Absence of Rotation Perception during Warm Water Caloric Irrigation in Some Seniors with Postural Instability.
Identifieur interne : 002351 ( PubMed/Corpus ); précédent : 002350; suivant : 002352Absence of Rotation Perception during Warm Water Caloric Irrigation in Some Seniors with Postural Instability.
Auteurs : Elodie Chiarovano ; Pierre-Paul Vidal ; Christophe Magnani ; Georges Lamas ; Ian S. Curthoys ; Catherine De WaeleSource :
- Frontiers in neurology [ 1664-2295 ] ; 2016.
Abstract
Falls in seniors are a major public health problem. Falls lead to fear of falling, reduced mobility, and decreased quality of life. Vestibular dysfunction is one of the fall risk factors. The relationship between objective measures of vestibular responses and age has been studied. However, the effects of age on vestibular perception during caloric stimulation have not been studied. Twenty senior subjects were included in the study, and separated in two groups: 10 seniors reporting postural instability (PI) and exhibiting absence of vestibular perception when they tested with caloric stimulation and 10 sex- and age-matched seniors with no such problems (controls). We assessed vestibular perception on a binary rating scale during the warm irrigation of the caloric test. The function of the various vestibular receptors was assessed using video head impulse test (vHIT), caloric tests, and cervical and ocular vestibular-evoked myogenic potentials. The Equitest was used to evaluate balance. No horizontal canal dysfunction assessed using both caloric test and vHIT was detected in either group. No significant difference was detected between PI and control groups for the peak SPV of caloric-induced ocular nystagmus or for the HVOR gain. All the controls perceived rotation when the maximal SPV during warm irrigation was equal to or ≥15°/s. None of the subjects in the PI group perceived rotation even while the peak SPV exceeded 15°/s, providing objective evidence of normal peripheral horizontal canal function. All the PI group had abnormal Equitest results, particularly in the two last conditions. These investigations show for the first time that vestibular perception can be absent during a caloric test despite normal horizontal canal function. We call this as dissociation vestibular neglect. Patients with poor vestibular perception may not be aware of postural perturbations and so will not correct for them. Thus, falls in the elderly may result, among other factors, from a vestibular neglect due to an inappropriate central processing of normal vestibular peripheral inputs. That is, failure to perceive rotation during caloric testing when the SPV is >15°/s, should prompt the clinician to envisage preventive actions to avoid future falls such as rehabilitation.
DOI: 10.3389/fneur.2016.00004
PubMed: 26834699
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Curthoys</name><affiliation><nlm:affiliation>Vestibular Research Laboratory, School of Psychology, University of Sydney , Sydney, NSW , Australia.</nlm:affiliation></affiliation></author><author><name sortKey="De Waele, Catherine" sort="De Waele, Catherine" uniqKey="De Waele C" first="Catherine" last="De Waele">Catherine De Waele</name><affiliation><nlm:affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes, Paris, France; ENT Department, Salpetriere Hospital, Paris, France.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26834699</idno><idno type="pmid">26834699</idno><idno type="doi">10.3389/fneur.2016.00004</idno><idno type="wicri:Area/PubMed/Corpus">002351</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002351</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Absence of Rotation Perception during Warm Water Caloric Irrigation in Some Seniors with Postural Instability.</title><author><name sortKey="Chiarovano, Elodie" sort="Chiarovano, Elodie" uniqKey="Chiarovano E" first="Elodie" last="Chiarovano">Elodie Chiarovano</name><affiliation><nlm:affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes, Paris, France; ENT Department, Salpetriere Hospital, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Vidal, Pierre Paul" sort="Vidal, Pierre Paul" uniqKey="Vidal P" first="Pierre-Paul" last="Vidal">Pierre-Paul Vidal</name><affiliation><nlm:affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes , Paris , France.</nlm:affiliation></affiliation></author><author><name sortKey="Magnani, Christophe" sort="Magnani, Christophe" uniqKey="Magnani C" first="Christophe" last="Magnani">Christophe Magnani</name><affiliation><nlm:affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes , Paris , France.