Vestibular Function Impairment in Alzheimer’s Disease

Nakamagoe, Kiyotaka; Fujimiya, Suguru; Koganezawa, Tadachika; Kadono, Kotarou; Shimizu, Kotone; Fujizuka, Natsu; Takiguchi, Shino; Ueno, Tomoyuki; Monzen, Tatsuya; Tamaoka, Akira

doi:10.3233/jad-142646

Cited by 31 publications

(37 citation statements)

References 58 publications

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“…5, 7 Nakamagoe et al 7 previously reported impaired caloric responses in 12 AD patients compared with younger controls, although there was no difference relative to age-matched controls. Further, in a study of postural sway among individuals with cognitive impairment, Leandri et al 30 observed progressively increased anterior-posterior sway in control, MCI and AD patients.…”

Section: Discussionmentioning

confidence: 96%

“…5, 7 One study found that individuals with AD had impaired caloric responses relative to younger, but not age-matched controls. 7 Patients with AD were also observed to have poorer postural control – a proxy measure of vestibular function and other sensory and motor inputs– compared to normal older individuals. 30 Another study found that individuals with different degrees of cognitive impairment had abnormal sacculocollic reflexes.…”

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confidence: 99%

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Vestibular Impairment in Dementia

Harun¹,

Oh²,

Bigelow³

et al. 2016

Otology &Amp; Neurotology

104

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Objective Recent studies suggest an association between vestibular and cognitive function. The goal of the study was to investigate whether vestibular function was impaired in individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) compared to cognitively normal individuals. Study Design Cross-sectional study. Setting Outpatient memory clinic and longitudinal observational study unit. Patients Older individuals ≥ 55 years with MCI or AD. Age, gender and education-matched normal controls were drawn from the Baltimore Longitudinal Study of Aging (BLSA). Intervention Saccular and utricular function was assessed with cervical and ocular vestibular-evoked myogenic potentials (c- and oVEMPs) respectively, and horizontal semicircular canal function was assessed with video head impulse testing. Main Outcome Measures Presence or absence of VEMP responses, VEMP amplitude and vestibular ocular reflex (VOR) gain were measured. Results Forty-seven individuals with cognitive impairment (MCI N=15 and AD N=32) underwent testing and were matched with 94 controls. In adjusted analyses, bilaterally absent cVEMPs were associated with an over three-fold odds of AD (OR 3.42, 95% CI 1.33–8.91, p=0.011). One microvolt increases in both cVEMP and oVEMP amplitudes were associated with decreased odds of AD (OR 0.28, 95% CI 0.09–0.93, p=0.038 and OR 0.92, 95% CI 0.85–0.99, p=0.036, respectively). There was no significant difference in VOR gain between the groups. Conclusions These findings confirm and extend emerging evidence of an association between vestibular dysfunction and cognitive impairment. Further investigation is needed to determine the causal direction for the link between peripheral vestibular loss and cognitive impairment.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

Vestibular Impairment in Dementia

Harun¹,

Oh²,

Bigelow³

et al. 2016

Otology &Amp; Neurotology

104

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“…16 Vestibular dysfunction may influence multiple biological processes, including bone integrity, 17 sense of self, 18 and even cognition in space; 19 therefore, it is difficult to distinguish cognitive dysfunctions due to vestibular effects from neurodegenerative diseases on Earth and in space.…”

Section: Differential Diagnosis Of Cognitive Dysfunctionmentioning

confidence: 99%

Protection against neurodegenerative disease on Earth and in space

et al. 2016

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All living organisms have evolutionarily adapted themselves to the Earth’s gravity, and failure to adapt to gravity changes may lead to pathological conditions. This perspective may also apply to abnormal aging observed in bedridden elderly patients with aging-associated diseases such as osteoporosis and sarcopenia. Given that bedridden elderly patients are partially analogous to astronauts in that both cannot experience the beneficial effects of gravity on the skeletal system and may suffer from bone loss and muscle weakness, one may wonder whether there are gravity-related mechanisms underlying diseases among the elderly. In contrast to numerous studies of the relevance of microgravity in skeletal disorders, little attention has been paid to neurodegenerative diseases. Therefore, the objective of this paper is to discuss the possible relevance of microgravity in these diseases. We particularly noted a proteomics paper showing that levels of hippocampal proteins, including β-synuclein and carboxyl-terminal ubiquitin hydrolase L1, which have been linked to familial neurodegenerative diseases, were significantly decreased in the hippocampus of mice subjected to hindlimb suspension, a model of microgravity. We suggest that microgravity-induced neurodegeneration may be further exacerbated by diabetes and other factors. On the basis of this view, prevention of neurodegenerative diseases through ‘anti-diabetes’ and ‘hypergravity’ approaches may be important as a common therapeutic approach on Earth and in space. Collectively, neurodegenerative diseases and space medicine may be linked to each other more strongly than previously thought.

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“…It has long been believed that the cerebellum uses neural circuits in the vestibular system to process visual input information from the eye and then regulates the brain stem vestibular nucleus. However, several studies have contended that the cerebral cortex may be a key player in the neural circuits in the vestibular system [ 1 , 2 , 3 , 4 , 5 ]. Previous animal experiments have demonstrated that multiple vestibular cortex areas are scattered over the parietal and temporal lobes [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…We previously reported that Alzheimer's disease-related pathology in the cerebral cortex can cause impairment of vestibular function which, in turn, leads to impaired visual control [ 5 ]. Taking into account the above-mentioned findings, the present study proposes a hypothesis about a system in which the cerebral cortex uses visual information to control vestibular neural circuits in Alzheimer's disease patients.…”

Section: Introductionmentioning

confidence: 99%

Vestibular Impairment in Frontotemporal Dementia Syndrome

Nakamagoe

Kadono

Koganezawa

et al. 2016

Dement Geriatr Cogn Disord Extra

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Background: No studies to date have attempted to evaluate frontotemporal lobar degeneration from the perspective of the vestibular system. Objective: The present study examined vestibular function in patients with frontotemporal dementia (FTD) clinical syndrome and evaluated whether vestibular disorders are involved in the clinical symptoms due to FTD. Methods: Fourteen patients with FTD syndrome, as well as healthy elderly controls without dementia, were included in the present study. All subjects underwent vestibular function tests using electronystagmography, such as caloric tests and visual suppression (VS) tests, in which the induced caloric nystagmus was suppressed by visual stimuli. The association between clinical symptoms and vestibular function in the FTD syndrome group was further examined. Results: In the FTD syndrome group, caloric nystagmus was not necessarily suppressed during VS tests. Furthermore, VS was observed to be significantly impaired in FTD syndrome patients with gait disturbance as compared to those without such disturbance. Conclusion: The present study revealed that impairment of VS in patients with FTD results in an inability to regulate vestibular function by means of visual perception, regardless of multiple presumed neuropathological backgrounds. This could also be associated with gait disturbance in patients with FTD syndrome.

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Vestibular Function Impairment in Alzheimer’s Disease

Abstract: AD could involve impairments in the vestibular control of balance. The VS test is useful for assessing the tendency to fall in AD. Impairment of VS in AD might arise from cerebral vestibular cortex impairment rather than comorbid peripheral vestibular disorders.

Cited by 31 publications

References 58 publications

Vestibular Impairment in Dementia

Vestibular Impairment in Dementia

Protection against neurodegenerative disease on Earth and in space

Vestibular Impairment in Frontotemporal Dementia Syndrome

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