Predictors of development of chronic vestibular insufficiency after vestibular neuritis

Adamec, I.; Skorić, Magdalena Krbot; Ozretić, David; Habek, Mario

doi:10.1016/j.jns.2014.10.001

Cited by 26 publications

(22 citation statements)

References 26 publications

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“…While prior studies have shown that anxiety, depression, and fear of body sensations are significantly associated with symptom recovery, the novel finding is that it is the combination of psychological factors and visual dependence that best predicts clinical outcome. In agreement with previous studies, the degree of peripheral vestibular recovery (caloric, head‐impulse test or VEMPs) bears little influence on global clinical outcome …”

Section: Discussionsupporting

confidence: 92%

Predictors of clinical recovery from vestibular neuritis: a prospective study

Cousins

Kaski

Cutfield

et al. 2017

Ann Clin Transl Neurol

118

139

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We sought to identify predictors of symptomatic recovery in vestibular neuritis. Forty VN patients were prospectively studied in the acute phase (median = 2 days) and 32 in the recovery phase (median = 10 weeks) with vestibulo‐ocular reflex, vestibular‐perceptual, and visual dependence tests and psychological questionnaires. Clinical outcome was Dizziness Handicap Inventory score at recovery phase. Acute visual dependency and autonomic arousal predicted outcome. Worse recovery was associated with a combination of increased visual dependence, autonomic arousal, anxiety/depression, and fear of bodily sensations, but not with vestibular variables. Findings highlight the importance of early identification of abnormal visual dependency and concurrent anxiety.

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Section: Discussionsupporting

confidence: 92%

Predictors of clinical recovery from vestibular neuritis: a prospective study

Cousins

Kaski

Cutfield

et al. 2017

Ann Clin Transl Neurol

118

139

View full text Add to dashboard Cite

show abstract

“…The relationship observed between increased severity (Fazekas 3) of WMH in our “ unexplained ” group suggests these abnormalities are likely contributory to the development of the dizziness. This is supported by the recent finding of WMH being a predictor of chronic dizziness in patients with previous vestibular neuritis [9] .…”

Section: Discussionsupporting

confidence: 76%

“…Influential studies by Colledge et al [7] , [8] concluded there were no differences in imaging between dizzy and non-dizzy subjects although increased midbrain white matter (WM) lesions were noted. A very recent study in this journal, however, indicates that the presence of WM lesions is an independent predictor of residual dizziness in patients with previous vestibular neuritis [9] . In order to reassess whether WMD may directly contribute to dizziness, a retrospective cohort study was conducted.…”

Section: Introductionmentioning

confidence: 75%

Are white matter abnormalities associated with “unexplained dizziness”?

Ahmad

Cerchiai

Mancuso

et al. 2015

Journal of the Neurological Sciences

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IntroductionAlthough cerebral small vessel disease is a significant contributor to the development of imbalance and falls in the elderly, whether it causes dizziness is not known.MethodsA retrospective case analysis was conducted for 122 dizzy patients referred to two neuro-otology tertiary centres in London and Pisa. Patients were divided into ‘explained’ causes of dizziness (e.g. benign positional vertigo, vestibular neuritis, orthostatic hypotension, cerebellar ataxias) and ‘unexplained’ dizziness. White matter hyperintensities (WMH) in MRI (T2 weighted and FLAIR sequences) were blindly rated according to the Fazekas scale.Results122 patients; 58 (mean age = 72, SD = 7.95 years) in the ‘unexplained’ group and 64 (mean age = 72.01, SD = 8.28 years) in the ‘explained’ group were recruited. The overall frequency of lesions (Fazekas 1–3) significantly differed between groups (p = 0.011). The frequency of severe lesions (Fazekas 3) was significantly higher in the ‘unexplained’ group (22%) than in the ‘explained’ group (5%; p = 0.003).ConclusionIncreased severity of WMH in cases of unexplained dizziness suggests that such abnormalities are likely contributory to the development of dizziness. WM lesions may induce dizziness either because patients perceive a degree of objective unsteadiness or by a disconnection syndrome involving vestibular or locomotor areas of the brain.

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“…Finally, in view of recent reports that the amount of small vessel disease can have an impact on outcome of VN ( Adamec et al, 2014 ) or induce dizziness in the elderly ( Ahmad et al, 2015 ) we decided to examine this in our data. Seven patients were scored non-zero on the Fazekas scale.…”

Section: Resultsmentioning

confidence: 99%

An fMRI study of visuo-vestibular interactions following vestibular neuritis

Roberts

Ahmad

Patel

et al. 2018

NeuroImage: Clinical

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Vestibular neuritis (VN) is characterised by acute vertigo due to a sudden loss of unilateral vestibular function. A considerable proportion of VN patients proceed to develop chronic symptoms of dizziness, including visually induced dizziness, specifically during head turns. Here we investigated whether the development of such poor clinical outcomes following VN, is associated with abnormal visuo-vestibular cortical processing. Accordingly, we applied functional magnetic resonance imaging to assess brain responses of chronic VN patients and compared these to controls during both congruent (co-directional) and incongruent (opposite directions) visuo-vestibular stimulation (i.e. emulating situations that provoke symptoms in patients). We observed a focal significant difference in BOLD signal in the primary visual cortex V1 between patients and controls in the congruent condition (small volume corrected level of p < .05 FWE). Importantly, this reduced BOLD signal in V1 was negatively correlated with functional status measured with validated clinical questionnaires. Our findings suggest that central compensation and in turn clinical outcomes in VN are partly mediated by adaptive mechanisms associated with the early visual cortex.

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Predictors of development of chronic vestibular insufficiency after vestibular neuritis

Cited by 26 publications

References 26 publications

Predictors of clinical recovery from vestibular neuritis: a prospective study

Predictors of clinical recovery from vestibular neuritis: a prospective study

Are white matter abnormalities associated with “unexplained dizziness”?

An fMRI study of visuo-vestibular interactions following vestibular neuritis

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