</nlm:affiliation></affiliation></author><author><name sortKey="Lamas, Georges" sort="Lamas, Georges" uniqKey="Lamas G" first="Georges" last="Lamas">Georges Lamas</name><affiliation><nlm:affiliation>ENT Department, Salpetriere Hospital , Paris , France.</nlm:affiliation></affiliation></author><author><name sortKey="Curthoys, Ian S" sort="Curthoys, Ian S" uniqKey="Curthoys I" first="Ian S" last="Curthoys">Ian S. Curthoys</name><affiliation><nlm:affiliation>Vestibular Research Laboratory, School of Psychology, University of Sydney , Sydney, NSW , Australia.</nlm:affiliation></affiliation></author><author><name sortKey="De Waele, Catherine" sort="De Waele, Catherine" uniqKey="De Waele C" first="Catherine" last="De Waele">Catherine De Waele</name><affiliation><nlm:affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes, Paris, France; ENT Department, Salpetriere Hospital, Paris, France.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Frontiers in neurology</title><idno type="ISSN">1664-2295</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Falls in seniors are a major public health problem. Falls lead to fear of falling, reduced mobility, and decreased quality of life. Vestibular dysfunction is one of the fall risk factors. The relationship between objective measures of vestibular responses and age has been studied. However, the effects of age on vestibular perception during caloric stimulation have not been studied. Twenty senior subjects were included in the study, and separated in two groups: 10 seniors reporting postural instability (PI) and exhibiting absence of vestibular perception when they tested with caloric stimulation and 10 sex- and age-matched seniors with no such problems (controls). We assessed vestibular perception on a binary rating scale during the warm irrigation of the caloric test. The function of the various vestibular receptors was assessed using video head impulse test (vHIT), caloric tests, and cervical and ocular vestibular-evoked myogenic potentials. The Equitest was used to evaluate balance. No horizontal canal dysfunction assessed using both caloric test and vHIT was detected in either group. No significant difference was detected between PI and control groups for the peak SPV of caloric-induced ocular nystagmus or for the HVOR gain. All the controls perceived rotation when the maximal SPV during warm irrigation was equal to or ≥15°/s. None of the subjects in the PI group perceived rotation even while the peak SPV exceeded 15°/s, providing objective evidence of normal peripheral horizontal canal function. All the PI group had abnormal Equitest results, particularly in the two last conditions. These investigations show for the first time that vestibular perception can be absent during a caloric test despite normal horizontal canal function. We call this as dissociation vestibular neglect. Patients with poor vestibular perception may not be aware of postural perturbations and so will not correct for them. Thus, falls in the elderly may result, among other factors, from a vestibular neglect due to an inappropriate central processing of normal vestibular peripheral inputs. That is, failure to perceive rotation during caloric testing when the SPV is >15°/s, should prompt the clinician to envisage preventive actions to avoid future falls such as rehabilitation.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">26834699</PMID><DateCreated><Year>2016</Year><Month>02</Month><Day>02</Day></DateCreated><DateCompleted><Year>2016</Year><Month>02</Month><Day>02</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1664-2295</ISSN><JournalIssue CitedMedium="Print"><Volume>7</Volume><PubDate><Year>2016</Year></PubDate></JournalIssue><Title>Frontiers in neurology</Title><ISOAbbreviation>Front Neurol</ISOAbbreviation></Journal><ArticleTitle>Absence of Rotation Perception during Warm Water Caloric Irrigation in Some Seniors with Postural Instability.