Journal of Vestibular Research - Volume 30, issue 2

Authors: Felipe, Lilian | Beukes, Eldré W. | Fox, Baylie A. | Manchaiah, Vinaya

Article Type: Research Article

Abstract: BACKGROUND: The Internet has become a powerful, accessible resource for many patients to use for their own medical management and knowledge. Vestibular disorders are prevalent, especially in the elderly. As the Internet is increasingly a major source of health-related information to the general public, it is often used to search for information regarding dizziness and vertigo. Ensuring that the information is accessible, unbiased, and appropriate can aid informed decision-making. OBJECTIVE: To evaluate the quality and readability of English-language Internet information related to vestibular disorders. METHODS: A cross-sectional website search using three keywords (nausea, dizziness, and vertigo) …in five country-specific versions of the most commonly used Internet search engine was conducted in March 2018. The language was limited to English for all websites. Quality was assessed by presence of Health on the Net (HON) certification and DISCERN scores. Readability was assessed using the Flesch Reading Ease (FRE) score, Flesch-Kincaid Grade Level Formula (F-KGL), and Simple Measure of Gobbledygook (SMOG). RESULTS: In total, 112 websites were included and analyzed. The majority were commercial (61%) websites. A total of 42% had obtained HON certification. No association was found between the presence of HON certification and the resource of the website. The DISCERN scores had a mean of 2.52 (SD 1.1). Readability measures indicated that an average of 14–18 years of education was required to read and understand the Internet information provided regarding vestibular disorders. CONCLUSIONS: To ensure the accessible to the general population, it is necessary to improve the quality and readability of Internet-based information regarding vestibular disorders. Show more

Keywords: Vestibular disorders, internet health information, health information quality, health information readability

DOI: 10.3233/VES-200698

Citation: Journal of Vestibular Research, vol. 30, no. 2, pp. 63-72, 2020

Authors: Cho, In Hee | Kwon, Jung Won | Yeo, Sang Seok

Article Type: Research Article

Abstract: OBJECTIVE: Subjective visual vertical (SVV) deviation can indicate impairments of motion perception and spatial orientation in individuals with vestibular disorders. This study investigated the influence of SVV on tandem gait ability by assessing differences between temporal, spatial, and kinematic characteristics in young adults. METHODS: We recruited sixteen young adults with increased SVV and 17 age-matched control subjects. All subjects recruited for this study were with no history of neurological or musculoskeletal diseases. Knee and hip-joint kinematic data, spatio-temporal parameters, and gait variability were measured during tandem gait. RESULTS: Stride time variability and stride velocity variability were …significantly greater in the experimental group than the control group (p  < 0.05). In addition, a significant correlation was observed between stride time variability and SVV results (r  = 0.345, p  < 0.05). However, hip and knee joint angles were non-significantly different in the experimental and control groups (p  > 0.05) and spatio-temporal parameters were similar between the two groups (p  > 0.05). CONCLUSION: Stride time variability and stride velocity variability during tandem gait were significantly different in the experimental and control groups. We presume that increased SVV deviation is related to greater gait variability during tandem gait. Show more

Keywords: Tandem gait, subjective visual vertical, gait analysis, gait variability

DOI: 10.3233/VES-200694

Citation: Journal of Vestibular Research, vol. 30, no. 2, pp. 73-79, 2020

Authors: Patel, Mitesh | Roberts, Ed | Arshad, Qadeer | Bunday, Karen | Golding, John F. | Kaski, Diego | Bronstein, Adolfo M.

Article Type: Research Article

Abstract: BACKGROUND: Although vestibular lesions degrade postural control we do not know the relative contributions of the magnitude of the vestibular loss and subjective vestibular symptoms to locomotor adaptation. OBJECTIVE: To study how dizzy symptoms interfere with adaptive locomotor learning. METHODS: We examined patients with contrasting peripheral vestibular deficits, vestibular neuritis in the chronic stable phase (n  = 20) and strongly symptomatic unilateral Meniere’s disease (n  = 15), compared to age-matched healthy controls (n  = 15). We measured locomotor adaptive learning using the “broken escalator” aftereffect, simulated on a motorised moving sled. RESULTS: Patients with Meniere’s disease had …an enhanced “broken escalator” postural aftereffect. More generally, the size of the locomotor aftereffect was related to how symptomatic patients were across both groups. Contrastingly, the degree of peripheral vestibular loss was not correlated with symptom load or locomotor aftereffect size. During the MOVING trials, both patient groups had larger levels of instability (trunk sway) and reduced adaptation than normal controls. CONCLUSION: Dizziness symptoms influence locomotor adaptation and its subsequent expression through motor aftereffects. Given that the unsteadiness experienced during the “broken escalator” paradigm is internally driven, the enhanced aftereffect found represents a new type of self-generated postural challenge for vestibular/unsteady patients. Show more

Keywords: Vestibular system, vertigo, dizziness, motor control, Meniere’s disease, vestibular neuritis, locomotor adaptation

