The vestibular system has traditionally been thought of as a balance apparatus; however, accumulating research suggests an association between vestibular function and psychiatric and cognitive symptoms, even when balance is measurably unaffected. There are several brain regions that are implicated in both vestibular pathways and psychiatric disorders. The present review examines the anatomical associations between the vestibular system and various psychiatric disorders. Despite the lack of direct evidence for vestibular pathology in the key psychiatric disorders selected for this review, there is a substantial body of literature implicating the vestibular system in each of the selected psychiatric disorders. The second part of this review provides complimentary evidence showing the link between vestibular dysfunction and vestibular stimulation upon cognitive and psychiatric symptoms. In summary, emerging research suggests the vestibular system can be considered a potential window for exploring brain function beyond that of maintenance of balance, and into areas of cognitive, affective and psychiatric symptomology. Given the paucity of biological and diagnostic markers in psychiatry, novel avenues to explore brain function in psychiatric disorders are of particular interest and warrant further exploration.
The present results provide support for the use of annulus electrodes in future applications in cortical neural prostheses.
Schizophrenia is a severe mental illness associated with multiple neuropathological, neurochemical and genetic abnormalities. The benefits of a validated, quantitative diagnosis tool are well established. Electrovestibulography, a new method similar to ECOG, can detect and record neural activity generated by the vestibular system. The normal EVestG response as well as dynamic measures averaged 'background-onAA' (onAA=acceleration phase of tilt) and 'background-onBB' (onBB=deceleration phase of tilt) of excitatory (ipsi-lateral tilt) vestibular responses are compared for a small group of schizophrenia patients (n=4) and age matched healthy controls (n=10). Our preliminary results show an apparent discrimination between control and schizophrenia groups. Schizophrenia patients appear not only to exhibit an overall decreased EVestG signal amplitude but a suppressed dynamic response calculated by the averaged EVestG 'background-onBB' measure. Increased sample size is required to validate these findings.
Background: Absence of quantitative techniques for objectively diagnosing many brain changes associated with mental illnesses hampers early intervention and effective treatment. Known bidirectional neural pathways closely link the vestibular system and regions involved in emotion processing. Objectives: To assess whether Electrovestibulography (EVestG) can detect specific neural responses, using an ear probe and tilt chair, to provide a quantitative indirect measure assessment of brain regions and pathways frequently compromised in mental illnesses. Materials and Methods: EVestG data was collected on 38 subjects with major depression, 22 with schizophrenia, 36 with bipolar disorder and 57 matched healthy controls. Data was analyzed using the NEER algorithm to generate the average field potentials and firing patterns. Characteristic features were extracted followed by AdaBoost subset feature selection and classification for separating data into four classes. To remove the bias of working on small size population, we used 10-fold cross validation to select the best diagnostic features. The accuracy of the diagnostic features' classification was tested using nonparametric statistical analysis. Results: EVestG signals were statistically different (P = 0.000 to 0.040) between the groups by using Kruskal-Wallis, and the best diagnostic accuracies for a four-way diagnostic group separation were on average (n = 100, 10 repeated 10-fold cross validations) 70.2% (SD = 9.6) using 10-fold cross validation. Conclusions: Comparing vestibular driven responses has the potential to be a valid and clinically useful diagnostic tool.
Schizophrenia (SZ) is the most disabling among the psychiatric disorders and associated with multiple abnormalities in brain structure and neurotransmitter systems. The benefits of a validated, quantitative diagnosis tool are well established. Electrovestibulography (EVestG) can detect and record neural activity of vestibular system and associated pathways by a wavelet based method, named Neural Event Extraction Routine, and provide a quantitative indirect measure of activity in brain regions and pathways that are compromised in SZ. We compared EVestG responses of eighteen SZ subjects with twenty one healthy control subjects. A number of biomarkers significantly (p<0.05) distinguished SZ from normal population. We also found significant correlations between the EVestG responses and positive and negative syndrome rating scale (PANNS) scores and/or disease duration.
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