of different structures belonging to either the anterior segment of the eye or its accessory visual apparatus, which all share common embryological, anatomical, functional, and physiological features, is discussed. Explanation of such terms, as ocular surface, lacrimal functional unit, and ocular surface system, is provided.

  14. [Descending ocular myopathy]. (United States)

    de Freitas, M R; Nascimento, O J


    The case of a 23 years old female patient, with primary involvement of the extraocular and faringeal muscles without familiar history is reported. Electromyographic and muscular biopsy studies proved the myogenic nature of the process. A clinical comparison between the ocular myopathy and the descending ocular myopathy is made, the authors thinking that both of them would be variants of the same muscle disease.

  15. Epidemiology of Ocular Toxoplasmosis

    NARCIS (Netherlands)

    Petersen, E.; Kijlstra, A.; Stanford, M.


    Retinal infection with Toxoplasma gondii is the most important cause of posterior uveitis, whereby prevalence and incidence of ocular symptoms after infection depend on socio-economic factors and the circulating parasite genotypes. Ocular toxoplasmosis is more common in South America, Central

  16. A vestibular phenotype for Waardenburg syndrome? (United States)

    Black, F. O.; Pesznecker, S. C.; Allen, K.; Gianna, C.


    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.

  17. Epidemiology and natural history of vestibular schwannomas

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Caye-Thomasen, Per


    This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma. A treatm......This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma...

  18. Video Head Impulse Test for Early Diagnosis of Vestibular Neuritis Among Acute Vertigo. (United States)

    Guan, Qiongfeng; Zhang, Lisan; Hong, Wenke; Yang, Yi; Chen, Zhaoying; Lu, Peilin; Zhang, Dan; Hu, Xingyue


    This study assesses the value of the video head impulse test (vHIT) for early diagnosis of vestibular neuritis (VN) among acute vertigo. Thirty-three cases of vestibular neuritis (VN), 96 patients with other acute vertigo (AV), and 50 cases of normal controls used vHIT to quantitatively test a pair of horizontal vestibulo-ocular reflection (VOR) gains, two pairs of vertical VOR gains, and the corresponding three pairs of VOR gain asymmetry. The peculiarity of VOR gains in VN and the differences between VN and other AV, normal controls by vHIT, were collected and analyzed. There were statistically significant differences in the three pairs of VOR gains asymmetry between VN and other AV, and normal controls (Pvertigo by vHIT. This study shows vHIT has advantages in the diagnosis of VN in acute vertigo with good sensitivity and specificity and indicates a widespread clinical application.

  19. FEFsem neuronal response during combined volitional and reflexive pursuit. (United States)

    Bakst, Leah; Fleuriet, Jérome; Mustari, Michael J


    Although much is known about volitional and reflexive smooth eye movements individually, much less is known about how they are coordinated. It is hypothesized that separate cortico-ponto-cerebellar loops subserve these different types of smooth eye movements. Specifically, the MT-MST-DLPN pathway is thought to be critical for ocular following eye movements, whereas the FEF-NRTP pathway is understood to be vital for volitional smooth pursuit. However, the role that these loops play in combined volitional and reflexive behavior is unknown. We used a large, textured background moving in conjunction with a small target spot to investigate the eye movements evoked by a combined volitional and reflexive pursuit task. We also assessed the activity of neurons in the smooth eye movement subregion of the frontal eye field (FEFsem). We hypothesized that the pursuit system would show less contribution from the volitional pathway in this task, owing to the increased involvement of the reflexive pathway. In accordance with this hypothesis, a majority of FEFsem neurons (63%) were less active during pursuit maintenance in a combined volitional and reflexive pursuit task than during purely volitional pursuit. Interestingly and surprisingly, the neuronal response to the addition of the large-field motion was highly correlated with the neuronal response to a target blink. This suggests that FEFsem neuronal responses to these different perturbations-whether the addition or subtraction of retinal input-may be related. We conjecture that these findings are due to changing weights of both the volitional and reflexive pathways, as well as retinal and extraretinal signals.

  20. [Effectiveness of Self-efficacy Promoting Vestibular Rehabilitation Program for Patients with Vestibular Hypofunction]. (United States)

    Lee, Hyun Jung; Choi-Kwon, Smi


    In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise selfefficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction. This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program. After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p=.018) exercise self-efficacy (pexercise self-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.

  1. Gaze-Stabilizing Central Vestibular Neurons Project Asymmetrically to Extraocular Motoneuron Pools. (United States)

    Schoppik, David; Bianco, Isaac H; Prober, David A; Douglass, Adam D; Robson, Drew N; Li, Jennifer M B; Greenwood, Joel S F; Soucy, Edward; Engert, Florian; Schier, Alexander F


    Within reflex circuits, specific anatomical projections allow central neurons to relay sensations to effectors that generate movements. A major challenge is to relate anatomical features of central neural populations, such as asymmetric connectivity, to the computations the populations perform. To address this problem, we mapped the anatomy, modeled the function, and discovered a new behavioral role for a genetically defined population of central vestibular neurons in rhombomeres 5-7 of larval zebrafish. First, we found that neurons within this central population project preferentially to motoneurons that move the eyes downward. Concordantly, when the entire population of asymmetrically projecting neurons was stimulated collectively, only downward eye rotations were observed, demonstrating a functional correlate of the anatomical bias. When these neurons are ablated, fish failed to rotate their eyes following either nose-up or nose-down body tilts. This asymmetrically projecting central population thus participates in both upward and downward gaze stabilization. In addition to projecting to motoneurons, central vestibular neurons also receive direct sensory input from peripheral afferents. To infer whether asymmetric projections can facilitate sensory encoding or motor output, we modeled differentially projecting sets of central vestibular neurons. Whereas motor command strength was independent of projection allocation, asymmetric projections enabled more accurate representation of nose-up stimuli. The model shows how asymmetric connectivity could enhance the representation of imbalance during nose-up postures while preserving gaze stabilization performance. Finally, we found that central vestibular neurons were necessary for a vital behavior requiring maintenance of a nose-up posture: swim bladder inflation. These observations suggest that asymmetric connectivity in the vestibular system facilitates representation of ethologically relevant stimuli without

  2. Evaluating ocular blood flow

    Directory of Open Access Journals (Sweden)

    Jyotsna Maram


    Full Text Available Studies have shown that vascular impairment plays an important role in the etiology and pathogenesis of various ocular diseases including glaucoma, age-related macular degeneration, diabetic retinopathy, and retinal venous occlusive disease. Thus, qualitative and quantitative assessment of ocular blood flow (BF is a topic of interest for early disease detection, diagnosis, and management. Owing to the rapid improvement in technology, there are several invasive and noninvasive techniques available for evaluating ocular BF, with each of these techniques having their own limitations and advantages. This article reviews these important techniques, with a particular focus on Doppler Fourier domain optical coherence tomography (OCT and OCT-angiography.

  3. [Threefold intraoperative electrophysiological monitoring of vestibular neurectomy]. (United States)

    Hausler, R; Kasper, A


    A threefold intraoperative monitoring of facial nerve, auditory nerve and vestibular nerve function was performed in 14 cases of retrosigmoidal neurectomy. The facial nerve was monitoring with a pressure transducer placed against the cheek (Opalarm system). The auditory nerve was monitored with acoustically (click) evoked early potentials and the vestibular nerve was monitored with electrically evoked vestibular potentials obtained by direct stimulation (biphasic current pulses of 0.75-mA p-p, 100 us, 20/s) of the exposed vestibular nerve in the cerebellopontine angle before, during and after neurectomy. A characteristic vertex negative peak having a latency of approximately 2 ms and approximately 0.5 uV amplitude was obtained between a forehead and an ipsilateral ear lobe electrode (2 x 1,000 averaged responses over 10 ms) before the neurectomy. This response disappeared after selective vestibular nerve section proximal to the stimulation site. A diminished response amplitude was measured after incomplete nerve section. Simultaneous acoustic masking had no influence on the vestibular potential. The 14 operated patients became all free of vertiginous spells and drop-attacks except one patient who developed a contralateral Menière's. Facial nerve function remained normal in all. Hearing preservation was obtained in 12 patients (86%). The threefold intraoperative monitoring has turned out to be an additional safety factor for facial and auditory nerve preservation and, thanks to the recording of vestibular potentials, it increased the efficiency of vestibular neurectomy.

  4. Vestibular Function and Activities of Daily Living

    Directory of Open Access Journals (Sweden)

    Aisha Harun MD


    Full Text Available Objective: Vestibular dysfunction increases with age and is associated with mobility difficulties and fall risk in older individuals. We evaluated whether vestibular function influences the ability to perform activities of daily living (ADLs. Method: We analyzed the 1999 to 2004 National Health and Nutrition Examination Survey of adults aged older than 40 years ( N = 5,017. Vestibular function was assessed with the Modified Romberg test. We evaluated the association between vestibular function and difficulty level in performing specific basic and instrumental ADLs, and total number of ADL impairments. Results: Vestibular dysfunction was associated with significantly higher odds of difficulty with nine ADLs, most strongly with difficulty managing finances (odds ratio [ OR ] = 2.64, 95% confidence interval [CI] = [1.18, 5.90]. In addition, vestibular dysfunction was associated with a significantly greater number of ADL impairments (β = .21, 95% CI = [0.09, 0.33]. This effect size was comparable with the influence of heavy smoking (β = .21, 95% CI = [0.06, 0.36] and hypertension (β = .10, 95% CI = [0.02, 0.18] on the number of ADL impairments. Conclusion: Vestibular dysfunction significantly influences ADL difficulty, most strongly with a cognitive rather than mobility-based task. These findings underscore the importance of vestibular inputs for both cognitive and physical daily activities.

  5. Astute and safe use of topical ocular corticosteroids in general practice

    African Journals Online (AJOL)

    Astute and safe use of topical ocular corticosteroids in general practice: ... is often contact-lens associated) and fungal keratitis. ... for 1 week in acute follicular conjunctivitis presumed to be ... Steroidal anti-inflammatory drugs. In: Rhee DJ. Ophthalmic Drug Guide. London: ... Cataract – by performing a red reflex test. • Herpes ...

  6. Early components of the human vestibulo-ocular response to head rotation: latency and gain

    NARCIS (Netherlands)

    H. Collewijn (Han); J.B.J. Smeets (Jeroen)


    textabstractTo characterize vestibulo-ocular reflex (VOR) properties in the time window in which contributions by other systems are minimal, eye movements during the first 50-100 ms after the start of transient angular head accelerations ( approximately 1000 degrees

  7. Reflexive Dressing: Rethinking Retro

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    Stella North


    Full Text Available This article undertakes a philosophical exploration of the act we know, or think we know, as ‘dressing’. Inhabiting, in thought, the moment in which we dress, I examine some of its constituent mechanisms, attending to the impulses by which dressing is generated out of subjective experience.  When those impulses are temporally marked, as they are in the case of retro dress, this generation is a two-pronged process, in which the holding of the body in time, and the holding of time in the body, recalibrate one another. The process of ‘dressing,’ in this understanding, has a reflexivity which is double; it entails the turning of the body, with dress as medium, towards itself, and the turning of present experience towards some felt notion of the past. Reflexively dressing, we are always becoming ourselves, and becoming other than ourselves, at once; a movement of circuitous internalisation and externalisation by which the ambiguation inherent in material experience is realised.

  8. Correlation between vestibular and autonomous function after 6 months of spaceflight: Data of the SPIN and GAZE-SPIN experiments. (United States)

    Wuyts, Floris; Clement, Gilles; Naumov, Ivan; Kornilova, Ludmila; Glukhikh, Dmitriy; Hallgren, Emma; MacDougall, Hamish; Migeotte, Pierre-Francois; Delière, Quentin; Weerts, Aurelie; Moore, Steven; Diedrich, Andre

    test protocol. The subjects were subjected to a passive tilt test of 60 degrees, during 15 minutes. The results show that cosmonauts clearly have a statistically significantly reduced ocular counter rolling during rotation upon return from space, when compared to the pre-flight condition, indicating a reduced sensitivity of the otolith system to gravito intertial acceleration. None of the subjects fainted or even approached presyncope. However, the resistance in the calf, measured with the impedance method, showed a significant increased pooling in the lower limbs. Additionally, this was statistically significantly correlated (p=0.024) with a reduced otolith response, when comparing for each subject the vestibular and autonomic data. This result shows that the vestibulo-autonomic reflex is reduced after 6 months of spaceflight. When compared with Neurolab, the otolith response in the current group of crew members that were not subjected to in-flight centrifugation is significantly reduced, corroborating the hypothesis that in-flight artificial gravity may be of great importance to mitigate the deleterious effects of microgravity. Projects are funded by PRODEX-BELSPO, ESA, IBMP

  9. The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. (United States)

    Stern, M E; Beuerman, R W; Fox, R I; Gao, J; Mircheff, A K; Pflugfelder, S C


    Most dry-eye symptoms result from an abnormal, nonlubricative ocular surface that increases shear forces under the eyelids and diminishes the ability of the ocular surface to respond to environmental challenges. This ocular-surface dysfunction may result from immunocompromise due to systemic autoimmune disease or may occur locally from a decrease in systemic androgen support to the lacrimal gland as seen in aging, most frequently in the menopausal female. Components of the ocular surface (cornea, conjunctiva, accessory lacrimal glands, and meibomian glands), the main lacrimal gland, and interconnecting innervation act as a functional unit. When one portion is compromised, normal lacrimal support of the ocular surface is impaired. Resulting immune-based inflammation can lead to lacrimal gland and neural dysfunction. This progression yields the OS symptoms associated with dry eye. Restoration of lacrimal function involves resolution of lymphocytic activation and inflammation. This has been demonstrated in the MRL/lpr mouse using systemic androgens or cyclosporine and in the dry-eye dog using topical cyclosporine. The efficacy of cyclosporine may be due to its immunomodulatory and antiinflammatory (phosphatase inhibitory capability) functions on the ocular surface, resulting in a normalization of nerve traffic. Although the etiologies of dry eye are varied, common to all ocular-surface disease is an underlying cytokine/receptor-mediated inflammatory process. By treating this process, it may be possible to normalize the ocular surface/lacrimal neural reflex and facilitate ocular surface healing.

  10. The subject-fixated coaxially sighted corneal light reflex: a clinical marker for centration of refractive treatments and devices. (United States)

    Chang, Daniel H; Waring, George O


    To describe the inconsistencies in definition, application, and usage of the ocular reference axes (optical axis, visual axis, line of sight, pupillary axis, and topographic axis) and angles (angle kappa, lambda, and alpha) and to propose a precise, reproducible, clinically defined reference marker and axis for centration of refractive treatments and devices. Perspective. Literature review of papers dealing with ocular reference axes, angles, and centration. The inconsistent definitions and usage of the current ocular axes, as derived from eye models, limit their clinical utility. With a clear understanding of Purkinje images and a defined alignment of the observer, light source/fixation target, and subject eye, the subject-fixated coaxially sighted corneal light reflex can be a clinically useful reference marker. The axis formed by connecting the subject-fixated coaxially sighted corneal light reflex and the fixation point, the subject-fixated coaxially sighted corneal light reflex axis, is independent of pupillary dilation and phakic status of the eye. The relationship of the subject-fixated coaxially sighted corneal light reflex axis to a refined definition of the visual axis without reference to nodal points, the foveal-fixation axis, is discussed. The displacement between the subject-fixated coaxially sighted corneal light reflex and pupil center is described not by an angle, but by a chord, here termed chord mu. The application of the subject-fixated coaxially sighted corneal light reflex to the surgical centration of refractive treatments and devices is discussed. As a clinically defined reference marker, the subject-fixated coaxially sighted corneal light reflex avoids the shortcomings of current ocular axes for clinical application and may contribute to better consensus in the literature and improved patient outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Ocular fishhook injuries. (United States)

    Ang, C S


    Ocular fishhook injuries are rare, yet potentially vision threatening as complications such as corneal scarring, retinal detachment and endophthalmitis may result. The surgical management of these cases is challenging due to the construction of barbed fishhooks.


    NARCIS (Netherlands)



    We conducted a prospective multicenter study of the efficacy of current therapeutic strategies for ocular toxoplasmosis in 149 patients. Treatment consisted of the following three triple-drug combinations: group 1, pyrimethamine, sulfadiazine, and corticosteroids; group 2, clindamycin, sulfadiazine,

  13. Mediators of ocular angiogenesis

    Indian Academy of Sciences (India)


    Aug 26, 2016 ... Keywords. ocular angiogenesis; corneal neovascularization; retinal neovascularization; diabetic retinopathy; age-related macular degeneration; retinopathy of prematurity; VEGF; PEDF; Flt-1; Flk-1; endostatin; angiopoietin; erythropoietin; Tie2; inflammation; complement; gene therapy; TLR-3; Robo4.

  14. Therapy for ocular toxoplasmosis

    NARCIS (Netherlands)

    Rothova, A.; Meenken, C.; Buitenhuis, H. J.; Brinkman, C. J.; Baarsma, G. S.; Boen-Tan, T. N.; de Jong, P. T.; Klaassen-Broekema, N.; Schweitzer, C. M.; Timmerman, Z.


    We conducted a prospective multicenter study of the efficacy of current therapeutic strategies for ocular toxoplasmosis in 149 patients. Treatment consisted of the following three triple-drug combinations: group 1, pyrimethamine, sulfadiazine, and corticosteroids; group 2, clindamycin, sulfadiazine,

  15. Challenging ocular image recognition (United States)

    Pauca, V. Paúl; Forkin, Michael; Xu, Xiao; Plemmons, Robert; Ross, Arun A.


    Ocular recognition is a new area of biometric investigation targeted at overcoming the limitations of iris recognition performance in the presence of non-ideal data. There are several advantages for increasing the area beyond the iris, yet there are also key issues that must be addressed such as size of the ocular region, factors affecting performance, and appropriate corpora to study these factors in isolation. In this paper, we explore and identify some of these issues with the goal of better defining parameters for ocular recognition. An empirical study is performed where iris recognition methods are contrasted with texture and point operators on existing iris and face datasets. The experimental results show a dramatic recognition performance gain when additional features are considered in the presence of poor quality iris data, offering strong evidence for extending interest beyond the iris. The experiments also highlight the need for the direct collection of additional ocular imagery.


    NARCIS (Netherlands)


    Reflex sympathetic dystrophy is a chronic pain syndrome characterized by chronic burning pain, restricted range of motion, oedema and vasolability. Patients are difficult to treat and the prognosis is very often poor. This report emphasizes that an amputation in case of a reflex sympathetic

  17. Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study,

    Directory of Open Access Journals (Sweden)

    Cibele Brugnera


    Full Text Available ABSTRACT INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR. OBJECTIVE: To evaluate the effectiveness of Vertiguard(tm biofeedback equipment as a sensory substitution (SS of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG, which received the vibrotactile stimulus from Vertiguard(tm for ten days, and a control group (CG, which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT protocol of the Computerized Dynamic Posturography (CDP and two scales of balance self-perception, Activities-specific Balance Confidence (ABC and Dizziness Handicap Inventory (DHI, were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p = 0.007 and C6 (p = 0.01. On the ABC scale, there was a significant difference in the SG (p= 0.04. The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04. CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard(tm system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.

  18. [Reflex seizures, cinema and television]. (United States)

    Olivares-Romero, Jesús


    In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot.

  19. Acute Bilateral Superior Branch Vestibular Neuropathy

    Directory of Open Access Journals (Sweden)

    Dario A. Yacovino


    Full Text Available The rapid onset of a bilateral vestibular hypofunction (BVH is often attributed to vestibular ototoxicity. However, without any prior exposure to ototoxins, the idiopathic form of BVH is most common. Although sequential bilateral vestibular neuritis (VN is described as a cause of BVH, clinical evidence for simultaneous and acute onset bilateral VN is unknown. We describe a patient with an acute onset of severe gait ataxia and oscillopsia with features compatible with acute BVH putatively due to a bilateral VN, which we serially evaluated with clinical and laboratory vestibular function testing over the course of 1 year. Initially, bilateral superior and horizontal semicircular canals and bilateral utricles were impaired, consistent with damage to both superior branches of each vestibular nerve. Hearing was spared. Only modest results were obtained following 6 months of vestibular rehabilitation. At a 1-year follow-up, only the utricular function of one side recovered. This case is the first evidence supporting an acute presentation of bilateral VN as a cause for BVH, which would not have been observed without critical assessment of each of the 10 vestibular end organs.

  20. Aging of the Human Vestibular System (United States)

    Zalewski, Christopher K.


    Aging affects every sensory system in the body, including the vestibular system. Although its impact is often difficult to quantify, the deleterious impact of aging on the vestibular system is serious both medically and economically. The deterioration of the vestibular sensory end organs has been known since the 1970s; however, the measurable impact from these anatomical changes remains elusive. Tests of vestibular function either fall short in their ability to quantify such anatomical deterioration, or they are insensitive to the associated physiologic decline and/or central compensatory mechanisms that accompany the vestibular aging process. When compared with healthy younger individuals, a paucity of subtle differences in test results has been reported in the healthy older population, and those differences are often observed only in response to nontraditional and/or more robust stimuli. In addition, the reported differences are often clinically insignificant insomuch that the recorded physiologic responses from the elderly often fall within the wide normative response ranges identified for normal healthy adults. The damaging economic impact of such vestibular sensory decline manifests itself in an exponential increase in geriatric dizziness and a subsequent higher prevalence of injurious falls. An estimated $10 to $20 billion dollar annual cost has been reported to be associated with falls-related injuries and is the sixth leading cause of death in the elderly population, with a 20% mortality rate. With an estimated 115% increase in the geriatric population over 65 years of age by the year 2050, the number of balanced-disordered patients with a declining vestibular system is certain to reach near epidemic proportions. An understanding of the effects of age on the vestibular system is imperative if clinicians are to better manage elderly patients with balance disorders, dizziness, and vestibular disease. PMID:27516717

  1. Improving Sensorimotor Adaptation Following Long Duration Space Flight by Enhancing Vestibular Information Transfer (United States)

    Mulavara, A. P.; Kofman, I. S.; De Dios, Y. E; Galvan, R.; Goel, R.; Miller, C.; Peters, B.; Cohen, H. S.; Jeevarajan, J.; Reschke, M.; hide


    performance in both ML and anteroposterior planes while stimulating in the ML axis only. We have shown the efficacy of VSR stimulations on enhancing physiological and perceptual responses of whole-body orientation during low frequency perturbations (0.1 Hz) on the ocular motor system using a variable radius centrifuge on both physiological (using eye movements) and perceptual responses (using a joystick) to track imposed oscillations. The variable radius centrifuge provides a selective tilting sensation that is detectable only by the otolith organs providing conflicting information from the canal organs of the vestibular system (intra-vestibular conflict). These results indicate that VSR can improve performance in sensory conflict scenarios like that experienced during space flight. We have showed the efficacy of VSR stimulation to improve balance and locomotor control on subjects exposed to continuous, sinusoidal lateral motion of the support surface while walking on a treadmill while viewing perceptually matched linear optic flow. We have shown the safety of short term continuous use of up to 4 hours of VSR stimulation and its efficacy in improving balance and locomotor function in Parkinson's Disease patients. This technique for improving vestibular signal detection may thus provide additional information to improve strategic abilities. We hypothesize that VSR stimulation will act synergistically with SA training to improve adaptability by increased utilization of vestibular information and therefore serve to optimize and personalize the SA countermeasure prescription. This forms the basis of its usefulness both as a training modality and further help in significantly reducing the number of days required to recover functional performance to preflight levels after long duration space flight.

  2. Influence of vestibular activation on respiration in humans (United States)

    Monahan, Kevin D.; Sharpe, Melissa K.; Drury, Daniel; Ertl, Andrew C.; Ray, Chester A.


    The purpose of this study was to determine the effects of the semicircular canals and otolith organs on respiration in humans. On the basis of animal studies, we hypothesized that vestibular activation would elicit a vestibulorespiratory reflex. To test this hypothesis, respiratory measures, arterial blood pressure, and heart rate were measured during engagement of semicircular canals and/or otolith organs. Dynamic upright pitch and roll (15 cycles/min), which activate the otolith organs and semicircular canals, increased respiratory rate (Delta2 +/- 1 and Delta3 +/- 1 breaths/min, respectively; P < 0.05). Dynamic yaw and lateral pitch (15 cycles/min), which activate the semicircular canals, increased respiration similarly (Delta3 +/- 1 and Delta2 +/- 1, respectively; P < 0.05). Dynamic chair rotation (15 cycles/min), which mimics dynamic yaw but eliminates neck muscle afferent, increased respiration (Delta3 +/- 1; P < 0.05) comparable to dynamic yaw (15 cycles/min). Increases in respiratory rate were graded as greater responses occurred during upright (Delta5 +/- 2 breaths/min) and lateral pitch (Delta4 +/- 1) and roll (Delta5 +/- 1) performed at 30 cycles/min. Increases in breathing frequency resulted in increases in minute ventilation during most interventions. Static head-down rotation, which activates otolith organs, did not alter respiratory rate (Delta1 +/- 1 breaths/min). Collectively, these data indicate that semicircular canals, but not otolith organs or neck muscle afferents, mediate increased ventilation in humans and support the concept that vestibular activation alters respiration in humans.

  3. Vestibulosympathetic reflex during mental stress (United States)

    Carter, Jason R.; Ray, Chester A.; Cooke, William H.


    Increases in sympathetic neural activity occur independently with either vestibular or mental stimulation, but it is unknown whether sympathetic activation is additive or inhibitive when both stressors are combined. The purpose of the present study was to investigate the combined effects of vestibular and mental stimulation on sympathetic neural activation and arterial pressure in humans. Muscle sympathetic nerve activity (MSNA), arterial pressure, and heart rate were recorded in 10 healthy volunteers in the prone position during 1) head-down rotation (HDR), 2) mental stress (MS; using arithmetic), and 3) combined HDR and MS. HDR significantly (P < 0.05) increased MSNA (9 +/- 2 to 13 +/- 2 bursts/min). MS significantly increased MSNA (8 +/- 2 to 13 +/- 2 bursts/min) and mean arterial pressure (87 +/- 2 to 101 +/- 2 mmHg). Combined HDR and MS significantly increased MSNA (9 +/- 1 to 16 +/- 2 bursts/min) and mean arterial pressure (89 +/- 2 to 100 +/- 3 mmHg). Increases in MSNA (7 +/- 1 bursts/min) during the combination trial were not different from the algebraic sum of each trial performed alone (8 +/- 2 bursts/min). We conclude that the interaction for MSNA and arterial pressure is additive during combined vestibular and mental stimulation. Therefore, vestibular- and stress-mediated increases of MSNA appear to occur independently in humans.

  4. Potenciais miogênicos evocados vestibulares: metodologias de registro em homens e cobaias Vestibular evoked myogenic potential: recording methods in humans and guinea pigs

    Directory of Open Access Journals (Sweden)

    Aline Cabral de Oliveira


    Full Text Available 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, SCIELO 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.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 ways used to record the vestibular evoked myogenic potentials in relation to the following factors: patient position at the time of recording

  5. Clinics of ocular tuberculosis. (United States)

    Gupta, Vishali; Shoughy, Samir S; Mahajan, Sarakshi; Khairallah, Moncef; Rosenbaum, James T; Curi, Andre; Tabbara, Khalid F


    Ocular tuberculosis is an extrapulmonary tuberculous condition and has variable manifestations. The purpose of this review is to describe the clinical manifestations of ocular tuberculosis affecting the anterior and posterior segments of the eye in both immunocompetent and immunocompromised patients. Review of literature using Pubmed database. Mycobacterium tuberculosis may lead to formation of conjunctival granuloma, nodular scleritis, and interstitial keratitis. Lacrimal gland and orbital caseating granulomas are rare but may occur. The intraocular structures are also a target of insult by M. tuberculosis and may cause anterior granulomatous uveitis, anterior and posterior synechiae, secondary glaucoma, and cataract. The bacillus may involve the ciliary body, resulting in the formation of a localized caseating granuloma. Posterior segment manifestations include vitritis, retinal vasculitis, optic neuritis, serpiginous-like choroiditis, choroidal tubercules, subretinal neovascularization, and, rarely, endophthalmitis. The recognition of clinical signs of ocular tuberculosis is of utmost importance as it can provide clinical pathway toward tailored investigations and decision making for initiating anti-tuberculosis therapy.

  6. Artefactos en ultrasonido ocular

    Directory of Open Access Journals (Sweden)

    Mariana Mayorquín Ruiz


    Full Text Available El ultrasonido ocular es un estudio dependiente del operador. Un buen estudio ecográfico debe tener como base el conocimiento de la anatomía y fisiología normales y de los cambios producidos en diferentes enfermedades, así como los cambios tras una cirugía ocular o trauma. El conocimiento de los fenómenos físicos producidos por el ultrasonido es la base para entender y reconocer la presencia de artefactos en el ultrasonido ocular. Esta revisión tiene como objetivo hacer un recuento de los artefactos que pueden ocasionar confusión al interpretar una imagen ecográfica, así como explicar la base física en la que se basan, reduciendo de esta manera los errores de interpretación y diagnósticos.

  7. Management of Reflex Anoxic Seizures

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available Investigators at the Roald Dahl EEG Unit, Alder Hey Children’s NHS Foundation, Liverpool, UK, review the definition, pathophysiology, clinical presentation, and management of reflex anoxic seizures (RAS in children.

  8. What Is an Ocular Migraine? (United States)

    ... When to seek help What is an ocular migraine? Is it a sign of something serious? Answers ... and retinal migraine, which could signal something serious. Migraine aura affecting your vision Ocular migraine sometimes describes ...

  9. Ocular complications of boxing (United States)

    Bianco, M; Vaiano, A; Colella, F; Coccimiglio, F; Moscetti, M; Palmieri, V; Focosi, F; Zeppilli, P; Vinger, P


    Objectives: To investigate the prevalence of ocular injuries in a large population of boxers over a period of 16 years, in particular, the most severe lesions that may be vision threatening. Methods: Clinical records of the medical archive of the Italian Boxing Federation were analysed. A total of 1032 boxers were examined from February 1982 to October 1998. A complete ophthalmological history was available for 956, who formed the study population (a total of 10 697 examinations). The following data were collected: age when started boxing; duration of competitive boxing career (from the date of the first bout); weight category; a thorough ocular history. The following investigations were carried out: measurement of visual acuity and visual fields, anterior segment inspection, applanation tonometry, gonioscopy, and examination of ocular fundus. Eighty age matched healthy subjects, who had never boxed, formed the control group. Results: Of the 956 boxers examined, 428 were amateur (44.8%) and 528 professional (55.2%). The median age at first examination was 23.1 (4.3) years (range 15–36). The prevalence of conjunctival, corneal, lenticular, vitreal, ocular papilla, and retinal alterations in the study population was 40.9% compared with 3.1% in the control group (p⩽0.0001). The prevalence of serious ocular findings (angle, lens, macula, and peripheral retina alterations) was 5.6% in boxers and 3.1% in controls (NS). Conclusions: Boxing does not result in a higher prevalence of severe ocular lesions than in the general population. However, the prevalence of milder lesions (in particular with regard to the conjunctiva and cornea) is noteworthy, justifying the need for adequate ophthalmological surveillance. PMID:15665199

  10. Hearing, speech, language, and vestibular disorders in the fetal alcohol syndrome: a literature review. (United States)

    Church, M W; Kaltenbach, J A


    Fetal alcohol syndrome (FAS) is characterized in part by mental impairment, as well as craniofacial and ocular anomalies. These conditions are traditionally associated with childhood hearing disorders, because they all have a common embryonic origin in malformations of the first and second branchial arches, and have similar critical periods of vulnerability to toxic insult. A review of human and animal research indicates that there are four types of hearing disorders associated with FAS. These are: (1) a developmental delay in auditory maturation, (2) sensorineural hearing loss, (3) intermittent conductive hearing loss due to recurrent serous otitis media, and (4) central hearing loss. The auditory and vestibular systems share the same peripheral apparatuses (the inner ear and eighth cranial nerve) and are embryologically and structurally similar. Consequently, vestibular disorders in FAS children might be expected. The evidence for vestibular dysfunction in FAS is ambiguous, however. Like other syndromes associated with craniofacial anomalies, hearing disorders, and mental impairment, FAS is also characterized by a high prevalence of speech and language pathology. Hearing disorders are a form of sensory deprivation. If present during early childhood, they can result in permanent hearing, language, and mental impairment. Early identification and intervention to treat hearing, language, and speech disorders could therefore result in improved outcome for the FAS child. Specific recommendations are made for intervention and future research.

  11. Utilidad clínica de los potenciales evocados miogénicos vestibulares (VEMPs

    Directory of Open Access Journals (Sweden)

    José Ignacio BENITO-OREJAS


    Full Text Available Introducción y objetivo: A principios de los años 90, Colebath y Halmagyi demuestran que es posible medir el potencial miogénico evocado del músculo esternocleidomastoideo a partir de una estimulación acústica o vibratoria del laberinto, dando nombre a los que desde entonces denominamos «potenciales evocados miogénicos vestibulares» (VEMPs: Vestibular-Evoked-Myogenic-Potentials. El objetivo de esta revisión consistirá en exponer las bases anatomofuncionales de los VEMPs y describir sus aplicaciones clínicas actuales. Método: Se trata de un trabajo descriptivo donde, a partir de la bibliografía que consideramos más destacada, se resumen las características, procedimientos de obtención y utilidad clínica de los VEMPs. Resultados y conclusiones: Mediante el registro de VEMPs oculares (oVEMPs y cervicales (cVEMPs, podemos obtener de forma práctica, información clínica sobre las funciones utricular y sacular. Ambos procedimientos son específicos, sencillos, rápidos, reproducibles y seguros. Cuando estos resultados se combinan con otras pruebas vestibulares, se consigue llegar a tener un conocimiento funcional de cada uno de los receptores sensoriales del laberinto.

  12. Vestibular function in patients with Niemann-Pick type C disease. (United States)

    Bremova, Tatiana; Krafczyk, Siegbert; Bardins, Stanislavs; Reinke, Jörg; Strupp, Michael


    We investigated whether vestibular dysfunction may cause or contribute to postural imbalance and falls in patients with Niemann-Pick type C disease (NP-C). Eight patients with NP-C disease and 20 healthy controls were examined using the video-based head impulse test (vHIT) and caloric irrigation to investigate horizontal canal function as well as ocular- and cervical vestibular evoked myogenic potentials (o- and cVEMP), and binocular subjective visual vertical estimation (SVV) for otolith function, and static posturography. There were no significant differences in vestibulo-ocular gain, caloric excitability, o-/cVEMP measures or SVV between the two groups. Posturographic total sway path (tSP) and root mean square (RMS) were significantly higher in NP-C than in controls in 3 out of 4 conditions. The Romberg quotient (RQ) to assess the amount of visual stabilization was significantly lower in the NP-C than in the HC group. In contrast to other inherited metabolic disorders, such as Morbus Gaucher type 3, we did not find any evidence for an impairment of canal or otolith function in patients with NP-C as their cause of postural imbalance. Since RQ was low in NP-C patients, indicating proper sensory input, the observed increased postural sway is most likely due to a cerebellar dysfunction in NP-C, which may therefore, explain postural imbalance.

  13. Unilateral vestibular loss impairs external space representation.

    Directory of Open Access Journals (Sweden)

    Liliane Borel

    Full Text Available The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal and far (extrapersonal spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation, and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss.

