Article
Geriatrics & Gerontology
Andrew R. Wagner, Megan J. Kobel, Daniel M. Merfeld
Summary: This study aimed to determine the associations between specific sources of vestibular noise and quantitative measures of quiet stance postural control. The results showed a strong positive association between roll tilt vestibular thresholds and the root mean square distance of the center of pressure captured during eyes closed stance on a sway referenced support surface.
FRONTIERS IN AGING NEUROSCIENCE
(2023)
Review
Clinical Neurology
Andrew R. Wagner, Olaoluwa Akinsola, Ajit M. W. Chaudhari, Kimberly E. Bigelow, Daniel M. Merfeld
Summary: Aging is associated with declines in both the vestibular and human balance systems, but the specific contributions of age-related vestibular declines to balance impairment are poorly understood. This lack of knowledge is due to the absence of a standardized method for measuring age-related changes to the vestibular balance pathways. The purpose of this manuscript is to provide an overview of the current methods used to infer vestibular contributions to age-related imbalance.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Birgul Balci, Gulden Akdal
Summary: This study investigated the effects of an individualized vestibular rehabilitation program on balance, gait performance, and self-perceived handicap in vestibular migraine patients with associated anxiety. The findings showed that vestibular exercises improved balance and gait performance and reduced self-perceived handicap, even in patients with anxiety complaints. Therefore, vestibular rehabilitation should be included in the treatment of vestibular migraine patients with both high and low anxiety levels to improve vestibular function.
JOURNAL OF NEUROLOGY
(2022)
Article
Neurosciences
Kevin Biju, Esther Oh, Paul Rosenberg, Qian-Li Xue, Paul Dash, M. Haroon Burhanullah, Yuri Agrawal
Summary: This study assessed the contribution of vestibular function to balance and fall risk in patients with Alzheimer's disease (AD). The results showed that vestibular dysfunction was associated with increased medio-lateral sway and higher likelihood of falls in AD patients.
JOURNAL OF ALZHEIMERS DISEASE
(2022)
Article
Pediatrics
Swetha Pinninti, Jennifer Christy, Anwar Almutairi, Graham Cochrane, Karen B. Fowler, Suresh Boppana
Summary: In children with asymptomatic cCMV, vestibular, gaze, and balance disorders are highly prevalent. This study found abnormalities in semicircular canals, the inner ear, and vestibulo-visual tracts, along with difficulties in maintaining gaze during head movement and balance. Screening and intervention for these disorders are needed in this population.
Article
Neurosciences
Kyla R. Hamling, Yunlu Zhu, Franziska Auer, David Schoppik
Summary: Animals utilize information about gravity and other destabilizing forces to maintain balance and navigate their environment. Measuring neural responses to these forces is technically complex and expensive. The authors propose a low-cost and noninvasive method called Tilt In Place Microscopy (TIPM) to measure neural activity during body orientation changes. Using TIPM, they studied vestibulospinal neurons in larval zebrafish and found reliable increases in activity in response to roll tilts. TIPM also allowed for longitudinal studies, revealing changes in response strength and neural representation. This method has important implications for understanding balance and neural development.
JOURNAL OF NEUROSCIENCE
(2023)
Review
Engineering, Biomedical
Soraya J. LeMarshall, Lachlan M. Stevens, Nicholas P. Ragg, Leia Barnes, Jacinta Foster, Elisa F. D. Canetti
Summary: This article reviews the use of virtual reality in the rehabilitation of vestibular and balance impairments post-concussion. The findings suggest that virtual reality is an effective tool for this purpose, although the current literature lacks high-quality evidence and further research is needed to establish quantitative standards and determine appropriate dosage of virtual reality intervention.
JOURNAL OF NEUROENGINEERING AND REHABILITATION
(2023)
Article
Engineering, Biomedical
Omid A. Zobeiri, Lin Wang, Jennifer L. Millar, Michael C. Schubert, Kathleen E. Cullen
Summary: This study aims to evaluate and prescribe compensation balance stability exercises for individuals with vestibular schwannoma by quantifying head motion kinematics. The results showed that individuals with vestibular schwannoma had more variable head motion, especially in the absence of visual input, both before and after surgery. There was a weak correlation between postoperative head kinematics and clinical measurements. Therefore, further development of metrics based on head motion quantification is important for the assessment and prescription of balance exercises.
