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Ear, Nose, & Throat Journal May 2024The vestibular system not only supports reflex function at the brainstem level, but is also associated with higher levels of cognitive function. Vertigo due to...
The vestibular system not only supports reflex function at the brainstem level, but is also associated with higher levels of cognitive function. Vertigo due to vestibular disorders may lead to or be associated with cognitive dysfunction. Patients with deficits of both vestibular as well as cognitive function may be at particularly high risk for events like falls or certain diseases, such as Alzheimer's. To analyze the current state of research and trends in the global research literature regarding the correlation between vestibular disorders, vertigo, and cognitive impairment. We utilized Bibliometrix package to search databases including PubMed, Web of Science, etc for search terms. Databases were searched up to December 15, 2022, and a total of 2222 publications were retrieved. Ultimately, 53 studies were included. A total of 261 authors published in 38 journals and conferences with an overall increasing annual growth rate of 6.94%. The most-published journal was . The most-published country was the United States, followed by Italy and Brazil. The most-published institution was Johns Hopkins University with a total of 13 articles. On performing trend analysis, we found that the most frequent focus of research in this field include the testing of vestibular perception, activation of the brain-related cortex, and the influence of stimulus-triggered vestibular snail reflex on visual space. The potential focal points are the risk of falling and the ability to extract spatial memory information, and the focus of research in recent decades has revolved around balance, falling, and Alzheimer's disease. Vestibular impairment in older adults affects cognitive function, particularly immediate memory, visuospatial cognition, and attention, with spatial cognition being the most significantly affected. In the future, virtual reality-based vestibular rehabilitation techniques and caloric stimulation could be potential interventions for the treatment of cognitive impairment.
PubMed: 38818829
DOI: 10.1177/01455613241257396 -
Clinical Otolaryngology : Official... May 2024This study aimed to evaluate the prevalence and psychometric properties of vertigo and dizziness in an obstructive sleep apnoea (OSA) population.
INTRODUCTION
This study aimed to evaluate the prevalence and psychometric properties of vertigo and dizziness in an obstructive sleep apnoea (OSA) population.
METHODS
Five hundred and twelve OSA patients and 53 controls were enroled. All eligible subjects were asked to complete the basic information questionnaire, the Chinese version of Vestibular Disorders Activities of Daily Living (VADL-C), the Dizziness Handicap Inventory (DHI) and the Activities-Specific Balance Confidence (ABC) scale.
RESULTS
Among 512 enroled OSA patients, a 22.46% (115) prevalence of vertigo and dizziness was found. The scores of the VADL-C, DHI and ABC of the study group were significantly worse (p < .001) than those of the control group, while the abnormal rates of the three scales in the study group were higher than those of the control group. In the study group, the results of the VADL-C were correlated with those of the DHI (r = .55, p < .001) and inversely correlated with those of the ABC (r = -.50, p < .001), and the results of the DHI were inversely correlated with those of the ABC (r = -.60, p < .001).
CONCLUSIONS
A high prevalence of vertigo and dizziness in the OSA population was detected. Psychometric results showed that vertigo and dizziness in OSA patients led to changes in activities of daily living, increased frequency of somatic symptoms, and reduced balance confidence. In the diagnosis and treatment of OSA patients, the occurrence of vertigo and dizziness is worth clinicians' attention.
PubMed: 38818535
DOI: 10.1111/coa.14189 -
BMJ Neurology Open 2024Benign paroxysmal positional vertigo (BPPV) affects approximately half of acute, moderate-severe traumatic brain injury (TBI) patients. To date, there have been no...
BACKGROUND
Benign paroxysmal positional vertigo (BPPV) affects approximately half of acute, moderate-severe traumatic brain injury (TBI) patients. To date, there have been no rigorous studies of BPPV assessment or treatment in this cohort. We aimed to determine the safety, practicability, and efficacy of therapist-led BPPV management in acute TBI and the feasibility of a larger effectiveness trial.
METHODS
This was a multi-centre, three-arm, parallel-groups, randomised, feasibility trial. Recruitment was via convenience sampling. The main inclusion criteria were age over 18 years and a confirmed, non-penetrating, acute TBI. BPPV-positive patients were randomly allocated to one of three interventions (repositioning manoeuvres, Brandt-Daroff exercises or advice) using minimisation criteria. Outcome assessors were blinded to the intervention.