  14. Metabolic disorders of the vestibular system. (United States)

    Rybak, L P


    This article reviews the impact of metabolic disorders on vestibular function. Diabetes mellitus is a disorder of glucose metabolism that can be associated with vestibular dysfunction. Vertigo can be alleviated by diet management in many cases. Elevated levels of blood lipids have been implicated in cochleovestibular disorders. Treatment with a lipid-lowering drug has resulted in improved auditory and vestibular function in a placebo-controlled trial. Hypothyroidism may affect different parts of the vestibular system depending on the severity and duration of thyroid deficiency. Severe congenital hypothyroidism can cause central vestibular disorders affecting the cerebellum, whereas mild hypothyroidism may result in peripheral vestibulopathy. Endogenous alterations in concentrations of estrogen and progesterone in the premenstrual syndrome or with the use of exogenous hormones such as oral contraceptives may trigger vertigo. Metabolic evaluations for unexplained vertigo should include a lipoprotein profile, with cholesterol and triglyceride levels, glucose tolerance test, and thyroid hormone measurements. Nutritional and drug therapy may be useful to reverse the vestibular dysfunction.

  15. Ocular manifestations of leptospirosis

    Directory of Open Access Journals (Sweden)

    Rathinam S


    Full Text Available Leptospiral uveitis is a common entity in tropical countries. Ocular manifestations are noted in the second phase of illness, but these remain under-diagnosed mainly because of the prolonged symptom-free period that separates the systemic manifestations from detection of ocular manifestations.Varying ophthalmic presentations and the intrinsic nature of different types of uveitis to mimic one another also challenge the accuracy of the diagnosis. Of the individual ocular signs, the combination of acute, non-granulomatous, panuveitis, hypopyon, vasculitis, optic disc edema, membranous vitreous opacities and absence of choroiditis or retinitis have high predictive value for the clinical diagnosis of leptospiral uveitis. Geographic location of the patient, occupation, socio-economic status, risk factors related to exposure, past history of fever or jaundice also aid in diagnosis.Steroids are the mainstay of treatment for leptospiral uveitis. Depending upon the severity and anatomical location of inflammatory lesion, topical, peri-ocular and/or systemic steroids are given. The prognosis is generally good, even when the inflammation is severe.

  16. Ocular straylight in albinism

    NARCIS (Netherlands)

    Kruijt, Bastiaan; Franssen, Luuk; Prick, Liesbeth J. J. M.; van Vliet, Johannes M. J.; van den Berg, Thomas J. T. P.


    Albinism is an inherited disorder that affects the melanin biosynthesis pathway, which results in reduced or absent pigment formation. This may lead to increased light transmission through the iris and more reflected light from the fundus. Both these effects contribute to the occurrence of ocular

  17. Therapy of ocular toxoplasmosis

    NARCIS (Netherlands)

    Rothova, A.; Buitenhuis, H. J.; Meenken, C.; Baarsma, G. S.; Boen-Tan, T. N.; de Jong, P. T.; Schweitzer, C. M.; Timmerman, Z.; de Vries, J.; Zaal, M. J.


    We performed a prospective multicentre study to evaluate the efficacy of therapeutic strategies currently used for ocular toxoplasmosis in a large number of patients (n = 106). Treatment was given for at least four weeks and consisted of three triple drug combinations: group 1, pyrimethamine,

  18. Adaptive Changes in the Vestibular System of Land Snail to a 30-Day Spaceflight and Readaptation on Return to Earth

    Directory of Open Access Journals (Sweden)

    Nikolay Aseyev


    Full Text Available The vestibular system receives a permanent influence from gravity and reflexively controls equilibrium. If we assume gravity has remained constant during the species' evolution, will its sensory system adapt to abrupt loss of that force? We address this question in the land snail Helix lucorum exposed to 30 days of near weightlessness aboard the Bion-M1 satellite, and studied geotactic behavior of postflight snails, differential gene expressions in statocyst transcriptome, and electrophysiological responses of mechanoreceptors to applied tilts. Each approach revealed plastic changes in the snail's vestibular system assumed in response to spaceflight. Absence of light during the mission also affected statocyst physiology, as revealed by comparison to dark-conditioned control groups. Readaptation to normal tilt responses occurred at ~20 h following return to Earth. Despite the permanence of gravity, the snail responded in a compensatory manner to its loss and readapted once gravity was restored.

  19. [H reflex in patients with spastic quadriplegia]. (United States)

    Miyama, Sahoko; Arimoto, Kiyoshi; Kimiya, Satoshi


    Hoffmann reflex (H reflex) is an electrically elicited spinal monosynaptic reflex. H reflex was examined in 18 patients with spastic quadriplegia who had perinatal or postnatal problems. H reflex was elicitable in 11 patients for the abductor pollicis brevis (61.1%), 10 for the abductor digiti minimi (55.6%) and 16 for the abductor hallucis (88.9%). Because the abductor pollicis brevis and the abductor digiti minimi do not exhibit H reflex in normal subjects, it was suggested that the excitability of alpha motor neurons innervating these muscles was increased. H reflex was not detected for the extensor digitorum brevis in any patients, indicating the difference in the excitability among alpha motor neurons. In some patients, H reflex did not disappear under supramaximal stimuli. We conclude that the mechanism of evolution of H reflex in patients with spastic quadriplegia is different from that in normal subjects.

  20. The frog vestibular system as a model for lesion-induced plasticity: basic neural principles and implications for posture control

    Directory of Open Access Journals (Sweden)

    Francois M Lambert


    Full Text Available Studies of behavioral consequences after unilateral labyrinthectomy have a long tradition in the quest of determining rules and limitations of the CNS to exert plastic changes that assist the recuperation from the loss of sensory inputs. Frogs were among the first animal models to illustrate general principles of regenerative capacity and reorganizational neural flexibility after a vestibular lesion. The continuous successful use of the latter animals is in part based on the easy access and identifiability of nerve branches to inner ear organs for surgical intervention, the possibility to employ whole brain preparations for in vitro studies and the limited degree of freedom of postural reflexes for quantification of behavioral impairments and subsequent improvements. Major discoveries that increased the knowledge of post-lesional reactive mechanisms in the central nervous system include alterations in vestibular commissural signal processing and activation of cooperative changes in excitatory and inhibitory inputs to disfacilitated neurons. Moreover, the observed increase of synaptic efficacy in propriospinal circuits illustrates the importance of limb proprioceptive inputs for postural recovery. Accumulated evidence suggests that the lesion-induced neural plasticity is not a goal-directed process that aims towards a meaningful restoration of vestibular reflexes but rather attempts a survival of those neurons that have lost their excitatory inputs. Accordingly, the reaction mechanism causes an improvement of some components but also a deterioration of other aspects as seen by spatio-temporally inappropriate vestibulo-motor responses, similar to the consequences of plasticity processes in various sensory systems and species. The generality of the findings indicate that frogs continue to form a highly amenable vertebrate model system for exploring molecular and physiological events during cellular and network reorganization after a loss of

  1. Vestibular Rehabilitation in a Patient with Whiplash-associated Disorders

    Directory of Open Access Journals (Sweden)

    Kwo-Shieng Tuo


    Full Text Available Whiplash-associated disorders are characterized by multiple physical complaints after a flexion-extension trauma to the neck. They are difficult to treat, and they often result in great impact on the patient's quality of life. In this paper, the comprehensive treatment of a patient with whiplash-associated disorders is presented. The purpose is to highlight the importance of accurate diagnosis and appropriate treatment plans to improve patients' quality of life. This 23-year-old woman experienced a traffic accident which caused severely painful neck disability, numbness over bilateral upper limbs, dizziness, double vision and loss of balance. Among these symptoms, dizziness was the problem that bothered the patient most. She received a comprehensive rehabilitation program including physical modalities, trigger point injections for relief of pain, as well as a vestibular rehabilitation program, which included exercises challenging and improving her balance function, head-eye coordination exercise, visual-ocular control exercise and sensory substitution-promoting exercises. She resumed her previous full-time work after 3 weeks of treatment. This successfully treated case illustrates the importance of correct diagnosis and appropriate treatment for patients who suffer from whiplash-associated disorders.

  2. Interactive Healthcare Systems in the Home: Vestibular Rehabilitation

    DEFF Research Database (Denmark)

    Aarhus, Rikke; Grönvall, Erik; Larsen, Simon Bo


    Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction.......Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction....

  3. Vestibular Schwannoma or acoustic neuroma

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    Hekmatara M


    Full Text Available Vestibular schwannoma is the most common tumor of the posterior fossa of the skull. Patients referred with the primary otologic symptoms such as hearing loss, tinnitus, vertigo, imbalance, and the cranial nerve palsy. Thirty-three patients were operated and treated by a team of otolaryngologist and neurosurgeon, anudiometrist, and internist. Patients'chiefcomplaint was due to 94% hearing loss and 27% tinnitus. They scarcely complain of vertigo. If a patient refers with the palsy or paralysis of facial nerve preoperation, we must think of the facial nerve schwannoma or hemangioma or congential cholestoma or malignant metastases rather than acoustic neuroma. The best way for preoperative diagnosis is audiometry, ABR (Auditory Brain Response, and SDS (speech discrimination score with 90% success, but computer Tomography (CT scan and MRI (Magnetic Resonance Image are the valuable anatomic diagnostic radiographic devices. The best method of operation is translabirynthine approach (TLA, since it has the advantages such as an easy access to nerve paths and being the nearest path to CPA (Cerebellopontine Angle. Physicians ought to talk to patients about the importance of the microscopic surgery, surgical methods, and their probable diverse effects such as hearing loss, facial nerve palsy, and intracranial problems.

  4. Vestibular Function Impairment in Alzheimer's Disease. (United States)

    Nakamagoe, Kiyotaka; Fujimiya, Suguru; Koganezawa, Tadachika; Kadono, Kotarou; Shimizu, Kotone; Fujizuka, Natsu; Takiguchi, Shino; Ueno, Tomoyuki; Monzen, Tatsuya; Tamaoka, Akira


    Falls and fractures due to impaired balance in patients with Alzheimer's disease (AD) have an adverse effect on the clinical course of the disease. To evaluate balance impairment in AD from the viewpoint of vestibular functional impairment. The subjects were 12 patients with AD, 12 dementia-free elderly adults, and 12 younger adults. Vestibular function was assessed using a stepping test, caloric nystagmus, and a visual suppression (VS) test. The stepping test was abnormal in 9 of the 12 patients in the AD group. An abnormal stepping test was not associated with self-reported dizziness or tendency to fall. Significant VS abnormalities were present in the AD group. The suppression rate of VS was lower in AD patients with either a tendency to fall or constructional apraxia than in AD patients without either. The velocity of the rapid phase of caloric nystagmus before the VS test was similar in the AD group and the elderly control group. Significant abnormalities of both caloric nystagmus and VS were not present in either the elderly or the younger control groups. AD could involve impairments in the vestibular control of balance. The VS test is useful for assessing the tendency to fall in AD. Impairment of VS in AD might arise from cerebral vestibular cortex impairment rather than comorbid peripheral vestibular disorders.

  5. Complications of Microsurgery of Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Jan Betka


    Full Text Available Background. The aim of this study was to analyze complications of vestibular schwannoma (VS microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225 removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI was observed in 124 cases (45% immediately after surgery and in 104 cases (33% on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%, headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery.

  6. Can a finding of cervical vestibular evoked myogenic potentials contribute to vestibular migraine diagnostics?

    Directory of Open Access Journals (Sweden)

    Tihana Vešligaj


    Full Text Available Aim To investigate differences in vestibular evoked myogenic potentials (VEMP results with patients suffering from vestibular migraine and healthy people, taking into consideration values of threshold and latency of occurrence of the characteristic wave complex, size of amplitude, and interaural amplitude ratio. According to the results, determine the importance and usefulness of VEMP in vestibular migraine diagnostics. Methods A total number of 62 subjects were included in the study, 32 of them belonging to a group of patients suffering from vestibular migraine (VM, while other 30 were in a control group of healthy subjects. Information was collected during the diagnostic evaluation. General and otoneurological history of patients and bedside tests, audiological results, videonystagmography and cervical vestibular evoked myogenic potentials (cVEMP were made. Results There was a difference in an interaural ratio of amplitudes in the experimental and control groups, but it was not found to be clinically significant. By ToneBurst 500 Hz method, the interaural amplitude ratio higher than 35% was measured in 46.97% subjects, while the response was totally unilaterally missing in 28.8% patients. Conclusion Even the sophisticated method as cVEMP does not give the ultimate result confirming the vestibular migraine diagnosis, and neither do other diagnostic methods. cVEMP result can contribute to the completion of full mosaic of vestibular migraine diagnostics.

  7. Expression of vesicular glutamate transporters in peripheral vestibular structures and vestibular nuclear complex of rat. (United States)

    Zhang, F X; Pang, Y W; Zhang, M M; Zhang, T; Dong, Y L; Lai, C H; Shum, D K Y; Chan, Y S; Li, J L; Li, Y Q


    Glutamate transmission from vestibular end organs to central vestibular nuclear complex (VNC) plays important role in transferring sensory information about head position and movements. Three isoforms of vesicular glutamate transporters (VGLUTs) have been considered so far the most specific markers for glutamatergic neurons/cells. In this study, VGLUT1 and VGLUT2 were immunohistochemically localized to axon terminals in VNC and somata of vestibular primary afferents in association with their central and peripheral axon endings, and VGLUT1 and VGLUT3 were co-localized to hair cells of otolith maculae and cristae ampullaris. VGLUT1 and VGLUT2 defined three subsets of Scarpa's neurons (vestibular ganglionic neurons): those co-expressing VGLUT1 and VGLUT2 or expressing only VGLUT2, and those expressing neither. In addition, many neurons located in all vestibular subnuclei were observed to contain hybridized signals for VGLUT2 mRNA and a few VNC neurons, mostly scattered in medial vestibular nucleus (MVe), displayed VGLUT1 mRNA labelling. Following unilateral ganglionectomy, asymmetries of VGLUT1-immunoreactivity (ir) and VGLUT2-ir occurred between two VNCs, indicating that the VNC terminals containing VGLUT1 and/or VGLUT2 are partly of peripheral origin. The present data indicate that the constituent cells/neurons along the vestibular pathway selectively apply VGLUT isoforms to transport glutamate into synaptic vesicles for glutamate transmission. © 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

  8. Sclerodermatomyositis, ocular manifestations. (United States)

    Pedroza-Seres, M; Serna-Ojeda, J C; Flores-Suárez, L F


    Sclerodermatomyositis is an overlap syndrome of myositis and scleroderma, with dermatological, muscular and joint involvement, but may also present with ocular manifestations. A 57 year-old woman presented with ophthalmological manifestations, including scleral thinning 360°, and the presence of cells in the anterior and posterior chamber. Oriented physical examination and laboratory studies led to the diagnosis, with the need for systemic treatment. Sclerodermatomyositis is a rare disease. Its diagnosis needs thorough clinical and laboratory studies, and its management should be multidisciplinary when inflammatory ocular manifestations may be present. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Origin of vestibular dysfunction in Usher syndrome type 1B.

    NARCIS (Netherlands)

    Sun, J.; Alphen, A.M. van; Wagenaar, M.; Huygen, P.L.M.; Hoogenraad, C.C.; Hasson, T.; Koekkoek, S.K.; Bohne, B.A.; Zeeuw, C.I. de


    It is still debated to what extent the vestibular deficits in Usher patients are due to either central vestibulocerebellar or peripheral vestibular problems. Here, we determined the origin of the vestibular symptoms in Usher 1B patients by subjecting them to compensatory eye movement tests and by

  10. Reflexive fatherhood in everyday life

    DEFF Research Database (Denmark)

    Westerling, Allan


    This article looks at fathering practices in Denmark, using the findings from a research project on everyday family life in Denmark. It takes a social psychological perspective and employs discursive psychology and theories about reflexive modernisation. It shows how fathers orient towards intimacy...... in their relationships with their children. Moreover, it discusses how fathers’ relatedness reflects individualisation and detraditionalisation. It is argued that reflexive modernisation entails subjective orientations that enable novel pathways to intimacy in contemporary father–child relationships. Through...... this analysis and discussion, the article offers a way to understand the complexities of fathering in everyday life from the perspective of fathers....

  11. Outside home. Notes on reflexivity

    Directory of Open Access Journals (Sweden)

    Mara Clemente


    The paper proffers the idea in which a “reflexive process” on subjectivity can involve and/or hopefully involve the entire experience of the researcher, going beyond the borders of a single research. In the process, unexpected elements of subjectivity can come into play; in other cases the meaning attributed to them can change in time or can have a role different from what had been expected. Some elements, objects of epistemological analyses, as imposed by a reflexive approach, can become objects of attention also on the phenomenological level.

  12. Educating the Reflexive Practitioner

    Directory of Open Access Journals (Sweden)

    Marc J. Neveu


    wearing any clothes.Notwithstanding such issues, I do believe the studio holds the potentialto be an empowering learning experience. The intention of this article is to question the mode of instruction in an architectural studio. I’ve structured the paper in three parts. First, I will briefly describe the findingsof the study made by the Carnegie Foundation for the Advancementof Teaching known as the Boyer Report.2 To develop and support the findings of the Boyer Report, I introduce the work of the educator Donald Schön. Though I see much merit in the Boyer Report, and Schön’sproposals, I argue that a more nuanced approach is required. I will recommend, therefore, in the second section of this paper that a meansof architectural education as based on the Socratic method may be amore productive approach. My reading of the Socratic method is basedprimarily on early Socratic dialogues and I will specifically use Charmidesto illustrate the issues that I believe are relevant to studio pedagogy.3 From my analysis of Charmides I will, in the third section of the essay,describe how the Socratic method is beneficial to studio pedagogy threeways: reflexive, non-propositional, and finally how Socrates’ approachmay indeed be practical. This last section will be illustrated with a studentproject. It is my conjecture that the Socratic method offers insight intocurrent discussions of educational theory, namely student-centered,project-based learning.

  13. Human ocular anatomy. (United States)

    Kels, Barry D; Grzybowski, Andrzej; Grant-Kels, Jane M


    We review the normal anatomy of the human globe, eyelids, and lacrimal system. This contribution explores both the form and function of numerous anatomic features of the human ocular system, which are vital to a comprehensive understanding of the pathophysiology of many oculocutaneous diseases. The review concludes with a reference glossary of selective ophthalmologic terms that are relevant to a thorough understanding of many oculocutaneous disease processes. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Miopatia ocular descendente

    Directory of Open Access Journals (Sweden)

    Nunjo Finkel


    Full Text Available São relatados 4 casos de miopatia ocular descendente (MOD com história familial levantada em três gerações. Biópsia musculares e eletromiografia em um caso confirmaram o caráter miogênico da doença. A MOD nada mais seria do que uma forma clínica especial de distrofia muscular, de início tardio.



    Mallika O. U; Suma Job


    BACKGROUND Hyperthyroidism can result in ocular manifestations even before systemic signs and symptoms develop. It is seen more in females and severe forms are more common in males. Early detection of ocular involvement can prevent vision threatening complications and troublesome discomforts affecting quality of vision. This clinical study highlights the importance of detailed ocular examination in hyperthyroidism. MATERIALS AND METHODS Fifty consecutive patients with ocu...

  16. Neural Correlates of Sensory Substitution in Vestibular Pathways Following Complete Vestibular Loss (United States)

    Sadeghi, Soroush G.; Minor, Lloyd B.; Cullen, Kathleen E.


    Sensory substitution is the term typically used in reference to sensory prosthetic devices designed to replace input from one defective modality with input from another modality. Such devices allow an alternative encoding of sensory information that is no longer directly provided by the defective modality in a purposeful and goal-directed manner. The behavioral recovery that follows complete vestibular loss is impressive and has long been thought to take advantage of a natural form of sensory substitution in which head motion information is no longer provided by vestibular inputs, but instead by extra-vestibular inputs such as proprioceptive and motor efference copy signals. Here we examined the neuronal correlates of this behavioral recovery after complete vestibular loss in alert behaving monkeys (Macaca mulata). We show for the first time that extra-vestibular inputs substitute for the vestibular inputs to stabilize gaze at the level of single neurons in the VOR premotor circuitry. The summed weighting of neck proprioceptive and efference copy information was sufficient to explain simultaneously observed behavioral improvements in gaze stability. Furthermore, by altering correspondence between intended and actual head movement we revealed a four-fold increase in the weight of neck motor efference copy signals consistent with the enhanced behavioral recovery observed when head movements are voluntary versus unexpected. Thus, taken together our results provide direct evidence that the substitution by extra-vestibular inputs in vestibular pathways provides a neural correlate for the improvements in gaze stability that are observed following the total loss of vestibular inputs. PMID:23077054

  17. Ocular injury in hurling.

    LENUS (Irish Health Repository)

    Flynn, T H


    OBJECTIVES: To describe the clinical characteristics of ocular injuries sustained in hurling in the south of Ireland and to investigate reasons for non-use of protective headgear and eye wear. METHODS: Retrospective review of the case notes of 310 patients who attended Cork University Hospital or Waterford Regional Hospital between 1 January 1994 and 31 December 2002 with ocular injuries sustained during a hurling match. A confidential questionnaire on reasons for non-use of protective headgear and eye wear was completed by 130 players. RESULTS: Hurling related eye injuries occurred most commonly in young men. Fifty two patients (17%) required hospital admission, with hyphaema accounting for 71% of admissions. Ten injuries required intraocular surgical INTERVENTION: retinal detachment repair (5); macular hole surgery (1); repair of partial thickness corneal laceration (1); repair of globe perforation (1); enucleation (1); trabeculectomy for post-traumatic glaucoma (1). Fourteen eyes (4.5%) had a final best corrected visual acuity (BCVA) of <6\\/12 and six (2%) had BCVA <3\\/60. In the survey, 63 players (48.5%) reported wearing no protective facemask while playing hurling. Impairment of vision was the most common reason cited for non-use. CONCLUSIONS: Hurling related injury is a significant, and preventable, cause of ocular morbidity in young men in Ireland. The routine use of appropriate protective headgear and faceguards would result in a dramatic reduction in the incidence and severity of these injuries, and should be mandatory.

  18. Ocular candidiasis: a review. (United States)

    Shah, C P; McKey, J; Spirn, M J; Maguire, J


    To review the epidemiology, diagnosis and changing treatment paradigm of ocular candidiasis, and report current prevalence rates and risk factors at one inpatient hospital. Retrospective review; systematic literature review. All Wills Eye Institute inpatient ophthalmology consultations from Thomas Jefferson University Hospital were retrospectively reviewed between June 2006 and November 2006. All consultations for candidaemia were included. The outcome variables included chorioretinitis, endophthalmitis, visual symptoms and Candida speciation. The ophthalmic literature was reviewed using PubMed. Keywords included Candida, candidaemia, chorioretinitis, vitritis and endophthalmitis. Bibliographies were manually searched. Three of the 38 consultations for candidaemia (7.9%) had chorioretinitis. There were no cases of vitritis or endophthalmitis. The presence of symptoms, or the inability to articulate symptoms, was significantly associated with risk of ocular candidiasis (p = 0.003). All three cases of chorioretinitis had positive blood cultures for Candida albicans (p = 0.089) and were treated with oral fluconazole. Various factors have led to the increasing prevalence of inpatient candidaemia. Risk factors for ocular involvement include albicans species and the presence of, or inability to articulate, visual symptoms. For those without abnormal findings on initial examination, a subsequent retinal examination should be performed in 2 weeks, particularly if new symptoms develop or if the patient is unable to relay symptoms. Patients with chorioretinitis should be treated with systemic antifungal agents. For those with vitritis or endophthalmitis, particularly if worsening on systemic therapy alone, intravitreal antifungal medications or early vitrectomy should be considered.

  19. Oculomotricidade e seus fundamentos Ocular motility: foundations

    Directory of Open Access Journals (Sweden)

    Harley E. A. Bicas


    ção com o olho esquerdo, para comparação de ações dos músculos retos superior direito e inferior esquerdo, respectivamente. Também é analisada a influência das inclinações de cabeça sobre essas ações. O artigo termina examinando a relação sincinética entre a acomodação e convergência, a convergência proximal e as unidades dessas funções.The paper starts from a schematic circuit establishing a relationship of the sensorial (visual, binocular with the oculomotor systems, whose defects of their afferent or efferent pathways, or of their interactions, explain the emergence of strabismus with its consequences. The foundations and referentials of ocular movements are then examined: the concepts of axes and planes, of the centers of mass and of rotation, of monocular displacements of translation and rotation, of binocular version and vergence displacements. The functions of centers of command for voluntary or reflex ocular movements are also presented, as well as the innervation of extrinsic ocular muscles. In a second part (physiology of the extrinsic ocular muscles, activities of contraction or relaxation and the importance of Sherrington's law are commented. The concepts of primary position of gaze and of the referentials for rotations are retaken leading to the diversity of the several systems of measurements. There follows analysis of the rotational actions of the ocular muscles, based on the so-called planes of muscular actions and on the anatomic distribution of the muscles, leading to the results in primary position of gaze and others. The effects of fascias and intermuscular membranes are also commented. Conclusively the modern concept of the muscular actions is presented (simultaneous actions of all muscles in each ocular position. Based on the conditions of Hering's law the concept of positions for the diagnosis of the oculomotor disfunctions, which differs from the classical one is developed: the muscles are considered in pairs, according to


    Directory of Open Access Journals (Sweden)

    Mallika O. U


    Full Text Available BACKGROUND Hyperthyroidism can result in ocular manifestations even before systemic signs and symptoms develop. It is seen more in females and severe forms are more common in males. Early detection of ocular involvement can prevent vision threatening complications and troublesome discomforts affecting quality of vision. This clinical study highlights the importance of detailed ocular examination in hyperthyroidism. MATERIALS AND METHODS Fifty consecutive patients with ocular signs of hyperthyroidism were evaluated and followed up for an average period of 1 year. Detailed ocular examination included exophthalmometric measurements, ocular movements and Worth four-dot test. T3, T4, TSH, CT scan and antimicrosomal antibodies and antithyroglobulin antibodies were done along with routine investigations. Study Design- Prospective cohort study. RESULTS Statistical analysis did not reveal any correlation between the level of serum T3 and severity of ocular findings. Majority of the cases were euthyroid with moderate ocular myopathy having multiple muscle involvement. Inferior rectus was affected most. CONCLUSION The ocular signs of hyperthyroidism in the present study seem to be mild. The severe eye changes like corneal involvement and optic nerve changes were less common.

  1. Neurodevelopmental Reflex Testing in Neonatal Rat Pups. (United States)

    Nguyen, Antoinette T; Armstrong, Edward A; Yager, Jerome Y


    Neurodevelopmental reflex testing is commonly used in clinical practice to assess the maturation of the nervous system. Neurodevelopmental reflexes are also referred to as primitive reflexes. They are sensitive and consistent with later outcomes. Abnormal reflexes are described as an absence, persistence, reappearance, or latency of reflexes, which are predictive indices of infants that are at high risk for neurodevelopmental disorders. Animal models of neurodevelopmental disabilities, such as cerebral palsy, often display aberrant developmental reflexes, as would be observed in human infants. The techniques described assess a variety of neurodevelopmental reflexes in neonatal rats. Neurodevelopmental reflex testing offers the investigator a testing method that is not otherwise available in such young animals. The methodology presented here aims to assist investigators in examining developmental milestones in neonatal rats as a method of detecting early-onset brain injury and/or determining the effectiveness of therapeutic interventions. The methodology presented here aims to provide a general guideline for investigators.

  2. MRI in ocular drug delivery


    Li, S. Kevin; Lizak, Martin J.; Jeong, Eun-Kee


    Conventional pharmacokinetic methods for studying ocular drug delivery are invasive and cannot be conveniently applied to humans. The advancement of MRI technology has provided new opportunities in ocular drug-delivery research. MRI provides a means to non-invasively and continuously monitor ocular drug-delivery systems with a contrast agent or compound labeled with a contrast agent. It is a useful technique in pharmacokinetic studies, evaluation of drug-delivery methods, and drug-delivery de...

  3. Fundamental Principles underlying Motor Reflexes

    NARCIS (Netherlands)

    K. Zhou (Kuikui)


    markdownabstractThe cerebellum has been suggested to be involved in motor control ever since the early 19th century. The motor control ranges from timing and strength of simple reflexes to multiple joint/limb coordination and complex motor sequence acquisition. The current thesis discusses the

  4. Soleus stretch reflex during cycling

    DEFF Research Database (Denmark)

    Grey, Michael James; Pierce, C. W.; Milner, T. E.


    The modulation and strength of the human soleus short latency stretch reflex was investigated by mechanically perturbing the ankle during an unconstrained pedaling task. Eight subjects pedaled at 60 rpm against a preload of 10 Nm. A torque pulse was applied to the crank at various positions durin...

  5. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris


    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

  6. Attentional modulation of reflex cough. (United States)

    Janssens, Thomas; Silva, Mitchell; Davenport, Paul W; Van Diest, Ilse; Dupont, Lieven J; Van den Bergh, Omer


    Reflex cough is a defensive response generated in the brainstem in response to chemical and mechanical stimulation of the airways. However, converging evidence shows that reflex cough is also influenced by central neural control processes. In this study, we investigate whether reflex cough can be modulated by attentional focus on either external stimuli or internal cough-related stimuli. Healthy volunteers (N = 24; seven men; age range, 18-25 years) completed four blocks of citric acid-induced cough challenges while, simultaneously, auditory stimuli were presented. Within each block, four concentrations were administered (30, 100, 300 and 1,000 mM, randomized). During two subsequent blocks, participants focused their attention externally (counting tones). During the other two blocks, participants focused their attention internally (counting coughs). The order of attentional focus was counterbalanced across participants. Ratings of the urge to cough were collected after each challenge. Cough frequency was determined by audio recording. Cough frequency was higher when participants focused their attention internally vs externally (P Reflex cough can be modulated by attentional focus. Internally focused attention may be a mechanism involved in excessive (idiopathic) cough, while an external focus may be introduced as part of treatments targeting excessive cough.

  7. Patterns of ocular trauma

    International Nuclear Information System (INIS)

    Babar, T.F.; Khan, M.T.; Marwat, M.; Shah, A.; Murad, Y.; Khan, M.D.


    To describe the patterns of ocular trauma, cause of injury and its effects on eye. A retrospective case series. Medical records of 1105 patients admitted with ocular trauma were reviewed. The details of patients regarding age, gender, literacy, cause of injury and its effects on eye were entered into specially-designed performa. Sample selection consisted of all patients with history of ocular trauma and who were admitted to hospital. Population details consisted patients who were referred to the hospital from all parts of N.W.F.P. Thus, the frequency of trauma in the hospital admissions was analysed. Ophthalmic trauma comprised 6.78% of the hospital admission. One thousand one hundred and five patients presented with eye injuries. Out of them, 21 patients suffered from trauma to both eyes. Almost 80% patients were male and 69% patients were below 30 years of age. Delayed presentation was more common and 63.61% patients presented after one week. Open globe injuries were more common (520 eyes (46.18%)) than closed globe injuries (484 eyes (42.98%)). 23.26% of open globe injuries were associated with intraocular and intra-orbital foreign bodies. Superficial non-perforating, eyelid and adnexal and burns were seen in 122 eyes (10.83%). Among the complications, lens damage and hyphema was seen in more than 50% of the patients, 16.60% eyes were infected at the time of admission and 4.88% of eyes needed enucleation or evisceration. The common causes of injury were violence in 37.37%, occupational in 24.43% and domestic accidents in 19.18%. Ophthalmic trauma is a major public health problem. Majority of the involved are male and under 30 years of age. Delayed presentation is more common. Open globe injuries are more frequent. Violence and occupational injuries are the major causes. (author)

  8. Central vestibular dysfunction in an otorhinolaryngological vestibular unit: incidence and diagnostic strategy. (United States)

    Mostafa, Badr E; Kahky, Ayman O El; Kader, Hisham M Abdel; Rizk, Michael


    Introduction Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis. Objective The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit. Methods This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction. All patients completed a structured questionnaire and received bedside and vestibular examination and neuroimaging as required. Results There were 69 women and 31 men. Their ages ranged between 28 and 73 (mean 42.48 years). Provisional videonystagmography (VNG) results were: 40% benign paroxysmal positional vertigo (BPPV), 23% suspicious of central causes, 18% undiagnosed, 15% Meniere disease, and 4% vestibular neuronitis. Patients with an unclear diagnosis or central features (41) had magnetic resonance imaging (MRI) and Doppler studies. Combining data from history, VNG, and imaging studies, 23 patients (23%) were diagnosed as having a central vestibular lesion (10 with generalized ischemia/vertebra basilar insufficiency, 4 with multiple sclerosis, 4 with migraine vestibulopathy, 4 with phobic postural vertigo, and 1 with hyperventilation-induced nystagmus). Conclusions Combining a careful history with clinical examination, VNG, MRI, and Doppler studies decreases the number of undiagnosed cases and increases the detection of possible central lesions.

  9. Central Vestibular Dysfunction in an Otorhinolaryngological Vestibular Unit: Incidence and Diagnostic Strategy

    Directory of Open Access Journals (Sweden)

    Mostafa, Badr E.


    Full Text Available Introduction Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis. Objective The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit. Methods This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction. All patients completed a structured questionnaire and received bedside and vestibular examination and neuroimaging as required. Results There were 69 women and 31 men. Their ages ranged between 28 and 73 (mean 42.48 years. Provisional videonystagmography (VNG results were: 40% benign paroxysmal positional vertigo (BPPV, 23% suspicious of central causes, 18% undiagnosed, 15% Meniere disease, and 4% vestibular neuronitis. Patients with an unclear diagnosis or central features (41 had magnetic resonance imaging (MRI and Doppler studies. Combining data from history, VNG, and imaging studies, 23 patients (23% were diagnosed as having a central vestibular lesion (10 with generalized ischemia/vertebra basilar insufficiency, 4 with multiple sclerosis, 4 with migraine vestibulopathy, 4 with phobic postural vertigo, and 1 with hyperventilation-induced nystagmus. Conclusions Combining a careful history with clinical examination, VNG, MRI, and Doppler studies decreases the number of undiagnosed cases and increases the detection of possible central lesions.

  10. Vestibular neuritis: three-dimensional videonystagmography and vestibular evoked myogenic potential results. (United States)

    Chen, C W; Young, Y H; Wu, C H


    Eight patients diagnosed with vestibular neuritis received the newly developed three-dimensional videonystagmography (3D VNG) and vestibular evoked myogenic potential (VEMP) examination in order to localize the lesion site. Two (25%) of the 8 patients exhibited spontaneous nystagmus with 3 components, indicating that both the horizontal semicircular canal (HSCC) and anterior semicircular canal (ASCC) were affected. The remaining 6 patients (75%) displayed only horizontal nystagmus, meaning that only the HSCC was involved. Seven (88%) of the 8 patients had bilateral normal VEMPs, revealing sparing of the posterior semicircular canal (PSCC). In a comparative study, another seven patients with vestibular neuritis 1 year post-treatment also received the caloric test, 3D VNG and VEMP examination. Only one patient exhibited spontaneous nystagmus. An absent caloric response of the lesioned side persisted in 5 (71%) of the 7 patients. However, all patients showed normal VEMPs bilaterally. 3D VNG and VEMP examination indicates that vestibular neuritis mainly affects the superior division of the vestibular nerve, which innervates the HSCC and ASCC. Meanwhile, the function of the PSCC and saccule, innervated by the inferior vestibular nerve, is preserved.

