Journal of Vestibular Research - Volume 33, issue 5

Authors: Espinosa-Sanchez, Juan Manuel | Kaski, Diego | Perez-Fernandez, Nicolas | Batuecas-Caletrio, Angel

Article Type: Research Article

Abstract: BACKGROUND: Rafael Lorente de Nó was a neuroscientist that worked alongside two of the giants of Medicine, the Nobel Prize winners Cajal and Bárány. OBJECTIVE: To describe the contributions of Lorente de Nó to vestibular neuroscience. METHODS: Detailed review of the publications of Lorente de Nó and analysis of the archives from Junta para Ampliación de Estudios e Investigaciones Científicas at Residencia de Estudiantes (Madrid, Spain), Casa de Salud Valdecilla at Hospital Universitario Marqués de Valdecilla (Santander, Spain), Becker Medical Library at Washington University (St. Louis, MO, USA), Rockefeller Archive Center (Sleepy Hollow, New York, NY, …USA), Archivo Fernando de Castro (Madrid, Spain), Biblioteca Nacional de España (Madrid, Spain) and Legado Cajal at Instituto Cajal (Madrid, Spain). Most of this material is unpublished and includes over a hundred letters to or from Lorente. RESULTS: Lorente de Nó made a substantial contribution to our understanding of the vestibular system. Amongst these, he meticulously detailed the course of the vestibular nerve and its central projections. He described the vestibulo-ocular reflex as the consequence of an integration of the various nuclei and connections across the vestibular system, rather than a simple three-neuron arc. He also highlighted the role of the reticular formation in the generation of the fast phase of the nystagmus. CONCLUSIONS: Lorente de Nó was a pioneer of modern neuro-otology, having made outstanding contributions to vestibular neuroscience, forging novel discoveries that still burn true today. Show more

Keywords: Lorente de Nó, vestibular, vestibulo-ocular reflex, history of neuro-otology, physiology, anatomy

DOI: 10.3233/VES-220034

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 287-297, 2023

Authors: Ertl, Matthias | zu Eulenburg, Peter | Woller, Marie | Mayadali, Ümit | Boegle, Rainer | Dieterich, Marianne

Article Type: Research Article

Abstract: BACKGROUND: Naturalistic head accelerations can be used to elicit vestibular evoked potentials (VestEPs). These potentials allow for analysis of cortical vestibular processing and its multi-sensory integration with a high temporal resolution. METHODS: We report the results of two experiments in which we compared the differential VestEPs elicited by randomized translations, rotations, and tilts in healthy subjects on a motion platform. RESULTS: An event-related potential (ERP) analysis revealed that established VestEPs were verifiable in all three acceleration domains (translations, rotations, tilts). A further analysis of the VestEPs showed a significant correlation between rotation axes (yaw, pitch, roll) …and the amplitude of the evoked potentials. We found increased amplitudes for rotations in the roll compared to the pitch and yaw plane. A distributed source localization analysis showed that the activity in the cingulate sulcus visual (CSv) area best explained direction-dependent amplitude modulations of the VestEPs, but that the same cortical network (posterior insular cortex, CSv) is involved in processing vestibular information, regardless of the motion direction. CONCLUSION: The results provide evidence for an anisotropic, direction-dependent processing of vestibular input by cortical structures. The data also suggest that area CSv plays an integral role in ego-motion perception and interpretation of spatial features such as acceleration direction and intensity. Show more

Keywords: Cingulate sulcus visual, direction dependency, vestibular anisotropy, vestibular evoked potentials, passive motion

DOI: 10.3233/VES-210121

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 299-312, 2023

Authors: Kolev, Ognyan I. | Clement, Gilles | Reschke, Millard F.

Article Type: Research Article

Abstract: BACKGROUND: Coordination of motor activity is adapted to Earth’s gravity (1 g). However, during space flight the gravity level changes from Earth gravity to hypergravity during launch, and to microgravity (0 g) in orbit. This transition between gravity levels may alter the coordination between eye and head movements in gaze performance. OBJECTIVE: We explored how weightlessness during space flight altered the astronauts’ eye-head coordination (EHC) with respect to flight day and target eccentricity. METHODS: Thirty-four astronauts of 20 Space Shuttle missions had to acquire visual targets with angular offsets of 20°, 30°, and 49°. RESULTS: Measurements …of eye, head, and gaze positions collected before and during flight days 1 to 15 indicated changes during target acquisition that varied as a function of flight days and target eccentricity. CONCLUSIONS: The in-flight alterations in EHC were presumably the result of a combination of several factors, including a transfer from allocentric to egocentric reference for spatial orientation in absence of a gravitational reference, the generation of slower head movements to attenuate motion sickness, and a decrease in smooth pursuit and vestibulo-ocular reflex performance. These results confirm that humans have several strategies for gaze behavior, between which they switch depending on the environmental conditions. Show more

Keywords: Eye-head coordination, microgravity, vestibulo-ocular reflex, saccades, gaze, space motion sickness

DOI: 10.3233/VES-220127

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 313-324, 2023

Authors: Govender, Sendhil | Biswas, Raaj Kishore | Welgampola, Miriam S. | Rosengren, Sally M.