RESULTS
Of 2014 patients screened for inclusion, 180 were assessed for BPPV. Of those assessed, 34% (62/180) had BPPV, and 58 patients received an intervention. Therapist-led interventions were delivered safely and accurately according to intervention monitoring criteria. Resolution of BPPV was observed in 35/58 (60%) patients. The resolution rate was highest following repositioning manoeuvres (78%), followed by the advice (53%) and Brandt-Daroff interventions (42%). 10 patients experienced recurrence. This was observed more frequently in those with skull fractures and bilateral or mixed BPPV.
CONCLUSIONS
Overall, the results provide strong evidence for the feasibility of a future trial. Therapist-led management of BPPV in acute TBI was safe and practicable. Repositioning manoeuvres seemingly yielded a superior treatment effect. However, given the high recurrence rate of post-traumatic BPPV, the optimal time to treat according to patients' specific recurrence risk requires further investigation.
TRIAL REGISTRATION
ISRCTN91943864, https://doi.org/10.1186/ISRCTN91943864.
PubMed: 38818242
DOI: 10.1136/bmjno-2023-000598 -
Cureus Apr 2024The onset of menopause, marked by hormonal fluctuations and a decline in estrogen levels, is suggested to be linked to increased susceptibility to vestibular... (Review)
Review
The onset of menopause, marked by hormonal fluctuations and a decline in estrogen levels, is suggested to be linked to increased susceptibility to vestibular disturbances. Estrogen, beyond its established association with reproductive physiology, plays modulatory roles in various physiological systems, including neurosensory function. The vestibular system, crucial for balance and spatial orientation, is influenced by hormonal changes during menopause, potentially contributing to the emergence of vertigo symptoms. This interplay between hormones and the vestibular system is a burgeoning area of research with clinical implications, offering insights into novel diagnostic and therapeutic approaches for managing postmenopausal women with vestibular disorders. The article reviews current scientific literature, delves into the hormonal intricacies of menopause, and investigates potential mechanisms underlying the connection between hormonal fluctuations and vertigo symptoms.
PubMed: 38813338
DOI: 10.7759/cureus.59277 -
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke... May 2024
Review
Topics: Humans; Benign Paroxysmal Positional Vertigo; Vertigo; Otolithic Membrane; Metabolic Diseases
PubMed: 38811184
DOI: 10.3760/cma.j.cn115330-20240117-00032 -
Journal of Pharmaceutical and... Sep 2024Posterior circulation ischemia vertigo (PCIV) is vertebrobasilar insufficiency resulting in vertigo. Banxia Baizhu Tianma Decoction (BBTD) is broadly applied to treat...
Comprehensive evaluation of the mechanism of Banxia Baizhu Tianma Decoction in ameliorating posterior circulation ischemia vertigo based on integrating fecal short-chain fatty acids and 16S rRNA sequencing.
Posterior circulation ischemia vertigo (PCIV) is vertebrobasilar insufficiency resulting in vertigo. Banxia Baizhu Tianma Decoction (BBTD) is broadly applied to treat PCIV in China, but its efficacy and detailed mechanism remains unclear. Therefore, this study aims to investigate the effects of BBTD on PCIV, and identify important gut microbiota and its derived short-chain fatty acid (SCFA) changes and the detailed mechanism through 16 S rRNA sequencing with SCFAs profiling. In this study, the model of PCIV was established by surgical ligation of the right subclavian artery (RSCA) and right common carotid artery (RCCA). We found that BBTD administration effectively reduced the volume of cerebral infarction and improved neurologic functions, reduced neuronal apoptosis and neuroinflammatory. Moreover, BBTD significantly modulated the diversity and composition of the gut microbiota, including increasing the relative abundance of Lactobacillus, Prevotella and Akkermansia and decreasing relative abundances of Lachnospiraceae, Bacteroidetes (S24-7) and Ruminococcaceae. BBTD treatment also increased propionate content. Propionate mediates the the recovery of neurological functions and anti-apoptotic effects of BBTD in PCIV rat. Our findings wish to discover the potential mechanism of BBTD treatment on PCIV and promote its clinical application.
