Recovery from Vestibular Ototoxicity

Black, F. Owen; Gianna-Poulin, Claire C.; Pesznecker, Susan

doi:10.1097/00129492-200109000-00018

Cited by 54 publications

(50 citation statements)

References 24 publications

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“…However, those with bilateral vestibular deficiency (BVD) due to ototoxic drug exposure, Ménière's disease, meningitis, genetic defects, or other insults to the inner ear often suffer from degraded visual acuity during head movements, in addition to postural instability and chronic disequilibrium (Minor 1998;Rinne et al 1998;Black et al 2001Black et al , 2004Mamoto et al 2002). For these individuals, an implantable neuroelectronic prosthesis that measures three-dimensional (3D) head rotation and stimulates the vestibular nerve accordingly could significantly improve quality of life.…”

Section: Introductionmentioning

confidence: 99%

Multichannel Vestibular Prosthesis Employing Modulation of Pulse Rate and Current with Alignment Precompensation Elicits Improved VOR Performance in Monkeys

Davidovics

Rahman

Dai

et al. 2013

JARO

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An implantable prosthesis that stimulates vestibular nerve branches to restore the sensation of head rotation and the three-dimensional (3D) vestibular ocular reflex (VOR) could benefit individuals disabled by bilateral loss of vestibular sensation. Our group has developed a vestibular prosthesis that partly restores normal function in animals by delivering biphasic current pulses via electrodes implanted in semicircular canals. Despite otherwise promising results, this approach has been limited by insufficient velocity of VOR response to head movements that should inhibit the implanted labyrinth and by misalignment between direction of head motion and prosthetically elicited VOR. We report that significantly larger VOR eye velocities in the inhibitory direction can be elicited by adapting a monkey to elevated baseline stimulation rate and current prior to stimulus modulation and then concurrently modulating ("co-modulating") both rate and current below baseline levels to encode inhibitory angular head velocity. Comodulation of pulse rate and current amplitude above baseline can also elicit larger VOR eye responses in the excitatory direction than do either pulse rate modulation or current modulation alone. Combining these stimulation strategies with a precompensatory 3D coordinate transformation improves alignment and magnitude of evoked VOR eye responses. By demonstrating that a combination of co-modulation and precompensatory transformation strategies achieves a robust VOR response in all directions with significantly improved alignment in an animal model that closely resembles humans with vestibular loss, these findings provide a solid preclinical foundation for application of vestibular stimulation in humans.

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Section: Introductionmentioning

confidence: 99%

Multichannel Vestibular Prosthesis Employing Modulation of Pulse Rate and Current with Alignment Precompensation Elicits Improved VOR Performance in Monkeys

Davidovics

Rahman

Dai

et al. 2013

JARO

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“…A common feature of these lesions is a reduction in the high frequency aVOR gain and a reduction in the vestibular time constant (Wade et al 1999). The reduction in the aVOR gain tested at frequencies of 2-6 Hz, can recover to normal range over about 1 year, but the time constant and low frequency aVOR gain may never recover (Fetter and Zee 1988;Black et al 2001;Palla and Straumann 2004;Newlands et al 2005).…”

mentioning

confidence: 98%

Labyrinthine lesions and motion sickness susceptibility

2007

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The angular vestibulo-ocular reflex (aVOR) has a fast pathway, which mediates compensatory eye movements, and a slow (velocity storage) pathway, which determines its low frequency characteristics and orients eye velocity toward gravity. We have proposed that motion sickness is generated through velocity storage, when its orientation vector, which lies close to the gravitational vertical, is misaligned with eye velocity during head motion. The duration of the misalignment, determined by the dominant time constant of velocity storage, causes the buildup of motion sickness. To test this hypothesis, we studied bilateral labyrinthine-defective subjects with short vestibular time constants but normal aVOR gains for their motion sickness susceptibility. Time constants and gains were taken from rotational responses. Motion sickness was generated by rolling the head while rotating, and susceptibility was assessed by the number of head movements made before reaching intolerable levels of nausea. More head movements signified lower motion sickness susceptibility. Labyrinthine-defective subjects made more head movements on their first exposure to roll while rotating than normals (39.8 ± 7.2 vs 13.7 ± 5.5; P < 0.0001). Normals were tested eight times, which habituated their time constants and reduced their motion sickness susceptibility. Combining data from all subjects, there was a strong inverse relationship between time constants and number of head movements (r = 0.94), but none between motion sickness susceptibility and aVOR gains. This provides further evidence that motion sickness is generated through velocity storage, not the direct pathway, and suggests that motion sickness susceptibility can be reduced by reducing the aVOR time constant.

