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Article type: Research Article
Authors: Wall III, C.a; b; c; * | Oddsson, L.I.c | Patronik, N.b; c | Sienko, K.b; d | Kentala, E.a; b; e
Affiliations: [a] Harvard Medical School, Department of Otology and Laryngology, Boston, MA, USA | [b] Jenks Vestibular Diagnostic Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA, USA | [c] NeuroMuscular Research Center, Boston University, Boston, USA | [d] MIT-Harvard Whitaker College of Health Science and Technology, Cambridge, USA | [e] Helsinki University Hospital, Helsinki, Finland
Correspondence: [*] Corresponding author: Conrad Wall III, Ph.D., Jenks Vestibular Diagnostic Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA 02114, USA. Tel.: +1 617 573 4153; Fax: +1 617 573 4154, E-mail: cwall@mit.edu
Abstract: We compared the mediolateral (M/L) responses to perturbations during locomotion of vestibulopathic (VP) subjects to those of controls. Eight subjects with unilateral vestibular loss (100% Reduced Vestibular Response from the caloric test) resulting from surgery for vestibular schwannoma and 11 controls were selected for this study. Despite their known vestibulopathy, all VP subjects scored within the normal range on computerized dynamic posturography Sensory Organization Tests. During gait, subjects were given surface perturbations of the right support-phase foot in two possible directions (forward-right and backward-left) at two possible magnitudes (5 and 10 cm) that were randomly mixed with trials having no perturbations. M/L stability was quantified by estimating the length of the M/L moment arm between the support foot and the trunk, and the M/L accelerations of the sternum and the head. The VP group had greater changes (p < 0.05) in their moment arm responses compared to controls. The number of steps that it took for the moment arm oscillations to return to normal and the variability in the moment arms were greater for the VP group. Differences in the sternum and head accelerations between VP and control groups were not as consistent, but there was a trend toward greater response deviations in the VP group for all 4 perturbation types. Increased response magnitude and variability of the VP group is consistent with an increase in their sensory noise of vestibular inputs due to the surgical lesion. Another possibility is a reduced sensitivity to motion inputs. This perturbation approach may prove useful for characterizing subtle vestibulopathies and similar changes in the human orientation mechanism after exposure to microgravity.
Keywords: balance, postural stability, vestibular, microgravity, vestibular testing, locomotor perturbations, impulse response
DOI: 10.3233/VES-2003-125-605
Journal: Journal of Vestibular Research, vol. 12, no. 5-6, pp. 239-253, 2003
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