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Svetlana A Dambinova, Joseph C Maroon, Alicia M Sufrinko, John David Mullins, Eugenia V Alexandrova, Alexander A Potapov
Concussion is a complex, heterogeneous process affecting the brain. Accurate assessment and diagnosis and appropriate management of concussion are essential to ensure that athletes do not prematurely return to play or others to work or active military duty, risking re-injury. To date, clinical diagnosis relies primarily on evaluating subjects for functional impairment using instruments that include neurocognitive testing, subjective symptom report, and neurobehavioral assessments, such as balance and vestibular-ocular reflex testing...
2016: Frontiers in Neurology
Richard F Lewis
Damage to the peripheral vestibular system can result in debilitating postural, perceptual, and visual symptoms. A new potential treatment for this clinical problem is to replace some aspects of peripheral vestibular function with an implant that senses head motion and provides this information to the brain by stimulating branches of the vestibular nerve. In this review I consider animal studies performed at our institution over the past fifteen years, which have helped elucidate how the brain processes information provided by a vestibular (semicircular canal) implant and how this information could be used to improve the problems experienced by patients with peripheral vestibular damage...
October 19, 2016: Journal of Neurophysiology
Nagisa Sugaya, Miki Arai, Fumiyuki Goto
CONCLUSIONS: Improvement in sleep, emotional distress, and health-related quality-of-life (QoL) accompanied the improvement in dizziness symptoms after vestibular rehabilitation. Persistent sleep disturbance could prevent improvements in self-perceived handicap due to chronic dizziness and anxiety. OBJECTIVE: The present study investigated prospectively the effects of intervention for dizziness (vestibular rehabilitation) on sleep disturbance, and the relationship between improvements in dizziness symptoms and improvements in sleep disturbance after the intervention...
October 19, 2016: Acta Oto-laryngologica
Katharina Rohloff, Mario Koopmann, Daniel Wei, Claudia Rudack, Eleftherios Savvas
OBJECTIVE: To compare the outcome of hearing rehabilitation in younger versus older adult cochlear implant recipients. Analysis of surgical and postoperative complications, as well as the number of auditory therapy sessions in the two age groups. STUDY DESIGN: Individual retrospective cohort study. METHODS: A cohort of 145 postlingually deafened adults was evaluated in this study. The patients were divided into two age groups based on the age at implantation: Group I, 18 to 69 years; and Group II, 70 and older...
October 14, 2016: Otology & Neurotology
Israel Pena, Erin Y Chew, Barcleigh P Landau, Joseph T Breen, Jose P Zevallos, Jeffrey T Vrabec
OBJECTIVE: To investigate the prevalence of vestibular schwannoma (VS) and asymmetric sensorineural hearing loss in the Veterans Administration hospital population and analyze a more efficient method of diagnosing VS in a population with significant noise exposure. STUDY DESIGN: Retrospective review of South Central (VISN 16) Veterans Administration hospitals. METHODS: Record query for ICD-9 codes for asymmetric sensorineural hearing loss or VS between 1999 and 2012...
October 14, 2016: Otology & Neurotology
David S Thylur, Russell E Jacobs, John L Go, Arthur W Toga, John K Niparko
OBJECTIVE: To evaluate the ability of ultra-high-field magnetic resonance imaging (UHF-MRI) at 11.7 T to visualize membranous structures of the human inner ear. SPECIMENS: Three temporal bones were extracted from cadaveric human heads for use with small-bore UHF-MRI. INTERVENTION: Ex vivo cadaveric temporal bone specimens were imaged using an 11.7 T magnetic resonance imaging (MRI) scanner via T1- and T2-weighted-imaging with and without contrast...
October 12, 2016: Otology & Neurotology
Daniel S Roberts, Steve Otto, Brian Chen, Kevin A Peng, Marc S Schwartz, Derald E Brackmann, John W House
OBJECTIVE: To evaluate whether an auditory brainstem implant (ABI) can impact levels of tinnitus in neurofibromatosis type-2 (NF2) patients who have undergone translabyrinthine craniotomy for vestibular schwannoma (VS) removal and to evaluate the burden of tinnitus in these patients. STUDY DESIGN: A retrospective case series and patient survey. SETTING: Tertiary neurotologic referral center. PATIENTS: NF2 patients who underwent translabyrinthine removal of VS and ABI placement between 1994 and 2015...