JOURNAL OF NEUROENGINEERING AND REHABILITATION
(2022)
Review
Clinical Neurology
Fabiane de Castro Vaz, Leonardo Petrus, Wagner Rodrigues Martins, Isabella Monteiro de Castro Silva, Jade Arielly Oliveira Lima, Nycolle Margarida da Silva Santos, Natalia Turri-Silva, Fayez Bahmad Jr
Summary: This study analyzes the effects of cochlear implant surgery on postural stability in adult patients through multiple vestibular function tests. The findings show that vestibular alterations and balance disorders are the most common complications caused by cochlear implant placement. VEMP and caloric test are the most commonly used tests to assess vestibular function.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
Josefine Eder, Silvy Kellerer, Tamara Amberger, Aram Keywan, Julia Dlugaiczyk, Max Wuehr, Klaus Jahn
Summary: There is no synergistic treatment effect when noisy galvanic vestibular stimulation (nGVS) is combined with vestibular rehabilitation training (VRT) in patients with bilateral vestibulopathy (BVP). However, nGVS may be used as a complementary therapeutic option during postural activities in daily life.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Max Wuehr, Josefine Eder, Aram Keywan, Klaus Jahn
Summary: In patients with bilateral vestibulopathy, imperceptible noisy galvanic vestibular stimulation (nGVS) has been found to improve impaired vestibular motion perception, especially in patients with poor baseline perceptual performance. This non-invasive vestibular noise stimulation offers a potential approach to target spatial memory, orientation, and navigation impairments associated with bilateral vestibulopathy.
JOURNAL OF NEUROLOGY
(2023)
Article
Audiology & Speech-Language Pathology
Jessie N. Patterson, Amanda I. Rodriguez, Katherine R. Gordon, Julie A. Honaker, Kristen L. Janky
Summary: Age significantly influenced the amplitudes of cervical and ocular VEMPs regardless of stimulus type (ACS, B81, IH). All stimuli are suitable for eliciting c- and oVEMPs in young individuals, while ACS resulted in higher cVEMP corrected amplitudes in older individuals. IH showed higher response rates and larger amplitudes for oVEMPs, followed by B81 and ACS. Overall, the B81 performed well across the lifespan for c- and oVEMPs, but may not be a replacement for ACS.
Article
Clinical Neurology
Christos Nikitas, Evangelia Kontogianni, Sofia Papadopoulou, Michalis Tsoukatos, Dimitris Kikidis
Summary: The objective of this cross-sectional study was to identify correlations among functional gait, cognitive function, and perceived dizziness in people with peripheral vestibular disorders and explore variables that could be used as prognostic factors of functional gait. The results showed that age, perceived level of disability, and vigilance were predictive factors of functional gait variability and high risk of falling. The study concluded that cognitive impairments affect functional gait in people with peripheral vestibular disorders, highlighting the importance of integrating cognitive assessment into rehabilitation programs.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2023)
Article
Biochemistry & Molecular Biology
Vasiliki Georgia Paplou, Nick M. A. Schubert, Marcel van Tuinen, Sarath Vijayakumar, Sonja J. Pyott
Summary: Age-related vestibular and hearing impairments are common disorders that significantly decrease quality of life. This study investigated the underlying mechanisms using young and old mice. The findings suggest that age-related vestibular hypofunction is linked to the loss of specific hair cells and inflammation. The comparison of gene expression between the vestibule and cochlea indicates both shared and distinct mechanisms contributing to these impairments.
Article
Clinical Neurology
Yizhen Jia, Martha W. Bagnall
Summary: This study describes the central targets of utricular afferents in the larval zebrafish brain, providing a better understanding of the gravity-sensing circuit. The findings suggest that central neurons with commissural projections have various directional tunings, and different locations of central utricular neurons are associated with different responses to tilt. The study also reveals an unexpected synaptic target of utricular afferents from the medial semicircular canal.
FRONTIERS IN NEUROLOGY
(2022)
Article
Neurosciences
Woohyoung Jeon, Jill Whitall, Lisa Griffin, Kelly P. Westlake
Summary: Older adults demonstrated shorter burst duration of RF EMG, reduced trunk flexion, and decreased stability compared to younger adults during the StandTS task. Trunk flexion angle and RF EMG burst duration were correlated with stability.
Article
Radiology, Nuclear Medicine & Medical Imaging
Carlos A. Sanchez-Catasus, Nicolaas Bohnen, Nicholas D'Cruz, Martijn L. T. M. Muller
Summary: This study examines the acetylcholine-dopamine imbalance in Parkinson's disease patients using neuroimaging techniques. The results provide evidence for the existence of striatal acetylcholine-dopamine imbalance in early PD and suggest the possibility of using therapeutic strategies to restore this balance.
