Functional Testing of Vestibulo-Spinal Contributions to Balance Control: Insights From Tracking Improvement Following Acute Bilateral Peripheral Vestibular Loss.
Identifieur interne : 000267 ( Main/Exploration ); précédent : 000266; suivant : 000268Functional Testing of Vestibulo-Spinal Contributions to Balance Control: Insights From Tracking Improvement Following Acute Bilateral Peripheral Vestibular Loss.
Auteurs : John H J. Allum [Suisse] ; Heiko Mario Rust [Suisse, Royaume-Uni] ; Flurin Honegger [Suisse]Source :
- Frontiers in neurology [ 1664-2295 ] ; 2019.
Abstract
Background: A battery of stance and gait tasks can be used to quantify functional deficits and track improvement in balance control following peripheral vestibular loss. An improvement could be due to at least 3 processes: partial peripheral recovery of sensory responses eliciting canal or otolith driven vestibular reflexes; central compensation of vestibular reflex gains, including substitution of intact otolith responses for pathological canal responses; or sensory substitution of visual and proprioceptive inputs for vestibular contributions to balance control. Results: We describe the presumed action of all 3 processes observed for a case of sudden incapacitating acute bilateral peripheral loss probably due to vestibular neuritis. Otolith responses were largely unaffected. However, pathological decreases in all canal-driven vestibular ocular reflex (VOR) gains were observed. After 3 months of vestibular rehabilitation, balance control was normal but VOR gains remained low. Conclusions: This case illustrates the difficulty in predicting balance control improvements from tests of the 10 vestibular end organs and emphasizes the need to test balance control function directly in order to determine if balance control has improved and is normal again despite remaining vestibular sensory deficits. This case also illustrates that the presence of residual otolithic function may be crucial for balance control improvement in cases of bilateral vestibular hypofunction.
DOI: 10.3389/fneur.2019.00550
PubMed: 31191439
PubMed Central: PMC6546919
Affiliations:
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Allum</name><affiliation wicri:level="1"><nlm:affiliation>Division of Audiology and Neurootology, Department of Otorhinolaryngology (ORL), University Hospital Basel, Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Division of Audiology and Neurootology, Department of Otorhinolaryngology (ORL), University Hospital Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Rust, Heiko Mario" sort="Rust, Heiko Mario" uniqKey="Rust H" first="Heiko Mario" last="Rust">Heiko Mario Rust</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University of Basel Hospital, Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neurology, University of Basel Hospital, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>Division of Brain Sciences, Academic Department of Neuro-Otology, Charing Cross Hospital, Imperial College, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Division of Brain Sciences, Academic Department of Neuro-Otology, Charing Cross Hospital, Imperial College, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Honegger, Flurin" sort="Honegger, Flurin" uniqKey="Honegger F" first="Flurin" last="Honegger">Flurin Honegger</name><affiliation wicri:level="1"><nlm:affiliation>Division of Audiology and Neurootology, Department of Otorhinolaryngology (ORL), University Hospital Basel, Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Division of Audiology and Neurootology, Department of Otorhinolaryngology (ORL), University Hospital Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author></analytic><series><title level="j">Frontiers in neurology</title><idno type="ISSN">1664-2295</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Background:</b> A battery of stance and gait tasks can be used to quantify functional deficits and track improvement in balance control following peripheral vestibular loss. An improvement could be due to at least 3 processes: partial peripheral recovery of sensory responses eliciting canal or otolith driven vestibular reflexes; central compensation of vestibular reflex gains, including substitution of intact otolith responses for pathological canal responses; or sensory substitution of visual and proprioceptive inputs for vestibular contributions to balance control. <b>Results:</b> We describe the presumed action of all 3 processes observed for a case of sudden incapacitating acute bilateral peripheral loss probably due to vestibular neuritis. Otolith responses were largely unaffected. However, pathological decreases in all canal-driven vestibular ocular reflex (VOR) gains were observed. After 3 months of vestibular rehabilitation, balance control was normal but VOR gains remained low. <b>Conclusions:</b> This case illustrates the difficulty in predicting balance control improvements from tests of the 10 vestibular end organs and emphasizes the need to test balance control function directly in order to determine if balance control has improved and is normal again despite remaining vestibular sensory deficits. This case also illustrates that the presence of residual otolithic function may be crucial for balance control improvement in cases of bilateral vestibular hypofunction.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">31191439</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>30</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1664-2295</ISSN><JournalIssue CitedMedium="Print"><Volume>10</Volume><PubDate><Year>2019</Year></PubDate></JournalIssue><Title>Frontiers in neurology</Title><ISOAbbreviation>Front Neurol</ISOAbbreviation></Journal><ArticleTitle>Functional Testing of Vestibulo-Spinal Contributions to Balance Control: Insights From Tracking Improvement Following Acute Bilateral Peripheral Vestibular Loss.</ArticleTitle><Pagination><MedlinePgn>550</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fneur.2019.00550</ELocationID><Abstract><AbstractText><b>Background:</b> A battery of stance and gait tasks can be used to quantify functional deficits and track improvement in balance control following peripheral vestibular loss. An improvement could be due to at least 3 processes: partial peripheral recovery of sensory responses eliciting canal or otolith driven vestibular reflexes; central compensation of vestibular reflex gains, including substitution of intact otolith responses for pathological canal responses; or sensory substitution of visual and proprioceptive inputs for vestibular contributions to balance control. <b>Results:</b> We describe the presumed action of all 3 processes observed for a case of sudden incapacitating acute bilateral peripheral loss probably due to vestibular neuritis. Otolith responses were largely unaffected. However, pathological decreases in all canal-driven vestibular ocular reflex (VOR) gains were observed. After 3 months of vestibular rehabilitation, balance control was normal but VOR gains remained low. <b>Conclusions:</b> This case illustrates the difficulty in predicting balance control improvements from tests of the 10 vestibular end organs and emphasizes the need to test balance control function directly in order to determine if balance control has improved and is normal again despite remaining vestibular sensory deficits. This case also illustrates that the presence of residual otolithic function may be crucial for balance control improvement in cases of bilateral vestibular hypofunction.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Allum</LastName><ForeName>John H J</ForeName><Initials>JHJ</Initials><AffiliationInfo><Affiliation>Division of Audiology and Neurootology, Department of Otorhinolaryngology (ORL), University Hospital Basel, Basel, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rust</LastName><ForeName>Heiko Mario</ForeName><Initials>HM</Initials><AffiliationInfo><Affiliation>Department of Neurology, University of Basel Hospital, Basel, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Brain Sciences, Academic Department of Neuro-Otology, Charing Cross Hospital, Imperial College, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Honegger</LastName><ForeName>Flurin</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Division of Audiology and Neurootology, Department of Otorhinolaryngology (ORL), University Hospital Basel, Basel, Switzerland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>05</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Front Neurol</MedlineTA><NlmUniqueID>101546899</NlmUniqueID><ISSNLinking>1664-2295</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">bilateral vestibular loss</Keyword><Keyword MajorTopicYN="N">posturography</Keyword><Keyword MajorTopicYN="N">vemps</Keyword><Keyword MajorTopicYN="N">vestibular evoked</Keyword><Keyword MajorTopicYN="N">vestibulo-ocular reflexes</Keyword><Keyword MajorTopicYN="N">vestibulo-spinal reflexes</Keyword><Keyword MajorTopicYN="N">video head impulse test</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>11</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>05</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>6</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>6</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>6</Month><Day>14</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31191439</ArticleId><ArticleId IdType="doi">10.3389/fneur.2019.00550</ArticleId><ArticleId 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