Vestibular compensation following vestibular neurotomy

Devèze, Arnaud; Montava, Marion; Lopez, Christophe; Lacour, Michel; Magnan, Jacques; Borel, Liliane

doi:10.1016/j.anorl.2015.04.003

Cited by 23 publications

(21 citation statements)

References 17 publications

(31 reference statements)

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“…To study set-point adaptation, we opted for a vestibular model since the unwanted spontaneous nystagmus that occurs after a unilateral labyrinthine lesion is an archetypical problem for the adaptation networks that adjust set points; they must restore balance centrally to overcome any persistent asymmetrical activity arriving from the periphery [10]. This nystagmus normally dissipates over time through adaptive processes [11, 12].…”

Section: Resultsmentioning

confidence: 99%

Multiple Time Courses of Vestibular Set-Point Adaptation Revealed by Sustained Magnetic Field Stimulation of the Labyrinth

et al. 2016

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SUMMARY A major focus in neurobiology is how the brain adapts its motor behavior to changes in its internal and external environments [1, 2]. Much is known about adaptively optimizing the amplitude and direction of eye and limb movements, for example, but little is known about another essential form of learning, “set-point” adaptation. Set-point adaptation balances tonic activity so that reciprocally acting, agonist and antagonist muscles have a stable platform from which to launch accurate movements. Here, we use the vestibulo-ocular reflex—a simple behavior that stabilizes the position of the eye while the head is moving—to investigate how tonic activity is adapted toward a new set point to prevent eye drift when the head is still [3, 4]. Set-point adaptation was elicited with magneto-hydrodynamic vestibular stimulation (MVS) by placing normal humans in a 7T MRI for 90 min. MVS is ideal for prolonged labyrinthine activation because it mimics constant head acceleration and induces a sustained nystagmus similar to natural vestibular lesions [5, 6]. The MVS-induced nystagmus diminished slowly but incompletely over multiple timescales. We propose a new adaptation hypothesis, using a cascade of imperfect mathematical integrators, that reproduces the response to MVS (and more natural chair rotations), including the gradual decrease in nystagmus as the set point changes over progressively longer time courses. MVS set-point adaptation is a biological model with applications to basic neurophysiological research into all types of movements [7], functional brain imaging [8], and treatment of vestibular and higher-level attentional disorders by introducing new biases to counteract pathological ones [9].

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Section: Resultsmentioning

confidence: 99%

Multiple Time Courses of Vestibular Set-Point Adaptation Revealed by Sustained Magnetic Field Stimulation of the Labyrinth

et al. 2016

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“…This finding could be related to the effect of head tilt on otolith-ocular function from both ears as opposed to the auditory stimuli in VEMPs which are essentially monaural. Since all patients in this study had chronic loss, the symmetric vOCR might also be due to long-term adaptive changes that can modify vestibular responses on both sides [11,12]. In such cases the symmetry in vOCR values between right and left sides may be useful to differentiate between chronic central and peripheral lesions, as patients with cerebellar or brainstem lesions are more likely to have asymmetric OCR gains [13].…”

Section: Discussionmentioning

confidence: 99%

The video ocular counter-roll (vOCR): a clinical test to detect loss of otolith-ocular function

Otero‐Millan

Treviño

Winnick

et al. 2017

Acta Oto-Laryngologica

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Conclusion vOCR can detect loss of otolith-ocular function without specifying the side of vestibular loss. Since vOCR is measured with a simple head tilt maneuver, it can be potentially used as a bedside clinical test in combination with video head impulse test. Objective Video-oculography (VOG) goggles are being integrated into the bedside assessment of patients with vestibular disorders. Lacking, however, is a method to evaluate otolith function. This study validated a VOG test for loss of otolith function. Methods VOG was used to measure ocular counter-roll (vOCR) in 12 healthy controls, 14 patients with unilateral vestibular loss (UVL), and six patients with bilateral vestibular loss (BVL) with a static lateral head tilt of 30°. The results were compared with vestibular evoked myogenic potentials (VEMP), a widely-used laboratory test of otolith function. Results The average vOCR for healthy controls (4.6°) was significantly different from UVL (2.7°) and BVL (1.6°) patients (p < 0.0001). The vOCR and VEMP measurements were correlated across subjects, especially the click and tap oVEMPs (click oVEMP R = 0.45, tap oVEMP R = 0.51; p < 0.0003). The receiver operator characteristic (ROC) analysis showed that vOCR and VEMPs detected loss of otolith function equally well. The best threshold for vOCR to detect vestibular loss was at 3°. The vOCR values from the side of vestibular loss and the healthy side were not different in UVL patients (2.53° vs 2.8°; p = 0.59).

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“…We are investigating Unilateral Vestibular Loss patients for the same paradigm (a search like behavior at the low frequency band versus a fall like behavior at the high frequency band) at both quiet and perturbed stance conditions as well [35]. Furthermore DETES is also being used for monitoring/following the progress of the disease in both UVL and BVL patients by being tested for their daily life performances at their compensation period after acute dizziness/vertigo attack [36]. On the other hand, the Vestibular Lab where DETES is mounted, is specialized for reporting whether the reason of the complaints of the navy staff about suffering from dizziness is due to the motion sickness, through simulating sea conditions [37].…”

Section: Discussionmentioning

confidence: 99%

Developing a Human Balance Test System (DETES) in Order to Investigate Control Mechanisms of Human Erect Posture

Gürses¹

2016

J. Advs. Biomed. Eng. Techno.

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An originally designed 3-dof (2-dof perturbation platform and 1-dof cabin) human balance testing system (DETES) has been developed for delivering mechanical and perceptual stimuli in a controlled embedding environment in order to investigate sensory-motor control of human erect posture at physiological and/or pathological conditions. The human balance (especially studying vestibular system involved mechanisms) demonstrating complex (nonlinear) dynamical behavior in the context of postural adjustments having ecological roots/meanings (information) is to be tested (by means of quiet and perturbed stance) and analyzed for supporting (differential) diagnosis, monitoring/following the progress of the disease, and creating the new adaptive motor learning protocols for rehabilitation.

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Vestibular compensation following vestibular neurotomy

Abstract: Understanding pre-operative interindividual variation in balance strategy is critical to screening for postural instability and tailoring vestibular rehabilitation.

Cited by 23 publications

References 17 publications

Multiple Time Courses of Vestibular Set-Point Adaptation Revealed by Sustained Magnetic Field Stimulation of the Labyrinth

Multiple Time Courses of Vestibular Set-Point Adaptation Revealed by Sustained Magnetic Field Stimulation of the Labyrinth

The video ocular counter-roll (vOCR): a clinical test to detect loss of otolith-ocular function

Developing a Human Balance Test System (DETES) in Order to Investigate Control Mechanisms of Human Erect Posture

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