  11. Miopatia ocular descendente Descending ocular myopathy: a case report

    Directory of Open Access Journals (Sweden)

    Marcos R. G. de Freitas


    Full Text Available Os autores apresentam caso de paciente jovem, do sexo feminino, com afecção muscular primária ocular e faríngea sem caráter familial. Foram feitos estudos eletromiográficos e histopatológicos musculares que confirmam o caráter miogênico do processo. É feita comparação entre a miopatia ocular e a miopatia ocular descendente, acreditando os autores que seriam variantesThe case of a 23 years old female patient, with primary involvement of the extraocular and faringeal muscles without familiar history is reported. Electromyographic and muscular biopsy studies proved the myogenic nature of the process. A clinical comparison between the ocular myopathy and the descending ocular myopathy is made, the authors thinking that both of them would be variants of the same muscle disease.

  12. Diabetes y enfermedad ocular


    Flores Ojeda, Desireé


    En el presente trabajo se lleva a cabo una revisión bibliográfica de la diabetes en relación con las diferentes patologías oculares a las que está asociada. La diabetes, es una enfermedad crónica que comporta un importante problema sanitario y social, que afecta a muchos órganos. De entre todos ellos, el ojo parece afectarse especialmente por los cambios de glucosa en sangre. Una vez entendida la estructura del ojo humano, el trabajo estudia las partes especialmente afectadas en pacientes ...

  13. Ocular Adnexal Follicular Lymphoma

    DEFF Research Database (Denmark)

    Rasmussen, Peter K; Coupland, Sarah E; Finger, Paul T


    that involved 6 eye cancer centers from January 1, 1980, through December 31, 2010. A total of 105 patients with follicular OAL were identified, of which 7 patients were excluded because of missing clinical data. The median follow-up time was 52 months (range, 13-118 months). MAIN OUTCOMES AND MEASURES Overall...... in conjunction with a concurrent systemic lymphoma, and 10 (10%) presented with an ocular adnexal relapse. The lacrimal gland (28%), conjunctiva (28%), and orbit (28%) were the most frequently involved sites. Of the 69 patients with primary follicular lymphoma, 38 (55%) presented with Ann Arbor stage IE lymphoma...

  14. Vestibular migraine: clinical and epidemiological aspects

    Directory of Open Access Journals (Sweden)

    Ligia Oliveira Gonçalves Morganti

    Full Text Available ABSTRACT INTRODUCTION: Vestibular migraine (VM is one of the most often common diagnoses in neurotology, but only recently has been recognized as a disease. OBJECTIVE: To analyze the clinical and epidemiological profile of patients with VM. METHODS: This was a retrospective, observational, and descriptive study, with analysis of patients' records from an outpatient VM clinic. RESULTS: 94.1% of patients were females and 5.9% were males. The mean age was 46.1 years; 65.6% of patients had had headache for a longer period than dizziness. A correlation was detected between VM symptoms and the menstrual period. 61.53% of patients had auditory symptoms, with tinnitus the most common, although tonal audiometry was normal in 68.51%. Vectoelectronystagmography was normal in 67.34%, 10.20% had hyporeflexia, and 22.44% had vestibular hyperreflexia. Electrophysiological assessment showed no abnormalities in most patients. Fasting plasma glucose and glycemic curve were normal in most patients, while the insulin curve was abnormal in 75%. 82% of individuals with MV showed abnormalities on the metabolism of carbohydrates. CONCLUSION: VM affects predominantly middle-aged women, with migraine headache representing the first symptom, several years before vertigo. Physical, auditory, and vestibular evaluations are usually normal. The most frequent vestibular abnormality was hyperreflexia. Most individuals showed abnormality related to carbohydrate metabolism.

  15. Interaural difference values of vestibular evoked myogenic.

    Directory of Open Access Journals (Sweden)

    Marziyeh Moallemi


    Full Text Available Migraine is a neurologic disease, which often is associated with a unilateral headache. Vestibular abnormalities are common in migraine. Vestibular evoked myogenic potentials (VEMPs assess otolith function in particular functional integrity of the saccule and the inferior vestibular nerve. We used VEMP to evaluate if the migraine headache can affect VEMP asymmetry parameters. A total of 25 patients with migraine (22 females and 3 males who were diagnosed according to the criteria of IHS-1988 were enrolled in this cross-sectional study. Control group consisted of 26 healthy participants (18 female and 8 male, without neurotological symptoms and history of migraine. The short tone burst (95 dB nHL, 500 Hz was presented to ears. VEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid (SCM muscle. Although current results showed that the amplitude ratio is greater in migraine patients than normal group, there was no statistical difference between two groups in mean asymmetry parameters of VEMP. Asymmetry measurements in vestibular evoked myogenic potentials probably are not indicators of unilateral deficient in saccular pathways of migraine patients.

  16. Relationships Between Vestibular Measures as Potential Predictors for Spaceflight Sensorimotor Adaptation (United States)

    Clark, T. K.; Peters, B.; Gadd, N. E.; De Dios, Y. E.; Wood, S.; Bloomberg, J. J.; Mulavara, A. P.


    Introduction: During space exploration missions astronauts are exposed to a series of novel sensorimotor environments, requiring sensorimotor adaptation. Until adaptation is complete, sensorimotor decrements occur, affecting critical tasks such as piloted landing or docking. Of particularly interest are locomotion tasks such as emergency vehicle egress or extra-vehicular activity. While nearly all astronauts eventually adapt sufficiently, it appears there are substantial individual differences in how quickly and effectively this adaptation occurs. These individual differences in capacity for sensorimotor adaptation are poorly understood. Broadly, we aim to identify measures that may serve as pre-flight predictors of and individual's adaptation capacity to spaceflight-induced sensorimotor changes. As a first step, since spaceflight is thought to involve a reinterpretation of graviceptor cues (e.g. otolith cues from the vestibular system) we investigate the relationships between various measures of vestibular function in humans. Methods: In a set of 15 ground-based control subjects, we quantified individual differences in vestibular function using three measures: 1) ocular vestibular evoked myogenic potential (oVEMP), 2) computerized dynamic posturography and 3) vestibular perceptual thresholds. oVEMP responses are elicited using a mechanical stimuli approach. Computerized dynamic posturography was used to quantify Sensory Organization Tests (SOTs), including SOT5M which involved performing pitching head movements while balancing on a sway-reference support surface with eyes closed. We implemented a vestibular perceptual threshold task using the tilt capabilities of the Tilt-Translation Sled (TTS) at JSC. On each trial, the subject was passively roll-tilted left ear down or right ear down in the dark and verbally provided a forced-choice response regarding which direction they felt tilted. The motion profile was a single-cycle sinusoid of angular acceleration with a

  17. Ocular defects in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Katoch Sabita


    Full Text Available There is a high prevalence of ocular defects in children with developmental disabilities. This study evaluated visual disability in a group of 200 cerebral palsy (CP patients and found that 68% of the children had significant visual morbidity. These findings emphasize the need for an early ocular examination in patients with CP.

  18. Ocular leech infestation

    Directory of Open Access Journals (Sweden)

    Lee YC


    Full Text Available Yueh-Chang Lee, Cheng-Jen Chiu Department of Ophthalmology, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan, ROC Abstract: This case report describes a female toddler with manifestations of ocular leech infestation. A 2-year-old girl was brought to our outpatient clinic with a complaint of irritable crying after being taken to a stream in Hualien 1 day previous, where she played in the water. The parents noticed that she rubbed her right eye a lot. Upon examination, the girl had good fix and follow in either eye. Slit-lamp examination showed conjunctival injection with a moving dark black–brown foreign body partly attached in the lower conjunctiva. After applying topical anesthetics, the leech, measuring 1 cm in length, was extracted under a microscope. The patient began using topical antibiotic and corticosteroid agents. By 1 week after extraction, the patient had no obvious symptoms or signs, except for a limited subconjunctival hemorrhage, and no corneal/scleral involvement was observed. Keywords: leech, ocular foreign body, conjunctival reaction, pediatric ophthalmology

  19. Being reflexive in qualitative grounded theory: discussion and application of a model of reflexivity. (United States)

    Engward, Hilary; Davis, Geraldine


    A discussion of the meaning of reflexivity in research with the presentation of examples of how a model of reflexivity was used in a grounded theory research project. Reflexivity requires the researcher to make transparent the decisions they make in the research process and is therefore important in developing quality in nursing research. The importance of being reflexive is highlighted in the literature in relation to nursing research, however, practical guidance as to how to go about doing research reflexively is not always clearly articulated. This is a discussion paper. The concept of reflexivity in research is explored using the Alvesson and Skoldberg model of reflexivity and practical examples of how a researcher developed reflexivity in a grounded theory project are presented. Nurse researchers are encouraged to explore and apply the concept of reflexivity in their research practices to develop transparency in the research process and to increase robustness in their research. The Alvesson and Skoldberg model is of value in applying reflexivity in qualitative nursing research, particularly in grounded theory research. Being reflexive requires the researcher to be completely open about decisions that are made in the research process. The Alvesson and Skolberg model of reflexivity is a useful model that can enhance reflexivity in the research process. It can be a useful practical tool to develop reflexivity in grounded theory research. © 2015 John Wiley & Sons Ltd.

  20. Integrating Reflexivity in Livelihoods Research

    DEFF Research Database (Denmark)

    Prowse, Martin


    Much poverty and development research is not explicit about its methodology or philosophical foundations. Based on the extended case method of Burawoy and the epistemological standpoint of critical realism, this paper discusses a methodological approach for reflexive inductive livelihoods research...... that overcomes the unproductive social science dualism of positivism and social constructivism. The approach is linked to a conceptual framework and a menu of research methods that can be sequenced and iterated in light of research questions....

  1. Vestibular evaluation in children with otitis media with effusion. (United States)

    Kolkaila, E A; Emara, A A; Gabr, T A


    Fifty per cent of children with serous otitis media may have some balance disturbances. To evaluate vestibular function in children with otitis media with effusion. The control group comprised 25 children with bilateral normal hearing and middle-ear function. The study group consisted of 30 children with bilateral otitis media with effusion; these were divided into 2 subgroups according to air-bone gap size. Measures included the Arabic Dizziness Handicap Inventory, an imbalance evaluation sheet for children, vestibular bedside tests for children, and air- and bone-conducted vestibular-evoked myogenic potential testing. Arabic Dizziness Handicap Inventory scores and some vestibular bedside test results were significantly abnormal, with normal video-nystagmography results, in children with otitis media with effusion. Air-conducted vestibular-evoked myogenic potentials were recorded in 73 per cent of children with otitis media with effusion, with significantly delayed latencies. Bone-conducted vestibular-evoked myogenic potentials were successfully detected in 100 per cent of children with otitis media with effusion with similar results to the control group. The Arabic Dizziness Handicap Inventory and vestibular bedside tests are valuable tools for detecting vestibular impairment in children. Bone-conducted vestibular-evoked myogenic potentials are useful for vestibular system evaluation.

  2. Reflex syncope: Diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Richard Sutton


    Full Text Available For the diagnosis of reflex syncope, diligent history-building with the patient and a witness is required. In the Emergency Department (ED, the assessment of syncope is a challenge which may be addressed by an ED Observation Unit or by a referral to a Syncope Unit. Hospital admission is necessary for those with life-threatening cardiac conditions although risk stratification remains an unsolved problem. Other patients may be investigated with less urgency by carotid sinus massage (>40 years, tilt testing, and electrocardiogram loop recorder insertion resulting in a clear cause for syncope. Management includes, in general terms, patient education, avoidance of circumstances in which syncope is likely, increase in fluid and salt consumption, and physical counter-pressure maneuvers. In older patients, those that will benefit from cardiac pacing are now well defined. In all patients, the benefit of drug therapy is often disappointing and there remains no ideal drug. A role for catheter ablation may emerge for the highly symptomatic reflex syncope patient. Keywords: Cardiac pacing, Catheter ablation, Diagnosis, Drugs, Management, Reflex syncope

  3. Review of external ocular compression: clinical applications of the ocular pressure estimator

    Directory of Open Access Journals (Sweden)

    Korenfeld MS


    during three additional compressions. After a 5-minute period, the surgeons were asked to reproduce this targeted IOP during subsequent compressions.Results: The mean IOP during the “sleep session” was 22±5 mmHg (SEM. The mean peak pressure was 40±11 mmHg (SEM and the mean trough pressure was 15±2 mmHg (SEM. There was a 78% agreement between the eye that was reported to be dependent during sleep and the eye with the larger vertical cup-to-disc ratio, for eyes with at least a 0.10 cup-to-disc ratio difference, P=0.001, n=137. The OPE estimated an average induced IOP during typical DOM of 104±8 mmHg (SEM, with each compression having an average range of 17±3 mmHg (SEM. After coaching, and a 5-minute waiting period, the average induced IOP reduced to 95±3 mmHg (SEM with a reduced average range of IOP to 11±1 mmHg.Conclusion: The OPE was successfully used to estimate the IOP while subjects experienced EOC during normal sleep postures. These EOC-induced elevations of IOP were considerable, and likely contribute to significant ocular pathology, not only for glaucoma, but for retinal vascular occlusive diseases, retinal vascular leakage, and the induction of the ocular-cardiac reflex in infants, as well. The correlation of a larger vertical cup-to-disc ratio in patients with a sleep posture preference suggests a causal relationship, since patients with other conditions known to be associated with cup-to disc ratio asymmetry were excluded from this study. The OPE is a useful device to teach DOM to surgeons and patients for home use. Keywords: sleep posture, intraocular pressure, nocturnal, cup-to-disc ratio asymmetry, glaucoma, digital ocular massage

  4. Exhibition of Stochastic Resonance in Vestibular Perception (United States)

    Galvan-Garza, R. C.; Clark, T. K.; Merfeld, D. M.; Bloomberg, J. J.; Oman, C. M.; Mulavara, A. P.


    Astronauts experience sensorimotor changes during spaceflight, particularly during G-transitions. Post flight sensorimotor changes include spatial disorientation, along with postural and gait instability that may degrade operational capabilities of the astronauts and endanger the crew. A sensorimotor countermeasure that mitigates these effects would improve crewmember safety and decrease risk. The goal of this research is to investigate the potential use of stochastic vestibular stimulation (SVS) as a technology to improve sensorimotor function. We hypothesize that low levels of SVS will improve sensorimotor perception through the phenomenon of stochastic resonance (SR), when the response of a nonlinear system to a weak input signal is enhanced by the application of a particular nonzero level of noise. This study aims to advance the development of SVS as a potential countermeasure by 1) demonstrating the exhibition of stochastic resonance in vestibular perception, a vital component of sensorimotor function, 2) investigating the repeatability of SR exhibition, and 3) determining the relative contribution of the semicircular canals (SCC) and otolith (OTO) organs to vestibular perceptual SR. A constant current stimulator was used to deliver bilateral bipolar SVS via electrodes placed on each of the mastoid processes, as previously done. Vestibular perceptual motion recognition thresholds were measured using a 6-degree of freedom MOOG platform and a 150 trial 3-down/1-up staircase procedure. In the first test session, we measured vestibular perceptual thresholds in upright roll-tilt at 0.2 Hz (SCC+OTO) with SVS ranging from 0-700 µA. In a second test session a week later, we re-measured roll-tilt thresholds with 0, optimal (from test session 1), and 1500 µA SVS levels. A subset of these subjects, plus naive subjects, participated in two additional test sessions in which we measured thresholds in supine roll-rotation at 0.2 Hz (SCC) and upright y-translation at 1 Hz

  5. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. (United States)

    Curthoys, Ian S; Manzari, Leonardo


    Through selective tests of the function of the canal and otolith sense organs, it is possible to assert that patient conditions are purely otolithic and that the canals are not involved. The video head impulse test selectively tests each semicircular canal; the ocular vestibular-evoked myogenic potential to 500 Hz Fz (Fz is the location on the forehead in the midline at the hairline) bone-conducted vibration (BCV) selectively tests the utricular macula and the cervical vestibular-evoked myogenic potential to 500 Hz Fz BCV selectively tests the saccular macula. The development of new specific tests of otolith function has shown that some patients may have specific deficits of just otolithic function. In the authors' experience, patients who complain strongly of postural unsteadiness should be suspected to have otolithic deficits. They may also have vertigo and in some cases have spontaneous nystagmus of peripheral origin, even though their semicircular canal function is normal. The prognosis for such patients is good. They usually appear to regain their postural stability spontaneously over weeks (or longer), even though they still have an otolithic deficit as shown by objective tests when they are free of symptoms. It is not known what procedures may accelerate the recovery of otolith function. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Gene therapy for ocular diseases. (United States)

    Liu, Melissa M; Tuo, Jingsheng; Chan, Chi-Chao


    The eye is an easily accessible, highly compartmentalised and immune-privileged organ that offers unique advantages as a gene therapy target. Significant advancements have been made in understanding the genetic pathogenesis of ocular diseases, and gene replacement and gene silencing have been implicated as potentially efficacious therapies. Recent improvements have been made in the safety and specificity of vector-based ocular gene transfer methods. Proof-of-concept for vector-based gene therapies has also been established in several experimental models of human ocular diseases. After nearly two decades of ocular gene therapy research, preliminary successes are now being reported in phase 1 clinical trials for the treatment of Leber congenital amaurosis. This review describes current developments and future prospects for ocular gene therapy. Novel methods are being developed to enhance the performance and regulation of recombinant adeno-associated virus- and lentivirus-mediated ocular gene transfer. Gene therapy prospects have advanced for a variety of retinal disorders, including retinitis pigmentosa, retinoschisis, Stargardt disease and age-related macular degeneration. Advances have also been made using experimental models for non-retinal diseases, such as uveitis and glaucoma. These methodological advancements are critical for the implementation of additional gene-based therapies for human ocular diseases in the near future.

  7. Cost-effective analysis of unilateral vestibular weakness investigation. (United States)

    Gandolfi, Michele M; Reilly, Erin K; Galatioto, Jessica; Judson, Randy B; Kim, Ana H


    To evaluate the cost-effectiveness of obtaining a magnetic resonance imaging (MRI) in patients with abnormal electronystagmography (ENG) or videonystagmography (VNG) results. Retrospective chart review. Academic specialty center. Patients presenting with vertigo between January 1, 2010, and August 30, 2013. Patients who fit the following abnormal criteria were included in the study: unilateral caloric weakness (≥20%), abnormal ocular motor testing, and nystagmus on positional testing. Patients with abnormal findings who then underwent MRI with gadolinium were evaluated. Of the 1,996 charts reviewed, there were 1,358 patients who met the inclusion criteria. The average age of these patients was 62 years (12-94 yr). The male:female ratio was approximately 1:2. Of the 1,358 patients, 253 received an MRI with the following pathologies: four vestibular schwannomas, three subcortical/periventricular white matter changes suspicious for demyelinating disease, four acute cerebellar/posterior circulation infarct, two vertebral artery narrowing, one pseudomeningocele of internal auditory canal, and two white matter changes indicative of migraines. The positive detection rate on MRI was 5.5% based on MRI findings of treatable pathologies causing vertigo. Average cost of an MRI is $1,200, thereby making the average cost of identifying a patient with a positive MRI finding $15,180. In our study, those patients with a positive MRI had a constellation of symptoms and findings (asymmetric sensorineural hearing loss, tinnitus, vertigo, and abnormal ENG/VNG). Cost-effectiveness can be improved by ordering an MRI only when clinical examination and VNG point toward a central pathology. Clinical examination and appropriate testing should be factored when considering the cost-effectiveness of obtaining an MRI in patients with abnormal ENG/VNG findings.

  8. Ocular tuberculosis: current perspectives

    Directory of Open Access Journals (Sweden)

    Shakarchi FI


    Full Text Available Faiz I Shakarchi1,21Ibn Al-Haetham Teaching Eye Hospital, 2Department of Opthalmology, Medical College, Al-Mustansiriya University, Baghdad, IraqAbstract: The World Health Organization currently estimates that nearly two billion people, or one-third of the world’s population, are infected by tuberculosis, and that roughly 10% of the infected people are symptomatic. Tuberculosis affects the lungs in 80% of patients, while in the remaining 20% the disease may affect other organs, including the eye. Uveitis can be seen concurrently with tuberculosis, but a direct association is difficult to prove. Ocular tuberculosis is usually not associated with clinical evidence of pulmonary tuberculosis, as up to 60% of extrapulmonary tuberculosis patients may not have pulmonary disease. The diagnosis of tuberculous uveitis is often problematic and in nearly all reported cases, the diagnosis was only presumptive. Tuberculous uveitis is a great mimicker of various uveitis entities and it can be considered in the differential diagnosis of any type of intraocular inflammation. It is still unknown if ocular manifestations result from a direct mycobacterium infection or hypersensitivity reaction and this is reflected on the management of tuberculous uveitis. Prevalence of tuberculosis as an etiology of uveitis may reach up to 10% in endemic areas. Tuberculous uveitis is a vision-threatening disease that inevitably leads to blindness if not properly diagnosed and treated. The aim of this review is to illustrate the various clinical features and management of presumed tuberculous uveitis. The current review focuses on the diagnostic criteria, significance of tuberculin skin test, and use of systemic corticosteroids in the management of tuberculous uveitis as recommended in recent publications.Keywords: tuberculosis, uveitis, choroiditis, tuberculin skin test

  9. Evaluation of postural control in unilateral vestibular hypofunction

    Directory of Open Access Journals (Sweden)

    Rafaela Maia Quitschal


    Full Text Available INTRODUCTION: Patients with vestibular hypofunction, a typical finding in peripheral vestibular disorders, show body balance alterations. OBJECTIVE: To evaluate the postural control of patients with vertigo and unilateral vestibular hypofunction. METHOD: This is a clinical cross-sectional study. Twenty-five patients with vertigo and unilateral vestibular hypofunction and a homogeneous control group consisting of 32 healthy individuals were submitted to a neurotological evaluation including the Tetrax Interactive Balance System posturography in eight different sensory conditions. RESULTS: For different positions, vertiginous patients with unilateral vestibular hypofunction showed significantly higher values of general stability index, weight distribution index, right/left and tool/heel synchronizations, Fourier transformation index and fall index than controls. CONCLUSION: Increased values in the indices of weight distribution, right/left and tool/heel synchronizations, Fourier transformation and fall risk characterize the impairment of postural control in patients with vertigo and unilateral vestibular hypofunction.

  10. Função vestibular no acidente vascular cerebral do território carot��deo Vestibular function in carotid territory stroke patients

    Directory of Open Access Journals (Sweden)

    Anna Paula Batista de Ávila Pires


    Full Text Available Pacientes após Acidente Vascular Cerebral (AVC podem apresentar sintomas otoneurológicos. OBJETIVO: Avaliar a função vestibular de pacientes com antecedente pessoal de AVC no território carotídeo. Desenho científico: estudo de coorte histórica com corte transversal. MÉTODO: Quarenta pacientes foram submetidos à anamnese, exame otorrinolaringológico, Dizziness Handicap Inventory e vectoeletronistagmografia. RESULTADOS: Anormalidades discretas dos movimentos sacádicos foram encontradas em 20 pacientes (50,0%; nove referiram desequilíbrio e um tontura. O ganho do rastreio pendular foi anormal em 17 casos (42,5%; seis referiram desequilíbrio e um tontura. Preponderância direcional anormal do nistagmoperrotatório ocorreu em dois casos (5,0%, que referiram desequilíbrio. A prova calórica identificou três casos (7,5% com predomínio labiríntico anormal e dois (5,0% com preponderância direcional anormal do nistagmo; os cinco casos relataram desequilíbrio. Dos 11 pacientes que não referiram manifestações de alteração do equilíbrio corporal, 10 apresentaram alterações nos movimentos sacádicos e no rastreio pendular e um apresentou exame vestibular normal. CONCLUSÃO: Pacientes com antecedente pessoal de AVC no território carotídeo podem apresentar tontura ou desequilíbrio corporal e sinais de comprometimento da motilidade ocular e da função vestibular.Stroke patients may present otoneurological symptoms. OBJECTIVE: To assess the vestibular function of subjects with a history of carotid territory stroke. METHOD: This historical cohort cross sectional study enrolled 40 patients; subjects answered the Dizziness Handicap Inventory, were interviewed and submitted to ENT examination and vectorelectronystagmography. RESULTS: Mild saccadic movement anomalies were seen in 20 patients (50.0%; nine complained of imbalance and dizziness. Abnormal smooth pursuit gain was seen in 17 cases (42.5%; six subjects reported imbalance and

  11. Ivane S. Beritashvili (1884-1974): from spinal cord reflexes to image-driven behavior. (United States)

    Tsagareli, M G; Doty, R W


    Ivane Beritashvili ("Beritoff" in Russian, and often in Western languages) was a major figure in 20th-century neuroscience. Mastering the string galvanometer, he founded the electrophysiology of spinal cord reflexes, showing that inhibition is a distinctly different process from excitation, contrary to the concepts of his famous mentor, Wedensky. Work on postural reflexes with Magnus was cut short by World War I, but he later demonstrated that navigation in two-dimensional space without vision is a function solely of the vestibular system rather than of muscle proprioception. Persevering in his experiments despite postwar turmoil he founded an enduring Physiology Institute in Tbilisi, where he pursued an ingenious and extensive investigation of comparative memory in vertebrates. This revealed the unique nature of mammalian memory processes, which he forthrightly called "image driven," and distinguished them unequivocally from those underlying conditional reflexes. For some 30 years the Stalinist terror confined his publications to the Russian language. Work with his colleague, Chichinadze, discovering that memory confined to one cerebral hemisphere could be accessed by the other via a specific forebrain commissure, did reach the West, and ultimately led to recognition of the fascinating "split brain" condition. In the 1950s he was removed from his professorial position for 5 years as being "anti-Pavlovian." Restored to favor, he was honorary president of the "Moscow Colloquium" that saw the foundation of the International Brain Research Organization.

  12. Ocular myasthenia gravis: A review (United States)

    Nair, Akshay Gopinathan; Patil-Chhablani, Preeti; Venkatramani, Devendra V; Gandhi, Rashmin Anilkumar


    Myasthenia gravis (MG) is a disease that affects the neuro-muscular junction resulting in classical symptoms of variable muscle weakness and fatigability. It is called the great masquerader owing to its varied clinical presentations. Very often, a patient of MG may present to the ophthalmologist given that a large proportion of patients with systemic myasthenia have ocular involvement either at presentation or during the later course of the disease. The treatment of ocular MG involves both the neurologist and ophthalmologist. Thus, the aim of this review was to highlight the current diagnosis, investigations, and treatment of ocular MG. PMID:25449931

  13. Acesso à universidade pública através de cotas: uma reflexão a partir da percepção dos alunos de um pré-vestibular inclusivo Acceso a la universidad pública a través de cuotas Quotas for assessing public university: una reflexión a partir de la percepción de los alumnos de un programa preuniversitario inclusivo

    Directory of Open Access Journals (Sweden)

    Simão Dias Vasconcelos


    Full Text Available Cotas para acesso ao ensino superior têm sido implementadas sem o merecido debate com os diversos segmentos envolvidos, incluindo os professores e os candidatos à universidade. Nessa pesquisa, procuramos conhecer a percepção de alunos de um pré-vestibular inclusivo sobre a implantação de cotas. A maioria dos estudantes posicionou-se favorável, e prioriza cotas para ex-alunos de escolas públicas em vez de minorias baseadas na raça/cor. Mais da metade dos entrevistados demonstra interesse em se beneficiar das cotas, desde que na categoria de egressos de escola pública. Esses mesmos alunos considerariam injusta a entrada de outro candidato beneficiado por cotas com média inferior à sua, se isso representasse sua exclusão da universidade. Discute-se no artigo a inadequação de um sistema de cotas baseados na cor da pele, um critério reconhecidamente sujeito a falhas e preconceitos. Pretende-se estimular o debate sobre formas alternativas de ampliar o acesso à universidade pública, tais como cursos pré-vestibulares inclusivos que têm aumentado a competitividade de alunos da rede pública.Cuotas para acceso a la enseñanza superior han sido implantadas sin el merecido debate con los segmentos envueltos, incluyendo los profesores y los candidatos a la universidad. En esta investigación, buscamos conocer la percepción de alumnos de un programa pre-universitario inclusivo sobre la implantación de las cuotas. La mayoría de los estudiantes es favorable, y prioriza cuotas para egresos de las escuelas públicas en lugar de minorías basadas en la raza/color. Más de la mitad de los entrevistados tiene interés en beneficiarse de las cuotas, si fueran de la categoría de egresos de escuela pública. Los mismos alumnos considerarían injusto el ingreso de otro candidato beneficiado por cuotas con nota inferior a la suya si eso representara su exclusión de la universidad. Se discute en este artículo la inadecuación de un sistema de

  14. Bedside examination for vestibular screening in occupational medicine. (United States)

    Zamysłowska-Szmytke, Ewa; Szostek-Rogula, Sylwia; Śliwińska-Kowalska, Mariola


    The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG) oculomotor tests (central group) and 43 subjects with normal VNG. Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT), Dynamic Visual Acuity (DVA) and gaze nystagmus assessment. Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73%) had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests. The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  15. Bedside examination for vestibular screening in occupational medicine

    Directory of Open Access Journals (Sweden)

    Ewa Zamysłowska-Szmytke


    Full Text Available Objectives: The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG oculomotor tests (central group and 43 subjects with normal VNG. Material and Methods: Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT, Dynamic Visual Acuity (DVA and gaze nystagmus assessment. Results: Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73% had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests. Conclusions: The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes.

  16. Complications of microsurgery of vestibular schwannoma

    Czech Academy of Sciences Publication Activity Database

    Betka, J.; Zvěřina, E.; Balogová, Zuzana; Profant, Oliver; Skřivan, J.; Kraus, J.; Lisý, J.; Syka, Josef; Chovanec, M.


    Roč. 2014, May 28 (2014), s. 315952 ISSN 2314-6133 R&D Projects: GA MZd NT12459 Grant - others:GA MZd(CZ) NT11543; GA MŠk(CZ) UNCE 204013; GA UK(CZ) SVV 266513; GA MŠk(CZ) Prvouk-P27/LF1/1 Institutional support: RVO:68378041 Keywords : acoustic neurona surgery * tumor surgery * vestibular schwannomas Subject RIV: FF - HEENT, Dentistry Impact factor: 1.579, year: 2014

  17. Two ways to support reflexivity

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine; Knudsen, Hanne


    A current challenge to public managers is the lack of a well-defined role. How can master’s programmes prepare managers to live up to an undefined function? In this paper we argue that the lack of role description enhances the need for reflexivity and show how it is done at Master in Educational...... Management (MEM). MEM provides the participating managers with a new language that can give them a critical distance to the overload of expectations they meet at work and MEM teaches the participants to translate this new language into practice. The pedagogy used for this is labelled ‘experimental management...

  18. Bernstein Lethargy Theorem and Reflexivity


    Aksoy, Asuman Güven; Peng, Qidi


    In this paper, we prove the equivalence of reflexive Banach spaces and those Banach spaces which satisfy the following form of Bernstein's Lethargy Theorem. Let $X$ be an arbitrary infinite-dimensional Banach space, and let the real-valued sequence $\\{d_n\\}_{n\\ge1}$ decrease to $0$. Suppose that $\\{Y_n\\}_{n\\ge1}$ is a system of strictly nested subspaces of $X$ such that $\\overline Y_n \\subset Y_{n+1}$ for all $n\\ge1$ and for each $n\\ge1$, there exists $y_n\\in Y_{n+1}\\backslash Y_n$ such that ...

  19. Radiotherapy for Vestibular Schwannomas: A Critical Review

    International Nuclear Information System (INIS)

    Murphy, Erin S.; Suh, John H.


    Vestibular schwannomas are slow-growing tumors of the myelin-forming cells that cover cranial nerve VIII. The treatment options for patients with vestibular schwannoma include active observation, surgical management, and radiotherapy. However, the optimal treatment choice remains controversial. We have reviewed the available data and summarized the radiotherapeutic options, including single-session stereotactic radiosurgery, fractionated conventional radiotherapy, fractionated stereotactic radiotherapy, and proton beam therapy. The comparisons of the various radiotherapy modalities have been based on single-institution experiences, which have shown excellent tumor control rates of 91-100%. Both stereotactic radiosurgery and fractionated stereotactic radiotherapy have successfully improved cranial nerve V and VII preservation to >95%. The mixed data regarding the ideal hearing preservation therapy, inherent biases in patient selection, and differences in outcome analysis have made the comparison across radiotherapeutic modalities difficult. Early experience using proton therapy for vestibular schwannoma treatment demonstrated local control rates of 84-100% but disappointing hearing preservation rates of 33-42%. Efforts to improve radiotherapy delivery will focus on refined dosimetry with the goal of reducing the dose to the critical structures. As future randomized trials are unlikely, we suggest regimented pre- and post-treatment assessments, including validated evaluations of cranial nerves V, VII, and VIII, and quality of life assessments with long-term prospective follow-up. The results from such trials will enhance the understanding of therapy outcomes and improve our ability to inform patients.

  20. Audiovestibular Function Deficits in Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Constantin von Kirschbaum


    Full Text Available Introduction. Vestibular schwannomas (VS are benign tumours of the vestibular nerve and can lead to hearing loss, tinnitus, vertigo, facial palsy, and brainstem compression. Audiovestibular diagnostic tests are essential for detection and treatment planning. Methods. Medline was used to perform a systematic literature review with regard to how audiovestibular test parameters correlate with symptoms, tumour size, and tumour location. Results. The auditory brainstem response can be used to diagnose retrocochlear lesions caused by VS. Since hearing loss correlates poorly with tumour size, a retrocochlear lesion is probably not the only cause for hearing loss. Also cochlear mechanisms seem to play a role. This can be revealed by abnormal otoacoustic emissions, despite normal ABR and new MRI techniques which have demonstrated endolymphatic hydrops of the inner ear. Caloric and head impulse tests show frequency specific dynamics and vestibular evoked myogenic potentials may help to identify the location of the tumour regarding the involved nerve parts. Conclusion. In order to preserve audiovestibular function in VS, it is important to stop the growth of the tumour and to avoid degenerative changes in the inner ear. A detailed neurotological workup helps to diagnose VS of all sizes and can also provide useful prognostic information.

  1. Ocular Tropism of Respiratory Viruses (United States)

    Rota, Paul A.; Tumpey, Terrence M.


