The Problem of Central Compensation of Peripheral Vestibular Dysfunctions

Pfaltz, C. R.; Kamath, Rupali

doi:10.3109/00016487109125362

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…24 Unfortunately, fluctuations in vestibular function delay effective compensation by the central nervous system. 25 Consequently, patients with PVDs may experience postural instability and gait disturbances that seriously interfere with daily activities. 20,26 Studies have reported that PVDs are associated with increased risks of specific types of injury, such as falls and traffic accidents.…”

Section: Discussionmentioning

confidence: 99%

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Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study

Wu¹,

Lin

Chien

et al. 2022

Otolaryngol.--head neck surg.

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Objective To investigate the risk of injury in patients with Ménière’s disease (MD) and the effects of treatment. Study Design Population-based retrospective cohort study. Setting Data were collected from the Longitudinal Health Insurance Database 2005, containing the information of 2 million randomly selected individuals in Taiwan. Methods We enrolled 90,481 patients with newly diagnosed MD between 2000 and 2017 and 361,924 matched individuals without MD. The study outcomes were diagnoses of all-cause injuries. The Kaplan-Meier method was used to determine the cumulative incidence rates of injury in the MD and non-MD cohorts, and a log-rank test was used to analyze the differences between the cohorts. Cox proportional hazards models were used to calculate the 18-year hazard ratios of each cohort. Results A total of 80,151 patients were diagnosed with injuries during the follow-up period: 24,031 and 56,120 from the MD and non-MD cohorts, respectively. The adjusted hazard ratio (aHR) was 2.19 (95% CI, 2.16-2.35) after adjusting for demographic characteristics and comorbidities. Subgroup analysis revealed that MD was associated with an increased incidence of unintentional and intentional injuries (aHR, 2.24 [95% CI, 2.21-2.41] and 2.05 [95% CI, 2.01-2.19], respectively). Treatment with diuretics, antivertigo medications, or surgery did not reduce the risk of injury (aHR, 0.98 [95% CI, 0.59-1.54], 0.94 [95% CI, 0.58-1.50], and 0.99 [95% CI, 0.61-1.54]). Conclusion MD is independently associated with an increased risk of injuries. Medical or surgical treatment for MD does not reduce the risk of injury in patients with MD. Physicians should counsel patients with MD regarding preventive measures for avoiding subsequent injuries.

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Section: Discussionmentioning

confidence: 99%

“…Vertigo and postural imbalance are hallmarks of PVDs 24 . Unfortunately, fluctuations in vestibular function delay effective compensation by the central nervous system 25 . Consequently, patients with PVDs may experience postural instability and gait disturbances that seriously interfere with daily activities 20,26 .…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study

Wu¹,

Lin

Chien

et al. 2022

Otolaryngol.--head neck surg.

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“…Vestibular compensation after unilateral labyrinthectomy has been described typically as consisting of an acute (or critical) phase, a partially compensated (or dynamic recovery) phase, and a compensated phase. [1][2][3][4][5] During the acute phase, humans or animals show spontaneous nystagmus in the light, postural symptoms (e.g., falling and neck torsion), and sensations of vertigo. During the second phase, symptomatic resolution occurs and the achievement of maximum recovery marks the beginning of the compensated phase.…”

Section: Temporal Gradients In Compensationmentioning

confidence: 99%

Role of Gene Regulation during Vestibular Compensation

Balaban

2001

Annals of the New York Academy of Sciences

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Identification of the role of gene regulation in vestibular compensation is one aspect of a larger issue: the identification of molecular bases for plasticity in multiple vestibulo‐ocular, vestibulo‐spinal, vestibulo‐collic, and vestibulo‐autonomic responses. To achieve this goal, it is incumbent on investigators to examine molecular events within the contexts of the single neuron, the location of the neuron in pathways, and the timing of the molecular events relative to behavioral compensation. Hence, the goal of identifying molecular bases for a particular compensatory response (e.g., the disappearance of spontaneous nystagmus in the light or the disappearance of static head tilt) requires careful attention to the time course of physiologic compensation and the location of the effects within central pathways that have the potential to affect the responses. The effects of impeding these site‐specific and time‐specific changes can then be tested to determine their role in the compensatory process. A consideration of the recent literature on molecular events related to the resolution of spontaneous nystagmus in the light indicates that a meaningful approach to these issues requires a broadening of our conceptual approach. Specifically, one must consider the roles of transcriptional, translational, and posttranslational events on the turnover of critical signaling substrates for vestibular compensation.

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“…Some clue as to the function of this efferent innervation of the vestibular organ can be obtained by considering the mechanisms of compensation for vestibular dysfunction which are said to be by either Accommodation or Substitution (Pfaltz and Kammath, 1971). Accommodation is the mechanism by which signals from an intact labyrinth are modulated either by inhibition or facilitation to adjust them to any functional deficiency in the other labyrinth.…”

Section: The Vestibular Efferent Systemmentioning

confidence: 99%

Possible implication of an efferent neuropathy in vestibular upset

Prescott

1986

J. Laryngol. Otol.

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SummaryThis essay examines two possible mechanisms whereby a neuropathy affecting the efferent vestibular innervation may cause incoordination of vestibular afferent input to the Vestibular Integrating Centres: firstly, by loss of the normal fine control of afferent impulses; secondly, by a disruption of the sodium-potassium pump mechanism that maintains the ionic stability of the inner ear fluids.

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The Problem of Central Compensation of Peripheral Vestibular Dysfunctions

Cited by 9 publications

References 6 publications

Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study

Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study

Role of Gene Regulation during Vestibular Compensation

Possible implication of an efferent neuropathy in vestibular upset

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