JOURNAL OF NUCLEAR MEDICINE
(2022)
Article
Geriatrics & Gerontology
Ruth Y. Akinlosotu, Nesreen Alissa, Shari R. Waldstein, Robert A. Creath, George F. Wittenberg, Kelly P. Westlake
Summary: This study found that distressing mental thoughts immediately prior to a balance perturbation lead to reduced effectiveness in reach-to-grasp balance responses compared to no or neutral cognitive tasks in older adults. Specifically, mental stress tasks resulted in the lowest frequency of protective grasps and increased harness assistance during grasp errors, indicating a potential risk factor for falls.
EXPERIMENTAL GERONTOLOGY
(2021)
Article
Clinical Neurology
Sygrid van der Zee, Prabesh Kanel, Marleen J. J. Gerritsen, Jeffrey M. Boertien, Anne C. Slomp, Martijn L. T. M. Muller, Nicolaas Bohnen, Jacoba M. Spikman, Teus van Laar
Summary: This study assessed the cholinergic innervation status in early-stage Parkinson's disease (PD) patients and found that cholinergic innervation changes were associated with cognitive impairment. Regardless of cognitive status, patients showed cholinergic denervation in the posterior cortical regions. Cognitively intact patients exhibited higher cholinergic activity in the cerebellar, frontal, and subcortical regions, suggesting compensatory cholinergic upregulation in early-stage PD. Limited or failing cholinergic upregulation may play an important role in early cognitive impairment in PD.
MOVEMENT DISORDERS
(2022)
Article
Clinical Neurology
Nicolaas Bohnen, Rui M. Costa, William T. Dauer, Stewart A. Factor, Nir Giladi, Mark Hallett, Simon J. G. Lewis, Alice Nieuwboer, John G. Nutt, Kaoru Takakusaki, Un Jung Kang, Serge Przedborski, Stella M. Papa
Summary: Gait and balance abnormalities are common in Parkinson's disease and are among the most difficult motor symptoms to treat effectively. Limited understanding of these complex disorders hinders efforts to develop therapies, highlighting the need for novel and targeted research to expedite progress in this area. The International Parkinson and Movement Disorder Society's Scientific Issues Committee has tasked experts to address knowledge gaps and determine research paths with the highest potential for generating groundbreaking data.
MOVEMENT DISORDERS
(2022)
Article
Clinical Neurology
Nicolaas Bohnen, Prabesh Kanel, Stiven Roytman, Peter J. H. Scott, Robert A. Koeppe, Roger L. Albin, Kevin A. Kerber, Martijn L. T. M. Muller
Summary: This study examines the presence of vestibular sensory conflict deficits (VSCD) in Parkinson's disease patients and its association with cholinergic brain deficits and postural instability and gait difficulties (PIGD). The results show that cholinergic deficits in VSCD are mainly localized in brain regions involved in multisensory and cognitive and motor integration. These deficits are significantly associated with symptoms such as imbalance, falls, and freezing of gait.
JOURNAL OF NEURAL TRANSMISSION
(2022)
Letter
Clinical Neurology
Nicolaas I. Bohnen, Rui M. Costa, William T. Dauer, Stewart A. Factor, Nir Giladi, Mark Hallett, Simon J. G. Lewis, Alice Nieuwboer, John G. Nutt, Kaoru Takakusaki, Un Jung Kang, Serge Przedborski, Stella M. Papa
MOVEMENT DISORDERS
(2022)
Article
Clinical Neurology
Nicolaas I. Bohnen, Prabesh Kanel, Miriam van Emde Boas, Stiven Roytman, Kevin A. Kerber
Summary: This study investigated the relationship between the performance on Romberg test condition 4 and freezing of gait and falls in patients with Parkinson's disease (PD). The results showed that patients who failed the Romberg condition 4 had a higher prevalence of freezing of gait, while the frequency of falls did not significantly differ between patients with abnormal performance and those without. These findings suggest that deficient vestibular processing may play a specific role in freezing of gait in PD, but not in falls.