Article Type: Research Article

Abstract: BACKGROUND: Acceleration and changes in acceleration (jerk) stimulate vestibular otolith afferents. Bone-conducted (BC) vibration applied to the skull accelerates the head and produces short latency reflexes termed vestibular evoked myogenic potentials (VEMPs). OBJECTIVE: To determine the magnitude, variability and symmetry in head acceleration/jerk during VEMP recordings and investigate the relationship between head acceleration/jerk and VEMP properties. METHODS: 3D head accelerometery (sagittal, interaural and vertical axes) was recorded bilaterally in thirty-two healthy subjects during cervical (cVEMP) and ocular (oVEMP) recordings. BC 500 Hz sinusoidal tones were applied to the midline forehead using a positive polarity stimulus. …RESULTS: The direction of induced acceleration/jerk was predominately backward, outward and downward on either side of the head during cVEMP and oVEMP recordings. Overall, acceleration/jerk was larger in the sagittal and interaural axes and peaked earlier in the interaural axis bilaterally. Acceleration was more symmetric in the sagittal and interaural axes whereas jerk symmetry did not differ between axes. Regression models did not show a systematic relationship between acceleration/jerk and either VEMP reflex. CONCLUSIONS: The pattern of skull acceleration/jerk was relatively consistent between the two sides of the head and across subjects, but there were differences in magnitude, leading to inter-side and inter-subject variability. Show more

Keywords: Sternocleidomastoid muscle, EMG, VEMP, accelerometry, otolith

DOI: 10.3233/VES-230008

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 325-338, 2023

Authors: Ainsworth, Carolyn | Davies, Rosalyn | Colvin, Ian | Murdin, Louisa

Article Type: Research Article

Abstract: BACKGROUND: Motorist Disorientation Syndrome (MDS) is a term used to describe patients who primarily experience symptoms of dizziness/disorientation whilst in a motor car [21 ]. There is uncertainty about the relevance of vestibular dysfunction and whether this disorder could instead be a visually induced dizziness (VV) or part of a functional disorder similar to Persistent postural perceptual dizziness (PPPD). OBJECTIVE: We present the largest case-series to date of patients whose main complaint is of illusions of movement of self/vehicle when driving, characterising features of this group. METHODS: 18 subjects underwent detailed clinical assessment including validated questionnaires. …A subset of patients underwent vestibular function testing. RESULTS: Mean onset age was 42 years, with no gender preponderance. Mean symptom duration was 6.39 years and was significantly longer in women. 50% reported moderate or severe handicap. Vestibular abnormalities were found in 60% of subjects tested. There was no significant difference in VSS total score between those with MDS and vestibular migraine (p  = 0.154) with both having higher scores than healthy controls (p  = 0.002, 0.000 respectively). CONCLUSIONS: MDS represents consistent symptoms, with high symptom burden, comparable to vestibular migraine. Vestibular deficits were not a consistent feature and similarities to VV and PPPD exist. Show more

Keywords: Motorist Disorientation Syndrome (MDS)

DOI: 10.3233/VES-220088

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 339-348, 2023

Authors: Kellerer, Silvy | Amberger, Tamara | Schlick, Cornelia | Dlugaiczyk, Julia | Wuehr, Max | Jahn, Klaus

Article Type: Research Article

Abstract: BACKGROUND: Vestibular rehabilitation therapy (VRT) is effective for most patients with dizziness and imbalance. Home exercise programs are widely used. It is unknown, however, how specific the instructions for exercises have to be. OBJECTIVE: To evaluate the effects of expert assessment and instructions in a booklet-based home VRT program for patients with chronic dizziness. METHODS: Randomized controlled study on 74 participants with disabling dizziness for >3 months. All study participants received a booklet-based VRT for training at home. Participants were prescribed 20 minutes of exercise, twice a day. The intervention group (n  = 37) received specific instructions …(expert physiotherapist). The control group (n  = 37) practiced without specific instructions. Primary outcome was the total score of the Dizziness Handicap Inventory (DHI-G). All outcomes were assessed at baseline, after 4 weeks, and at follow up 4 weeks later. RESULTS: Both groups improved (DHI-G 43.94±18.89 at inclusion to 33.06±19.67 at follow-up in controls and 42.82±16.60 to 22.65±19.12 in the intervention group). The intervention group, however, improved more (p  = 0.014). CONCLUSIONS: We show a significant effect of expert physiotherapy guidance in home-based VRT. This strengthens the role of the physiotherapist in VRT: Tailored, personalized instructions are needed to get the best effect of VRT. Show more

Keywords: Dizziness, physiotherapy, vertigo, vestibular rehabilitation therapy, vestibular disorder

DOI: 10.3233/VES-220122

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 349-361, 2023

Authors: Micarelli, Alessandro | Viziano, Andrea | Alessandrini, Marco

Article Type: Letter

DOI: 10.3233/VES-200724

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 363-364, 2023

Authors: Kim, Sung-Hee

Article Type: Letter

DOI: 10.3233/VES-200723

Citation: Journal of Vestibular Research, vol. 33, no. 5, pp. 365-365, 2023