Topics: Animals; Rats; Gastrointestinal Microbiome; Drugs, Chinese Herbal; Male; RNA, Ribosomal, 16S; Fatty Acids, Volatile; Feces; Rats, Sprague-Dawley; Vertigo; Disease Models, Animal; Vertebrobasilar Insufficiency; Apoptosis
PubMed: 38810328
DOI: 10.1016/j.jpba.2024.116195 -
CNS Drugs May 2024Migraine and dizziness often coexist, with vestibular migraine (VM) presenting with vestibular symptoms and headaches. Calcitonin gene-related peptide (CGRP) may be...
BACKGROUND
Migraine and dizziness often coexist, with vestibular migraine (VM) presenting with vestibular symptoms and headaches. Calcitonin gene-related peptide (CGRP) may be involved in motion-induced symptoms; however, studies on the use of anti-CGRP monoclonal antibodies (mAbs) for the treatment of VM have yielded conflicting results. This study aimed to clarify the effectiveness of anti-CGRP mAbs in VM treatment.
METHODS
This retrospective observational cohort study, conducted between 1 January 2021 and 31 March 2023, assessed 12 Japanese patients with VM who were treated with anti-CGRP mAbs (CGRP group) for 6 months and 11 Japanese patients who received standard of care for VM and served as controls. Clinical questionnaires and equilibrium tests were administered, with primary outcomes including changes in Dizziness Handicap Inventory (DHI) scores compared with baseline values. Objective variables included the DHI score and explanatory variables included demographic data, balance test results, head-up tilt (HUT) test results, vestibular test results and questionnaire survey results. Analysis of variance was used to assess the treatment effects of anti-CGRP mAbs, and multivariate regression analysis was performed to identify mAb responders.
RESULTS
After 6 months, the CGRP group showed significant improvements in DHI scores [0 versus 6 months, odds ratio (95% confidence interval): 22.01 (0.13-43.88)] and number of vertigo/dizziness attacks per month [0 versus 6 months: 10.28 (2.80-17.76)]. No significant difference was observed in the control group [DHI scores, 0 versus 6 months: 0.65 (-26.84 to 28.14); number of vertigo/dizziness attacks per month, 0 versus 6 months: - 8.07 (- 23.77 to 7.62)]. Multivariate regression analysis showed that autonomic function at baseline was associated with mAb response in patients [β estimates (95% confidence interval): 3.63 (0.21-7.06)].
CONCLUSIONS
Treatment with anti-CGRP mAbs was more effective than conventional treatment in preventing migraine in patients with VM. While the identified factors associated with treatment responsiveness offer valuable insights into personalised treatment approaches, further prospective studies are warranted to validate the findings due to our study's retrospective design and limited sample size.
PubMed: 38809343
DOI: 10.1007/s40263-024-01094-z -
Sisli Etfal Hastanesi Tip Bulteni 2024The aim of this study was to evaluate vestibulo-ocular reflex (VOR) of individuals over 60 years of age who have not been diagnosed with a specific vestibular pathology.
OBJECTIVES
The aim of this study was to evaluate vestibulo-ocular reflex (VOR) of individuals over 60 years of age who have not been diagnosed with a specific vestibular pathology.
METHODS
Bilateral six-semicircular canal video head impulse test (vHIT), Dizziness Handicap Inventory and European Evaluation of Vertigo scales were applied to participants.
RESULTS
In total, 103 participants were included in the study (75 male, 28 female), and the mean age was 69.35 ± 7.41 years. The mean age of 7th decade group was 64.32±3.12 (59 participants; 38 male, 21 female), and the mean age of 8th decade and older group was 76.11±5.93 (44 participants; 37 male, 7 female). No significant differences were found between the VOR gains of the lateral or vertical semicircular canals between the 7th decade and 8th decade and older groups (p>0.05). In the 8th decade and older group, the presence of right lateral semicircular canal corrective saccade and left posterior semicircular canal corrective saccade showed a positively moderate correlation with VOR gains of the same semicircular canals (r=0.455, p=0.002, and r=0.518, p=0.001, respectively). No significant correlation was found between age and VOR gain in the 7th decade group, however, there was a negatively weak correlation between age and left lateral semicircular canal VOR gain (r=-0.366, p=0.017) in the 8th decade and older group.