October 12, 2016: Otology & Neurotology
Melania Ester Mercado-Pimentel, Craig Miller, Daniela N Rolph, Edrick F Villalobos, Allison M Dunn, Prithvi M Mohan, Suzu Igarashi, Xiangdang Liu, Macken Yrun-Duffy, Neal K Patel, Cecilia M Read, Ross H Francis, Adelina Isabella Lane, Swaroop Murugesh, Abraham Jacob
HYPOTHESIS: p21-activated kinase (PAK) regulates signaling pathways that promote cell survival and proliferation; therefore, pharmacological inhibition of PAK will induce cell death in vestibular schwannomas (VS) and meningiomas. BACKGROUND: All VS and many meningiomas result from loss of the neurofibromatosis type 2 (NF2) gene product merlin, with ensuing PAK hyperactivation and increased cell proliferation/survival. METHODS: The novel small molecule PAK inhibitors PI-8 and PI-15-tested in schwannoma and meningioma cells-perturb molecular signaling and induce cell death...
October 12, 2016: Otology & Neurotology
Kevin K Ohlemiller, Sherri M Jones, Kenneth R Johnson
Laboratory mice (Mus musculus) have become the major model species for inner ear research. The major uses of mice include gene discovery, characterization, and confirmation. Every application of mice is founded on assumptions about what mice represent and how the information gained may be generalized. A host of successes support the continued use of mice to understand hearing and balance. Depending on the research question, however, some mouse models and research designs will be more appropriate than others...
October 17, 2016: Journal of the Association for Research in Otolaryngology: JARO
Yuan Zhang, Yong-Hua Cui, Ying Hu, Zhong-Yao Mao, Qiu-Xia Wang, Chu Pan, Ai-Guo Liu
The purpose of the study was to observe changes in endolymphatic hydrops by using intratympanic injection of gadolinium and magnetic resonance imaging (MRI) before and after endolymphatic sac surgery in patients with unilateral Meniere's disease. Thirteen patients with unilateral Meniere's disease undergoing endolymphatic sac surgery were retrospectively and prospectively analyzed. Three-dimensional fluid-attenuated inversion recovery or three-dimensional real inversion recovery MRI was performed 24 h after an intratympanic injection of gadolinium to grade the presence of endolymphatic hydrops...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Hjalte C R Sass, Rehannah Borup, Mikkel Alanin, Finn Cilius Nielsen, Per Cayé-Thomasen
The objective of this study was to determine global gene expression in relation to Vestibular schwannomas (VS) growth rate and to identify signal transduction pathways and functional molecular networks associated with growth. Repeated magnetic resonance imaging (MRI) prior to surgery determined tumor growth rate. Following tissue sampling during surgery, mRNA was extracted from 16 sporadic VS. Double stranded cDNA was synthesized from the mRNA and used as template for in vitro transcription reaction to synthesize biotin-labeled antisense cRNA, which was hybridized to Affymetrix HG-U133A arrays and analyzed by dChip software...
October 17, 2016: Journal of Neuro-oncology
Myreille D'Astous, Allen L Ho, Arjun Pendharkar, Clara Y H Choi, Scott G Soltys, Iris C Gibbs, Armine T Tayag, Patricia A Thompson, John R Adler, Steven D Chang
Non-vestibular cranial nerve schwannomas (NVCNS) are rare lesions, representing <10 % of cranial nerve schwannomas. The optimal treatment for NVCNS is often derived from vestibular schwannomas experience. Surgical resection has been referred to as the first line treatment for those benign tumors, but significant complication rates are reported. Stereotactic radiosurgery (SRS) has arisen as a mainstay of treatment for many benign tumors, including schwanommas. We retrospectively reviewed the outcomes of NVCNS treated by SRS to characterize tumor control, symptom relief, toxicity, and the role of hypo-fractionation of SRS dose...
October 17, 2016: Journal of Neuro-oncology
Adam J Toth, Laurence R Harris, John Zettel, Leah R Bent
Visuo-vestibular recalibration, in which visual information is used to alter the interpretation of vestibular signals, has been shown to influence both oculomotor control and navigation. Here we investigate whether vision can recalibrate the vestibular feedback used during the re-establishment of equilibrium following a perturbation. The perturbation recovery responses of nine participants were examined following exposure to a period of 11 s of galvanic vestibular stimulation (GVS). During GVS in VISION trials, occlusion spectacles provided 4 s of visual information that enabled participants to correct for the GVS-induced tilt and associate this asymmetric vestibular signal with a visually provided 'upright'...