    SUMMARY Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism. PMID:23471620

  2. Cervical Vestibular Evoked Myogenic Potential in Hypoglossal Nerve Schwannoma: A Case Report. (United States)

    Rajasekaran, Aravind Kumar; Savardekar, Amey Rajan; Shivashankar, Nagaraja Rao


    Schwannoma of the hypoglossal nerve is rare. This case report documents an atypical abnormality of the cervical vestibular evoked myogenic potential (cVEMP) in a patient with schwannoma of the hypoglossal nerve. The observed abnormality was attributed to the proximity of the hypoglossal nerve to the spinal accessory nerve in the medullary cistern and base of the skull. To report cVEMP abnormality in a patient with hypoglossal nerve schwannoma and provide an anatomical correlation for this abnormality. Case report. A 44-yr-old woman. Pure-tone and speech audiometry, tympanometry, acoustic stapedial reflex, auditory brainstem response, and cVEMP testing were performed. The audiological test results were normal except for the absence of cVEMP on the lesion side (right). A cVEMP abnormality indicating a compromised spinal accessory nerve was observed in a patient with hypoglossal nerve schwannoma. This case report highlights the importance of recording cVEMP in relevant neurological conditions and provides clinical proof for the involvement of the spinal accessory nerve in the vestibulocollic reflex pathway. American Academy of Audiology

  3. Ocular Effects of Sulfur Mustard

    Directory of Open Access Journals (Sweden)

    Yunes Panahi


    Full Text Available Purpose: To review current knowledge about ocular effects of sulfur mustard (SM and the associated histopathologic findings and clinical manifestationsMethods: Literature review of medical articles (human and animal studies was accomplished using PubMed, Scopus and ISI databases. A total of 274 relevant articles in English were retrieved and reviewed thoroughly.Results: Eyes are the most sensitive organs to local toxic effects of mustard gas. Ocular injuries are mediated through different toxic mechanisms including: biochemical damages, biomolecular and gene expression modification, induction of immunologic and inflammatory reactions, disturbing ultrastructural architecture of the cornea, and long-lasting corneal denervation. The resulting ocular injuries can roughly be categorized into acute or chronic complications. Most of the patients recover from acute injuries, but a minority of victims will suffer from chronic ocular complications. Mustard gas keratopathy (MGK is a devastating late complication of SM intoxication that proceeds from limbal stem cell deficiency (LSCD.Conclusion: SM induces several different damaging changes in case of ocular exposure; hence leading to a broad spectrum of ocular manifestations in terms of severity, timing and form. Unfortunately, no effective strategy has been introduced yet to inhibit or restore these damaging changes.

  4. Traumatismos oculares en el deporte

    Directory of Open Access Journals (Sweden)

    Javier Elizalde


    Full Text Available Los traumatismos oculares durante la práctica deportiva son relativamente frecuentes, pueden acontecer en el contexto de cualquier deporte y son muy variados, tanto en su origen, gravedad y forma de presentación clínica (traumatismos incisos, contusos o inciso-contusos. A pesar de que el diagnóstico precoz y un tratamiento adecuado a cargo de un oftalmólogo especialista suele ayudar a mejorar el pronóstico de estos casos, es cierto que en algunas situaciones las lesiones oculares secundarias al traumatismo son clínicamente irreversibles. El autor revisa la repercusión clínica ocular de los accidentes deportivos con compromiso de la órbita, de los párpados, del segmento anterior y/o posterior del globo ocular, y de las vías ópticas. La mayoría de estas lesiones se pueden evitar optimizando el estado físico (y ocular antes de la práctica deportiva, y utilizando la técnica y el material adecuado para cada situación. Asimismo una buena educación deportiva desde la infancia y la utilización de gafas de protección ocular adaptadas a cada deporte juegan un papel esencial en la prevención de estos accidentes.

  5. Ocular allergy latin american consensus

    Directory of Open Access Journals (Sweden)

    Myrna Serapião dos Santos


    Full Text Available PURPOSE: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. METHODS: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes. RESULTS: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. CONCLUSION: The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.

  6. Vestibular evoked myogenic potentials and digital vectoelectronystagmography's study in patients with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Lira-Batista, Marta Maria da Silva


    Full Text Available Introduction: Benign Paroxysmal Positional Vertigo (BPPV is a very common vestibular disorder characterized by brief but intense attacks of rotatory vertigo triggered by simple rapid movement of the head. The integrity of the vestibular pathways can be assessed using tests such as digital vectoelectronystagmography (VENG and vestibular evoked myogenic potentials (VEMP. Aim: This study aimed to determine the VEMP findings with respect to latency, amplitude, and waveform peak to peak and the results of the oculomotor and vestibular components of VENG in patients with BPPV. Method: Although this otoneurological condition is quite common, little is known of the associated VEMP and VENG changes, making it important to research and describe these results. Results: We examined the records of 4438 patients and selected 35 charts after applying the inclusion and exclusion criteria. Of these, 26 patients were women and 9 men. The average age at diagnosis was 52.7 years, and the most prevalent physiological cause, accounting for 97.3% of cases, was ductolithiasis. There was a statistically significant association between normal hearing and mild contralateral sensorineural hearing loss. The results of the oculomotor tests were within the normal reference ranges for all subjects. Patients with BPPV exhibited symmetrical function of the semicircular canals in their synergistic pairs (p < 0.001. The caloric test showed statistically normal responses from the lateral canals. The waveforms of all patients were adequate, but the VEMP results for the data-crossing maneuver with positive positioning showed a trend toward a relationship for the left ear Lp13. There was also a trend towards an association between normal reflexes in the caloric test and the inter-peak VEMP of the left ear. It can be concluded that although there are some differences between the average levels of the VENG and VEMP results, these differences were not statistically significant

  7. Ocular TRUST: nationwide antimicrobial susceptibility patterns in ocular isolates. (United States)

    Asbell, Penny A; Colby, Kathryn A; Deng, Sophie; McDonnell, Peter; Meisler, David M; Raizman, Michael B; Sheppard, John D; Sahm, Daniel F


    Ocular Tracking Resistance in U.S. Today (TRUST) annually evaluates in vitro antimicrobial susceptibility of Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae to ciprofloxacin, gatifloxacin, levofloxacin, moxifloxacin, penicillin, azithromycin, tobramycin, trimethoprim, and polymyxin B in national samples of ocular isolates. Laboratory investigation. Prospectively collected ocular isolates (197 S. aureus, 49 S. pneumoniae, and 32 H. influenzae) from 35 institutions and archived ocular isolates (760 S. pneumoniae and 356 H. influenzae) from 34 institutions were tested by an independent, central laboratory. Mean minimum inhibitory concentrations that would inhibit growth of 90% of the tested isolates (MIC(90)) were interpreted as susceptible, intermediate, or resistant according to standardized breakpoints for systemic treatment. S. aureus isolates were classified as methicillin susceptible (MSSA) or methicillin resistant (MRSA). MSSA or MRSA susceptibility patterns were virtually identical for the fluoroquinolones, that is, MSSA susceptibility was 79.9% to 81.1% and MRSA susceptibility was 15.2%. Trimethoprim was the only agent tested with high activity against MRSA. All S. pneumoniae isolates were susceptible to gatifloxacin, levofloxacin, and moxifloxacin; 89.8% were susceptible to ciprofloxacin. H. influenzae isolates were 100% susceptible to all tested agents but trimethoprim. Ocular TRUST 1 data were consistent with the eight-year longitudinal sample of archived ocular isolates. The fluoroquinolones were consistently active in MSSA, S. pneumoniae, and H. influenzae. After more than a decade of intensive ciprofloxacin and levofloxacin use as systemic therapy, 100% of ocular S. pneumoniae isolates were susceptible to gatifloxacin, levofloxacin, and moxifloxacin; nonsusceptibility to ciprofloxacin was less than 15%. High-level in vitro MRSA resistance suggests the need to consider alternative therapy to fluoroquinolones when MRSA is a

  8. Neurectomia vestibular e coclear no guinea pig vivo: uma via occipital Vestibular and cochlear neurectomy in the alive guinea pig: an occipital approach

    Directory of Open Access Journals (Sweden)

    Ricardo David


    Full Text Available Forma de estudo: Experimental. Objetivo: Este artigo descreve uma nova via cirúrgica para atingir a inervatura vestíbulo-coclear (VIII par no Guinea pig vivo. Essa via é totalmente óssea (exceto o acesso ao próprio osso, o que implica em poucos danos às estruturas nobres do animal, o qual é passível de recuperação para estudos posteriores do sistema vestibular e coclear e todas as suas referências, com o ouvido interno, médio e externo. Conclusão: Mesmo exigindo precisão e controle, dada a proximidade com estruturas vitais, ela se mostra bastante viável do ponto de vista prático e muito menos invasiva e danosa em relação a outras cirurgias realizadas com a mesma finalidade, por permitir exames de imitanciometria, Bera, vemp, reflexos estapediais e do tensor do tímpano, entre outros físicos ou fisioelétricos.Study design: Experimental. Aim: This paper describes a new surgery neurectomy technique to the VIII pair in Guinea pig alive. This is a full boned way, except for the access to the bone itself, what implies in minor damage to important structures of the animal. The animal recuperation is pretty good for later studies of the vestibular and cochlear system, and all its references to inner, middle and external ears. Conclusion: Even though the precision and control necessary, because of the neighbourhoods vital structures, it shows enough availability from the practice sight, and much less invasible and damage than other surgeries with the same finality. It allows imitaciometry, bera, vemp, stapediun and tympanic tensor reflexes and others (physicals or physioelectric.

  9. Radiotherapy in ocular tumours

    International Nuclear Information System (INIS)

    Pinto, J.M.


    Ocular tumours at the Tata Memorial Hospital, Bombay, form about 0.14% of all the proved cancer cases. In case of unilateral retinoblastoma with the other eye being not non-seeing for any reason, enucleation is advised, as the diagnosis may sometimes be in doubt. If after enucleation, optic nerve and/or peribulbar tissues are found to be involved, post-operative irradiation is given to the whole orbit. In bilateral retinoblastoma the more affected eye is enucleated and an attempt is made to preserve vision in the other eye. A tumour dose of 3500 to 4000 rad in about 4 weeks is given with a cobalt beam using a direct anterior field. A cataract that may develop has to be taken care of. Lateral and/or medial fields are used with deep X-rays. In certain cases, an implant of cobalt-60 or gold-198 grain is done. For carcinoma of conjuctiva, small lesions or early lesions are excised and a beta radiation dose of 2000 rad weekly for about 4 to 5 weeks is given; larger lesions require enucleation or exenteration followed by irradiation with super-voltage radiation. Post-irradiation sarcomas may develop many years later. Irradiation is repeated for recurrences. (M.G.B.)

  10. Complications of presumed ocular tuberculosis. (United States)

    Hamade, Issam H; Tabbara, Khalid F


    To determine the effect of steroid treatment on visual outcome and ocular complications in patients with presumed ocular tuberculosis. Retrospective review of patients with presumptive ocular tuberculosis. The clinical diagnosis was made based on ocular findings, positive purified protein derivative (PPD) testing of more than 15 mm induration, exclusion of other causes of uveitis and positive ocular response to anti-tuberculous therapy (ATT) within 4 weeks. Group 1 included patients who had received oral prednisone or subtenon injection of triamcinolone acetonide prior to ATT. Group 2 included patients who did not receive corticosteroid therapy prior to administration of ATT.   Among 500 consecutive new cases of uveitis encountered in 1997-2007 there were 49 (10%) patients with presumed ocular tuberculosis. These comprised 28 (57%) male and 21 (43%) female patients with a mean age of 45 years (range 12-76 years). Four (20%) patients in group 1 had initial visual acuity of 20/40 or better, in comparison to eight (28%) patients in group 2. At 1-year follow-up, six (30%) patients in group 1 had a visual acuity of 20/40 or better compared with 20 (69%) patients in group 2 (p = 0.007). Of 20 eyes (26%) in group 1 that had visual acuity of < 20/50 at 1-year follow up, 14 (70%) eyes developed severe chorioretinal lesion (p = 0.019). Early administration of corticosteroids without anti-tuberculous therapy in presumed ocular tuberculosis may lead to poor visual outcome compared with patients who did not receive corticosteroids prior to presentation. Furthermore, the severity of chorioretinitis lesion in the group of patients given corticosteroid prior to ATT may account for the poor visual outcome. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

  11. Internal Models, Vestibular Cognition, and Mental Imagery: Conceptual Considerations. (United States)

    Mast, Fred W; Ellis, Andrew W


    Vestibular cognition has recently gained attention. Despite numerous experimental and clinical demonstrations, it is not yet clear what vestibular cognition really is. For future research in vestibular cognition, adopting a computational approach will make it easier to explore the underlying mechanisms. Indeed, most modeling approaches in vestibular science include a top-down or a priori component. We review recent Bayesian optimal observer models, and discuss in detail the conceptual value of prior assumptions, likelihood and posterior estimates for research in vestibular cognition. We then consider forward models in vestibular processing, which are required in order to distinguish between sensory input that is induced by active self-motion, and sensory input that is due to passive self-motion. We suggest that forward models are used not only in the service of estimating sensory states but they can also be drawn upon in an offline mode (e.g., spatial perspective transformations), in which interaction with sensory input is not desired. A computational approach to vestibular cognition will help to discover connections across studies, and it will provide a more coherent framework for investigating vestibular cognition.

  12. Translabyrinthine surgery for disabling vertigo in vestibular schwannoma patients

    NARCIS (Netherlands)

    Godefroy, W. P.; Hastan, D.; van der Mey, A. G. L.


    To determine the impact of translabyrinthine surgery on the quality of life in vestibular schwannoma patients with rotatory vertigo. Prospective study in 18 vestibular schwannoma patients. The study was conducted in a multispecialty tertiary care clinic. All 18 patients had a unilateral

  13. Assessment of auditory and vestibular functions in vitiligo patients

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    Eman Abd Elmohsin Dawoud


    Conclusion: The results in this study showed that 50% of vitiligo patients suffered from peripheral vestibular disorders in addition to auditory affection. Vitiligo patients require routine monitoring for auditory and vestibular functions for early identification and monitoring of changes as the disease progress.

  14. Inner ear malformations in siblings presenting with vestibular ...

    African Journals Online (AJOL)

    Although the association between inner ear abnormalities and progressive sensorineural hearing loss is well known, vestibular signs or loss of vestibular function in these ... We provide a brief overview of the latest classification of these inner ear defects as well as a review of the literature pertaining to children with inner ear ...

  15. Body ownership and embodiment: vestibular and multisensory mechanisms. (United States)

    Lopez, C; Halje, P; Blanke, O


    Body ownership and embodiment are two fundamental mechanisms of self-consciousness. The present article reviews neurological data about paroxysmal illusions during which body ownership and embodiment are affected differentially: autoscopic phenomena (out-of-body experience, heautoscopy, autoscopic hallucination, feeling-of-a-presence) and the room tilt illusion. We suggest that autoscopic phenomena and room tilt illusion are related to different types of failures to integrate body-related information (vestibular, proprioceptive and tactile cues) in addition to a mismatch between vestibular and visual references. In these patients, altered body ownership and embodiment has been shown to occur due to pathological activity at the temporoparietal junction and other vestibular-related areas arguing for a key importance of vestibular processing. We also review the possibilities of manipulating body ownership and embodiment in healthy subjects through exposition to weightlessness as well as caloric and galvanic stimulation of the peripheral vestibular apparatus. In healthy subjects, disturbed self-processing might be related to interference of vestibular stimulation with vestibular cortex leading to disintegration of bodily information and altered body ownership and embodiment. We finally propose a differential contribution of the vestibular cortical areas to the different forms of altered body ownership and embodiment.

  16. Vestibular morphology in the German Waltzing guinea pig. (United States)

    Kawaguchi, Sachie; Hultcrantz, Malou; Jin, Zhe; Ulfendahl, Mats; Suzuki, Mamoru


    The German waltzing guinea pig is a special strain of animal with a recessively inherited inner ear defect, resulting in deafness and a severe vestibular dysfunction. The hearing loss in the cochlea of the German strain is a result of a collapse of the Reissner membrane and the absence of scala media. The vestibular organ has not yet been described. German waltzing guinea pigs (homozygote and heterozygote) of different ages ranging from embryologic age 25 days to adulthood were investigated. The living animals were tested with four different vestibular tests, and the fetuses were controlled according to breeding. The morphology of the vestibular parts (ampulla, saccule, and utricle) was observed by using the light and transmission electron microscopy. Collapse of the membranous labyrinth was found already at embryologic age 50 days and progressed over time. Vestibular dysfunction was noted already from birth. Vestibular atelectasis has been shown to have the same morphology as the reported vestibular dysfunction in the German waltzing guinea pig. Owing to this similarity, this animal can be a good model for vestibular research.

  17. A review of the interrelationship between vestibular dysfunction ...

    African Journals Online (AJOL)

    functions, the effect of rehabilitation focused on the functioning of a specific canal, and the effect of different rehabilitation programmes on different vestibular deficiencies are suggested. Keywords: Vestibular dysfunction; Motor development; Learning disabilities; Posture; Rehabilitation and exercises. South African Journal ...

  18. Acute Unilateral Vestibular Failure Does Not Cause Spatial Hemineglect.

    Directory of Open Access Journals (Sweden)

    Julian Conrad

    Full Text Available Visuo-spatial neglect and vestibular disorders have common clinical findings and involve the same cortical areas. We questioned (1 whether visuo-spatial hemineglect is not only a disorder of spatial attention but may also reflect a disorder of higher cortical vestibular function and (2 whether a vestibular tone imbalance due to an acute peripheral dysfunction can also cause symptoms of neglect or extinction. Therefore, patients with an acute unilateral peripheral vestibular failure (VF were tested for symptoms of hemineglect.Twenty-eight patients with acute VF were assessed for signs of vestibular deficits and spatial neglect using clinical measures and various common standardized paper-pencil tests. Neglect severity was evaluated further with the Center of Cancellation method. Pathological neglect test scores were correlated with the degree of vestibular dysfunction determined by the subjective visual vertical and caloric testing.Three patients showed isolated pathological scores in one or the other neglect test, either ipsilesionally or contralesionally to the VF. None of the patients fulfilled the diagnostic criteria of spatial hemineglect or extinction.A vestibular tone imbalance due to unilateral failure of the vestibular endorgan does not cause spatial hemineglect, but evidence indicates it causes mild attentional deficits in both visual hemifields.

  19. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko


    The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

  20. Reflexive Aero Structures for Enhanced Survivability, Phase I (United States)

    National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) proposes to develop an advanced reflexive structure system to increase the survivability of aerostructures. This reflexive...

  1. Vestibular characterization in the menstrual cycle Caracterização vestibular no ciclo menstrual

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    Cintia Ishii


    Full Text Available Hormonal disorders in the menstrual cycle can affect labyrinthine fluid homeostasis, causing balance and hearing dysfunctions. STUDY DESIGN: Clinical prospective. AIM: compare the results from vestibular tests in young women, in the premenstrual and postmenstrual periods. MATERIALS AND METHODS: twenty women were selected with ages ranging from 18 to 35 years, who were not using any kind of contraceptive method for at least six months, and without vestibular or hearing complaints. The test was carried out in each subject before and after the menstrual period, respecting the limit of ten days before or after menstruation. RESULTS: there was a statistically significant difference in the menstrual cycle phases only in the following vestibular tests: calibration, saccadic movements, PRPD and caloric-induced nystagmus. We also noticed that age; a regular menstrual cycle; hearing loss or dizziness cases in the family; and premenstrual symptoms such as tinnitus, headache, sleep disorders, anxiety, nausea and hyperacusis can interfere in the vestibular test. CONCLUSION: there are differences in the vestibular tests of healthy women when comparing their pre and postmenstrual periods.As alterações hormonais do ciclo menstrual podem comprometer a homeostase dos fluidos labirínticos, gerando alterações no equilíbrio e na audição. FORMA DO ESTUDO: Clínico prospectivo. OBJETIVO: Comparar os resultados dos testes do exame vestibular em mulheres jovens, nos períodos pré e pós-menstrual. MATERIAL E MÉTODO: Foram selecionadas vinte mulheres, entre dezoito e trinta e cinco anos, que não fizessem uso de qualquer tipo de anticoncepcional, com audição normal e sem queixas vestibulares. O exame vestibular foi realizado em cada participante no período pré e no período pós-menstrual, em ordem aleatória, e respeitando o limite de até dez dias antes do início da menstruação e até dez dias após o início da menstruação. RESULTADO: Foi observada

  2. Regeneration of hair cells in the mammalian vestibular system. (United States)

    Li, Wenyan; You, Dan; Chen, Yan; Chai, Renjie; Li, Huawei


    Hair cells regenerate throughout the lifetime of non-mammalian vertebrates, allowing these animals to recover from hearing and balance deficits. Such regeneration does not occur efficiently in humans and other mammals. Thus, balance deficits become permanent and is a common sensory disorder all over the world. Since Forge and Warchol discovered the limited spontaneous regeneration of vestibular hair cells after gentamicininduced damage in mature mammals, significant efforts have been exerted to trace the origin of the limited vestibular regeneration in mammals after hair cell loss. Moreover, recently many strategies have been developed to promote the hair cell regeneration and subsequent functional recovery of the vestibular system, including manipulating the Wnt, Notch and Atoh1. This article provides an overview of the recent advances in hair cell regeneration in mammalian vestibular epithelia. Furthermore, this review highlights the current limitations of hair cell regeneration and provides the possible solutions to regenerate functional hair cells and to partially restore vestibular function.

  3. Development and regeneration of vestibular hair cells in mammals. (United States)

    Burns, Joseph C; Stone, Jennifer S


    Vestibular sensation is essential for gaze stabilization, balance, and perception of gravity. The vestibular receptors in mammals, Type I and Type II hair cells, are located in five small organs in the inner ear. Damage to hair cells and their innervating neurons can cause crippling symptoms such as vertigo, visual field oscillation, and imbalance. In adult rodents, some Type II hair cells are regenerated and become re-innervated after damage, presenting opportunities for restoring vestibular function after hair cell damage. This article reviews features of vestibular sensory cells in mammals, including their basic properties, how they develop, and how they are replaced after damage. We discuss molecules that control vestibular hair cell regeneration and highlight areas in which our understanding of development and regeneration needs to be deepened. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Vestibular schwannoma with contralateral facial pain – case report

    Directory of Open Access Journals (Sweden)

    Ghodsi Mohammad


    Full Text Available Abstract Background Vestibular schwannoma (acoustic neuroma most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. Case presentation Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. Conclusion The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported.

  5. Reflexive criteria of sociological research

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    R T Ubaydullaeva


    Full Text Available The article is devoted to the sociological criteria of explaining the way of thinking and actions of subjects, their spiritual and moral positions and intellectual forces that form the laws of social life. The author seeks to adapt such categories as ‘meaning of life’, ‘human dignity’, ‘rationality’ etc. for the purposes of sociological analysis by methodological construction of some real life dichotomies such as ‘subjective meaning and social function’, ‘the real and the ideal’, ‘the demanded and the excluded’. Thus, the author studies economic, political and technical processes in terms of both positivity and negativity of social interaction and states that given the increasing differentiation of the society and the contradictory trends of social development the reflexive criteria that take into account the socio-cultural nature of the man help to find one’s own model of development.

  6. Sex differences in cough reflex. (United States)

    Plevkova, J; Buday, T; Kavalcikova-Bogdanova, N; Ioan, I; Demoulin-Alexikova, S


    Majority of patients visiting cough clinics are postmenopausal women, who are affected by intractable cough for years. Why the cough reflex becomes exaggerated in women is not known. Basic research excludes females from the studies contributing to the sex bias which may be responsible for lack of understanding of "hypersensitive" cough in women. Biological and behavioural differences between women and men are the factors affecting cough physiology. Gender also shapes the patterns of behaviour and determines the character of environmental exposures which differs between sexes. The article offers an insight into the physiology of the cough, differences in the maturation of it and biological, social and behavioural factors contributing to the sex differences in cough. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Evaluation of Galvanic Vestibular Stimulation System (United States)

    Kofman, I. S.; Warren, E.; DeSoto, R.; Moroney, G.; Chastain, J.; De Dios, Y. E.; Gadd, N.; Taylor, L.; Peters, B. T.; Allen, E.; hide


    Microgravity exposure results in an adaptive central reinterpretation of information from multiple sensory sources to produce a sensorimotor state appropriate for motor actions in this unique environment, but this new adaptive state is no longer appropriate for the 1-g gravitational environment on Earth. During these gravitational transitions, astronauts experience deficits in both perceptual and motor functions including impaired postural control, disruption in spatial orientation, impaired control of locomotion that include alterations in muscle activation variability, modified lower limb kinematics, alterations in head-trunk coordination as well as reduced dynamic visual acuity. Post-flight changes in postural and locomotor control might have adverse consequences if a rapid egress was required following a long-duration mission, where support personnel may not be available to aid crewmembers. The act of emergency egress includes, but is not limited to standing, walking, climbing a ladder, jumping down, monitoring displays, actuating discrete controls, operating auxiliary equipment, and communicating with Mission Control and recovery teams while maintaining spatial orientation, mobility and postural stability in order to escape safely. The average time to recover impaired postural control and functional mobility to preflight levels of performance has been shown to be approximately two weeks after long-duration spaceflight. The postflight alterations are due in part to central reinterpretation of vestibular information caused by exposure to microgravity. In this study we will use a commonly used technique of transcutaneous electrical stimulation applied across the vestibular end organs (galvanic vestibular stimulation, GVS) to disrupt vestibular function as a simulation of post-flight disturbances. The goal of this project is an engineering human-in-the-loop evaluation of a device that can degrade performance of functional tasks (e.g. to maintain upright balance

  8. GABAergic systems in the vestibular nucleus and their contribution to vestibular compensation. (United States)

    Gliddon, Catherine M; Darlington, Cynthia L; Smith, Paul F


    GABA and the GABAA and GABAB receptors play a pivotal role in the coordination of the central vestibular pathways. The commissural inhibition, which exists between the two vestibular nucleus complexes (VNCs) and which is responsible for enhancing the dynamic sensitivity of VNC neurons to head acceleration, is known to be substantially mediated by GABA acting on GABAA and GABAB receptors. After unilateral vestibular deafferentation (UVD), the large asymmetry in spontaneous resting activity between the two VNCs is reinforced and exacerbated by the GABAergic interaction between the ipsilateral and contralateral sides. Although it has been suggested that reduced GABAergic inhibition of the ipsilateral VNC may be partially responsible for the recovery of resting activity that underlies vestibular compensation of the static symptoms of UVD, at present there are few data available to test this hypothesis systematically. There is some evidence that GABA concentrations change in the ipsilateral VNC during the development of compensation; however, it is unclear whether these changes relate to GABA release or to metabolic pools of GABA. Most biochemical studies of GABA receptors have been conducted at the gene expression level. Therefore, it is unclear whether changes in the receptor protein also occur, although the most recent data suggest that changes in GABAA and GABAB receptor density in the VNC are unlikely. The few radioligand binding data relate to GABAA receptors with benzodiazepine binding sites only. A decrease in the sensitivity of ipsilateral VNC neurons from compensated animals to GABA receptor agonists has been reported; however, these studies have employed brainstem slices and therefore the functional identity of the neurons involved has been unclear. Although it seems likely that some changes in central GABAergic systems accompany the recovery of resting activity in the ipsilateral VNC during the development of vestibular compensation, at the present stage

  9. Purinergic Receptors in Ocular Inflammation

    Directory of Open Access Journals (Sweden)

    Ana Guzman-Aranguez


    Full Text Available Inflammation is a complex process that implies the interaction between cells and molecular mediators, which, when not properly “tuned,” can lead to disease. When inflammation affects the eye, it can produce severe disorders affecting the superficial and internal parts of the visual organ. The nucleoside adenosine and nucleotides including adenine mononucleotides like ADP and ATP and dinucleotides such as P1,P4-diadenosine tetraphosphate (Ap4A, and P1,P5-diadenosine pentaphosphate (Ap5A are present in different ocular locations and therefore they may contribute/modulate inflammatory processes. Adenosine receptors, in particular A2A adenosine receptors, present anti-inflammatory action in acute and chronic retinal inflammation. Regarding the A3 receptor, selective agonists like N6-(3-iodobenzyl-5′-N-methylcarboxamidoadenosine (CF101 have been used for the treatment of inflammatory ophthalmic diseases such as dry eye and uveoretinitis. Sideways, diverse stimuli (sensory stimulation, large intraocular pressure increases can produce a release of ATP from ocular sensory innervation or after injury to ocular tissues. Then, ATP will activate purinergic P2 receptors present in sensory nerve endings, the iris, the ciliary body, or other tissues surrounding the anterior chamber of the eye to produce uveitis/endophthalmitis. In summary, adenosine and nucleotides can activate receptors in ocular structures susceptible to suffer from inflammatory processes. This involvement suggests the possible use of purinergic agonists and antagonists as therapeutic targets for ocular inflammation.

  10. Task-dependent vestibular feedback responses in reaching. (United States)

    Keyser, Johannes; Medendorp, W Pieter; Selen, Luc P J


    When reaching for an earth-fixed object during self-rotation, the motor system should appropriately integrate vestibular signals and sensory predictions to compensate for the intervening motion and its induced inertial forces. While it is well established that this integration occurs rapidly, it is unknown whether vestibular feedback is specifically processed dependent on the behavioral goal. Here, we studied whether vestibular signals evoke fixed responses with the aim to preserve the hand trajectory in space or are processed more flexibly, correcting trajectories only in task-relevant spatial dimensions. We used galvanic vestibular stimulation to perturb reaching movements toward a narrow or a wide target. Results show that the same vestibular stimulation led to smaller trajectory corrections to the wide than the narrow target. We interpret this reduced compensation as a task-dependent modulation of vestibular feedback responses, tuned to minimally intervene with the task-irrelevant dimension of the reach. These task-dependent vestibular feedback corrections are in accordance with a central prediction of optimal feedback control theory and mirror the sophistication seen in feedback responses to mechanical and visual perturbations of the upper limb. NEW & NOTEWORTHY Correcting limb movements for external perturbations is a hallmark of flexible sensorimotor behavior. While visual and mechanical perturbations are corrected in a task-dependent manner, it is unclear whether a vestibular perturbation, naturally arising when the body moves, is selectively processed in reach control. We show, using galvanic vestibular stimulation, that reach corrections to vestibular perturbations are task dependent, consistent with a prediction of optimal feedback control theory. Copyright © 2017 the American Physiological Society.

  11. Electric Current Transmission Through Tissues of the Vestibular Labyrinth of a Patient: Perfection of the Vestibular Implant (United States)

    Demkin, V. P.; Shchetinin, P. P.; Melnichuk, S. V.; Kingma, H.; Van de Berg, R.; Pleshkov, M. O.; Starkov, D. N.


    An electric model of current transmission through tissues of the vestibular labyrinth of a patient is suggested. To stimulate directly the vestibular nerve in surgical operation, terminations of the electrodes are implanted through the bone tissue of the labyrinth into the perilymph in the vicinity of the vestibular nerve. The biological tissue of the vestibular labyrinth surrounding the electrodes and having heterogeneous composition possesses conductive and dielectric properties. Thus, when a current pulse from the vestibular implant is applied to one of the electrodes, conductive disturbance currents may arise between the electrodes and the vestibular nerves that can significantly deteriorate the direct signal quality. To study such signals and to compensate for the conductive disturbance currents, an equivalent electric circuit with actual electric impedance properties of tissues of the vestibular system is suggested, and the time parameters of the conductive disturbance current transmission are calculated. It is demonstrated that these parameters can reach large values. The suggested electric model and the results of calculations can be used for perfection of the vestibular implant.


    Directory of Open Access Journals (Sweden)

    Dr. Hamlet Suárez


    Full Text Available El vértigo, la inestabilidad y las caídas tienen una incidencia relevante en el adulto mayor, disminuye su calidad de vida y puede ser causa de muerte en esta población. Este artículo describe las presentaciones clínicas y el abordaje de la evaluación de la patología vestibular en este grupo de edad, utilizando diferentes instrumentos para el diagnóstico así como también las reglas generales del tratamiento.

  13. Vestibular function in the space environment (United States)

    Von Baumgarten, R. J.; Harth, O.; Thuemler, R.; Baldrighi, G.; Shillinger, G. L., Jr.


    The present work presents new results about the interdependence of optical illusory sensations and eye movements in man. To establish to what degree certain illusions previously obtained during centrifugation and parabolic flight can be explained by eye movements and by neuronal integration in the brain, real eye movements were measured as they occurred in the dark without optical fixation, during rectilinear accelerations on the ground, and during weightlessness in parabolic flight. Results provide valuable insight into normal vestibular function as well as resolution of within-the-eye and behind-the-eye contributions to the above illusions.

  14. ROCK inhibitors in ocular disease

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    Eva Halasz


    Full Text Available Rho kinases (ROCKs have a crucial role in actin-cytoskeletal reorganization and thus are involved in broad aspects of cell motility, from smooth muscle contraction to neurite outgrowth. The first marketed ROCK inhibitor, called fasudil, has been used safely for treatment of cerebral vasospasm since 1995 in Japan. During the succeeding decades ROCK inhibitors have been applied in many pathological conditions from central nervous system disorders to cardiovascular disease as potential therapeutic agents or experimental tools to help understand the underlying (pathomechanisms. In 2014, a fasudil derivate named ripasudil was accepted for clinical use in glaucoma and ocular hypertension. Since ROCK kinases are widely expressed in ocular tissues, they have been implicated in the pathology of many ocular conditions such as corneal dysfunction, glaucoma, cataract, diabetic retinopathy, age-related macular degeneration, and retinal detachment. This paper aims to provide an overview of the most recent status/application of ROCK inhibitors in the field of eye disease.

  15. The Ocular Surface Chemical Burns

    Directory of Open Access Journals (Sweden)

    Medi Eslani


    Full Text Available Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients’ needs.

  16. 21 CFR 882.1790 - Ocular plethysmograph. (United States)


    ...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1790 Ocular plethysmograph. (a) Identification. An ocular plethysmograph is a device used to measure or detect volume changes in the eye produced...

  17. Model-based Vestibular Afferent Stimulation: Modular Workflow for Analyzing Stimulation Scenarios in Patient Specific and Statistical Vestibular Anatomy

    Directory of Open Access Journals (Sweden)

    Michael Handler


    Full Text Available Our sense of balance and spatial orientation strongly depends on the correct functionality of our vestibular system. Vestibular dysfunction can lead to blurred vision and impaired balance and spatial orientation, causing a significant decrease in quality of life. Recent studies have shown that vestibular implants offer a possible treatment for patients with vestibular dysfunction. The close proximity of the vestibular nerve bundles, the facial nerve and the cochlear nerve poses a major challenge to targeted stimulation of the vestibular system. Modeling the electrical stimulation of the vestibular system allows for an efficient analysis of stimulation scenarios previous to time and cost intensive in vivo experiments. Current models are based on animal data or CAD models of human anatomy. In this work, a (semi-automatic modular workflow is presented for the stepwise transformation of segmented vestibular anatomy data of human vestibular specimens to an electrical model and subsequently analyzed. The steps of this workflow include (i the transformation of labeled datasets to a tetrahedra mesh, (ii nerve fiber anisotropy and fiber computation as a basis for neuron models, (iii inclusion of arbitrary electrode designs, (iv simulation of quasistationary potential distributions, and (v analysis of stimulus waveforms on the stimulation outcome. Results obtained by the workflow based on human datasets and the average shape of a statistical model revealed a high qualitative agreement and a quantitatively comparable range compared to data from literature, respectively. Based on our workflow, a detailed analysis of intra- and extra-labyrinthine electrode configurations with various stimulation waveforms and electrode designs can be performed on patient specific anatomy, making this framework a valuable tool for current optimization questions concerning vestibular implants in humans.

