Visual Acuity While Walking and Oscillopsia Severity in Healthy Subjects and Patients With Unilateral and Bilateral Vestibular Function Loss

Guinand, Nils; Pijnenburg, Mfj Mark; Janssen, Mja Maurice; Kingma, Herman

doi:10.1001/archoto.2012.4

Cited by 77 publications

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“…As a consequence, such patients complain about oscillopsia, the illusory perception of movement of the visual surroundings in dynamic situations. The direct functional consequence of this is an abnormal decrease of visual acuity when in movement 1,2 , which translates into the difficulty to read signs and recognize faces while walking. This considerably contributes to the significant impairment of the quality of life of affected patients.…”

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First functional rehabilitation via vestibular implants

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Guinand

et al. 2014

Cochlear Implants International

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The vestibular system is part of the multisensory balance sense, which is responsible for postural control, gaze stabilization, and spatial orientation. More in particular, the Vestibulo-Ocular Reflex (VOR) is responsible for generating compensatory eye movements relative to head movements while moving. In patients with a bilateral loss of the vestibular function, the VOR is absent or very weak. As a consequence, such patients complain about oscillopsia, the illusory perception of movement of the visual surroundings in dynamic situations. The direct functional consequence of this is an abnormal decrease of visual acuity when in movement 1,2 , which translates into the difficulty to read signs and recognize faces while walking. This considerably contributes to the significant impairment of the quality of life of affected patients.Currently, there is no evidence of an effective treatment for these patients. The idea of electrically stimulating the vestibular system emerged about a decade ago and is based on a concept very similar to that of cochlear implants. Briefly, such a system would use inertial sensors (i.e., a gyroscope and/or accelerometer) to detect motion information. Such information is translated into a pattern of neural excitation code by an external signal processor. This pattern is wirelessly transmitted to an implanted stimulator which finally delivers the corresponding patterns of electrical stimulation via electrodes implanted near the vestibular structures to the neural system.

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First functional rehabilitation via vestibular implants

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Guinand

et al. 2014

Cochlear Implants International

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“…Türk Beyin Damar Hastalıkları Dergisi 2017; 23(1): [1][2][3][4][5][6][7][8][9] Örnek bir egzersiz programı Tablo I'de verilmiştir (30). Substitition (yerine koyma): Diğer duyusal yollar servikooküler refleks ve göz hareketlerinin yeniden programlanması ile VOR yetersizliğine destek olmak amaçlanır (31)(32)(33).…”

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“…Ayrıca üst servikal faset eklem reseptörleri, servikooküler reflekse de geri bildirim sağlayarak, dengede rol oynar (4). Dengeyi oluşturan kompleks sistem içinde vestibuler sistemin görevleri nedeniyle İTV, hastalarda önemli fonksiyonel ve fiziksel yetersizliklere yol açar (5,6). Amerika Birleşik Devletleri'nde 2008'de yapılan Ulusal Sağlık Araştırma sonuçlarına göre prevelansı 100.000'de 28 olarak tespit edilmiştir ve dünya çapında 1.8 milyon hasta olduğu tahmin edilmektedir (7).…”

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Vestibuler rehabilitation in bilateral vestibulopaty

Armağan¹

2017

Türk Beyin Damar Hast Derg

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ÖZETİki taraflı vestibulopati vestibuler organ, vestibuler sinir ya da her ikisinin birden fonksiyonlarında iki taraflı kayıp ya da azalmayla karakterize hetrerojen bir gurup hastalıktır. Vestibuler sistem dengenin multisensorial kontrolünde önemli bir rol oynar. Vestibuler işlev kaybolduğunda, özellikle postural kontrol, bakış stabilizasyonu ve denge gibi temel görevler bozulur ve hastaların yaşam kalitesini önemli ölçüde zayıflar. Dengeyi oluşturan kompleks sistem içinde vestibuler sistemin görevleri nedeniyle iki taraflı vestibuler hastalık, hastalarda önemli fonksiyonel ve fiziksel yetersizliklere yol açar. Günümüzde iki taraflı vestibuler hastalıkta, yaygın olarak kullanılan tedavi vestibuler rehabilitasyondur. Vestibuler rehabilitasyonda amaç, insan beyninde var olan adaptif ve kompansatuvar mekanizmaların harekete geçirilmesidir. Bu makalede vestibuler rehabilitasyon uygulamaları, farklı egzersiz programları ve teknikleri son literatür sonuçları gözden geçirilerek sunulmuştur. Anahtar Sözcükler: İki taraflı, vestibulopati, rehabilitasyon. VESTIBULER REHABILITATION IN BILATERAL VESTIBULOPATY ABSTRACTBilateral vestibulopathy is a heterogeneous chronic condition characterized by a bilateral reduced or absent function of the vestibular organs, the vestibular nerves or a combination of both. The vestibular system plays a crucial role in the multisensory control of balance. When vestibular function is lost, essential tasks such as postural control, gaze stabilization, and balance deteriorate and the quality of life of patients is significantly impaired. Nowadays the widely available treatment of bilateral vestibulopathy is vestibular rehabilitation. The aim of the vestibular rehabiltation is to use adaptive mechanisms of brain and to activate compensation mechanisms. In this review, applications of vestibular rehabilitation, different exercise programs and techniques are presented by reviewing recent literature results.

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“…Further studies investigating both, the semicircular canal function by caloric and head impulse testing as well as otolithic function by vestibular evoked myogenic potentials will allow gaining a better insight on the pattern of vestibular nerve affection and on the extent of recovery. Further possible explanations of protracted recovery include age, the percept of vestibular symptoms including visual disturbances [76] and the previous function of the vestibular system [5,77].…”

Section: The Impact Of Vc On Recoverymentioning

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Neurobiological Mechanisms of Acute Vertigo

Tarnutzer

Palla

2013

Future Neurol.

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The vestibular system provides us with reflexive responses of eye movements and balance control, as well as with perceptual estimates of self-motion and gravity direction. Crucial to its proper functioning is a bilaterally balanced vestibular signal originating from the vestibular end organs in the inner ears and projecting via vestibular nerve afferents to the brainstem vestibular nuclei. Disturbances of the bilateral vestibular interplay become evident in cases of acute unilateral peripheral vestibular deafferentation. The resultant sudden imbalance of vestibular afferent tone at the level of the vestibular nuclei leads to pronounced ocular-motor and postural impairment, as well as to intensive vertigo and/or dizziness, accompanied by autonomic symptoms, such as nausea and vomiting. Subsequent compensatory mechanisms efficiently diminish these static symptoms (such as spontaneous nystagmus) within days and allow functional recovery of dynamic symptoms (such as blurred vision during fast head turns) to such a degree that most patients return to their normal daily activities within weeks. This article aims to provide an understanding about the pathophysiological changes after unilateral vestibular deafferentation and the current knowledge on the compensatory mechanisms. SummaryThe vestibular system provides us with reflexive responses of eye movement and

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Visual Acuity While Walking and Oscillopsia Severity in Healthy Subjects and Patients With Unilateral and Bilateral Vestibular Function Loss

Abstract: We designed a highly sensitive, simple, cost-effective protocol to assess dynamic VA under physiologic conditions and a questionnaire to determine oscillopsia severity. Both tools could be used for the evaluation of new treatments for BV and patients with UVL.

Cited by 77 publications

References 28 publications

First functional rehabilitation via vestibular implants

First functional rehabilitation via vestibular implants

Vestibuler rehabilitation in bilateral vestibulopaty

Neurobiological Mechanisms of Acute Vertigo

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