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“…Os extremos de idade têm sido implicados como fatores de risco para a ototoxicidade 29 . Esse fator não está presente neste estudo que teve a média de idade situada em 37,16 anos no grupo estudo e em 37,02 anos no grupo controle.…”

Section: Discussionunclassified

“…As lesões renais associadas aos aminoglicosídeos nefrotóxicos são da mesma forma em sua maioria no túbulo proximal que é considerado o sítio mais comum de lesão 29 . O primeiro passo do efeito ototóxico dos aminoglicosídeos é uma interação eletrostática com a membrana das células ciliadas.…”

Section: Discussionunclassified

“…Dessa forma, mesmo após cessar a exposição ao metal, ele continua acumulado no organismo, sendo eliminado muito lentamente. Os estudos em animais são muito prejudicados, pois a ação dos diferentes agentes geralmente sofre grandes variações com as particularidades específicas de cada espécie, dificultando a padronização de modelos de estudo 29 . Os poucos estudos em animais relativos aos efeitos do cádmio associado ao ruído se restringem aos efeitos renais, neurotoxicidade e alterações na formação do esqueleto ósseo 13 .…”

Section: Discussionunclassified

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Avaliação audiométrica de trabalhadores ocupacionalmente expostos a ruído e cádmio

Abreu

Suzuki²

2002

Rev. Bras. Otorrinolaringol.

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Introdução:O ruído é caracterizado como o fator mais prevalente na origem de doenças ocupacionais. Também é o agente físico nocivo à saúde mais comum nos ambientes de trabalho, causando perda auditiva. Além do ruído, agentes químicos presentes no meio ocupacional, como solventes e metais pesados, são descritos como causadores de alteração auditiva. Objetivo: Avaliar dois grupos de indivíduos expostos à mesma intensidade de ruído industrial, sendo um desses grupos exposto ao cádmio e outro não, e verificar se a exposição aos dois agentes poluentes é mais prejudicial do que a exposição ao ruído isoladamente. Forma de estudo: Clínico prospectivo. Material e Método: Foi realizado estudo audiométrico de 36 trabalhadores de indústria metalúrgica, expostos a ruído e fumos de cádmio em seu ambiente de trabalho, no período de 1994 a 1998. Os resultados obtidos nesse grupo foram comparados aos de um grupo controle composto de 36 trabalhadores dos mesmos setores da empresa, porém expostos somente ao ruído. Resultados: Observou-se uma perda auditiva concentrada principalmente nas freqüências de 4000 e 6000 Hz, mais acentuada no grupo exposto ao ruído e cádmio. Conclusão: Os dados indicaram uma provável ação ototóxica do metal cádmio quando associado à exposição ao ruído.

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Recovery from Vestibular Ototoxicity

Cited by 54 publications

References 24 publications

Multichannel Vestibular Prosthesis Employing Modulation of Pulse Rate and Current with Alignment Precompensation Elicits Improved VOR Performance in Monkeys

Multichannel Vestibular Prosthesis Employing Modulation of Pulse Rate and Current with Alignment Precompensation Elicits Improved VOR Performance in Monkeys

Labyrinthine lesions and motion sickness susceptibility

Avaliação audiométrica de trabalhadores ocupacionalmente expostos a ruído e cádmio

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