  18. Eye position signals modify vestibulo- and cervico-ocular fast phases during passive yaw rotations in humans. (United States)

    Anastasopoulos, D; Mandellos, D; Kostadima, V; Pettorossi, V E


    We studied the amplitude, latency, and probability of occurrence of fast phases (FP) in darkness to unpredictable vestibular and/or cervical yaw stimulation in normal human subjects. The rotational stimuli were smoothed trapezoidal motion transients of 14 degrees amplitude and 1.25 s duration. Eye position before stimulus application (initial eye position, IEP) was introduced as a variable by asking the subjects to fixate a spot appearing either straight ahead or at 7 degrees eccentric positions. The recordings demonstrated that the generation of FP during vestibular stimulation was facilitated when the whole-body rotation was directed opposite the eccentric IEP. Conversely, FP were attenuated if the whole-body rotation was directed toward the eccentric IEP; i.e., the FP attenuated if they were made to further eccentric positions. Cervical stimulation-induced FP were small and variable in direction when IEP was directed straight ahead before stimulus onset. Eccentric IEPs resulted in large FP, the direction of which was essentially independent of the neck-proprioceptive stimulus. They tended to move the eye toward the primary position, both when the trunk motion under the stationary head was directed toward or away from the IEP. FP dependence on IEP was evident also during head-on-trunk rotations. No consistent interaction between vestibularly and cervically induced FP was found. We conclude that extraretinal eye position signals are able to modify vestibularly evoked reflexive FP in darkness, aiming at minimizing excursions of the eyes away from the primary position. However, neck-induced FP do not relate to specific tasks of stabilization or visual search. By keeping the eyes near the primary position, FP may permit flexibility of orienting responses to incoming stimuli. This recentering bias for both vestibularly and cervically generated FP may represent a visuomotor optimizing strategy.

  19. Ocular manifestations of systemic diseases


    Andonegui, J.


    Existe un gran número de enfermedades sistémicas que pueden presentar en algún momento de su evolución manifestaciones oculares. Estas alteraciones pueden provocar sintomatología por sí mismas, pueden ayudar a diagnosticar la enfermedad sistémica que las originó o pueden servir para monitorizar el curso evolutivo de la misma. Se destacan las principales características de una serie de enfermedades sistémicas asociadas a patología ocular que serán estudiadas en detalle a lo largo de esta monog...

  20. Method optimization of ocular patches

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    Kamalesh Upreti


    Full Text Available The intraocular patches were prepared using gelatin as the polymer. Ocular patch were prepared by solvent casting method. The patches were prepared for six formulations GP1, GP2, GP3, GP4, GP5 and GP6. Petri dishes were used for formulation of ocular patch. Gelatin was used as a polymer of choice. Glutaraldehyde used as cross linking agent and (DMSO dimethylsulfoxide used as solubility enhancer. The elasticity depends upon the concentration of gelatin. 400 mg amount of polymer i.e gelatin gave the required elasticity for the formulation.

  1. Ocular complications of diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Nihat Sayin; Necip Kara; Gokhan Pekel


    Diabetes mellitus (DM) is a important health problemthat induces ernestful complications and it causessignificant morbidity owing to specific microvascularcomplications such as, retinopathy, nephropathy andneuropathy, and macrovascular complications such as,ischaemic heart disease, and peripheral vasculopathy.It can affect children, young people and adults and isbecoming more common. Ocular complications associatedwith DM are progressive and rapidly becoming theworld's most significant cause of morbidity and arepreventable with early detection and timely treatment.This review provides an overview of five main ocularcomplications associated with DM, diabetic retinopathyand papillopathy, cataract, glaucoma, and ocular surfacediseases.

  2. The Multiple Faces of Reflexive Research Designs

    Directory of Open Access Journals (Sweden)

    Karl H. Müller


    Full Text Available Reflexive research can be grouped into five clusters with circular relations between two elements x ↔ x, namely circular relations between observers, between scientific building blocks like concepts, theories or models, between systemic levels, between rules and rule systems or as circular relations or x ↔ y between these four components. By far the most important cluster is the second cluster which becomes reflexive through a re-entry operation RE into a scientific element x and which establishes its circular formation as x(x. Many of the research problems in these five clusters in reflexivity research are still unexplored and pose grand challenges for future research.

  3. A near catastrophe from trigeminocardiac reflex

    Directory of Open Access Journals (Sweden)

    Parmod K Bithal


    Full Text Available Trigeminocardiac reflex is a brainstem reflex that results from stimulation of any branch of the trigeminal nerve along its course. It produces a constellation of signs and symptoms decrease in blood pressure (BP and heart rate, dysrhythmias, apnoea and increased gastric motility. We present a case of 80-year-old female patient who developed alarming hypotension and bradycardia during craniotomy for meningioma excision resulting from this reflex. In the face of refractory hypotension despite administering ephedrine and phenylephrine, we had to resort to adrenaline to restore her normal BP.

  4. Tumor ocular metastásico Metastatic ocular tumor

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    Martha G Domínguez Expósito


    Full Text Available El carcinoma metastásico del ojo es considerado la neoplasia maligna que más frecuente se encuentra de forma intraocular. Solo cerca del 10 % de las personas que tienen una o más lesiones metastásicas intraoculares son detectadas clínicamente antes de la muerte. A menudo, el carcinoma metastásico ocular es diagnosticado por el oftalmólogo ante la presencia de síntomas oculares. Las lesiones están localizadas con preferencia en coroides. Nos motivo a realizar la presentación de este caso la presencia de lesiones intraoculares múltiples tumorales metastásicos en un paciente cuyo síntoma de presentación fue la disminución de la agudeza visualThe eye metastatic carcinoma is considered the most frequently found intraocular malignant neoplasia. Only 10 % of the persons with one or more metastatic intraocular injuries are clinically detected before death. The metastatic ocular carcinoma is often diagnosed by the ophthalmologist in the presence of ocular symptoms. The injuries are preferably located in the choroid. The appearance of multiple metastatic intraaocular tumoral injuries in a patient whose chief complaint was the reduction of visual acuity motivated us to presente this case

  5. Galvanic vestibular stimulation speeds visual memory recall. (United States)

    Wilkinson, David; Nicholls, Sophie; Pattenden, Charlotte; Kilduff, Patrick; Milberg, William


    The experiments of Alessandro Volta were amongst the first to indicate that visuo-spatial function can be altered by stimulating the vestibular nerves with galvanic current. Until recently, the beneficial effects of the procedure were masked by the high levels of electrical current applied, which induced nystagmus-related gaze deviation and spatial disorientation. However, several neuropsychological studies have shown that much weaker, imperceptible currents that do not elicit unpleasant side-effects can help overcome visual loss after stroke. Here, we show that visual processing in neurologically healthy individuals can also benefit from galvanic vestibular stimulation. Participants first learnt the names of eight unfamiliar faces and then after a short delay, answered questions from memory about how pairs of these faces differed. Mean correct reaction times were significantly shorter when sub-sensory, noise-enhanced anodal stimulation was administered to the left mastoid, compared to when no stimulation was administered at all. This advantage occurred with no loss in response accuracy, and raises the possibility that the procedure may constitute a more general form of cognitive enhancement.

  6. Effectiveness of vestibular exercise in acute vertigo

    International Nuclear Information System (INIS)

    Hashim, N.D.; Abdullah, A.; Ami, M.; Rahman, R.A.


    To evaluate effectiveness of vestibular exercises in acute vertigo. 45 patients with acute vertigo were divided into 2 groups; 23 in study group (SG) and 22 in control group (CG). All patients were given tablet betahistine 24 mg twice daily as basic medical treatment and tablet Stemetil 5mg as a rescue. Those in SG also received vestibular exercise. Assessment was done using validated questionnaires, neuro-otology tests and individual diaries. Results : Intragroup comparison of intensity of symptoms showed a significant improvement from baseline, 3-month and 6-month visit with p<0.001. While intergroup comparison showed reduction of scores in both groups and which was greater in SG at 6 months visit. An improvement of neuro-otology tests was seen in all five tests whereby the Romber test, Unterberger-Fukuda test and spontaneous nystagmus test showed earlier improvement in SG at 3-month visit than CG. The SG also recovered faster and used lesser medication. 30.4% patients in SG were asymptomatic as early as first to third week after intervention. The number of rescue medications required in each group lessened towards the end of study. By week 7, 56.3% of SG and 43.8% of CG needed no rescue medication. (author)

  7. Treatment of peripheral vestibular dysfunction using photobiomodulation (United States)

    Lee, Min Young; Hyun, Jai-Hwan; Suh, Myung-Whan; Ahn, Jin-Chul; Chung, Phil-Sang; Jung, Jae Yun; Rhee, Chung Ku


    Gentamicin, which is still used in modern medicine, is a known vestibular toxic agent, and various degrees of balance problems have been observed after exposure to this pharmacologic agent. Photobiomodulation is a candidate therapy for vertigo due to its ability to reach deep inner ear organs such as the cochlea. Previous reports have suggested that photobiomodulation can improve hearing and cochlea function. However, few studies have examined the effect of photobiomodulation on balance dysfunction. We used a rat model to mimic human vestibulopathy resulting from gentamicin treatment and evaluated the effect of photobiomodulation on vestibular toxicity. Slow harmonic acceleration (SHA) rotating platform testing was used for functional evaluation and both qualitative and quantitative epifluorescence analyses of cupula histopathology were performed. Animals were divided into gentamicin only and gentamicin plus laser treatment groups. Laser treatment was applied to one ear, and function and histopathology were evaluated in both ears. Decreased function was observed in both ears after gentamicin treatment, demonstrated by low gain and no SHA asymmetry. Laser treatment minimized the damage resulting from gentamicin treatment as shown by SHA asymmetry and recovered gain in the treated ear. Histology results reflected the functional results, showing increased hair cell density and epifluorescence intensity in laser-treated cupulae.

  8. Impedance pattern of vaginal and vestibular mucosa in cyclic goats

    Directory of Open Access Journals (Sweden)

    Ivo Křivánek


    Full Text Available The changes of vaginal and vestibular impedance during the oestrous cycle in goats were examined. The onset of oestrus was teased with a buck once a day during the experiment. Impedance was mea­sured by a four-terminal method. The vaginal impedance was recorded under slight pressure of electrodes to the vaginal dorsal wall at the cervix. The vestibular impedance was recorded under slight pressure of electrodes to the vestibular dorsal wall 5 cm from the vulva and at the vulva. The im­pe­dan­ce was measured once a day from 4 days before the expected oestrus to 6 days after onset of oestrus. The vaginal impedance at the cervix decreased during pro-oestrus (P < 0.01 and increased du­ring oestrus (P < 0.01. The vestibular impedance 5 cm from the vulva decreased during pro-oestrus (P < 0.01 and increased after oestrus (P < 0.01. The decrease of vaginal impedance during peri-oestrus was nearly twofold in comparison with the vestibular impedance 5 cm from the vulva. No sig­ni­fi­cant decrease of the vestibular impedance at the vulva was found during the oestrous cycle. The results indicate that the vaginal impedance at the cervix and vestibular impedance 5 cm from the vulva measured by means of a four-terminal method during the oestrous cycle display cyclic changes that are closely related to the oestrous behaviour of goats.

  9. Vestibular and balance issues following sport-related concussion. (United States)

    Valovich McLeod, Tamara C; Hale, Troy D


    To review relevant literature regarding the effect of concussion on vestibular function, impairments, assessments and management strategies. REASONING: Dizziness and balance impairments are common following sport-related concussion. Recommendations regarding the management of sport-related concussion suggest including tests of balance within the multifactorial assessment paradigm for concussive injuries. The literature was searched for guidelines and original studies related to vestibular impairments following concussion, oculomotor and balance assessments and treatment or rehabilitation of vestibular impairments. The databases searched included Medline, CINAHL, Sport Discus and the Cochrane Database of Systematic Reviews through October 2013. Dizziness following concussion occurs in ∼67-77% of cases and has been implicated as a risk factor for a prolonged recovery. Balance impairments also occur after concussion and last 3-10 days post-injury. Assessments of balance can be done using both clinical and instrumented measures with success. Vestibular rehabilitation has been shown to improve outcomes in patients with vestibular impairments, with one study demonstrating success in decreasing symptoms and increasing function following concussion. Best practices suggest that the assessment of vestibular function through cranial nerve, oculomotor and balance assessments are an important aspect of concussion management. Future studies should evaluate the effectiveness of vestibular rehabilitation for improving patient outcomes.

  10. Clinical evaluation of elderly people with chronic vestibular disorder. (United States)

    Gazzola, Juliana Maria; Ganança, Fernando Freitas; Aratani, Mayra Cristina; Perracini, Monica Rodrigues; Ganança, Maurício Malavasi


    Dizziness is common among the elderly. To characterize social, demographic, clinical, functional and otoneurological data in elderly patients with chronic vestibular disorder. A sequential study of 120 patients with chronic vestibular disorder. Simple descriptive analyses were undertaken. Most of the patients were female (68.3%) with a mean age of 73.40+/-5.77 years. The average number of illnesses associated with the vestibular disorder was 3.83+/-1.84; the patients were taking on average 3.86+/-2.27 different medications. The most prevalent diagnosis on the vestibular exam was unilateral vestibular loss (29.8%) and the most prevalent etiology was metabolic vestibulopathy (40.0%) followed by benign paroxysmal positional vertigo (36.7%). Fifty-two patients (43.3%) had experienced dizziness for 5 years or more. Sixty-four patients (53.3%) had at least one fall in the last year and thirty-five (29.2%) had recurrent falls. Most of the sample included females with associated diseases, and using many different drugs. The most prevalent vestibular diseases were metabolic and vascular labyrinth conditions. Dizziness is a chronic symptom in elderly patients. The association of two vestibular diseases is common. Falls are prevalent in chronic dizzy elderly patients.

  11. Improving Sensorimotor Function Using Stochastic Vestibular Stimulation (United States)

    Galvan, R. C.; Clark, T. K.; Merfeld, D. M.; Bloomberg, J. J.; Mulavara, A. P.; Oman, C. M.


    Astronauts experience sensorimotor changes during spaceflight, particularly during G-transition phases. Post flight sensorimotor changes may include postural and gait instability, spatial disorientation, and visual performance decrements, all of which can degrade operational capabilities of the astronauts and endanger the crew. Crewmember safety would be improved if these detrimental effects of spaceflight could be mitigated by a sensorimotor countermeasure and even further if adaptation to baseline could be facilitated. The goal of this research is to investigate the potential use of stochastic vestibular stimulation (SVS) as a technology to improve sensorimotor function. We hypothesize that low levels of SVS will improve sensorimotor performance through stochastic resonance (SR). The SR phenomenon occurs when the response of a nonlinear system to a weak input signal is optimized by the application of a particular nonzero level of noise. Two studies have been initiated to investigate the beneficial effects and potential practical usage of SVS. In both studies, electrical vestibular stimulation is applied via electrodes on the mastoid processes using a constant current stimulator. The first study aims to determine the repeatability of the effect of vestibular stimulation on sensorimotor performance and perception in order to better understand the practical use of SVS. The beneficial effect of low levels of SVS on balance performance has been shown in the past. This research uses the same balance task repeated multiple times within a day and across days to study the repeatability of the stimulation effects. The balance test consists of 50 sec trials in which the subject stands with his or her feet together, arms crossed, and eyes closed on compliant foam. Varying levels of SVS, ranging from 0-700 micro A, are applied across different trials. The subject-specific optimal SVS level is that which results in the best balance performance as measured by inertial

  12. Portraying Reflexivity in Health Services Research. (United States)

    Rae, John; Green, Bill


    A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. © The Author(s) 2016.

  13. The Relationship Between Ocular Itch, Ocular Pain, and Dry Eye Symptoms (An American Ophthalmological Society Thesis). (United States)

    Galor, Anat; Small, Leslie; Feuer, William; Levitt, Roy C; Sarantopoulos, Konstantinos D; Yosipovitch, Gil


    To evaluate associations between sensations of ocular itch and dry eye (DE) symptoms, including ocular pain, and DE signs. A cross-sectional study of 324 patients seen in the Miami Veterans Affairs eye clinic was performed. The evaluation consisted of questionnaires regarding ocular itch, DE symptoms, descriptors of neuropathic-like ocular pain (NOP), and evoked pain sensitivity testing on the forehead and forearm, followed by a comprehensive ocular surface examination including corneal mechanical sensitivity testing. Analyses were performed to examine for differences between those with and without subjective complaints of ocular itch. The mean age was 62 years with 92% being male. Symptoms of DE and NOP were more frequent in patients with moderate-severe ocular itch compared to those with no or mild ocular itch symptoms. With the exception of ocular surface inflammation (abnormal matrix metalloproteinase 9 testing) which was less common in those with moderate-severe ocular itch symptoms, DE signs were not related to ocular itch. Individuals with moderate-severe ocular itch also demonstrated greater sensitivity to evoked pain on the forearm and had higher non-ocular pain, depression, and post-traumatic stress disorders scores, compared to those with no or mild itch symptoms. Subjects with moderate-severe ocular itch symptoms have more severe symptoms of DE, NOP, non-ocular pain and demonstrate abnormal somatosensory testing in the form of increased sensitivity to evoked pain at a site remote from the eye, consistent with generalized hypersensitivity.

  14. Ocular emergencies presenting to Menelik II Hospital. (United States)

    Negussie, Dereje; Bejiga, Abebe


    Ocular conditions such as trauma, painful red eye of any cause, painless sudden visual loss and others are commonly seen as ocular emergencies, and can lead to ocular morbidity and visual loss. To determine types and causes of ocular emergencies seen at Menelik II hospital. A cross-sectional study was conducted from April to October, 2007. Consecutive patients who presented with ocular emergencies at any time of the day were prospectively evaluated and registered on a formatted questionnaire. Evaluation of the patients included history of presenting illness, visual acuity testing intraocular pressure measurement on non-perforated and non-infected eyes, and complete eye examination in order to arrive at the diagnosis. A total of 26,400 patients attended Menelik II hospital during the study period. Of these, 758 (3%) were persons with an ocular emergency. The majority of patients (n=551; 72.7%) were male, with a male to female ratio of 2.7:1. The age group of 16 to 30 years was the most affected (47.9%), followed by those aged 15 years or younger (27.3%). Ocular trauma and ocular infections accounted for 75.6% and 13.1% of cases, respectively. Of the total ocular emergencies, open globe injuries constituted 171 (22.6%), corneal foreign bodies and abrasion 125 (16.5%), and open adnexal injuries 119 (15.7%). Metal and wood were the commonest work-related causes of ocular injuries in adults, with both together accounting for 60% of all ocular injuries. Children, on the other hand, sustained ocular injury while playing with others in 128 (22.3%) of cases. This study was able to provide a more complete picture to improve understanding of the nature and circumstances of ocular emergencies in Ethiopia. Ocular emergencies were dominated by ocular trauma, particularly affecting males and working-age adults. Public education and use of protective safety measures are recommended to alleviate the problem.

  15. Saccular impact on ocular torsion

    NARCIS (Netherlands)

    Graaf, B. de; Bos, J.E.; Groen, E.L.


    When someone is tilted laterally the sheer force on the maculae of the utriculus and the sacculus is described by the sine and the cosine of the angle of tilt, respectively. So both the sacculus and the utriculus are stimulated, but in the litera-ture ocular torsion is normally attributed to

  16. Imaging the ocular motor nerves.

    NARCIS (Netherlands)

    Ferreira, T.; Verbist, B.M.; Buchem, M. van; Osch, T. van; Webb, A.


    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic

  17. haematological changes accompanying prolonged ocular ...

    African Journals Online (AJOL)

    Dr Olaleye

    oral chloramphenicol provided the basis for comparison. 20 adult male rabbits were randomly but equally divided into two main groups based on the route of administration of the drug (i.e ocular or oral). In each group of ten rabbits equal number of rabbits were randomly divided into test (n=5) and control (n=5) subgroups.

  18. Ocular Toxoplasmosis: Lessons from Brazil (United States)

    • A new attention to post-natally acquired infections. Previously, most attention was focused on infection during pregnancy, and the risk of congenital disease, with the feeling that infection in older individuals was benign, without a substantial risk of disease morbidity, such as ocular involvemen...

  19. The ocular complications of boxing. (United States)

    Giovinazzo, V J; Yannuzzi, L A; Sorenson, J A; Delrowe, D J; Cambell, E A


    In cooperation with the New York State Athletic Commission, 74 boxers applying for a new or yearly renewal license were sequentially referred over a 2-year period for a complete dilated ocular examination at the Sports Vision Institute of the Manhattan Eye, Ear and Throat Hospital. At least one ocular injury was found in 66% of boxers. Vision-threatening injuries, defined as significant damage to the angle, lens, macula, or peripheral retina occurred in 58% of boxers. Nineteen percent of boxers had angle abnormalities. Nineteen percent of boxers had pathologic cataracts, over 70% of these were posterior subcapsular. Six boxers had macular lesions. A total of 24% of boxers had retinal tears. Standardized photographs were used to distinguish pathologic cataracts from congenital opacities and pathologic retinal tears from atrophic holes. Attempts were made to identify risk factors in boxing that might be predictive for ocular injury. Variables included age, weight division, left- or right-handedness, total number of losses, and total number of bouts. Significant correlations were found between the total number of bouts and the total number of losses, and the presence of retinal tears. College varsity athletes were selected as controls. Significant differences were found between boxers and controls for the total number of injuries, total vision-threatening injuries, and the number of retinal tears. A series of recommendations are proposed to aide in the early detection and prevention of serious ocular injuries.

  20. Adverse ocular reactions to drugs.


    Spiteri, M. A.; James, D. G.


    Drugs acting on various parts of the body may also affect the eye insidiously. Increased awareness of such drug toxicity by the prescribing doctor should encourage him to consider effects on the cornea, lens, retina, optic nerve and elsewhere when checking the patient's progress. The following review concerns adverse ocular effects of systemic drug administration.

  1. Surfing-related ocular injuries. (United States)

    Kim, J W; McDonald, H R; Rubsamen, P E; Luttrull, J K; Drouilhet, J H; Frambach, D A; Boyer, D S; Lambrou, F H; Hendrick, A; Weiss, J N; Engstrom, R E; Ing, M


    This report evaluates the clinical characteristics of surfing-related ocular trauma to learn the nature of such injuries and propose possible preventive measures. The authors reviewed 11 cases of surfing-related eye injuries caused by direct trauma from the surfboard, studying their mechanism of injury, the associated ocular complications, and the anatomic and visual outcomes of surgical repair. Surfing-related ocular injuries occurred exclusively in young males (mean age, 24.8 years; range, 14-37 years). The mechanism of injury most frequently responsible was impact with the sharp nose of the surfboard following a fall. Serious posterior segment complications were observed in all 11 patients, with nine patients suffering ruptured globes. Despite immediate medical attention, five patients did not recover ambulatory levels of visual acuity (>5/200). Surfing-related ocular trauma presenting to the retinal specialist typically leaves the patient with a permanent visual disability. Important factors contributing to these high-velocity injuries include the sharply pointed nose of the surfboard and the leash keeping the surfer in close proximity to the board following a fall. A simple modification in surfboard design such as blunting the sharp nose of the surfboard, or appropriate protective guards fitted over the surfboard nose, should lessen the severity of such injuries.

  2. Three-dimensional organization of vestibular related eye movements to rotational motion in pigeons (United States)

    Dickman, J. D.; Beyer, M.; Hess, B. J.


    During rotational motions, compensatory eye movement adjustments must continually occur in order to maintain objects of visual interest as stable images on the retina. In the present study, the three-dimensional organization of the vestibulo-ocular reflex in pigeons was quantitatively examined. Rotations about different head axes produced horizontal, vertical, and torsional eye movements, whose component magnitude was dependent upon the cosine of the stimulus axis relative to the animal's visual axis. Thus, the three-dimensional organization of the VOR in pigeons appears to be compensatory for any direction of head rotation. Frequency responses of the horizontal, vertical, and torsional slow phase components exhibited high pass filter properties with dominant time constants of approximately 3 s.

  3. Outcomes after vestibular rehabilitation and Wii® therapy in patients with chronic unilateral vestibular hypofunction. (United States)

    Verdecchia, Daniel H; Mendoza, Marcela; Sanguineti, Florencia; Binetti, Ana C


    Vestibular rehabilitation therapy is an exercise-based programme designed to promote central nervous system compensation for inner ear deficit. The objective of the present study was to analyse the differences in the perception of handicap, the risk of falls, and gaze stability in patients diagnosed with chronic unilateral vestibular hypofunction before and after vestibular rehabilitation treatment with complementary Wii® therapy. A review was performed on the clinical histories of patients in the vestibular rehabilitation area of a university hospital between April 2009 and May 2011. The variables studied were the Dizziness Handicap Inventory, the Dynamic Gait Index and dynamic visual acuity. All subjects received complementary Wii® therapy. There were 69 cases (41 woman and 28 men), with a median age of 64 years. The initial median Dizziness Handicap Inventory score was 40 points (range 0-84, percentile 25-75=20-59) and the final, 24 points (range 0-76, percentile 25-75=10.40), P<.0001. The initial median for the Dynamic Gait Index score was 21 points (range 8-24, percentile 25-75=17.5-2.3) and the final, 23 (range 12-24, percentile 25-75=21-23), P<.0001. The initial median for dynamic visual acuity was 2 (range 0-6, percentile 25-75=1-4) and the final, 1 (range 0-3, percentile 25-75=0-2), P<.0001. A reduction was observed in the Dizziness Handicap Inventory Values. Values for the Dynamic Gait Index increased and dynamic visual acuity improved. All these variations were statistically significant. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  4. The passive of reflexive verbs in Icelandic

    Directory of Open Access Journals (Sweden)

    Hlíf Árnadóttir


    Full Text Available The Reflexive Passive in Icelandic is reminiscent of the so-called New Passive (or New Impersonal in that the oblique case of a passivized object NP is preserved. As is shown by recent surveys, however, speakers who accept the Reflexive Passive do not necessarily accept the New Passive, whereas conversely, speakers who accept the New Passive do also accept the Reflexive Passive. Based on these results we suggest that there is a hierarchy in the acceptance of passive sentences in Icelandic, termed the Passive Acceptability Hierarchy. The validity of this hierarchy is confirmed by our diachronic corpus study of open access digital library texts from Icelandic journals and newspapers dating from the 19th and 20th centuries (tí Finally, we sketch an analysis of the Reflexive Passive, proposing that the different acceptability rates of the Reflexive and New Passives lie in the argument status of the object. Simplex reflexive pronouns are semantically dependent on the verbs which select them, and should therefore be analyzed as syntactic arguments only, and not as semantic arguments of these verbs.

  5. Methotrexate for ocular inflammatory diseases. (United States)

    Gangaputra, Sapna; Newcomb, Craig W; Liesegang, Teresa L; Kaçmaz, R Oktay; Jabs, Douglas A; Levy-Clarke, Grace A; Nussenblatt, Robert B; Rosenbaum, James T; Suhler, Eric B; Thorne, Jennifer E; Foster, C Stephen; Kempen, John H


    To evaluate the outcome of treatment with methotrexate for noninfectious ocular inflammation. Retrospective cohort study. Patients with noninfectious ocular inflammation managed at 4 tertiary ocular inflammation clinics in the United States observed to add methotrexate as a single, noncorticosteroid immunosuppressive agent to their treatment regimen, between 1979 and 2007, inclusive. Participants were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Demographic and clinical characteristics, including dosage, route of administration of methotrexate, and main outcome measures, were obtained for every eye of every patient at every visit via medical record review by trained expert reviewers. Control of inflammation, corticosteroid-sparing effects, and incidence of and reason for discontinuation of therapy. Among 384 patients (639 eyes) observed from the point of addition of methotrexate to an anti-inflammatory regimen, 32.8%, 9.9%, 21.4%, 14.6%, 15.1%, and 6.3%, respectively, had anterior uveitis, intermediate uveitis, posterior or panuveitis, scleritis, ocular mucous membrane pemphigoid, and other forms of ocular inflammation. In these groups, complete suppression of inflammation sustained for >or=28 days was achieved within 6 months in 55.6%, 47.4%, 38.6%, 56.4%, 39.5%, and 76.7%, respectively. Corticosteroid-sparing success (sustained suppression of inflammation with prednisone Methotrexate was discontinued within 1 year by 42% of patients. It was discontinued owing to ineffectiveness in 50 patients (13%); 60 patients (16%) discontinued because of side effects, which typically were reversible with dose reduction or discontinuation. Remission was seen in 43 patients, with 7.7% remitting within 1 year of treatment. Our data suggest that adding methotrexate to an anti-inflammatory regimen not involving other noncorticosteroid immunosuppressive drugs is moderately effective for management of inflammatory activity and for achieving


    Directory of Open Access Journals (Sweden)

    Kanukollu Venkata Madusudana Rao


    Full Text Available BACKGROUND This prospective study aimed to evaluate the incidence of ocular manifestations in head injury and their correlation with the intracranial lesions. MATERIALS AND METHODS A total of 108 consecutive cases of closed head injury admitted in the neurosurgical ward of a tertiary teaching hospital underwent a thorough ophthalmic assessment. Clinical examination, radiological imaging and Glasgow Coma Scale (GCS were applied to grade the severity of injury. RESULTS Total number of 108 patients of head injury were examined of which 38 patients had ocular manifestations (35.18%. Of these, 85.18% were males, 84% of injuries were due to road traffic accidents and 16% were due to fall from a height. The ocular manifestations were as follows- Orbital complications were seen in 6 patients (15.8%. Anterior segment manifestations included black eyes seen in 10 patients (26.3%, subconjunctival haemorrhage in 10.5% of patients (4 patients, corneal involvement in 21% of patients (8 patients and pupillary involvement in 50% of patients (19 patients. Posterior segment manifestations were seen in 26.3% of patients (10 patients and were as follows- Purtscher’s retinopathy in 2 patients and optic atrophy in 5 patients. Cranial nerve palsies were seen in 15 patients (39.47% and supranuclear movement disorders were seen in 3 patients (8%. CONCLUSION Even though, neurosurgeons perform comprehensive clinical examination including eye examination, the main purpose is limited to aid topical diagnosis of neurological lesions. This study emphasises the importance of a detailed eye examination by an ophthalmologist to prevent irreversible visual loss in addition to aiding in the neurological diagnosis. Pupillary involvement, papilloedema and ocular motor paresis pointed to a more severe head injury. This observational prospective study helped us to correlate the severity of head injuries in association with ocular findings in patients admitted in neurosurgical ward

  7. An Investigation and Analysis of the Vestibulo-Ocular Reflex (VOR) in a Vibration Environment (United States)


    could not have had breast implants. Participants with corrective vision through LASIK , PRK or soft contacts were qualified but individuals requiring...corrective lenses (glasses/contact lenses)? YES/NO Have you had corrective eye surgery ( PRK / LASIK )? YES/NO Have you been diagnosed or...Figure 6. Relative Intensity vs . Forward Current for Everlight 5mm Infrared LED ........ 30 Figure 7. IR LED Circuit

  8. Improved results for vestibular schwannoma radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Flickinger, J C; Kondziolka, D; Pollock, B; Lunsford, L D


    PURPOSE/OBJECTIVE: Treatment techniques in radiosurgery have changed since 1987. We reviewed patients who received radiosurgery for vestibular schwannoma to identify these changes and to investigate any differences in tumor control and complications. MATERIALS and METHODS: One hundred thirty-eight unilateral vestibular schwannoma patients with a minimum follow-up of two years after treatment with gamma knife radiosurgery between 1987 and 1992 were analyzed. The early treatment group consisted of 55 patients treated between 1987-1989 (median: tumor volume 3.63 cc, Dmin 18.1 Gy, Dmax 35.4 Gy, isocenters 2.3, follow-up 50.4 mos.). The later treatment group consisted of 83 patients treated between 1990-1992 (median: tumor volume 3.81 cc, Dmin 16.0 Gy, Dmax 31.6 Gy, isocenters 4.7, follow-up 35.8 mos.) RESULTS: Clinical tumor recurrence requiring surgical intervention occurred in one patient in each group. The overall actuarial clinical tumor control rate was 98%. Slight increases in tumor size (1 to 2 mm) were identified in five other patients not requiring intervention, because of no further tumor growth (n=4) or shrinkage (n=1). This led to an overall radiologic tumor control rate of 92% (not significantly different in either group). Compared to the early treatment group, the incidence of facial neuropathy (temporary or permanent) decreased in the later group (49% vs. 11%, p < 0.0001), as did trigeminal neuropathy (40% vs. 8%, p < 0.0001). Serviceable hearing preservation improved only slightly in the later group (27% vs. 40%, p = 0.70). CONCLUSION: We document a significant decrease in the morbidity of vestibular schwannoma radiosurgery over this time period with no decrease in the high rate of tumor control. This improvement is attributed to a) better conformal dose-planning with stereotactic MRI rather than CT, b) an increase in the number of isocenters used, and c) a reduction in the average dose administered by 2 Gy.

  9. Proton beam stereotactic radiosurgery of vestibular schwannomas

    International Nuclear Information System (INIS)

    Harsh, Griffith R.; Thornton, Allan F.; Chapman, Paul H.; Bussiere, Marc R.; Rabinov, James D.; Loeffler, Jay S.


    Purpose: The proton beam's Bragg peak permits highly conformal radiation of skull base tumors. This study, prompted by reports of transient (30% each) and permanent (10% each) facial and trigeminal neuropathy after stereotactic radiosurgery of vestibular schwannomas with marginal doses of 16-20 Gy, assessed whether proton beam radiosurgery using a marginal dose of only 12 Gy could control vestibular schwannomas while causing less neuropathy. Methods and Materials: Sixty-eight patients (mean age 67 years) were treated between 1992 and 1998. The mean tumor volume was 2.49 cm 3 . The dose to the tumor margin (70% isodose line) was 12 Gy. The prospectively specified follow-up consisted of neurologic evaluation and MRI at 6, 12, 24, and 36 months. Results: After a mean clinical follow-up of 44 months and imaging follow-up of 34 months in 64 patients, 35 tumors (54.7%) were smaller and 25 (39.1%) were unchanged (tumor control rate 94%; actuarial control rate 94% at 2 years and 84% at 5 years). Three tumors enlarged: one shrank after repeated radiosurgery, one remained enlarged at the time of unrelated death, and one had not been imaged for 4 years in a patient who remained asymptomatic at last follow-up. Intratumoral hemorrhage into one stable tumor required craniotomy that proved successful. Thus, 97% of tumors required no additional treatment. Three patients (4.7%) underwent shunting for hydrocephalus evident as increased ataxia. Of 6 patients with functional hearing ipsilaterally, 1 improved, 1 was unchanged, and 4 progressively lost hearing. Cranial neuropathies were infrequent: persistent facial hypesthesia (2 new, 1 exacerbated; 4.7%); intermittent facial paresthesias (5 new, 1 exacerbated; 9.4%); persistent facial weakness (2 new, 1 exacerbated; 4.7%) requiring oculoplasty; transient partial facial weakness (5 new, 1 exacerbated; 9.4%), and synkinesis (5 new, 1 exacerbated; 9.4%). Conclusion: Proton beam stereotactic radiosurgery of vestibular schwannomas at the

  10. Effects of Bed Rest on Conduction Velocity of the Triceps Surae Stretch Reflex and Postural Control (United States)

    Reschke, M. F.; Wood, S. J.; Cerisano, J. M.; Kofman, I. S.; Fisher, E. A.; Esteves, J. T.; Taylor, L. C.; DeDios, Y. E.; Harm, D. L.