MOVEMENT DISORDERS
(2022)
Article
Neurosciences
Woohyoung Jeon, Shuaijie Wang, Tanvi Bhatt, Kelly P. Westlake
Summary: This study aimed to investigate the modulation of arm responses to slip perturbations and its relationship with compensatory stepping stability in older adults. The results showed that older adults had decreased arm response modulation compared to younger adults, and arm elevation velocity was positively correlated with stepping stability. Fall prevention interventions may benefit from focusing on arm elevation velocity control.
Article
Clinical Neurology
Stiven Roytman, Rebecca Paalanen, Alexis Griggs, Simon David, Chatkaew Pongmala, Robert A. Koeppe, Peter J. H. Scott, Uros Marusic, Prabesh Kanel, Nicolaas Bohnen
Summary: Postural instability and freezing of gait are the most debilitating motor impairments in advanced stages of Parkinson's disease. Recent findings suggest that individuals with freezing of gait have difficulty utilizing vestibular information, with changes in cholinergic system integrity. This study examined the association between cerebral cholinergic system changes and sensory postural control processing features in patients with Parkinson's disease. The findings suggest that cortical cholinergic system may play a role in supporting postural control after dopamine loss in Parkinson's disease, and failure of visual-vestibular integration may impair detection of postural instability without reliable proprioceptive cues.
Article
Clinical Neurology
Julia Schumacher, Prabesh Kanel, Martin Dyrba, Alexander Storch, Nicolaas Bohnen, Stefan Teipel, Michel J. Grothe
Summary: The study aimed to investigate the relationship between basal forebrain degeneration and cortical acetylcholinesterase activity in Parkinson’s disease, as well as their contribution to cognitive impairment. The findings demonstrated that the hypo-cholinergic Parkinson’s group had significantly reduced posterior basal forebrain volume compared to both the normo-cholinergic Parkinson’s group and the control group. Furthermore, the volume of posterior basal forebrain was significantly associated with cortical acetylcholinesterase activity in Parkinson’s patients, and both cholinergic markers were independently associated with multi-domain cognitive deficits.
Article
Clinical Neurology
Nicolaas Bohnen, Stiven Roytman, Prabesh Kanel, Martijn L. T. M. Muller, Peter J. H. Scott, Kirk A. Frey, Roger L. Albin, Robert A. Koeppe
Summary: This study presents the first longitudinal cholinergic PET study in the Parkinson's population. The findings suggest a posterior-to-anterior denervation gradient in the posterior cortices and an anterior-to-posterior gradient in the frontal cortices, which are associated with changes in blood flow. These results contribute to our understanding of the cognitive decline and other deficits in Parkinson's disease related to cortical cholinergic deficits. The importance of this study is rated 8 out of 10.
BRAIN COMMUNICATIONS
(2022)
Review
Rehabilitation
Cara E. Felter, Leslie B. Glickman, Kelly Westlake, Andrea G. Shipper, Victoria Marchese
Summary: This study reviewed the current status and characteristics of global health education for DPT students in the United States, finding a lack of unified best practices in the field. The primary purposes of academic programs in IGH included service learning, clinical education, cultural immersion, and research. Future research should focus on the efficacy and efficiency of program types.
PHYSICAL THERAPY REVIEWS
(2022)
Article
Clinical Neurology
Nicolaas Bohnen, Prabesh Kanel, Robert A. Koeppe, Carlos A. Sanchez-Catasus, Kirk A. Frey, Peter Scott, Gregory M. Constantine, Roger L. Albin, Martijn L. T. M. Muller
Summary: The study found that in Parkinson's disease patients, cholinergic brain regions associated with postural instability and gait difficulties include the medial geniculate nucleus, lateral geniculate nucleus, and entorhinal cortex. Cholinergic brain regions associated with tremor domain included the cerebellar vermis section of lobule VIIIb and the putamen. For the distal limb bradykinesia domain, cholinergic brain regions included the globus pallidus pars externa and the paracentral lobule.
BRAIN COMMUNICATIONS
(2021)
Article
Clinical Neurology
Sygrid van der Zee, Martijn L. T. M. Muller, Prabesh Kanel, Teus van Laar, Nicolaas I. Bohnen
Summary: This study investigated the relationship between cognitive functioning and regional cholinergic innervation in patients with PD, utilizing [F-18]Fluoroethoxybenzovesamicol positron emission tomography imaging. The results showed partial overlapping topography across cognitive domains, with most robust correlations in the domains of memory, attention, and executive functioning. The findings confirm and expand on previous observations of cholinergic system involvement in cognitive functioning in PD, reflecting a combination of disease-specific and aging effects.
MOVEMENT DISORDERS
(2021)