October 17, 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
María Carolina Bermúdez Rey, Torin K Clark, Wei Wang, Tania Leeder, Yong Bian, Daniel M Merfeld
We measured vestibular perceptual thresholds in 105 healthy humans (54F/51M) ranging from 18 to 80 years of age. Direction-recognition thresholds were measured using standard methods. The motion consisted of single cycles of sinusoidal acceleration at 0.2 Hz for roll tilt and 1.0 Hz for yaw rotation about an earth-vertical axis, inter-aural earth-horizontal translation (y-translation), inferior-superior earth-vertical translation (z-translation), and roll tilt. A large subset of this population (99 of 105) also performed a modified Romberg test of standing balance...
2016: Frontiers in Neurology
Jonas Frodlund, Henrik Harder, Elina Mäki-Torkko, Torbjörn Ledin
OBJECTIVE: To investigate the vestibular function after cochlear implantation with different types of electrode arrays. STUDY DESIGN: Retrospective cohort study. SETTING: Academic tertiary referral center. MATERIALS AND METHODS: Forty three adults underwent first cochlear implantation. Three consecutive series of patients: Group 1 (n = 13) implanted with a precurved electrode, Group 2 (n = 15) implanted with a straight electrode, Group 3 (n = 15) implanted with a flexible electrode...
September 30, 2016: Otology & Neurotology
Yuka Morita, Kuniyuki Takahashi, Shuji Izumi, Yamato Kubota, Shinsuke Ohshima, Arata Horii
OBJECTIVE: Otitis media (OM) with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is a novel concept of ear disease that is characterized by progressive mixed or sensorineural hearing loss with occasional systemic involvement. Considering the accumulating knowledge about the characteristics of and treatment for auditory dysfunction in OMAAV, the objective of this study was to investigate the vestibular function and symptoms of patients with OMAAV. STUDY DESIGN: Retrospective chart review...
September 30, 2016: Otology & Neurotology
Nikolaus E Wolter, Sharon L Cushing, Luis D Vilchez Madrigal, Adrian L James, Jennifer Campos, Blake C Papsin, Karen A Gordon
OBJECTIVE: To determine if children with unilateral sensorineural hearing loss (UHL) demonstrate impaired balance compared with their normal hearing (NH) peers. STUDY DESIGN: Prospective, case-control study. METHODS: Balance was assessed in14 UHL and 14 NH children using the Bruininks-Oseretsky Test-2 (BOT-2) and time to fall (TTF) in an immersive, virtual-reality laboratory. Postural control was quantified by center of pressure (COP) using force plates...
September 30, 2016: Otology & Neurotology
Yi Zhang, Bo Liu, Rui Wang, Ruo Jia, Xin Gu
BACKGROUND: Meniere's disease is a unique, progressive disease of the inner ear. The complex manifestation presents diagnostic challenges. The cochlear symptoms often present before vertigo and tend to be ignored. This study aimed to analyze the characteristics of cochlear symptoms and functions associated with Meniere's disease to investigate the regularity of the development of this disorder. METHODS: One-hundred fifteen patients who were diagnosed with definite unilateral Meniere's disease at the Hearing and Vestibular Clinic of the Department of Otorhinolaryngology of Beijing Tongren Hospital from August 2013 to November 2015 were recruited in this retrospective study...
2016: Chinese Medical Journal
A Thakar
BACKGROUND: Laboratory experiments indicate that changes in retinal image size result in adaptive recalibration or suppression of the vestibulo-ocular reflex. Myopia correction with spectacles or contact lenses also leads to retinal image size changes, and may bring about similar vestibulo-ocular reflex alterations. METHODS: A hypothesis-generating preliminary investigation was conducted. In this cross-sectional study, findings of electronystagmography including bithermal caloric testing were compared between 17 volunteer myopes using spectacles or contact lenses and 17 volunteer emmetropes (with no refractive error)...
October 17, 2016: Journal of Laryngology and Otology
Jennifer C Reneker, Vinay Cheruvu, Jingzhen Yang, Chad E Cook, Mark A James, M Clay Moughiman, Joseph A Congeni
BACKGROUND: Dizziness is often reported after a sports-related concussion. Forces experienced at the time of the concussion can cause an injury to multiple anatomical areas, including the central nervous system, the vestibular system, and the cervical spine, each of which is sufficient to cause dizziness. Medical professionals routinely use the subjective history to develop hypotheses about what may be causing a patient's dizziness. No previous studies have attempted to differentiate the source of the dizziness through precise patient descriptors or the triggers of dizziness...
December 2015: Injury Epidemiology
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