    Despite rigorous exercise and nutritional management during space missions, astronauts returning from microgravity exhibit neuromuscular deficits and a significant loss in muscle mass in the postural muscles of the lower leg. Similar changes in the postural muscles occur in subjects participating in long-duration bed rest studies. These adaptive muscle changes manifest as a reduction in reflex conduction velocity during head-down bed rest. Because the stretch reflex encompasses both the peripheral (muscle spindle and nerve axon) and central (spinal synapse) components involved in adaptation to calf muscle unloading, it may be used to provide feedback on the general condition of neuromuscular function, and might be used to evaluate the effectiveness of countermeasures aimed at preserving muscle mass and function during periods of unloading. Stretch reflexes were measured on 18 control subjects who spent 60 to 90 days in continuous 6 deg head-down bed rest. Using a motorized system capable of rotating the foot around the ankle joint (dorsiflexion) through an angle of 10 degrees at a peak velocity of about 250 deg/sec, a stretch reflex was recorded from the subject's left triceps surae muscle group. Using surface electromyography, about 300 reflex responses were obtained and ensemble-averaged on 3 separate days before bed rest, 3 to 4 times in bed, and 3 times after bed rest. The averaged responses for each test day were examined for reflex latency and conduction velocity (CV) across gender. Computerized posturography was also conducted on these same subjects before and after bed rest as part of the standard measures. Peak-to-peak sway was measured during Sensory Organization Tests (SOTs) to evaluate changes in the ability to effectively use or suppress visual, vestibular, and proprioceptive information for postural control. Although no gender differences were found, a significant increase in reflex latency and a significant decrease in CV were observed during the bed

  11. Further studies of the effects of aging on arginine metabolites in the rat vestibular nucleus and cerebellum. (United States)

    Liu, P; Gupta, N; Jing, Y; Collie, N D; Zhang, H; Smith, P F


    Some studies have demonstrated that aging is associated with impaired vestibular reflexes, especially otolithic reflexes, resulting in postural instability. However, the neurochemical basis of these age-related changes is still poorly understood. The l-arginine metabolic system has been implicated in changes in the brain associated with aging. In the current study, we examined the levels of l-arginine and its metabolizing enzymes and downstream metabolites in the vestibular nucleus complex (VNC) and cerebellum (CE) of rats with and without behavioral testing which were young (4months old), middle-aged (12months old) or aged (24months old). We found that aging was associated with lower nitric oxide synthase activity in the CE of animals with testing and increased arginase in the VNC and CE of animals with testing. l-citrulline and l-ornithine were lower in the VNC of aged animals irrespective of testing, while l-arginine and l-citrulline were lower in the CE with and without testing, respectively. In the VNC and CE, aging was associated with lower levels of glutamate in the VNC, irrespective of testing. In the VNC it was associated with higher levels of agmatine and putrescine, irrespective of testing. In the CE, aging was associated with higher levels of putrescine in animals without testing and with higher levels of spermine in animals with testing, and spermidine, irrespective of testing. Multivariate analyses indicated significant predictive relationships between the different variables, and there were correlations between some of the neurochemical variables and behavioral measurements. Cluster analyses revealed that aging altered the relationships between l-arginine and its metabolites. The results of this study demonstrate that there are major changes occurring in l-arginine metabolism in the VNC and CE as a result of age, as well as behavioral activity. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  12. Balancing awareness: Vestibular signals modulate visual consciousness in the absence of awareness. (United States)

    Salomon, Roy; Kaliuzhna, Mariia; Herbelin, Bruno; Blanke, Olaf


    The processing of visual and vestibular information is crucial for perceiving self-motion. Visual cues, such as optic flow, have been shown to induce and alter vestibular percepts, yet the role of vestibular information in shaping visual awareness remains unclear. Here we investigated if vestibular signals influence the access to awareness of invisible visual signals. Using natural vestibular stimulation (passive yaw rotations) on a vestibular self-motion platform, and optic flow masked through continuous flash suppression (CFS) we tested if congruent visual-vestibular information would break interocular suppression more rapidly than incongruent information. We found that when the unseen optic flow was congruent with the vestibular signals perceptual suppression as quantified with the CFS paradigm was broken more rapidly than when it was incongruent. We argue that vestibular signals impact the formation of visual awareness through enhanced access to awareness for congruent multisensory stimulation. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. [Presbyastasis and application of vestibular rehabilitation in geriatrics]. (United States)

    Costa de Araujo, P; Demanez, L; Lechien, J; Bauvir, P; Petermans, J


    Balance disorders can have a major functional impact among the elderly. The main risk is falling. Three elements are implicated in the loss of balance: vision, proprioception and the vestibular system. This article will discuss mainly vestibular damage and its implications. The assessment of balance disorders, particularly in geriatric patients, is based on validated scales composed of several items. These provide scores and are based on the results of chronometric measurements. They can be useful for the application of Vestibular Rehabilitation (VR), a technique improving the adaptation and autonomy of these patients. Vestibular rehabilitation is therefore part of an overall support, the goal of therapy being to improve daily life and to reduce the risk of falls.

  14. Inner ear malformations in siblings presenting with vestibular ...

    African Journals Online (AJOL)

    Any child presenting with vestibular symptoms should be referred for an audiological assessment. I R T Butler, MMed ... rhythmically to music. The patient was ... was enrolled in an intensive speech therapy programme at age 2 years 7 months.

  15. Distinct spontaneous shrinkage of a sporadic vestibular schwannoma

    DEFF Research Database (Denmark)

    Huang, Xiaowen; Cayé-Thomasen, Per; Stangerup, Sven-Eric


    on "shrinkage" or "negative growth" or "regression" or "involution" of the tumor were selected, and the contents on the rate, extent and mechanism of spontaneous tumor shrinkage were extracted and reviewed. The reported rate of spontaneous shrinkage of vestibular schwannoma is 5-10% of patients managed......We present a case with outspoken spontaneous vestibular schwannoma shrinkage and review the related literature. The patient was initially diagnosed with a left-sided, intrameatal vestibular schwannoma, which subsequently grew into the cerebello-pontine angle (CPA), followed by total shrinkage...... of the CPA component without any intervention over a 12-year observation period. The literature on spontaneous tumor shrinkage was retrieved by searching the subject terms "vestibular schwannoma, conservative management" in PubMed/MEDLINE database, without a time limit. Of the published data, the articles...

  16. Caloric vestibular stimulation in aphasic syndrome

    Directory of Open Access Journals (Sweden)

    David eWilkinson


    Full Text Available Caloric vestibular stimulation (CVS is commonly used to diagnose brainstem disorder but its therapeutic application is much less established. Based on the finding that CVS increases blood flow to brain structures associated with language and communication, we assessed whether the procedure has potential to relieve symptoms of post-stroke aphasia. Three participants, each presenting with chronic, unilateral lesions to the left hemisphere, were administered daily CVS for 4 consecutive weeks. Relative to their pre-treatment baseline scores, two of the three participants showed significant improvement on both picture and responsive naming at immediate and one-week follow-up. One of these participants also showed improved sentence repetition, and another showed improved auditory word discrimination. No adverse reactions were reported. These data provide the first, albeit tentative, evidence that CVS may relieve expressive and receptive symptoms of aphasia. A larger, sham-controlled study is now needed to further assess efficacy.

  17. Vestibular syndrome in giant anteater (Myrmecophaga tridactyla)


    Oliveira, Fabricio Singaretti de; Gubulin Carvalho, Paula Fernanda; Bueno de Camargo, Mauro Henrique; Delfini, Aline; Martins, Leandro [UNESP


    A síndrome vestibular é uma afecção bem descrita em animais domésticos e pouco relatada em selvagens. Este relato descreveu essa afecção de origem central em uma fêmea adulta de tamanduá-bandeira (Myrmecophaga tridactyla), caquética, apresentando deambulação em círculos, hipermetria extensora nos membros torácicos, desvio da cabeça e nistagmo espontâneo horizontal e posicional vertical. O animal foi alimentado por sonda oral, 2x/dia e instituiu-se tratamento com dexametasona subcutânea na dos...

  18. Outcome after translabyrinthine surgery for vestibular schwannomas

    DEFF Research Database (Denmark)

    Springborg, Jacob Bertram; Fugleholm, Kåre; Poulsgaard, Lars


    The objective of this article is to study the outcome after translabyrinthine surgery for vestibular schwannomas, with special focus on the facial nerve function. The study design is a case series from a national centralized database and it is set in two University Hospitals in Denmark....... Participants were 1244 patients who underwent translabyrinthine surgery during a period of 33 years from 1976 to 2009. Main outcome measures were tumor removal, intraoperative facial nerve preservation, complications, and postoperative facial nerve function. In 84% patients, the tumor was totally resected...... and in ~85% the nerve was intact during surgery. During 33 years, 12 patients died from complications to surgery and ~14% had cerebrospinal fluid leakage. Before surgery, 74 patients had facial paresis and 46% of these improved after surgery. In patients with normal facial function, overall ~70% had a good...

  19. Vestibular feedback maintains reaching accuracy during body movement (United States)

    Reynolds, Raymond F.


    Key points Reaching movements can be perturbed by vestibular input, but the function of this response is unclear.Here, we applied galvanic vestibular stimulation concurrently with real body movement while subjects maintained arm position either fixed in space or fixed with respect to their body.During the fixed‐in‐space conditions, galvanic vestibular stimulation caused large changes in arm trajectory consistent with a compensatory response to maintain upper‐limb accuracy in the face of body movement.Galvanic vestibular stimulation responses were absent during the body‐fixed task, demonstrating task dependency in vestibular control of the upper limb.The results suggest that the function of vestibular‐evoked arm movements is to maintain the accuracy of the upper limb during unpredictable body movement, but only when reaching in an earth‐fixed reference frame. Abstract When using our arms to interact with the world, unintended body motion can introduce movement error. A mechanism that could detect and compensate for such motion would be beneficial. Observations of arm movements evoked by vestibular stimulation provide some support for this mechanism. However, the physiological function underlying these artificially evoked movements is unclear from previous research. For such a mechanism to be functional, it should operate only when the arm is being controlled in an earth‐fixed rather than a body‐fixed reference frame. In the latter case, compensation would be unnecessary and even deleterious. To test this hypothesis, subjects were gently rotated in a chair while being asked to maintain their outstretched arm pointing towards either earth‐fixed or body‐fixed memorized targets. Galvanic vestibular stimulation was applied concurrently during rotation to isolate the influence of vestibular input, uncontaminated by inertial factors. During the earth‐fixed task, galvanic vestibular stimulation produced large polarity‐dependent corrections in arm

  20. Timing of neuron development in the rodent vestibular system (United States)

    Keefe, J. R.


    The timing of cell generation (onset and duration) in the developing rat vestibular and proprioceptive systems is investigated. The results clearly indicate a defined time-span for generation of all neurons in the central nervous system nuclei studied. This cytogenetic period in both vestibular and proprioceptive sensory nuclei is determined to occur during and immediately after placentation, a potentially critical period for spaceflight exposure due to alterations in maternal physiology.

  1. Morphological analysis of the vestibular aqueduct by computerized tomography images

    International Nuclear Information System (INIS)

    Marques, Sergio Ricardo; Smith, Ricardo Luiz; Isotani, Sadao; Alonso, Luis Garcia; Anadao, Carlos Augusto; Prates, Jose Carlos; Lederman, Henrique Manoel


    Objective: In the last two decades, advances in the computerized tomography (CT) field revise the internal and medium ear evaluation. Therefore, the aim of this study is to analyze the morphology and morphometric aspects of the vestibular aqueduct on the basis of computerized tomography images (CTI). Material and method: Computerized tomography images of vestibular aqueducts were acquired from patients (n = 110) with an age range of 1-92 years. Thereafter, from the vestibular aqueducts images a morphometric analysis was performed. Through a computerized image processing system, the vestibular aqueduct measurements comprised of its area, external opening, length and the distance from the vestibular aqueduct to the internal acoustic meatus. Results: The morphology of the vestibular aqueduct may be funnel-shaped, filiform or tubular and the respective proportions were found to be at 44%, 33% and 22% in children and 21.7%, 53.3% and 25% in adults. The morphometric data showed to be of 4.86 mm 2 of area, 2.24 mm of the external opening, 4.73 mm of length and 11.88 mm of the distance from the vestibular aqueduct to the internal acoustic meatus, in children, and in adults it was of 4.93 mm 2 , 2.09 mm, 4.44 mm, and 11.35 mm, respectively. Conclusions: Computerized tomography showed that the vestibular aqueduct presents high morphological variability. The morphometric analysis showed that the differences found between groups of children and adults or between groups of both genders were not statistically significant

  2. Early and phasic cortical metabolic changes in vestibular neuritis onset.

    Directory of Open Access Journals (Sweden)

    Marco Alessandrini

    Full Text Available Functional brain activation studies described the presence of separate cortical areas responsible for central processing of peripheral vestibular information and reported their activation and interactions with other sensory modalities and the changes of this network associated to strategic peripheral or central vestibular lesions. It is already known that cortical changes induced by acute unilateral vestibular failure (UVF are various and undergo variations over time, revealing different cortical involved areas at the onset and recovery from symptoms. The present study aimed at reporting the earliest change in cortical metabolic activity during a paradigmatic form of UVF such as vestibular neuritis (VN, that is, a purely peripheral lesion of the vestibular system, that offers the opportunity to study the cortical response to altered vestibular processing. This research reports [(18F]fluorodeoxyglucose positron emission tomography brain scan data concerning the early cortical metabolic activity associated to symptoms onset in a group of eight patients suffering from VN. VN patients' cortical metabolic activity during the first two days from symptoms onset was compared to that recorded one month later and to a control healthy group. Beside the known cortical response in the sensorimotor network associated to vestibular deafferentation, we show for the first time the involvement of Entorhinal (BAs 28, 34 and Temporal (BA 38 cortices in early phases of symptomatology onset. We interpret these findings as the cortical counterparts of the attempt to reorient oneself in space counteracting the vertigo symptom (Bas 28, 34 and of the emotional response to the new pathologic condition (BA 38 respectively. These interpretations were further supported by changes in patients' subjective ratings in balance, anxiety, and depersonalization/derealization scores when tested at illness onset and one month later. The present findings contribute in expanding

  3. Vestibular Function in Adults With Epilepsy of Unknown Etiology. (United States)

    Hamed, Sherifa A; Tohamy, Amal M; Oseilly, Amira M


    This study aimed to evaluate vestibular function in adults with chronic epilepsy of unknown etiology in the inter-ictal period. Epilepsy is a chronic medical disorder. Life-long therapy may be required in one-third of patients. Epilepsy is associated with comorbid somatic conditions which impairs patients' quality of life. This cross-sectional study included 28 with generalized tonic clonic (GTC) convulsions and 14 and 3 with temporal (TLE) and frontal lobe (FLE) epilepsies with secondary generalization (all were on regular carbamazepine therapy) and 40 healthy control subjects. The patients' mean age was 34.97 ± 7.35 years and the duration of illness was 18.75 ± 7.99 years. All underwent videonystagmography (VNG). Compared with controls, patients had frequent vestibular symptoms including dizziness (62.22%) (p = 0.0001) and sense of imbalance (44.44%) (p = 0.0001). Eleven patients (24.44%) had central vestibular dysfunction (p = 0.0001); 9 (20%) had mixed vestibular dysfunction and one (2.22%) had peripheral vestibular dysfunction (p = 0.0001). Abnormalities were observed in saccadic (44.4%) and pursuit (42.2%) eye movements, optokinetic nystagmus (42.2%) and positioning/positional (11.11%) and caloric (13.33%) testing. TLE and FLE were associated with more VNG abnormalities than GTC. No significant differences were observed in the demographic and clinical characteristics between patients with and without VNG abnormalities. Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems.

  4. Quality of life in patients after vestibular Schwannoma surgery


    Hajná, Barbora


    TVestibular schwannoma is a benign tumor that arises from the Schwann cells of the vestibular nerve. Unilateral hearing loss, tinnitus, facial and trigeminal dysfunction and vertigo are the most common symptoms. Surgical removal of the tumor is one of the treatment modalities of this disease. Surgical excision usually involves the complete vestibular nerve resection and there is also a risk of cochlear and facial nerve lesion. This thesis deals with changes in quality of life in patients afte...

  5. Reflex and Non-Reflex Torque Responses to Stretch of the Human Knee Extensors

    National Research Council Canada - National Science Library

    Mrachacz-Kersting, N


    .... The quadriceps muscles were stretched at various background torques, produced either voluntarily or electrically and thus the purely reflex-mediated torque could be calculated. The contribution of the reflex mediated stiffness initially low, increased with increasing background torques for the range of torques investigated.

  6. "On Becoming a Critically Reflexive Practitioner" Redux: What Does It Mean to "Be" Reflexive? (United States)

    Cunliffe, Ann L.


    In this commentary, Cunliffe states that is convinced that reflexivity offers a way of foregrounding our moral and ethical responsibility for people and for the world around us. To "BE" reflexive was defined as embracing "subjective understandings of reality as a basis for thinking more critically about the impact of our…

  7. Isolation and culture of adult mouse vestibular nucleus neurons (United States)

    Him, Aydın; Altuntaş, Serap; Öztürk, Gürkan; Erdoğan, Ender; Cengiz, Nureddin


    Background/aim: Isolated cell cultures are widely used to study neuronal properties due to their advantages. Although embryonic animals are preferred for culturing, their morphological or electrophysiological properties may not reflect adult neurons, which may be important in neurodegenerative diseases. This paper aims to develop a method for preparing isolated cell cultures of medial vestibular nucleus (MVN) from adult mice and describe its morphological and electrophysiological properties.Materials and methods: Vestibular nucleus neurons were mechanically and enzymatically isolated and cultured using a defined medium with known growth factors. Cell survival was measured with propidium iodide, and electrophysiological properties were investigated with current-clamp recording.Results: Vestibular neurons grew neurites in cultures, gaining adult-like morphological properties, and stayed viable for 3 days in culture. Adding bovine calf serum, nerve growth factor, or insulin-like growth factor into the culture medium enhanced neuronal viability. Current-clamp recording of the cultured neurons revealed tonic and phasic-type neurons with similar input resistance, resting membrane potential, action potential amplitude, and duration. Conclusion: Vestibular neurons from adult mice can be cultured, and regenerate axons in a medium containing appropriate growth factors. Culturing adult vestibular neurons provides a new method to study age-related pathologies of the vestibular system.

  8. Should intranasal corticosteroids be used for the treatment of ocular symptoms of allergic rhinoconjunctivitis? A review of their efficacy and safety profile. (United States)

    Lightman, Sue; Scadding, Glenis K


    Allergic rhinoconjunctivitis (ARC) presents as nasal symptoms, eye watering and additional signs of ocular allergy (e.g. itchy/burning eyes). Intranasal corticosteroids (INSs) are the most effective treatment for the nasal symptoms of seasonal allergic rhinitis (SAR; based on 4 meta-analyses) and are considered first-line therapy when nasal congestion forms a substantial component of the patient's rhinitis symptoms. Clinical trial evidence shows that INSs also provide some relief from ocular symptoms of SAR and seasonal ARC in adults. INSs probably alleviate eye watering, the main ocular symptom of SAR, by relieving nasal congestion. Other ocular symptoms also improve with INSs. The mechanism for this effect is unknown, but might relate to naso-ocular reflex reduction. There are limited data on ocular safety with INSs. However, the literature supports the use of INSs over several months as there appears to be no considerable increase in the risk of ocular hypertension or glaucoma. Copyright © 2012 S. Karger AG, Basel.

  9. An innovative and simple approach to fabricate a hollow ocular prosthesis with functional lubricant reservoir: A solution to artificial eye comfort

    Directory of Open Access Journals (Sweden)

    Aditya Anil Kavlekar


    Full Text Available The loss of an eye is an emotional and psychological setback to the patient. An ocular prosthesis is created to restore the lost anatomical structure and to correct the cosmetic defect. The tear reflexes do not function at optimal levels in anophthalmic sockets which make prosthesis wear uncomfortable. This case report presents an innovative hollow ocular prosthesis with functional lubricant reservoir which upon normal blinking would draw the lubricant from the reservoir through an exit hole which spreads over the prosthesis allowing a comfortable and long duration of prosthesis wear.

  10. A novel reflex cough testing device. (United States)

    Fujiwara, Kazunori; Kawamoto, Katsuyuki; Shimizu, Yoko; Fukuhara, Takahiro; Koyama, Satoshi; Kataoka, Hideyuki; Kitano, Hiroya; Takeuchi, Hiromi


    The reflex cough test is useful for detecting silent aspiration, a risk factor for aspiration pneumonia. However, assessing the risk of aspiration pneumonia requires measuring not only the cough reflex but also cough strength. Currently, no reflex cough testing device is available that can directly measure reflex cough strength. We therefore developed a new testing device that can easily and simultaneously measure cough strength and the time until the cough reflex, and verified whether screening with this new instrument is feasible for evaluating the risk of aspiration pneumonia. This device consists of a special pipe with a double lumen, a nebulizer, and an electronic spirometer. We used a solution of prescription-grade L-tartaric acid to initiate the cough reflex. The solution was inhaled through a mouthpiece as a microaerosol produced by an ultrasonic nebulizer. The peak cough flow (PCF) of the induced cough was measured with the spirometer. The 70 patients who participated in this study comprised 49 patients without a history of pneumonia (group A), 21 patients with a history of pneumonia (group B), and 10 healthy volunteers (control group). With the novel device, PCF and time until cough reflex could be measured without adverse effects. The PCF values were 118.3 ± 64.0 L/min, 47.7 ± 38.5 L/min, and 254.9 ± 83.8 L/min in group A, group B, and the control group, respectively. The PCF of group B was significantly lower than that of group A and the control group (p reflex was 4.2 ± 5.9 s, 7.0 ± 7.0 s, and 1 s in group A, group B, and the control group, respectively. This duration was significantly longer for groups A and B than for the control group (A: p reflex and the strength of involuntary coughs for assessment of patients at risk of aspiration pneumonia.

  11. Using ESO Reflex with Web Services (United States)

    Järveläinen, P.; Savolainen, V.; Oittinen, T.; Maisala, S.; Ullgrén, M. Hook, R.


    ESO Reflex is a prototype graphical workflow system, based on Taverna, and primarily intended to be a flexible way of running ESO data reduction recipes along with other legacy applications and user-written tools. ESO Reflex can also readily use the Taverna Web Services features that are based on the Apache Axis SOAP implementation. Taverna is a general purpose Web Service client, and requires no programming to use such services. However, Taverna also has some restrictions: for example, no numerical types such integers. In addition the preferred binding style is document/literal wrapped, but most astronomical services publish the Axis default WSDL using RPC/encoded style. Despite these minor limitations we have created simple but very promising test VO workflow using the Sesame name resolver service at CDS Strasbourg, the Hubble SIAP server at the Multi-Mission Archive at Space Telescope (MAST) and the WESIX image cataloging and catalogue cross-referencing service at the University of Pittsburgh. ESO Reflex can also pass files and URIs via the PLASTIC protocol to visualisation tools and has its own viewer for VOTables. We picked these three Web Services to try to set up a realistic and useful ESO Reflex workflow. They also demonstrate ESO Reflex abilities to use many kind of Web Services because each of them requires a different interface. We describe each of these services in turn and comment on how it was used

  12. Oxaliplatin-Related Ocular Toxicity

    Directory of Open Access Journals (Sweden)

    Marina Mesquida


    Full Text Available We report the case of a 52-year-old woman with advanced colorectal cancer who was treated with oxaliplatin on a FOLFOX schedule. After 3 cycles of chemotherapy, she started to complain of visual loss, altered color vision and neurological symptoms. Due to the suspicion of ocular and neurological toxicity, antineoplastic treatment was stopped. Her visual field showed a concentric bilateral scotoma and the electrooculogram test revealed severe impairment of the retinal pigment epithelium. Visual acuity, color vision and visual field recovered completely 8 months later, although electrooculogram remained abnormal. Ocular toxicity has been reported as an infrequent adverse event of oxaliplatin. Findings in this case indicate toxicity of this chemotherapeutic agent on the retinal pigment epithelium, which has not been reported before. This damage could be permanent, and it thus differs from previously described oxaliplatin-induced ocular toxicities, which are usually transient and reversible. With increasing use of oxaliplatin as first-line treatment in advanced colorectal cancer, we have to be aware of this possible toxicity.

  13. [A pilot study of ocular diseases screening for neonates in China]. (United States)

    Nie, Wen-ying; Wu, Han-rong; Qi, Yi-sheng; Zhang, Min; Hou, Qian; Yang, Hai-xia; Gong, Lu-xia; Dong, Yan-ru; Guo, Yu-luan; Shi, Jin-na; Yin, Su-ying; Li, Ping-yu


    To explore the clinical strategies for the screening of newborn eye diseases and obtain information concerning the incidence of newborn ocular diseases. Newborns in a baby-friendly nursery were evaluated for mass screening of eye diseases 2 to 7 days after birth (including reaction to light stimulation, external ocular examination and test for pupil red reflex) and those with abnormalities were subjected to diagnostic examination (external ocular examination with a hand-held slit-lamp, pupil red reflex and mydriatic examination). Newborns in neonatal intensive care unit (NICU) were subjected to screening 5 to 14 days after birth and then, together with those with high risk factors, received a comprehensive examination for screening and diagnostic purposes. The suspected cases were referred to department of ophthalmology for definite diagnosis. Among the 15,398 (91.65%) newborns who were enrolled the screening program, 12 different eye diseases (involving 1266 cases) were detected, with a prevalence of 8.22%. Of these eye diseases, 7 were congenital ocular diseases, involving 809 cases (5. 254%) and including congenital ptosis in 2 cases (0.013%), congenital corneal opacity in 6 cases (0.039%), persistent pupillary membrane in 724 cases (4.702%), congenital cataract in 15 cases (0.097%), persistent hyaloid artery in 54 cases (0.351%), obstruction of nasolacrimal duct in 7 cases (0.046%) and lacrimal gland prolapse in 1 cases (0.007%). Five different diseases (457 cases, 2. 968%) detected were acquired in nature, including neonatal conjunctivitis in 391 case (2.539%), vitreous hemorrhage in 6 cases (0.039%), retinal hemorrhage in 34 cases (0.221%), and neonatal dacryocystitis in 23 cases (0.149%). Of 27 premature babies with body weight lower than 1500 g, 3 had retinopathy of prematurity (ROP, 6 eyes involved). Early intervention is of great importance for the prevention and treatment of neonatal ocular diseases. The screening of newborn ocular diseases is not only

  14. Follicular lymphoma of the ocular adnexal region

    DEFF Research Database (Denmark)

    Rasmussen, Peter Kristian; Ralfkiaer, E.; Prause, J.U.


    Purpose To characterize the clinicopathological features of follicular lymphoma of the ocular adnexal region. Methods Retrospective nation-based study of Danish patients with ocular adnexal follicular lymphoma from January 1st 1980 through December 31st 2009. Results Twenty-four patients...... with ocular adnexal follicular lymphoma were identified. Fourteen (58%) of the patients were females. The median age was 63 years (range: 42–96 years). Eleven (46%) of the patients had primary ocular adnexal lymphoma, seven (29%) had an ocular adnexal lesion in conjunction with a concurrent systemic lymphoma...... and six patients (25%) presented with an ocular adnexal relapse. The most frequently affected sites were the lacrimal gland (38%) and the orbit (33%). Thirteen patients (54%) presented with Ann Arbor stage IE lymphoma, four (17%) had stage IIE, two patients (8%) stage IIIE, and five patients (21%) had...

  15. Reflexive Planning as Design and Work

    DEFF Research Database (Denmark)

    Lissandrello, Enza; Grin, John


    in planning emerges as a new tool for generating critical knowledge and dialogue that can synthesise the perspectives of multiple actors in a common understanding, existing structural constraints and a collective imagination of alternative future possibilities. Such research highlights the potential......In recent years, planning theorists have advanced various interpretations of the notion of reflexivity, inspired by American pragmatism, complexity theory, hermeneutics, discursive and collaborative planning. Scholars agree that “reflexivity” has a strong temporal dimension: it not only aims...... to solve present planning problems, but to imagine and understand alternative trajectories for future action. This article explores the practical utility of reflexivity for planners, through a case study that focuses on a project to promote sustainable development in the Port of Amsterdam. Reflexivity...

  16. Cerebellar interaction with the acoustic reflex. (United States)

    Jastreboff, P J


    The involvement of the cerebellar vermis in the acoustic reflex was analyzed in 12 cats, decerebrated or in pentobarbital anesthesia. Anatomical data suggested the existence of a connection of lobules VIII with the ventral cochlear nucleus. Single cell recording and evoked potential techniques demonstrated the existence of the acoustic projection to lobulus VIII. Electrical stimulation of this area changed the tension of the middle ear muscle and caused evoked potential responses in the caudal part of the ventral cochlear nucleus. Electrical stimulation of the motor nucleus of the facial nerve evoked a slow wave in the recording taken from the surrounding of the cochlear round window. A hypothesis is proposed which postulates the involvement of the acoustic reflex in space localization of acoustic stimuli and the action of cerebellar vermis in order to assure the stability and plasticity of the acoustic reflex arc.

  17. Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input. (United States)

    Sprenger, Andreas; Wojak, Jann F; Jandl, Nico M; Helmchen, Christoph


    Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive

  18. Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input

    Directory of Open Access Journals (Sweden)

    Andreas Sprenger


    Full Text Available Patients with bilateral vestibular failure (BVF suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC, visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs. Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly

  19. Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input (United States)

    Sprenger, Andreas; Wojak, Jann F.; Jandl, Nico M.; Helmchen, Christoph


    Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive

  20. Ocular findings in systemic lupus erythemato

    Directory of Open Access Journals (Sweden)

    Samir S. Shoughy


    Full Text Available Systemic lupus erythematosus (SLE is a chronic multisystem autoimmune disease. Ocular complications occur in up to one-third of patients with SLE. The ocular findings may represent the initial manifestation of the disease and may lead to severe ocular morbidity and loss of vision. Early diagnosis and prompt management of patients with SLE are mandatory and require collaboration between the ophthalmologist and the rheumatologist.

  1. Ocular findings in systemic lupus erythematosus. (United States)

    Shoughy, Samir S; Tabbara, Khalid F


    Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease. Ocular complications occur in up to one-third of patients with SLE. The ocular findings may represent the initial manifestation of the disease and may lead to severe ocular morbidity and loss of vision. Early diagnosis and prompt management of patients with SLE are mandatory and require collaboration between the ophthalmologist and the rheumatologist.

  2. Ocular myasthenia gravis: Side effect of urografin

    Directory of Open Access Journals (Sweden)

    Nitin Modi


    Full Text Available Ocular myasthenia gravis is an autoimmune disorder of the neuromuscular junction. Diplopia and ptosis are common symptoms at the onset of ocular myasthenia gravis. It may occur due to the antibodies developed against various drugs. We are reporting a case of ocular myasthenia gravis which was developed in a patient post angiography which may be due to antibody developed against the dye used in angiography.

  3. Unusual ocular manifestations of silent sinus syndrome


    Fonseca, Fabricio Lopes da; Mazoti, Luciana; Polati, Mariza


    Silent sinus syndrome is an acquired condition in which there is a gradual collapse of the orbital floor and inward retraction of the maxillary sinus (atelectasis of the maxillary sinus). This in turn may cause associated ocular occurrences of enophthalmos and hypotropia. This is a report of an 8 year-old boy with silent sinus syndrome and associated ocular motility disorders. The association between silent sinus syndrome and ocular motility disturbance has been recently described in the lite...

  4. The stretch reflex and the contributions of C David Marsden

    Directory of Open Access Journals (Sweden)

    Kalyan B Bhattacharyya


    Full Text Available The stretch reflex or myotatic reflex refers to the contraction of a muscle in response to its passive stretching by increasing its contractility as long as the stretch is within physiological limits. For ages, it was thought that the stretch reflex was of short latency and it was synonymous with the tendon reflex, subserving the same spinal reflex arc. However, disparities in the status of the two reflexes in certain clinical situations led Marsden and his collaborators to carry out a series of experiments that helped to establish that the two reflexes had different pathways. That the two reflexes are dissociated has been proved by the fact that the stretch reflex and the tendon reflex, elicited by stimulation of the same muscle, have different latencies, that of the stretch reflex being considerably longer. They hypothesized that the stretch reflex had a transcortical course before it reached the spinal motor neurons for final firing. Additionally, the phenomenon of stimulus-sensitive cortical myoclonus lent further evidence to the presence of the transcortical loop where the EEG correlate preceded the EMG discharge. This concept has been worked out by later neurologists in great detail , and the general consensus is that indeed, the stretch reflex is endowed with a conspicuous transcortical component.

  5. Orthodoxy and reflexivity in international comparative analysis

    DEFF Research Database (Denmark)

    Lind, Jens; Valkenburg, Ben


    This contribution aims at four points.First we want to argue why we think a reflexive social science is more adequate than the orthodox consensus. In current practice much of the criticism on the orthodox consensus is shared on a theoretical level, without considering the implications and acting...... upon the consequences on the level of empirical research. We want to avoid that, so our second and third subject will be the practical implications of reflexivity for empirical research as well as for social policy. Our discussion on these subjects is based on the practical experiences in the INPART...