DOI: 10.3233/VES-200693

Citation: Journal of Vestibular Research, vol. 30, no. 2, pp. 81-94, 2020

Authors: Lee, Hyung | Kim, Hyun Ah

Article Type: Research Article

Abstract: BACKGROUND: In benign paroxysmal positional vertigo (BPPV), the otolithic debris may alter the dynamics of the endolymph or cupula during head-shaking. This dynamic may generate head-shaking nystagmus (HSN) but exact pathomechanism of HSN in BPPV has not been elucidated. The association of positional nystagmus induced by head-bending or lying-down with HSN may help to understand the dynamics of HSN. OBJECTIVE: To assess the presence, pattern, and relationship with head-bending nystagmus (HBN) and lying-down nystagmus (LDN) of HSN in horizontal canal (HC)-BPPV. METHODS: We recruited 173 patients with HC-BPPV (76 geotropic and 97 apogeotropic). We analyzed the …pattern of HSN, and correlation with HBN and LDN. RESULTS: Half of patients (83/173, 48%) with HC-BPPV showed HSN. The directional preponderance of HSN was also not found in patients with geotropic or apogeotropic HC BPPV (p  = 0.488). The presence of HSN was related with the occurrence of HBN in both geotropic (p  = 0.005) and apogeotropic type (p  = 0.001). The direction of HSN was same with HBN and was opposite to LDN in both geotropic and apogeotropic type. CONCLUSIONS: HSN was frequently found in patients with HC-BPPV and related with HBN and LDN. HSN in BPPV might be contributed by the otolith movements related with endolymph dynamics. Show more

Keywords: Benign paroxysmal positional vertigo, pathologic nystagmus, semicircular canals

DOI: 10.3233/VES-200696

Citation: Journal of Vestibular Research, vol. 30, no. 2, pp. 95-100, 2020

Authors: Fujiwara, Keishi | Morita, Shinya | Fukuda, Atsushi | Akamatsu, Hiroki | Yanagi, Hiroko | Hoshino, Kimiko | Nakamaru, Yuji | Kano, Satoshi | Homma, Akihiro

Article Type: Research Article

Abstract: OBJECTIVE: The aim of the present study was to investigate the factors influencing semicircular canal function as evaluated by video Head Impulse Test (vHIT) in patients with vestibular schwannoma. METHODS: Twenty-four patients with untreated vestibular schwannoma underwent vHIT examination. The correlations between semicircular canal function and factors including age, tumor size, disease duration and hearing loss were evaluated. RESULTS: The functions of all three semicircular canals on the affected side evaluated by vHIT were significantly lower than those on the unaffected side. Although there were no significant correlations between semicircular canal function and age, tumor size …or disease duration, a negative significant correlation between vestibulo-ocular reflex (VOR) gain as evaluated by vHIT and hearing loss was observed. CONCLUSIONS: From the results of the relationship between hearing loss and VOR gain, the damage to the audio and vestibular systems in patients with VS may be correlated. As it has been suggested that tumor size was not a significant factor in the VOR gain evaluated by vHIT, multifactorial causes rather than the simple compression of the vestibular nerves alone may be related to the dysfunction of the semicircular canals in patients with vestibular schwannoma. Show more

Keywords: vestibular schwannoma, video head impulse test, semicircular canal function, tumor size, hearing loss

DOI: 10.3233/VES-200695

Citation: Journal of Vestibular Research, vol. 30, no. 2, pp. 101-108, 2020

Authors: Caçador, Maria | Papoila, Ana | Brás-Geraldes, Carlos | Garcia, Carlos Stapleton | Constantino, Tânia | Almeida, Mafalda | Stapleton-Garcia, Pedro | Paço, João

Article Type: Research Article

Abstract: BACKGROUND: Although there are articles and studies that associate postural changes with changes in vocal quality, to the best of our knowledge, this was the first study investigating the association between balance disorders and voice. OBJECTIVE: This study aimed to determine whether patients with balance disorders present any clinical, acoustic, or endoscopic vocal changes, and if the correction of balance impairments, such as through vestibular rehabilitation, lead to improvement in vocal quality. METHODS: This was a prospective cohort study that analyzed vocal differences (clinical, videoendostroboscopic, audio-perceptual, and acoustic vocal parameters) in a sample of 43 patients …with vestibular dysfunction at three different time points (pre-treatment, post-treatment, and 3 months’ post-treatment) diagnosed by videonystagmography with changes in computerized dynamic posturography who were treated with vestibular rehabilitation. RESULTS: In pre-treatment, all of the patients presented supraglottic hyperfunction during videoendoscopic examination and abnormal values in the audio-perceptual scale. After treatment for balance disorders, there was a statistically significant improvement in some parameters of the videoendoscopic and audio-perceptual measures. These improvements were detected immediately after treatment and remained present until at least three months after treatment. CONCLUSIONS: The results suggested that the treatment for balance disorders results in changes in posture and consequently in voice quality. Show more

Keywords: Posture, voice, posturography, vestibular rehabilitation

DOI: 10.3233/VES-200697

Citation: Journal of Vestibular Research, vol. 30, no. 2, pp. 109-120, 2020

Article Type: Abstract

DOI: 10.3233/VES-200699

Citation: Journal of Vestibular Research, vol. 30, no. 2, pp. 121-152, 2020