</ArticleTitle><Pagination><MedlinePgn>4</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fneur.2016.00004</ELocationID><Abstract><AbstractText>Falls in seniors are a major public health problem. Falls lead to fear of falling, reduced mobility, and decreased quality of life. Vestibular dysfunction is one of the fall risk factors. The relationship between objective measures of vestibular responses and age has been studied. However, the effects of age on vestibular perception during caloric stimulation have not been studied. Twenty senior subjects were included in the study, and separated in two groups: 10 seniors reporting postural instability (PI) and exhibiting absence of vestibular perception when they tested with caloric stimulation and 10 sex- and age-matched seniors with no such problems (controls). We assessed vestibular perception on a binary rating scale during the warm irrigation of the caloric test. The function of the various vestibular receptors was assessed using video head impulse test (vHIT), caloric tests, and cervical and ocular vestibular-evoked myogenic potentials. The Equitest was used to evaluate balance. No horizontal canal dysfunction assessed using both caloric test and vHIT was detected in either group. No significant difference was detected between PI and control groups for the peak SPV of caloric-induced ocular nystagmus or for the HVOR gain. All the controls perceived rotation when the maximal SPV during warm irrigation was equal to or ≥15°/s. None of the subjects in the PI group perceived rotation even while the peak SPV exceeded 15°/s, providing objective evidence of normal peripheral horizontal canal function. All the PI group had abnormal Equitest results, particularly in the two last conditions. These investigations show for the first time that vestibular perception can be absent during a caloric test despite normal horizontal canal function. We call this as dissociation vestibular neglect. Patients with poor vestibular perception may not be aware of postural perturbations and so will not correct for them. Thus, falls in the elderly may result, among other factors, from a vestibular neglect due to an inappropriate central processing of normal vestibular peripheral inputs. That is, failure to perceive rotation during caloric testing when the SPV is >15°/s, should prompt the clinician to envisage preventive actions to avoid future falls such as rehabilitation.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chiarovano</LastName><ForeName>Elodie</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes, Paris, France; ENT Department, Salpetriere Hospital, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vidal</LastName><ForeName>Pierre-Paul</ForeName><Initials>PP</Initials><AffiliationInfo><Affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes , Paris , France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Magnani</LastName><ForeName>Christophe</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes , Paris , France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lamas</LastName><ForeName>Georges</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>ENT Department, Salpetriere Hospital , Paris , France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Curthoys</LastName><ForeName>Ian S</ForeName><Initials>IS</Initials><AffiliationInfo><Affiliation>Vestibular Research Laboratory, School of Psychology, University of Sydney , Sydney, NSW , Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Waele</LastName><ForeName>Catherine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>CNRS UMR 8257, Cognition and Action Group, Centre Universitaire des Saints-Pères, Université Paris Descartes, Paris, France; ENT Department, Salpetriere Hospital, Paris, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>01</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Front Neurol</MedlineTA><NlmUniqueID>101546899</NlmUniqueID><ISSNLinking>1664-2295</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Arch Intern Med. 2009 May 25;169(10):938-44</RefSource><PMID Version="1">19468085</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Ear Hear. 2014 Sep-Oct;35(5):565-70</RefSource><PMID Version="1">25144251</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Brain Res Cogn Brain Res. 2001 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1962;24:65-93</RefSource><PMID Version="1">14452374</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Acta Otolaryngol Suppl. 2007 Oct;(558):128-31</RefSource><PMID Version="1">17882583</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Acta Otolaryngol. 1975 Jan-Feb;79(1-2):67-80</RefSource><PMID Version="1">167544</PMID></CommentsCorrections></CommentsCorrectionsList><OtherID Source="NLM">PMC4725157</OtherID><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">balance</Keyword><Keyword MajorTopicYN="N">otolith</Keyword><Keyword MajorTopicYN="N">semicircular canal</Keyword><Keyword MajorTopicYN="N">seniors</Keyword><Keyword MajorTopicYN="N">vertigo</Keyword><Keyword MajorTopicYN="N">vestibular neglect</Keyword><Keyword MajorTopicYN="N">video head impulse test</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>10</Month><Day>12</Day></PubMedPubDate><PubMedPubDate 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