  6. Probabilities on Streams and Reflexive Games

    Directory of Open Access Journals (Sweden)

    Andrew Schumann


    Full Text Available Probability measures on streams (e.g. on hypernumbers and p-adic numbers have been defined. It was shown that these probabilities can be used for simulations of reflexive games. In particular, it can be proved that Aumann's agreement theorem does not hold for these probabilities. Instead of this theorem, there is a statement that is called the reflexion disagreement theorem. Based on this theorem, probabilistic and knowledge conditions can be defined for reflexive games at various reflexion levels up to the infinite level. (original abstract

  7. MR imaging features and clinical value of vestibular aqueduct and endolymphatic sac in patients with large vestibular aqueduct syndrome

    International Nuclear Information System (INIS)

    Fang Zheming; Lou Xin; Lan Lan; Wang Hui; Wang Qiuju; Wu Nanzhou; Zhang Xiaojing


    Objective: To investigate MR imaging features of endolymphatic sac and vestibular aqueduct in patients with large vestibular aqueduct syndrome (LVAS) and its correlation with hearing loss. Methods: MR imaging findings of LVAS were analyzed in 31 cases (62 ears) retrospectively. MR imaging features were grouped into 4 types. In the first type, the signals of endolymphatic and vestibular aqueduct were hypointense without any hyperintense area. In the second type, the signals of endolymphatic sac and vestibular were hyperintense which were confined within vestibular fissure. In the third type, the area from vestibular aqueduct backward out of the edge of the petrous bone was hyperintense, but its lower boundary was above posterior semicircular. In the fourth type the area which was hyperintense was below the posterior semicircular. To avoid errors in visual inspection, the hyperintense and hypointense area of endolymphatic and the signal intensity of vestibular aqueduct and cerebrospinal fluid (CSF) were measured. The differences of signal intensity among the vestibular endolymphatic sac between the high-signal areas and low signal areas were compared with paired t-test. The correlation of the endolymphatic sac MRI classification and degree of hearing loss was analyzed by corrected Chi-square test and Spearman correlation analysis. Result: Ten ears belonged to type Ⅰ (moderate hearing loss in 1 ear,severe in 4 ears,profound in 5 ears), 17 ears belonged to type Ⅱ (moderate hearing loss in 1 ear; severe in 5 ears,profound in 11 ears), 23 ears to type Ⅲ (moderate hearing loss in 3 ear, severe in 5 ears, profound in 15 ears) and 12 ears belonged to Ⅳ (mild hearing loss in 1 ear, moderate in 1 ear, severe 3 ear, profound in 7 ears). The boundary between hyperintense and hypointense area was clear, and the signal intensity ratios was 2.02 ± 0.06. The signal ratios of hyperintense and hypointense area to vestibular and CSF were 0.95 ±0.12, 0.49 ±0.10, 0.99 ± 0

  8. Wavelet-Based Artifact Identification and Separation Technique for EEG Signals during Galvanic Vestibular Stimulation (United States)

    Adib, Mani; Cretu, Edmond


    We present a new method for removing artifacts in electroencephalography (EEG) records during Galvanic Vestibular Stimulation (GVS). The main challenge in exploiting GVS is to understand how the stimulus acts as an input to brain. We used EEG to monitor the brain and elicit the GVS reflexes. However, GVS current distribution throughout the scalp generates an artifact on EEG signals. We need to eliminate this artifact to be able to analyze the EEG signals during GVS. We propose a novel method to estimate the contribution of the GVS current in the EEG signals at each electrode by combining time-series regression methods with wavelet decomposition methods. We use wavelet transform to project the recorded EEG signal into various frequency bands and then estimate the GVS current distribution in each frequency band. The proposed method was optimized using simulated signals, and its performance was compared to well-accepted artifact removal methods such as ICA-based methods and adaptive filters. The results show that the proposed method has better performance in removing GVS artifacts, compared to the others. Using the proposed method, a higher signal to artifact ratio of −1.625 dB was achieved, which outperformed other methods such as ICA-based methods, regression methods, and adaptive filters. PMID:23956786

  9. Wavelet-Based Artifact Identification and Separation Technique for EEG Signals during Galvanic Vestibular Stimulation

    Directory of Open Access Journals (Sweden)

    Mani Adib


    Full Text Available We present a new method for removing artifacts in electroencephalography (EEG records during Galvanic Vestibular Stimulation (GVS. The main challenge in exploiting GVS is to understand how the stimulus acts as an input to brain. We used EEG to monitor the brain and elicit the GVS reflexes. However, GVS current distribution throughout the scalp generates an artifact on EEG signals. We need to eliminate this artifact to be able to analyze the EEG signals during GVS. We propose a novel method to estimate the contribution of the GVS current in the EEG signals at each electrode by combining time-series regression methods with wavelet decomposition methods. We use wavelet transform to project the recorded EEG signal into various frequency bands and then estimate the GVS current distribution in each frequency band. The proposed method was optimized using simulated signals, and its performance was compared to well-accepted artifact removal methods such as ICA-based methods and adaptive filters. The results show that the proposed method has better performance in removing GVS artifacts, compared to the others. Using the proposed method, a higher signal to artifact ratio of −1.625 dB was achieved, which outperformed other methods such as ICA-based methods, regression methods, and adaptive filters.

  10. Medicina regenerativa y superficie ocular Regenerative medicine and ocular surface

    Directory of Open Access Journals (Sweden)

    Taimi Cárdenas Díaz


    Full Text Available En los últimos años se ha producido un extraordinario avance en los conocimientos relacionados con diferentes ramas biomédicas, entre ellas, la biología celular. Esto ha dado un notable impulso a una nueva rama de la medicina denominada medicina regenerativa. Esta nueva disciplina médica se basa fundamentalmente en los nuevos conocimientos sobre las células madre y en su capacidad de convertirse en células de diferentes tejidos. Una de las estructuras que tiene más interés, desde el punto de vista de la medicina regenerativa, es la superficie ocular. Por esto, se ha logrado notables progresos en la reconstrucción de la superficie ocular mediante la aplicación de procederes regenerativos. Los cultivos de células del epitelio corneal humano están siendo utilizados en el tratamiento de la insuficiencia limbar. Esto permite disminuir la incidencia de opacidades tipo Haze tras queratectomía fotorrefractiva, acelerar la curación y evitar la aparición de leucomas en pacientes con defectos epiteliares persistentes e intentar disminuir la incidencia de opacidades corneales en pacientes sometidos a queratectomía fototerapéutica por diferentes distrofias corneales.In the last few years, an extraordinary advance has taken place in the knowledge about several biomedical branches as is the case of cellular biology, which has remarkably encouraged the development of a new medical branch called regenerative medicine. This medical discipline is fundamentally based on the new knowledge on the stem cells and their capacity to become cells for different tissues. One of the most interesting structures for the regenerative medicine is the ocular surface. In the last few years, significant advances have been achieved in the field of the ocular surface reconstruction with regenerative procedures. Some cell cultures of the human corneal epithelium are being used to treat limber insufficiency, to reduce the incidence of haze-type opacities after

  11. Charitable giving and reflexive individuals: How personal reflexivity mediates between structure and agency. (United States)

    Sanghera, Balihar


    This article examines how individuals are reflexive beings who interpret the world in relation to things that matter to them, and how charitable acts are evaluated and embedded in their lives with different degrees of meaning and importance. Rather than framing the discussion of charitable practices in terms of an altruism/egoism binary or imputing motivations and values to social structures, the article explains how reflexivity is an important and neglected dimension of social practices, and how it interacts with sympathy, sentiments and discourses to shape giving. The study also shows that there are different modes of reflexivity, which have varied effects on charity and volunteering.

  12. Role of ocular VEMP test in assessing the occurrence of vertigo in otosclerosis patients. (United States)

    Lin, Kuei-You; Young, Yi-Ho


    This study adopted an inner ear test battery comprising audiometry, caloric test, ocular vestibular-evoked myogenic potential (oVEMP) test and cervical VEMP (cVEMP) test to find the factors related to the occurrence of vertigo in patients with otosclerosis. Fifty otosclerosis patients comprising 27 patients with vertigo (Group A) and 23 patients without vertigo/dizziness (Group B) were enrolled. Each patient underwent otoscopy, image study, audiometry, caloric test, and oVEMP and cVEMP tests via bone vibration stimuli. The sequence of inner ear deficits in Group A was in the order from oVEMP test (84%), cVEMP test (51%), caloric test (38%) and mean bone-conducted (BC) hearing threshold (14%), exhibiting a significantly declining trend (p0.05). Further, no significant differences existed between the BC hearing threshold and vestibular function test results. Otosclerosis patients with vertigo have more frequent abnormalities of oVEMPs to impulsive stimulation than do those without, consistent with more frequent abnormalities of the utricle. Abnormalities of oVEMPs and cVEMPs are more frequent than for caloric testing and BC hearing thresholds. The relative frequency of abnormalities may reflect the degree of pathological involvement of the utricle, saccule, semicircular canals and cochlea in otosclerosis patients with vertigo. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  13. A simple measurement hammer for quantitative reflex studies

    NARCIS (Netherlands)

    Stam, J.; van Leeuwen, J. R.


    A reflex hammer for measurement of the mechanical stimulus strength was designed. Combined with standard EMG equipment this instrument permits the study of both stimulus-response relations and latencies of myotatic reflexes. Some results in normal subjects are discussed

  14. A Prototype Analysis of Spanish Indeterminate Reflexive Constructions. (United States)

    Turley, Jeffrey S.


    Discussion of the Spanish indeterminate reflexive construction, the impersonal reflexive, finds that prototype theory allows this subjectless Spanish construction to be included within the category of generally subject-bearing indeterminates in Romance languages. (MSE)

  15. Comparison of Stretch Reflex Torques in Ankle Dorsiflexors and Plantarflexors

    National Research Council Canada - National Science Library

    Tung, J


    ...) ankle muscles, Pulse, step, and a combination of random perturbation and step inputs were used to identify the reflex and intrinsic contributions to the measured torque, TA reflex torques were very...

  16. Unilateral vestibular deafferentation-induced changes in calcium signaling-related molecules in the rat vestibular nuclear complex. (United States)

    Masumura, Chisako; Horii, Arata; Mitani, Kenji; Kitahara, Tadashi; Uno, Atsuhiko; Kubo, Takeshi


    Inquiries into the neurochemical mechanisms of vestibular compensation, a model of lesion-induced neuronal plasticity, reveal the involvement of both voltage-gated Ca(2+) channels (VGCC) and intracellular Ca(2+) signaling. Indeed, our previous microarray analysis showed an up-regulation of some calcium signaling-related genes such as the alpha2 subunit of L-type calcium channels, calcineurin, and plasma membrane Ca(2+) ATPase 1 (PMCA1) in the ipsilateral vestibular nuclear complex (VNC) following unilateral vestibular deafferentation (UVD). To further elucidate the role of calcium signaling-related molecules in vestibular compensation, we used a quantitative real-time polymerase chain reaction (PCR) method to confirm the microarray results and investigated changes in expression of these molecules at various stages of compensation (6 h to 2 weeks after UVD). We also investigated the changes in gene expression during Bechterew's phenomenon and the effects of a calcineurin inhibitor on vestibular compensation. Real-time PCR showed that genes for the alpha2 subunit of VGCC, PMCA2, and calcineurin were transiently up-regulated 6 h after UVD in ipsilateral VNC. A subsequent UVD, which induced Bechterew's phenomenon, reproduced a complete mirror image of the changes in gene expressions of PMCA2 and calcineurin seen in the initial UVD, while the alpha2 subunit of VGCC gene had a trend to increase in VNC ipsilateral to the second lesion. Pre-treatment by FK506, a calcineurin inhibitor, decelerated the vestibular compensation in a dose-dependent manner. Although it is still uncertain whether these changes in gene expression are causally related to the molecular mechanisms of vestibular compensation, this observation suggests that after increasing the Ca(2+) influx into the ipsilateral VNC neurons via up-regulated VGCC, calcineurin may be involved in their synaptic plasticity. Conversely, an up-regulation of PMCA2, a brain-specific Ca(2+) pump, would increase an efflux of Ca

  17. The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Amir Abbas Ebrahimi


    Full Text Available The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys with the profound sensorineural hearing loss (PTA>90 dB. They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP. For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT was completed pre- and post-intervention with SPS (Synapsys, Marseille, France. Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS, vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05. The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program.

  18. Deconvolution of the vestibular evoked myogenic potential. (United States)

    Lütkenhöner, Bernd; Basel, Türker


    The vestibular evoked myogenic potential (VEMP) and the associated variance modulation can be understood by a convolution model. Two functions of time are incorporated into the model: the motor unit action potential (MUAP) of an average motor unit, and the temporal modulation of the MUAP rate of all contributing motor units, briefly called rate modulation. The latter is the function of interest, whereas the MUAP acts as a filter that distorts the information contained in the measured data. Here, it is shown how to recover the rate modulation by undoing the filtering using a deconvolution approach. The key aspects of our deconvolution algorithm are as follows: (1) the rate modulation is described in terms of just a few parameters; (2) the MUAP is calculated by Wiener deconvolution of the VEMP with the rate modulation; (3) the model parameters are optimized using a figure-of-merit function where the most important term quantifies the difference between measured and model-predicted variance modulation. The effectiveness of the algorithm is demonstrated with simulated data. An analysis of real data confirms the view that there are basically two components, which roughly correspond to the waves p13-n23 and n34-p44 of the VEMP. The rate modulation corresponding to the first, inhibitory component is much stronger than that corresponding to the second, excitatory component. But the latter is more extended so that the two modulations have almost the same equivalent rectangular duration. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Stereotactic radiation therapy for large vestibular schwannomas

    International Nuclear Information System (INIS)

    Mandl, Ellen S.; Meijer, Otto W.M.; Slotman, Ben J.; Vandertop, W. Peter; Peerdeman, Saskia M.


    Background and purpose: To evaluate the morbidity and tumor-control rate in the treatment of large vestibular schwannomas (VS) after stereotactic radiation therapy in our institution. Material and methods: Twenty-five consecutive patients (17 men, 8 women) with large VS (diameter 3.0 cm or larger), treated with stereotactic radiotherapy (SRT) or stereotactic radiosurgery (SRS) between 1992 and 2007, were retrospectively studied after a mean follow-up period of three years with respect to tumor-control rate and complications. Results: Actuarial 5-year maintenance of pre-treatment hearing level probability of 30% was achieved. Five of 17 patients suffered permanent new facial nerve dysfunction. The actuarial 5-year facial nerve preservation probability was 80%. Permanent new trigeminal nerve neuropathy occurred in two of 15 patients, resulting in an actuarial 5-year trigeminal nerve preservation probability of 85%. Tumor progression occurred in four of 25 (16%) patients. The overall 5-year tumor control probability was 82%. Conclusion: Increased morbidity rates were found in patients with large VS treated with SRT or SRS compared to the published series on regular sized VS and other smaller retrospective studies on large VS.

  20. Impaired math achievement in patients with acute vestibular neuritis. (United States)

    Moser, Ivan; Vibert, Dominique; Caversaccio, Marco D; Mast, Fred W


    Broad cognitive difficulties have been reported in patients with peripheral vestibular deficit, especially in the domain of spatial cognition. Processing and manipulating numbers relies on the ability to use the inherent spatial features of numbers. It is thus conceivable that patients with acute peripheral vestibular deficit show impaired numerical cognition. Using the number Stroop task and a short math achievement test, we tested 20 patients with acute vestibular neuritis and 20 healthy, age-matched controls. On the one hand, patients showed normal congruency and distance effects in the number Stroop task, which is indicative of normal number magnitude processing. On the other hand, patients scored lower than healthy controls in the math achievement test. We provide evidence that the lower performance cannot be explained by either differences in prior math knowledge (i.e., education) or slower processing speed. Our results suggest that peripheral vestibular deficit negatively affects numerical cognition in terms of the efficient manipulation of numbers. We discuss the role of executive functions in math performance and argue that previously reported executive deficits in patients with peripheral vestibular deficit provide a plausible explanation for the lower math achievement scores. In light of the handicapping effects of impaired numerical cognition in daily living, it is crucial to further investigate the mechanisms that cause mathematical deficits in acute PVD and eventually develop adequate means for cognitive interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Influence of cochlear implantation on peripheral vestibular receptor function. (United States)

    Krause, Eike; Louza, Julia P R; Wechtenbruch, Juliane; Gürkov, Robert


    The objectives of this study were 1) to assess the influence of a cochlear implantation on peripheral vestibular receptor function in the inner ear in the implant and in the nonimplant side, and 2) to analyze a possible correlation with resulting vertigo symptoms. Prospective clinical study. Cochlear implant center at tertiary referral hospital. A total of 32 patients, aged 15 to 83 years, undergoing cochlear implantation were assessed pre- and postoperatively for caloric horizontal semicircular canal response and vestibular-evoked myogenic potentials of the sacculus, and postoperatively for subjective vertigo symptoms. Patients with vertigo were compared with patients without symptoms with regard to the findings of the vestibular function tests. Cochlear implantation represents a significant risk factor for horizontal semicircular canal impairment (P 0.05). Cochlear implantation is a relevant risk factor for damage of peripheral vestibular receptor function. Therefore, preservation not only of residual hearing function but also of vestibular function should be aimed for, by using minimally invasive surgical techniques. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  2. Síndrome de Cogan: achados oculares em um caso da forma atípica Cogan's syndrome: ocular findings in an atypical case

    Directory of Open Access Journals (Sweden)

    Ana Karina Santiago de Medeiros Lima


    Full Text Available A síndrome de Cogan é entidade multissistêmica rara caracterizada por ceratite intersticial associada à disfunção áudio-vestibular e possível surdez irreversível classificada em duas formas clínicas: típica e atípica. Há discordância na literatura quanto à presença de acometimento corneano na forma atípica. Uma paciente de 32 anos queixando-se de hiperemia e dor ocular, fotofobia e baixa da acuidade visual no olho direito, associada à perda súbita de audição à esquerda, vômitos, diarréia, oligúria, dor na orofaringe e febre. História prévia de semelhante acometimento do olho esquerdo e audição direita. Havia intensa hiperemia conjuntival, esclerite nodular, episclerite e infiltrados circulares no estroma corneano. A paciente recebeu pulsoterapia com metilprednisolona e ciclofosfamida. Evoluiu com grande melhora ocular, porém com resposta auditiva pobre. O caso reportado pode constituir forma típica da síndrome de Cogan (de acordo com autores que defendem o não-acometimento corneano na forma atípica com alguns achados característicos da forma atípica ou um caso da forma atípica da síndrome de Cogan (para aqueles que defendem o acometimento corneano na forma atípica. O diagnóstico diferencial também é discutido.Cogan's syndrome is an unusual multisystemic disease characterized by intersticial keratitis in association with vestibuloauditory dysfunction and possible irreversible deafness, classified into 2 clinical types: typical and atypical. There is disagreement in the literature about corneal disease in the atypical variety. A 32-year-old woman complaining of ocular hyperemia and ocular pain, photophobia and visual acuity loss in the right eye associated with sudden left hearing loss, vomiting, diarrhea, oliguria, oropharynx pain and fever. Previous history of similar disease in left eye and right hearing. There was intense conjunctival hyperemia, nodular scleritis, episcleritis, and circular infiltrates

  3. Vestibular and stabilometric findings in whiplash injury and minor head trauma. (United States)

    Nacci, A; Ferrazzi, M; Berrettini, S; Panicucci, E; Matteucci, J; Bruschini, L; Ursino, F; Fattori, B


    Vertigo and postural instability following whiplash and/or minor head injuries is very frequent. According to some authors, post-whiplash vertigo cannot be caused by real injury to vestibular structures; other authors maintain that vestibular damage is possible even in the case of isolated whiplash, with vascular or post-traumatic involvement. Furthermore, many of the balance disorders reported after trauma can be justified by post-traumatic modification to the cervical proprioceptive input, with consequent damage to the vestibular spinal reflex. The aim of this study was to evaluate the vestibular condition and postural status in a group of patients (Group A, n = 90) affected with balance disorders following whiplash, and in a second group (Group B, n = 20) with balance disorders after minor head injury associated with whiplash. Both groups were submitted to videonystagmography (VNG) and stabilometric investigation (open eyes - O E, closed eyes - CE, closed eyes with head retroflexed - CER) within 15 days of their injuries and repeated within 10 days after conclusion of cervical physiotherapy treatment. The VNG tests revealed vestibulopathy in 19% of cases in Group A (11% peripheral, 5% central, 3% in an undefined site) and in 60% of subjects in Group B (50% peripheral, 10% central). At the follow-up examination, all cases of non-compensated labyrinth deficit showed signs of compensation, while there were two cases (2%) in Group A and one case (5%) in Group B of PPV. As far as the altered posturographic recordings are concerned, while there was no specific pattern in the two groups, they were clearly pathologic, especially during CER. Both in OE and in CE there was an increase in the surface values and in those pertaining to shifting of the gravity centre on the sagittal plane, which was even more evident during CER. In Group A, the pre-post-physiotherapy comparison of CER results showed that there was a statistically significant improvement in the majority of the

  4. Biological Motion Cues Trigger Reflexive Attentional Orienting (United States)

    Shi, Jinfu; Weng, Xuchu; He, Sheng; Jiang, Yi


    The human visual system is extremely sensitive to biological signals around us. In the current study, we demonstrate that biological motion walking direction can induce robust reflexive attentional orienting. Following a brief presentation of a central point-light walker walking towards either the left or right direction, observers' performance…

  5. Dilemmas and Deliberations in Reflexive Ethnographic Research (United States)

    Robinson, Janean Valerie


    This paper traces insights into the challenges and dilemmas experienced whilst researching students' interpretations and understandings of the Behaviour Management in Schools policy in Western Australia. Journal records, supported by student transcripts, are woven together in a reflexive ethnographic journey--from the beginning phase of searching…

  6. Reflex epilepsy: triggers and management strategies

    Directory of Open Access Journals (Sweden)

    Okudan ZV


    Full Text Available Zeynep Vildan Okudan,1 Çiğdem Özkara2 1Department of Neurology, Bakirkoy Dr Sadi Konuk Education and Research Hospital, 2Department of Neurology and Clinical Neurophysiology, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey Abstract: Reflex epilepsies (REs are identified as epileptic seizures that are consistently induced by identifiable and objective-specific triggers, which may be an afferent stimulus or by the patient’s own activity. RE may have different subtypes depending on the stimulus characteristic. There are significant clinical and electrophysiologic differences between different RE types. Visual stimuli-sensitive or photosensitive epilepsies constitute a large proportion of the RE and are mainly related to genetic causes. Reflex epilepsies may present with focal or generalized seizures due to specific triggers, and sometimes seizures may occur spontaneously. The stimuli can be external (light flashes, hot water, internal (emotion, thinking, or both and should be distinguished from triggering precipitants, which most epileptic patients could report such as emotional stress, sleep deprivation, alcohol, and menstrual cycle. Different genetic and acquired factors may play a role in etiology of RE. This review will provide a current overview of the triggering factors and management of reflex seizures. Keywords: seizure, reflex epilepsy, photosensitivity, hot water, reading, thinking

  7. The acoustic reflex threshold in aging ears. (United States)

    Silverman, C A; Silman, S; Miller, M H


    This study investigates the controversy regarding the influence of age on the acoustic reflex threshold for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators between Jerger et al. [Mono. Contemp. Audiol. 1 (1978)] and Jerger [J. Acoust. Soc. Am. 66 (1979)] on the one hand and Silman [J. Acoust. Soc. Am. 66 (1979)] and others on the other. The acoustic reflex thresholds for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators were evaluated under two measurement conditions. Seventy-two normal-hearing ears were drawn from 72 subjects ranging in age from 20-69 years. The results revealed that age was correlated with the acoustic reflex threshold for BBN activator but not for any of the tonal activators; the correlation was stronger under the 1-dB than under the 5-dB measurement condition. Also, the mean acoustic reflex thresholds for broadband noise activator were essentially similar to those reported by Jerger et al. (1978) but differed from those obtained in this study under the 1-dB measurement condition.

  8. A reflexive perspective in problem solving


    Chio, José Angel; Álvarez, Aida; López, Margarita


    The objective of this paper is to favour the methodological process of reflexive analysis in problem solving in the general teaching methods that concentrates in strengthening the dimensional analysis, to gain a greater preparation of the students for the solution of mathematical problems.

  9. Association between vestibular function and motor performance in hearing-impaired children. (United States)

    Maes, Leen; De Kegel, Alexandra; Van Waelvelde, Hilde; Dhooge, Ingeborg


    The clinical balance performance of normal-hearing (NH) children was compared with the balance performance of hearing-impaired (HI) children with and without vestibular dysfunction to identify an association between vestibular function and motor performance. Prospective study. Tertiary referral center. Thirty-six children (mean age, 7 yr 5 mo; range, 3 yr 8 mo-12 yr 11 mo) divided into three groups: NH children with normal vestibular responses, HI children with normal vestibular responses, and HI children with abnormal vestibular function. A vestibular test protocol (rotatory and collic vestibular evoked myogenic potential testing) in combination with three clinical balance tests (balance beam walking, one-leg hopping, one-leg stance). Clinical balance performance. HI children with abnormal vestibular test results obtained the lowest quotients of motor performance, which were significantly lower compared with the NH group (p beam walking and one-leg stance; p = 0.003 for one-leg hopping). The balance performance of the HI group with normal vestibular responses was better in comparison with the vestibular impaired group but still significantly lower compared with the NH group (p = 0.020 for balance beam walking; p = 0.001 for one-leg stance; not significant for one-leg hopping). These results indicate an association between vestibular function and motor performance in HI children, with a more distinct motor deterioration if a vestibular impairment is superimposed to the auditory dysfunction.

  10. Morphology and electrophysiology of the vestibular organ in the guinea pig

    NARCIS (Netherlands)

    Oei, Markus Lee Yang Murti


    To obtain more information about the anatomy and function of the vestibular organ in normal and pathological conditions, evaluation methods are needed. For experimental purposes, the vestibular organ of the guinea pig is often used as a model for the human vestibular organ. The purpose of the

  11. Evaluation of diagnostic tests of the otolith organs and their application in various vestibular pathologies

    NARCIS (Netherlands)

    Winters, S.M.


    Current vestibular testing is limited. The general function of the vestibular system on both sides of the head can be tested, and one part of the peripheral vestibular organ, the horizontal semicircular canal, can be tested unilaterally. However, recently a test for the function of the otolith

  12. Ocular dirofilariasis in Dubai, UAE

    Directory of Open Access Journals (Sweden)

    Mittal Mamta


    Full Text Available A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.

  13. Miasis ocular por Oestrus ovis

    Directory of Open Access Journals (Sweden)

    María Beltrán F


    Full Text Available Se presentan tres casos de miasis ocular (dos adultos y un niñoprocedentes de zonas ganaderas de la provincia de Huaura,departamento de Lima,que acudieron al Hospital Regional de Huacho por presentar el ojo rojo,fotofobia, edema palpebral y sensación de cuerpo extraño;se extrajeron larvas adheridas al canto interno del ojo,las cuales se recibieron en el Instituto Nacional de Salud y fueron identificadas como Oestrus ovis .

  14. Raman Spectroscopy of Ocular Tissue (United States)

    Ermakov, Igor V.; Sharifzadeh, Mohsen; Gellermann, Warner

    The optically transparent nature of the human eye has motivated numerous Raman studies aimed at the non-invasive optical probing of ocular tissue components critical to healthy vision. Investigations include the qualitative and quantitative detection of tissue-specific molecular constituents, compositional changes occurring with development of ocular pathology, and the detection and tracking of ocular drugs and nutritional supplements. Motivated by a better understanding of the molecular mechanisms leading to cataract formation in the aging human lens, a great deal of work has centered on the Raman detection of proteins and water content in the lens. Several protein groups and the hydroxyl response are readily detectable. Changes of protein compositions can be studied in excised noncataractous tissue versus aged tissue preparations as well as in tissue samples with artificially induced cataracts. Most of these studies are carried out in vitro using suitable animal models and conventional Raman techniques. Tissue water content plays an important role in optimum light transmission of the outermost transparent ocular structure, the cornea. Using confocal Raman spectroscopy techniques, it has been possible to non-invasively measure the water to protein ratio as a measure of hydration status and to track drug-induced changes of the hydration levels in the rabbit cornea at various depths. The aqueous humor, normally supplying nutrients to cornea and lens, has an advantageous anterior location for Raman studies. Increasing efforts are pursued to non-invasively detect the presence of glucose and therapeutic concentrations of antibiotic drugs in this medium. In retinal tissue, Raman spectroscopy proves to be an important tool for research into the causes of macular degeneration, the leading cause of irreversible vision disorders and blindness in the elderly. It has been possible to detect the spectral features of advanced glycation and advanced lipooxydation end products in

  15. Snout and Visual Rooting Reflexes in Infantile Autism. Brief Report. (United States)

    Minderaa, Ruud B.; And Others


    The authors conducted extensive neurological evaluations of 42 autistic individuals and were surprised to discover a consistently positive snout reflex in most of them. Difficulties with assessing the reflex are noted. The authors then reassessed the Ss for a series of primitive reflexes which are interpreted as signs of diffuse cortical brain…

  16. A curious fact: Photic sneeze reflex. Autosomical dominant compelling helio-ophthalmic outburst syndrome. (United States)

    Sevillano, C; Parafita-Fernández, A; Rodriguez-Lopez, V; Sampil, M; Moraña, N; Viso, E; Cores, F J


    To assess ocular involvement in the pathophysiology of autosomal dominant compelling helio-ophthalmic outburst syndrome (ACHOOs). An interview was conducted with a Caucasian family that showed clinical features of ACHOOs. Twelve of them had photic reflex and were recruited. A complete eye evaluation was made. A dominant autosomal inheritance with mild penetrance was demonstrated, with 67% of the studied subjects showing some degree of prominent corneal nerves. No other eye changes were found. Prominent corneal nerves may be associated with ACHOOs. The other eye structures studied do not seem to play a role in ACHOOs. Further studies are needed to understand the physiology of the ACHOOs. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  17. Effect of chronic and acute cigarette smoking on the pharyngo-upper oesophageal sphincter contractile reflex and reflexive pharyngeal swallow


    Dua, K; Bardan, E; Ren, J; Sui, Z; Shaker, R


    Background—Cigarette smoking is known to affect adversely the defence mechanisms against gastro-oesophageal reflux. The effect of smoking on the supraoesophageal reflexes that prevent aspiration of gastric contents has not been previously studied. 
Aims—To elucidate the effect of cigarette smoking on two of the supraoesophageal reflexes: the pharyngo-upper oesophageal sphincter (UOS) contractile reflex; and the reflexive pharyngeal swallow. 
Methods—Ten chronic smokers and 10 non-...

  18. Immunocytochemical and stereological analysis of GABA(B) receptor subunit expression in the rat vestibular nucleus following unilateral vestibular deafferentation. (United States)

    Zhang, Rong; Ashton, John; Horii, Arata; Darlington, Cynthia L; Smith, Paul F


    The process of behavioral recovery that occurs following damage to one vestibular labyrinth, vestibular compensation, has been attributed in part to a down-regulation of GABA(B) receptors in the vestibular nucleus complex (VNC) ipsilateral to the lesion, which could potentially reduce commissural inhibition from the contralateral VNC. In this study, we tested the possibility that this occurs through a decrease in the expression of either the GABA(B1) or GABA(B2) subunits of the GABA(B) receptor. We used Western blotting to quantify the expression of these subunits in the VNC at 10 h and 50 h following unilateral vestibular deafferentation (UVD) or sham surgery in rats. We then used immunocytochemistry and stereological counting methods to estimate the number of neurons expressing these subunits in the MVN at 10 h and 2 weeks following UVD or sham surgery. Compared to sham controls, we found no significant changes in either the expression of the two GABA(B) receptor subunits in the VNC or in the number of MVN neurons expressing these GABA(B) receptor subunits post-UVD. These results suggest that GABA(B) receptor expression does not change substantially in the VNC during the process of vestibular compensation.

  19. Ocular morbidity among porters at high altitudes. (United States)

    Gnyawali, Subodh; Shrestha, Gauri Shankar; Khanal, Safal; Dennis, Talisa; Spencer, John C


    High altitude, often characterized by settings over 2400m, can be detrimental to the human body and pose a significant risk to ocular health. Reports concerning various ocular morbidities occurring as a consequence of high altitude are limited in the current literature. This study was aimed at evaluating the ocular health of porters working at high altitudesof Himalayas in Nepal. A mobile eye clinic was set up in Ghat and patient data were collected from its out- patient unit by a team of seven optometrists which was run for five days. Ghat is a small village in north-eastern Nepal, located at 2860 m altitude. Travellers walking through the trekking route were invited to get their eyes checked at the clinic. Comprehensive ocular examinations were performed, including visual acuities, objective and subjective refraction, anterior and posterior segment evaluations, and intraocular pressure measurements; blood pressure and blood glucose levels were also measured as required. Ocular therapeutics, prescription glasses, sunglasses and ocular health referrals were provided free of cost as necessary. A total of 1890 people visited the eye clinic, among which 57.4% (n=1084) were porters. Almost half of the porters had an ocular morbidity. Correctable refractive error was most prevalent, with other ocular health-related complications, including dry eye disease, infectious disorders, glaucoma and cataract. Proper provision of regular and effective eye care services should be made more available for those residing at these high altitudes in Nepal. © NEPjOPH.

  20. Sonographic measurements of ocular biometry of indigenous ...

    African Journals Online (AJOL)

    This study was aimed at conducting ophthalmic sonographic examination of Nigerian indigenous dogs to provide baseline information on some major ocular parameters. Healthy eyes of eighty (80) indigenous dogs were used for the study. The dogs were adequately restrained physically and the structure of the ocular ...


    African Journals Online (AJOL)

    Cerebral palsy is commonly associated with ocular abnormalities which often impact on their development and education. There is paucity of studies on this in Nigeria. We decided to study/ determine the prevalence of ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of ...

  2. 21 CFR 886.1040 - Ocular esthesiometer. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ocular esthesiometer. 886.1040 Section 886.1040 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED.... An ocular esthesiometer is a device, such as a single-hair brush, intended to touch the cornea to...

  3. The effects of aging on clinical vestibular evaluations

    Directory of Open Access Journals (Sweden)

    Maxime eMaheu


    Full Text Available Balance disorders are common issues for aging populations due to the effects of normal aging on peripheral vestibular structures. These changes affect the results of vestibular function evaluations and make the interpretation of these results more difficult. The objective of this article is to review the current state of knowledge of clinically relevant vestibular measures. We will first focus on otolith function assessment methods cVEMP and oVEMP, then the caloric and vHIT methods for semi-circular canals assessment. cVEMP and oVEMP are useful methods, though research on the effects of age for some parameters are still inconclusive. vHIT results are largely independent of age as compared to caloric stimulation and should therefore be preferred for the evaluation of the semi-circular canals function.

  4. Visual gravitational motion and the vestibular system in humans

    Directory of Open Access Journals (Sweden)

    Francesco eLacquaniti


    Full Text Available The visual system is poorly sensitive to arbitrary accelerations, but accurately detects the effects of gravity on a target motion. Here we review behavioral and neuroimaging data about the neural mechanisms for dealing with object motion and egomotion under gravity. The results from several experiments show that the visual estimates of a target motion under gravity depend on the combination of a prior of gravity effects with on-line visual signals on target position and velocity. These estimates are affected by vestibular inputs, and are encoded in a visual-vestibular network whose core regions lie within or around the Sylvian fissure, and are represented by the posterior insula/retroinsula/temporo-parietal junction. This network responds both to target motions coherent with gravity and to vestibular caloric stimulation in human fMRI studies. Transient inactivation of the temporo-parietal junction selectively disrupts the interception of targets accelerated by gravity.

  5. Visual gravitational motion and the vestibular system in humans. (United States)

    Lacquaniti, Francesco; Bosco, Gianfranco; Indovina, Iole; La Scaleia, Barbara; Maffei, Vincenzo; Moscatelli, Alessandro; Zago, Myrka


    The visual system is poorly sensitive to arbitrary accelerations, but accurately detects the effects of gravity on a target motion. Here we review behavioral and neuroimaging data about the neural mechanisms for dealing with object motion and egomotion under gravity. The results from several experiments show that the visual estimates of a target motion under gravity depend on the combination of a prior of gravity effects with on-line visual signals on target position and velocity. These estimates are affected by vestibular inputs, and are encoded in a visual-vestibular network whose core regions lie within or around the Sylvian fissure, and are represented by the posterior insula/retroinsula/temporo-parietal junction. This network responds both to target motions coherent with gravity and to vestibular caloric stimulation in human fMRI studies. Transient inactivation of the temporo-parietal junction selectively disrupts the interception of targets accelerated by gravity.

  6. Rapid adaptation of multisensory integration in vestibular pathways

    Directory of Open Access Journals (Sweden)

    Jerome eCarriot


    Full Text Available Sensing gravity is vital for our perception of spatial orientation, the control of upright posture, and generation of our every day activities. When an astronaut transitions to microgravity or returns to earth, the vestibular input arising from self-motion will not match the brain’s expectation. Our recent neurophysiological studies have provided insight into how the nervous system rapidly reorganizes when vestibular input becomes unreliable by both 1 updating its internal model of the sensory consequences of motion and 2 up-weighting more reliable extra-vestibular information. These neural strategies, in turn, are linked to improvements in sensorimotor performance (e.g., gaze and postural stability, locomotion, orienting and perception characterized by similar time courses. We suggest that furthering our understanding of the neural mechanisms that underlie sensorimotor adaptation will have important implications for optimizing training programs for astronauts before and after space exploration missions and for the design of goal-oriented rehabilitation for patients.