CONCLUSION
While assessing the age-related changes in VOR using vHIT, it must be considered that the changes related to aging of the vestibular system begin to emerge in the population over 70 years of age, and corrective saccade findings may be more informative than VOR gains in revealing these changes.
PubMed: 38808050
DOI: 10.14744/SEMB.2023.31967 -
Audiology Research May 2024(1) Background: Patients affected by Ménière's disease can experience Tumarkin's syndrome, which is characterized by postural instability, gait abnormalities, and,...
(1) Background: Patients affected by Ménière's disease can experience Tumarkin's syndrome, which is characterized by postural instability, gait abnormalities, and, occasionally, an abrupt loss of balance known as vestibular drop attack or Tumarkin's crisis. In this study, semicircular canal plugging is proposed as the definitive treatment for this condition. The outcomes of this type of surgery are discussed. (2) Methods: A total of 9 patients with a confirmed diagnosis of Ménière disease suffering from Tumarkin crisis underwent posterior semicircular canal plugging. These patients were assessed with Video Head Impulse Tests, vestibular evoked myogenic potentials, and Pure Tone Audiometry preoperatively and postoperatively. (3) Results: VHIT showed a postoperative decrease in PSC gain median (Preop. 0.86 and postop. 0.52; < 0.009). No statistically significant differences were described for the anterior semicircular canal and the lateral semicircular canal. No patient experienced new Tumarkin crisis after the surgical treatment. (4) Conclusions: Our ten years of experience with posterior semicircular canal plugging in Ménière disease patients with Tumarkin's syndrome has shown that this type of surgical procedure is successful in controlling Tumarkin's crisis, with high patient satisfaction and little worsening in hearing level.
PubMed: 38804460
DOI: 10.3390/audiolres14030036 -
Journal of Functional Morphology and... May 2024Persistent dizziness and balance deficits are common, often with unknown etiology. Persistent Postural-Perceptual Dizziness (3PD) is a relatively new diagnosis with...
Persistent dizziness and balance deficits are common, often with unknown etiology. Persistent Postural-Perceptual Dizziness (3PD) is a relatively new diagnosis with symptoms that may include dizziness, unsteadiness, or non-vertiginous dizziness and be persistent the majority of time over a minimum of 90 days. The purpose of this case series was to investigate short-term outcomes of reducing dizziness symptoms using a manual therapy intervention focused on restoring mobility in the fascia using a pragmatically applied biomechanical approach, the Fascial Manipulation method (FM), in patients with 3PD. The preliminary prospective case series consisted of twelve ( = 12) patients with persistent complaints of dizziness who received systematic application of manual therapy to improve fascial mobility after previously receiving vestibular rehabilitation. The manual therapy consisted of strategic assessment and palpation based on the model proposed in the FM Stecco Method. This model utilizes tangential oscillations directed toward the deep fascia at strategic points. Six males ( = 6) and females ( = 6) were included with a mean age of 68.3 ± 19.3 years. The average number of interventions was 4.5 ± 0.5. Nonparametric paired sample -tests were performed. Significant improvements were observed toward the resolution of symptoms and improved outcomes. The metrics included the Dizziness Handicap Inventory and static and dynamic balance measures. The Dizziness Handicap Inventory scores decreased (i.e., improved) by 43.6 points ( = -3.1 and = 0.002). The timed up and go scores decreased (i.e., improved) by 3.2 s ( = -2.8 and = 0.005). The tandem left increased (i.e., improved) by 8.7 s ( = 2.8 and = 0.005) and the tandem right increased (i.e., improved) by 7.5 s ( = 2.8 and = 0.005). Four to five manual therapy treatment sessions appear to be effective for short-term improvements in dizziness complaints and balance in those with 3PD. These results should be interpreted with caution as future research using rigorous methods and a control group must be conducted.
PubMed: 38804448
DOI: 10.3390/jfmk9020082