  7. Imaging the ocular motor nerves

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Teresa [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Verbist, Berit [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Buchem, Mark van [Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Osch, Thijs van [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:; Webb, Andrew [C.J. Gorter for High-Field MRI, Department of Radiology, Leiden University Medical Center (Netherlands)], E-mail:


    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic resonance imaging is the imaging method of choice in the evaluation of the normal and pathologic ocular motor nerves. CT still plays a limited but important role in the evaluation of the intraosseous portions at the skull base and bony foramina. We describe for each segment of these cranial nerves, the normal anatomy, the most appropriate image sequences and planes, their imaging appearance and pathologic conditions. Magnetic resonance imaging with high magnetic fields is a developing and promising technique. We describe our initial experience with a Phillips 7.0 T MRI scanner in the evaluation of the brainstem segments of the OMNs. As imaging becomes more refined, an understanding of the detailed anatomy is increasingly necessary, as the demand on radiology to diagnose smaller lesions also increases.

  8. Ocular Surface Reconstruction: Recent Innovations

    Directory of Open Access Journals (Sweden)

    Madhavan HN


    Full Text Available The ocular surface is exceptionally rich in complexity and functionality. Severe ocular surface disorders/conditions, such as chemical or thermal injuries, Stevens-Johnson syndrome (SJS, ocular cicatricial pemphigoid, neurotrophic keratopathy, chronic limbitis, and severe microbial keratitis cause significant morbidities and even corneal blindness. Hypofunction may be caused by Aniridia, Neurotrophy, Endocrine, Pterygium and Chronic limbitis Approximately 6000 patients are seen in Ocular Surface Clinic every year; almost 80% have some form of dry eyes. About 125 new patients of Stevens Johnson Syndrome are seen in a year of which approximately 25% may benefit from Cultured Epithelial Transplant and 75 new patients of thermal/chemical injury in a year of which almost 80% will benefit from Stem Cell Transplantation. Of the 128 severe vernal keratoconjunctivitis which were seen in the ocular surface clinic, 10% require stem cell transplantation. Nearly 30 new cases of Ocular cicatrical pemphigoid every year are seen and they may need stem cell transplantation. In addition, several patients with persistent epithelial defects may benefit from limbal stem cell transplantation to alleviate, maintain conjunctivalization regression and corneal avascularity limbal deficiency, and restore vision. Even if granted that this statistics is for a single large ophthalmic hospital, for a large country as India with 1.1 billion populations, the number of patients requiring corneal stem cell transplantation is enormous. Stem cells in the palisades of Vogt participate in regeneration and preservation of corneal transparency and avascularity. The diminished regenerative capacity seen in LSCD is characterized by persistent epithelial defects, erosion and ulceration, conjunctivalization and neovascularization, and chronic inflammation. Standard corneal transplantation for restoration of corneal clarity and avascularity is a contraindication in the surgical management

  9. Motor Performance is Impaired Following Vestibular Stimulation in Ageing Mice (United States)

    Tung, Victoria W. K.; Burton, Thomas J.; Quail, Stephanie L.; Mathews, Miranda A.; Camp, Aaron J.


    Balance and maintaining postural equilibrium are important during stationary and dynamic movements to prevent falls, particularly in older adults. While our sense of balance is influenced by vestibular, proprioceptive, and visual information, this study focuses primarily on the vestibular component and its age-related effects on balance. C57Bl/6J mice of ages 1, 5–6, 8–9 and 27–28 months were tested using a combination of standard (such as grip strength and rotarod) and newly-developed behavioral tests (including balance beam and walking trajectory tests with a vestibular stimulus). In the current study, we confirm a decline in fore-limb grip strength and gross motor coordination as age increases. We also show that a vestibular stimulus of low frequency (2–3 Hz) and duration can lead to age-dependent changes in balance beam performance, which was evident by increases in latency to begin walking on the beam as well as the number of times hind-feet slip (FS) from the beam. Furthermore, aged mice (27–28 months) that received continuous access to a running wheel for 4 weeks did not improve when retested. Mice of ages 1, 10, 13 and 27–28 months were also tested for changes in walking trajectory as a result of the vestibular stimulus. While no linear relationship was observed between the changes in trajectory and age, 1-month-old mice were considerably less affected than mice of ages 10, 13 and 27–28 months. Conclusion: this study confirms there are age-related declines in grip strength and gross motor coordination. We also demonstrate age-dependent changes to finer motor abilities as a result of a low frequency and duration vestibular stimulus. These changes showed that while the ability to perform the balance beam task remained intact across all ages tested, behavioral changes in task performance were observed. PMID:26869921

  10. Motor performance is impaired following vestibular stimulation in ageing mice.

    Directory of Open Access Journals (Sweden)

    Victoria W.K. Tung


    Full Text Available Balance and maintaining postural equilibrium are important during stationary and dynamic movements to prevent falls, particularly in older adults. While our sense of balance is influenced by vestibular, proprioceptive, and visual information, this study focuses primarily on the vestibular component and its age-related effects on balance. C57Bl/6J mice of ages 1, 5-6, 8-9 and 27-28 months were tested using a combination of standard (such as grip strength and rotarod and newly-developed behavioural tests (including balance beam and walking trajectory tests with a vestibular stimulus. In the current study, we confirm a decline in fore-limb grip strength and gross motor coordination as age increases. We also show that a vestibular stimulus of low frequency (2-3 Hz and duration can lead to age-dependent changes in balance beam performance, which was evident by increases in latency to begin walking on the beam as well as the number of times hind-feet slip from the beam. Furthermore, aged mice (27-28 months that received continuous access to a running wheel for 4 weeks did not improve when retested. Mice of ages 1, 10, 13, and 27-28 months were also tested for changes in walking trajectory as a result of the vestibular stimulus. While no linear relationship was observed between the changes in trajectory and age, 1-month-old mice were considerably less affected than mice of ages 10, 13, and 27-28 months. Conclusion: This study confirms there are age-related declines in grip strength and gross motor coordination. We also demonstrate age-dependent changes to finer motor abilities as a result of a low frequency and duration vestibular stimulus. These changes showed that while the ability to perform the balance beam task remained intact across all ages tested, behavioural changes in task performance were observed.

  11. Motor Performance is Impaired Following Vestibular Stimulation in Ageing Mice. (United States)

    Tung, Victoria W K; Burton, Thomas J; Quail, Stephanie L; Mathews, Miranda A; Camp, Aaron J


    Balance and maintaining postural equilibrium are important during stationary and dynamic movements to prevent falls, particularly in older adults. While our sense of balance is influenced by vestibular, proprioceptive, and visual information, this study focuses primarily on the vestibular component and its age-related effects on balance. C57Bl/6J mice of ages 1, 5-6, 8-9 and 27-28 months were tested using a combination of standard (such as grip strength and rotarod) and newly-developed behavioral tests (including balance beam and walking trajectory tests with a vestibular stimulus). In the current study, we confirm a decline in fore-limb grip strength and gross motor coordination as age increases. We also show that a vestibular stimulus of low frequency (2-3 Hz) and duration can lead to age-dependent changes in balance beam performance, which was evident by increases in latency to begin walking on the beam as well as the number of times hind-feet slip (FS) from the beam. Furthermore, aged mice (27-28 months) that received continuous access to a running wheel for 4 weeks did not improve when retested. Mice of ages 1, 10, 13 and 27-28 months were also tested for changes in walking trajectory as a result of the vestibular stimulus. While no linear relationship was observed between the changes in trajectory and age, 1-month-old mice were considerably less affected than mice of ages 10, 13 and 27-28 months. this study confirms there are age-related declines in grip strength and gross motor coordination. We also demonstrate age-dependent changes to finer motor abilities as a result of a low frequency and duration vestibular stimulus. These changes showed that while the ability to perform the balance beam task remained intact across all ages tested, behavioral changes in task performance were observed.

  12. Plasticity during vestibular compensation: the role of saccades

    Directory of Open Access Journals (Sweden)

    Hamish Gavin MacDougall


    Full Text Available This paper is focussed on one major aspect of compensation: the recent behavioural findings concerning oculomotor responses in human vestibular compensation and their possible implications for recovery after unilateral vestibular loss (UVL. New measurement techniques have provided new insights into how patients recover after UVL and have given clues for vestibular rehabilitation. Prior to this it has not been possible to quantify the level of function of all the peripheral vestibular sense organs. Now it is. By using vestibular-evoked myogenic potentials to measure utricular and saccular function and by new video head impulse testing to measure semicircular canal function to natural values of head accelerations. With these new video procedures it is now possible to measure both slow phase eye velocity and also saccades during natural head movements. The present evidence is that there is little or no recovery of slow phase eye velocity responses to natural head accelerations. It is doubtful as to whether the modest changes in slow phase eye velocity to small angular accelerations are functionally effective during compensation. On the other hand it is now clear that saccades can play a very important role in helping patients compensate and return to a normal lifestyle. Preliminary evidence suggests that different patterns of saccadic response may predict how well patients recover. It may be possible to train patients to produce more effective saccadic patterns in the first days after their unilateral loss. Some patients do learn new strategies, new behaviours, to conceal their inadequate VOR but when those strategies are prevented from operating by using passive, unpredictable, high acceleration natural head movements, as in the head impulse test, their vestibular loss can be demonstrated. It is those very strategies which the tests exclude, which may be the cause of their successful compensation.

  13. Visual and proprioceptive interaction in patients with bilateral vestibular loss. (United States)

    Cutfield, Nicholas J; Scott, Gregory; Waldman, Adam D; Sharp, David J; Bronstein, Adolfo M


    Following bilateral vestibular loss (BVL) patients gradually adapt to the loss of vestibular input and rely more on other sensory inputs. Here we examine changes in the way proprioceptive and visual inputs interact. We used functional magnetic resonance imaging (fMRI) to investigate visual responses in the context of varying levels of proprioceptive input in 12 BVL subjects and 15 normal controls. A novel metal-free vibrator was developed to allow vibrotactile neck proprioceptive input to be delivered in the MRI system. A high level (100 Hz) and low level (30 Hz) control stimulus was applied over the left splenius capitis; only the high frequency stimulus generates a significant proprioceptive stimulus. The neck stimulus was applied in combination with static and moving (optokinetic) visual stimuli, in a factorial fMRI experimental design. We found that high level neck proprioceptive input had more cortical effect on brain activity in the BVL patients. This included a reduction in visual motion responses during high levels of proprioceptive input and differential activation in the midline cerebellum. In early visual cortical areas, the effect of high proprioceptive input was present for both visual conditions but in lateral visual areas, including V5/MT, the effect was only seen in the context of visual motion stimulation. The finding of a cortical visuo-proprioceptive interaction in BVL patients is consistent with behavioural data indicating that, in BVL patients, neck afferents partly replace vestibular input during the CNS-mediated compensatory process. An fMRI cervico-visual interaction may thus substitute the known visuo-vestibular interaction reported in normal subject fMRI studies. The results provide evidence for a cortical mechanism of adaptation to vestibular failure, in the form of an enhanced proprioceptive influence on visual processing. The results may provide the basis for a cortical mechanism involved in proprioceptive substitution of vestibular

  14. Kv1 channels and neural processing in vestibular calyx afferents

    Directory of Open Access Journals (Sweden)

    Frances L Meredith


    Full Text Available Potassium-selective ion channels are important for accurate transmission of signals from auditory and vestibular sensory end organs to their targets in the central nervous system. During different gravity conditions, astronauts experience altered input signals from the peripheral vestibular system resulting in sensorimotor dysfunction. Adaptation to altered sensory input occurs, but it is not explicitly known whether this involves synaptic modifications within the vestibular epithelia. Future investigations of such potential plasticity require a better understanding of the electrophysiological mechanisms underlying the known heterogeneity of afferent discharge under normal conditions. This study advances this understanding by examining the role of the Kv1 potassium channel family in mediating action potentials in specialized vestibular afferent calyx endings in the gerbil crista and utricle. Pharmacological agents selective for different sub-types of Kv1 channels were tested on membrane responses in whole cell recordings in the crista. Kv1 channels sensitive to α-dendrotoxin and dendrotoxin-K were found to prevail in the central regions, whereas K+ channels sensitive to margatoxin, which blocks Kv1.3 and 1.6 channels, were more prominent in peripheral regions. Margatoxin-sensitive currents showed voltage-dependent inactivation. Dendrotoxin-sensitive currents showed no inactivation and dampened excitability in calyces in central neuroepithelial regions. The differential distribution of Kv1 potassium channels in vestibular afferents supports their importance in accurately relaying gravitational and head movement signals through specialized lines to the central nervous system. Pharmacological modulation of specific groups of K+ channels could help alleviate vestibular dysfunction on earth and in space.

  15. Kv1 channels and neural processing in vestibular calyx afferents. (United States)

    Meredith, Frances L; Kirk, Matthew E; Rennie, Katherine J


    Potassium-selective ion channels are important for accurate transmission of signals from auditory and vestibular sensory end organs to their targets in the central nervous system. During different gravity conditions, astronauts experience altered input signals from the peripheral vestibular system resulting in sensorimotor dysfunction. Adaptation to altered sensory input occurs, but it is not explicitly known whether this involves synaptic modifications within the vestibular epithelia. Future investigations of such potential plasticity require a better understanding of the electrophysiological mechanisms underlying the known heterogeneity of afferent discharge under normal conditions. This study advances this understanding by examining the role of the Kv1 potassium channel family in mediating action potentials in specialized vestibular afferent calyx endings in the gerbil crista and utricle. Pharmacological agents selective for different sub-types of Kv1 channels were tested on membrane responses in whole cell recordings in the crista. Kv1 channels sensitive to α-dendrotoxin and dendrotoxin-K were found to prevail in the central regions, whereas K(+) channels sensitive to margatoxin, which blocks Kv1.3 and 1.6 channels, were more prominent in peripheral regions. Margatoxin-sensitive currents showed voltage-dependent inactivation. Dendrotoxin-sensitive currents showed no inactivation and dampened excitability in calyces in central neuroepithelial regions. The differential distribution of Kv1 potassium channels in vestibular afferents supports their importance in accurately relaying gravitational and head movement signals through specialized lines to the central nervous system. Pharmacological modulation of specific groups of K(+) channels could help alleviate vestibular dysfunction on earth and in space.

  16. The Vestibular Effects of Repeated Low-Level Blasts. (United States)

    Littlefield, Philip D; Pinto, Robin L; Burrows, Holly L; Brungart, Douglas S


    The objective of this study was to use a prospective cohort of United States Marine Corps (USMC) instructors to identify any acute or long-term vestibular dysfunction following repeated blast exposures during explosive breaching training. They were assessed in clinic and on location during training at the USMC Methods of Entry School, Quantico, VA. Subjects received comprehensive baseline vestibular assessments and these were repeated in order to identify longitudinal changes. They also received shorter assessments immediately following blast exposure in order to identify acute findings. The main outcome measures were the Neurobehavioral Symptom Inventory, vestibular Visual Analog Scale (VAS) of subjective vestibular function, videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP), rotary chair (including the unilateral centrifugation test), computerized dynamic posturography, and computerized dynamic visual acuity. A total of 11 breachers and 4 engineers were followed for up to 17 months. No acute effects or longitudinal deteriorations were identified, but there were some interesting baseline group differences. Upbeat positional nystagmus was common, and correlated (p<0.005) with a history of mild traumatic brain injury (mTBI). Several instructors had abnormally short low-frequency phase leads on rotary chair testing. This study evaluated breaching instructors over a longer test period than any other study, and the results suggest that this population appears to be safe from a vestibular standpoint at the current exposure levels. Upbeat positional nystagmus correlated with a history of mTBI in this population, and this has not been described elsewhere. The data trends also suggest that this nystagmus could be an acute blast effect. However, the reasons for the abnormally short phase leads seen in rotary chair testing are unclear at this time. Further investigation seems warranted.

  17. Repeat Gamma Knife surgery for vestibular schwannomas (United States)

    Lonneville, Sarah; Delbrouck, Carine; Renier, Cécile; Devriendt, Daniel; Massager, Nicolas


    Background: Gamma Knife (GK) surgery is a recognized treatment option for the management of small to medium-sized vestibular schwannoma (VS) associated with high-tumor control and low morbidity. When a radiosurgical treatment fails to stop tumor growth, repeat GK surgery can be proposed in selected cases. Methods: A series of 27 GK retreatments was performed in 25 patients with VS; 2 patients underwent three procedures. The median time interval between GK treatments was 45 months. The median margin dose used for the first, second, and third GK treatments was 12 Gy, 12 Gy, and 14 Gy, respectively. Six patients (4 patients for the second irradiation and 2 patients for the third irradiation) with partial tumor regrowth were treated only on the growing part of the tumor using a median margin dose of 13 Gy. The median tumor volume was 0.9, 2.3, and 0.7 cc for the first, second, and third treatments, respectively. Stereotactic positron emission tomography (PET) guidance was used for dose planning in 6 cases. Results: Mean follow-up duration was 46 months (range 24–110). At the last follow-up, 85% of schwannomas were controlled. The tumor volume decreased, remained unchanged, or increased after retreatment in 15, 8, and 4 cases, respectively. Four patients had PET during follow-up, and all showed a significant metabolic decrease of the tumor. Hearing was not preserved after retreatment in any patients. New facial or trigeminal palsy did not occur after retreatment. Conclusions: Our results support the long-term efficacy and low morbidity of repeat GK treatment for selected patients with tumor growth after initial treatment. PMID:26500799

  18. Vestibular schwannoma and fitness to fly. (United States)

    Pons, Yoann; Raynal, Marc; Hunkemöller, Iris; Lepage, Pierre; Kossowski, Michel


    When a pilot is referred for vestibular schwannoma (VS), his or her fitness to fly may be questioned. The objective of this retrospective study was to describe a series of VS cases in a pilot population and to discuss their fitness to fly options. Between September 2002 and March 2010, the ENT/Head and Neck Surgery Department of the National Pilot Expertise Center conducted nearly 120,000 expert consultations for 40,000 pilots. We examined the files of 10 pilots who were referred to our 2 national experts for VS. At the time of the expert consultation, hypoacusis was present in nine cases (four with total deafness), tinnitus in one case, and vertigo in nine cases. In our series, only 2 of the 10 pilots experienced a negative impact on their fitness to fly. Decisions on fitness to fly were based on several factors: minimally disturbed audition, i.e., less than a 35-dB hearing loss with a good speech discrimination score; good balance, i.e., no reported difficulties; no spontaneous nystagmus recorded on videonystagmography (VNG); no postural deviation; and a normal head-shaking test. The delay and the VS's evolution between diagnosis and expert consultation are important because the selection of a treatment to control VS is critical in minimizing the possible associated complications. When a pilot is referred for VS, his or her fitness to fly is determined by the size of the tumor, balance, auditory status, and the follow-up results of these findings. The complications that may arise from VS treatments must also be considered.

  19. [Cavernous haemangiomas: hearing and vestibular inaugural symptoms]. (United States)

    Dumas, G; Schmerber, S


    Cavernous haemangiomas (cavernomas)(CH) are relatively rare (2% of cranial tumoral pathology) vascular malformations mostly observed in the central nervous system. Their most common topographical site in brain stem is midline in the pons, for which clinical course may mimic symptoms of peripheral origin (sudden deafness, fluctuating hearing loss, Meniere-like vertigo). To establish the correlation between the clinical manifestations of hearing and balance disturbance and the anatomical site within the pons of cavernous haemangiomas, and to describe their clinical features, and the findings on auditory brainstem response (ABR) and magnetic resonance imaging (MRI). To propose a literature review about CH and its implications. We made a retrospective review of the histories of three patients aged 24, 44 and 45 years, diagnosed as having cavernomas of the brainstem in which audiometric evaluation, videonystagmography (VNG), ABR and imaging techniques lead to the diagnosis of intracranial cavernoma. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all 3 patients, especially in relation to our understanding of the auditory and vestibular pathways within the brainstem. The literature regarding cavernomas of the pons is reviewed and the clinical, neuroimage, pathological, natural course and management aspects of the disease are discussed. We recommend the use of cerebral MRI for initial diagnosis which shows a typical rosette-like appearance with a heterogeneous signal on T2-weighted images, along with follow-up and investigation into similar profiles among family members. At present there is no consensus about the treatment to follow when cavernomas are located in the brain stem. There is no specific medical treatment for this condition, and surgery is indicated only exceptionally. Anticoagulant therapy, platelet-dispersing medication and violent sports activities are contraindicated.

  20. A Stimulator ASIC Featuring Versatile Management for Vestibular Prostheses. (United States)

    Dai Jiang; Demosthenous, Andreas; Perkins, Timothy; Xiao Liu; Donaldson, Nick


    This paper presents a multichannel stimulator ASIC for an implantable vestibular prosthesis. The system features versatile stimulation management which allows fine setting of the parameters for biphasic stimulation pulses. To address the problem of charge imbalance due to rounding errors, the digital processor can calculate and provide accurate charge correction. A technique to reduce the data rate to the stimulator is described. The stimulator ASIC was implemented in 0.6-μ m high-voltage CMOS technology occupying an area of 2.27 mm(2). The measured performance of the ASIC has been verified using vestibular electrodes in saline.

  1. Vestibular migraine: the most frequent entity of episodic vertigo. (United States)

    Dieterich, Marianne; Obermann, Mark; Celebisoy, Nese


    Vestibular migraine (VM) is the most common cause of episodic vertigo in adults as well as in children. The diagnostic criteria of the consensus document of the International Bárány Society for Neuro-Otology and the International Headache Society (2012) combine the typical signs and symptoms of migraine with the vestibular symptoms lasting 5 min to 72 h and exclusion criteria. Although VM accounts for 7% of patients seen in dizziness clinics and 9% of patients seen in headache clinics it is still underdiagnosed. This review provides an actual overview on the pathophysiology, the clinical characteristics to establish the diagnosis, the differential diagnosis, and the treatment of VM.

  2. Temporal dynamics of 2D motion integration for ocular following in macaque monkeys. (United States)

    Barthélemy, Fréderic V; Fleuriet, Jérome; Masson, Guillaume S


    Several recent studies have shown that extracting pattern motion direction is a dynamical process where edge motion is first extracted and pattern-related information is encoded with a small time lag by MT neurons. A similar dynamics was found for human reflexive or voluntary tracking. Here, we bring an essential, but still missing, piece of information by documenting macaque ocular following responses to gratings, unikinetic plaids, and barber-poles. We found that ocular tracking was always initiated first in the grating motion direction with ultra-short latencies (approximately 55 ms). A second component was driven only 10-15 ms later, rotating tracking toward pattern motion direction. At the end the open-loop period, tracking direction was aligned with pattern motion direction (plaids) or the average of the line-ending motion directions (barber-poles). We characterized the dependency on contrast of each component. Both timing and direction of ocular following were quantitatively very consistent with the dynamics of neuronal responses reported by others. Overall, we found a remarkable consistency between neuronal dynamics and monkey behavior, advocating for a direct link between the neuronal solution of the aperture problem and primate perception and action.

  3. A Protective Eye Shield for Prevention of Media Opacities during Small Animal Ocular Imaging (United States)

    Bell, Brent A.; Kaul, Charles; Hollyfield, Joe G.


    Optical coherence tomography (OCT), scanning laser ophthalmoscopy (SLO) and other non-invasive imaging techniques are increasingly used in eye research to document disease-related changes in rodent eyes. Corneal dehydration is a major contributor to the formation of ocular opacities that can limit the repeated application of these techniques to individual animals. General anesthesia is usually required for imaging, which is accompanied by the loss of the blink reflex. As a consequence, the tear film cannot be maintained, drying occurs and the cornea becomes dehydrated. Without supplemental hydration, structural damage to the cornea quickly follows. Soon thereafter, anterior lens opacities can also develop. Collectively these changes ultimately compromise image quality, especially for studies involving repeated use of the same animal over several weeks or months. To minimize these changes, a protective shield was designed for mice and rats that prevent ocular dehydration during anesthesia. The eye shield, along with a semi-viscous ophthalmic solution, is placed over the corneas as soon as the anesthesia immobilizes the animal. Eye shields are removed for only the brief periods required for imaging and then reapplied before the fellow eye is examined. As a result, the corneal surface of each eye is exposed only for the time required for imaging. The device and detailed methods described here minimize the corneal and lens changes associated with ocular surface desiccation. When these methods are used consistently, high quality images can be obtained repeatedly from individual animals. PMID:25245081

  4. Focal increase of blood flow in the cerebral cortex of man during vestibular stimulation

    DEFF Research Database (Denmark)

    Friberg, L; Olsen, T S; Roland, P E


    This study is an attempt to reveal projection areas for vestibular afferents to the human brain. Changes in regional cerebral blood flow (rCBF) were measured over 254 cortical regions during caloric vestibular stimulation with warm water (44 degrees C). rCBF was measured when the external auditory...... meatus was irrigated with water at body temperature as a control to vestibular stimulation. During vestibular stimulation there was only a single cortical area, located in the superior temporal region, which showed a consistent focal activation in the hemisphere contralateral to the stimulated side...... stimulation that gives rise to the associated conscious vestibular sensation of vertigo....

  5. Ocular and non-ocular manifestations of hypohidrotic ectodermal dysplasia (United States)

    Tyagi, Pallavi; Tyagi, Vipin; Hashim, Adnan A


    Hypohidrotic ectodermal dysplasia (HED) is a group of rare multisystemic genetic syndromes that affects ectodermal structures such as skin, hair, nails, teeth and sweat glands. The authors present a case of a child with ocular and dermatological signs of HED along with severe involvement of other multiple organ systems. The family history could be traced to four generations and there was an observed trend of increase in severity of signs and symptoms occurring at younger age. The purpose of this case report is to create awareness in ophthalmic community of its diagnosis and clinical manifestations. This case highlights the role of multidisciplinary approach for management of systemic disease, genetic evaluation of affected individuals and carriers and genetic counselling. PMID:22700604

  6. Componentes oculares em anisometropia The ocular components in anisometropia

    Directory of Open Access Journals (Sweden)

    David Tayah


    Full Text Available OBJETIVO: Comparar as correlações dos componentes oculares (comprimento axial, comprimento do segmento anterior, poder médio da córnea, profundidade da câmara vítrea e poder refrativo equivalente com o erro refrativo total do olho portador da menor e da maior ametropia em anisométropes. MÉTODOS: Foi realizado um "survey" analítico conduzido em população de 68 anisométropes de duas ou mais dioptrias atendida no Ambulatório da Clinica Oftalmológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Os anisométropes foram submetidos à refração estática objetiva e subjetiva, ceratometria e biometria ultra-sônica. RESULTADOS: Não houve diferença significativa entre os valores dos componentes oculares medidos dos olhos portadores da menor e da maior ametropia. Os olhos portadores da menor ametropia apresentaram as mesmas correlações significantes observadas em olhos emétropes, ou seja, correlação da refração com comprimento do segmento anterior e comprimento axial, e correlação do comprimento axial com poder corneano e profundidade da câmara vítrea. Os olhos portadores da maior ametropia apresentaram correlação significante da refração com o comprimento axial e do comprimento axial com a profundidade da câmara vítrea. Ainda em ambos os olhos observou-se correlação significante do poder do cristalino com a profundidade da câmara anterior. CONCLUSÃO: Os olhos portadores da menor ametropia desenvolveram as correlações mais freqüentemente observadas nos olhos emétropes. Os olhos portadores da maior ametropia não desenvolveram as mesmas correlações dos emétropes.PURPOSE: To asses the correlation between ocular components (axial length, anterior segment length, corneal power, vitreous length and equivalent power of the eye and refractive error in eyes with higher and lower ametropia of subjects with anisometropia. METHODS: An analytical survey was carried out in 68 patients

  7. Vestibular evoked myogenic potentials: an overview Potencial evocado miogênico vestibular: uma visão geral

    Directory of Open Access Journals (Sweden)

    Renato Cal


    Full Text Available The vestibular evoked myogenic potential (VEMP test is a relatively new diagnostic tool that is in the process of being investigated in patients with specific vestibular disorders. Briefly, the VEMP is a biphasic response elicited by loud clicks or tone bursts recorded from the tonically contracted sternocleidomastoid muscle, being the only resource available to assess the function of the saccule and the lower portion of the vestibular nerve. AIM: In this review, we shall highlight the history, methods, current VEMP status, and discuss its specific application in the diagnosis of the Ménière's Syndrome.O teste do potencial evocado miogênico vestibular (PEMV é um instrumento diagnóstico relativamente novo e ainda em processo de validação em estudos com pacientes portadores de desordens vestibulares específicas. De forma resumida, o PEMV é uma resposta bifásica em resposta a estímulos sonoros gravados a partir de contrações do músculo esternocleidomastóideo e é o único recurso existente para avaliar a função do sáculo e da divisão inferior do nervo vestibular. OBJETIVO: Nesta revisão iremos destacar a história, método de realização, situação atual da pesquisa envolvendo o PEMV, além de discutir as suas aplicações específicas no diagnóstico da síndrome de Ménière.

  8. Immunohistochemical profile of cytokines and growth factors expressed in vestibular schwannoma and in normal vestibular nerve tissue. (United States)

    Taurone, Samanta; Bianchi, Enrica; Attanasio, Giuseppe; Di Gioia, Cira; Ierinó, Rocco; Carubbi, Cecilia; Galli, Daniela; Pastore, Francesco Saverio; Giangaspero, Felice; Filipo, Roberto; Zanza, Christian; Artico, Marco


    Vestibular schwannomas, also known as acoustic neuromas, are benign tumors, which originate from myelin-forming Schwann cells. They develop in the vestibular branch of the eighth cranial nerve in the internal auditory canal or cerebellopontine angle. The clinical progression of the condition involves slow and progressive growth, eventually resulting in brainstem compression. The objective of the present study was to investigate the expression level and the localization of the pro-inflammatory cytokines, transforming growth factor-β1 (TGF-β1) interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α), as well as the adhesion molecules, intracellular adhesion molecule-1 and vascular endothelial growth factor (VEGF), in order to determine whether these factors are involved in the transformation and development of human vestibular schwannoma. The present study investigated whether changes in inflammation are involved in tumor growth and if so, the mechanisms underlying this process. The results of the current study demonstrated that pro-inflammatory cytokines, including TGF-β1, IL-1β and IL-6 exhibited increased expression in human vestibular schwannoma tissue compared with normal vestibular nerve samples. TNF-α was weakly expressed in Schwann cells, confirming that a lower level of this cytokine is involved in the proliferation of Schwann cells. Neoplastic Schwann cells produce pro-inflammatory cytokines that may act in an autocrine manner, stimulating cellular proliferation. In addition, the increased expression of VEGF in vestibular schwannoma compared with that in normal vestibular nerve tissue, suggests that this factor may induce neoplastic growth via the promotion of angiogenesis. The present findings suggest that inflammation may promote angiogenesis and consequently contribute to tumor progression. In conclusion, the results of the present study indicated that VEGF and pro-inflammatory cytokines may be potential therapeutic targets in vestibular

  9. Reflexive cartography a new perspective in mapping

    CERN Document Server

    Casti, Emanuela


    Reflexive Cartography addresses the adaptation of cartography, including its digital forms (GIS, WebGIS, PPGIS), to the changing needs of society, and outlines the experimental context aimed at mapping a topological space. Using rigorous scientific analysis based on statement consistency, relevance of the proposals, and model accessibility, it charts the transition from topographical maps created by state agencies to open mapping produced by citizens. Adopting semiotic theory to uncover the complex communicative mechanisms of maps and to investigate their ability to produce their own messages and new perspectives, Reflexive Cartography outlines a shift in our way of conceptualizing maps: from a plastic metaphor of reality, as they are generally considered, to solid tools that play the role of agents, assisting citizens as they think and plan their own living place and make sense of the current world. Applies a range of technologies to theoretical perspectives on mapping to innovatively map the world's geogr...

  10. The Reflexive Principle of Sociological Theorization

    Directory of Open Access Journals (Sweden)

    R T Ubaidullayeva


    Full Text Available The article attempts to describe the reflexive principle in theory-making, which integrates the basic modern methodological paradigms and lays the foundation for the development of sociology. On the basis of the theoretical ideas of P. Bourdieu, A. Giddens and P. Ricoeur the author defines the concept of social reflexion and reveals its peculiarities in sociology as compared to reflexion in philosophy. According to the author, the fulfillment of reflexive functions in sociology is connected with the task of analyzing the complex structure of the polysemantic object, considering the specific quality of the subjects and their various trends of development. The presence of the poles — objectivity-subjectivity, rationality-irrationality, consciousness-unconsciousness etc, requires a reproduction of the dichotomies engendering them in social life and development of cognitive methods for their study in sociology.

  11. Human investigations into the exercise pressor reflex

    DEFF Research Database (Denmark)

    Secher, Niels H; Amann, Markus


    During exercise, neural input from skeletal muscles reflexly maintains or elevates blood pressure (BP) despite a maybe fivefold increase in vascular conductance. This exercise pressor reflex is illustrated by similar heart rate (HR) and BP responses to electrically induced and voluntary exercise....... The importance of the exercise pressor reflex for tight cardiovascular regulation during dynamic exercise is supported by studies using pharmacological blockade of lower limb muscle afferent nerves. These experiments show attenuation of the increase in BP and cardiac output when exercise is performed...... with attenuated neural feedback. Additionally, there is no BP response to electrically induced exercise with paralysing epidural anaesthesia or when similar exercise is evoked in paraplegic patients. Furthermore, BP decreases when electrically induced exercise is carried out in tetraplegic patients. The lack...

  12. Modulation of high-frequency vestibuloocular reflex during visual tracking in humans (United States)

    Das, V. E.; Leigh, R. J.; Thomas, C. W.; Averbuch-Heller, L.; Zivotofsky, A. Z.; Discenna, A. O.; Dell'Osso, L. F.


    1. Humans may visually track a moving object either when they are stationary or in motion. To investigate visual-vestibular interaction during both conditions, we compared horizontal smooth pursuit (SP) and active combined eye-head tracking (CEHT) of a target moving sinusoidally at 0.4 Hz in four normal subjects while the subjects were either stationary or vibrated in yaw at 2.8 Hz. We also measured the visually enhanced vestibuloocular reflex (VVOR) during vibration in yaw at 2.8 Hz over a peak head velocity range of 5-40 degrees/s. 2. We found that the gain of the VVOR at 2.8 Hz increased in all four subjects as peak head velocity increased (P modulation in vestibuloocular reflex gain occurred with increasing peak head velocity during a control condition when subjects were rotated in darkness. 3. During both horizontal SP and CEHT, tracking gains were similar, and the mean slip speed of the target's image on the retina was held below 5.5 degrees/s whether subjects were stationary or being vibrated at 2.8 Hz. During both horizontal SP and CEHT of target motion at 0.4 Hz, while subjects were vibrated in yaw, VVOR gain for the 2.8-Hz head rotations was similar to or higher than that achieved during fixation of a stationary target. This is in contrast to the decrease of VVOR gain that is reported while stationary subjects perform CEHT.(ABSTRACT TRUNCATED AT 250 WORDS).

  13. Republ