Utricular Dysfunction and Hearing Impairment Affect Spatial Navigation in Community-Dwelling Healthy Adults: Analysis from the Baltimore Longitudinal Study of Aging.
Colin R Grove, Eric R Anson, Yuri Agrawal, Eleanor M Simonsick, Michael C Schubert
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引用次数: 0
Abstract
Introduction: Spatial navigation, the ability to move through one's environment, is a complex skill utilized in everyday life. The effects of specific vestibular end-organ deficits and hearing impairments on spatial navigation have received little to no attention. We hypothesized that hearing impairment adversely affects spatial navigation and that bimodal impairments (vestibular and hearing) further impair navigation ability.
Methods: Data from 182 participants in the Baltimore Longitudinal Study of Aging who had interpretable results for the video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular evoked myogenic potentials (oVEMP), audiometric testing, and the triangle completion test (TCT) were retrospectively analyzed. Multiple linear regression, controlling for age, sex, and cognition, was employed to identify predictors of TCT performance in terms of end-point error, angle deviation, and distance walked.
Results: oVEMP abnormalities were associated with larger end-point error (p = 0.008) and larger angle deviation (p = 0.002) but were not associated with distance walked (p = 0.392). Abnormalities on cVEMP testing and vHIT were not associated with distance walked (p = 0.835, p = 0.300), end-point error (p = 0.256, p = 0.808), or angle deviation (p = 0.192, p = 0.966). Compared with normal-hearing adults, hearing-impaired adults walked a shorter distance during the TCT (p = 0.049) but had a similar end-point error (p = 0.302) and angle deviation (p = 0.466). There was no interaction between vestibular and hearing function for predicting spatial navigation ability.
Conclusion: In this cohort analysis, utricular dysfunction and hearing impairment were associated with poorer spatial navigation performance. We postulate that hearing impairment negatively affects one's ability to use real-time, intrinsic auditory cues and/or prior experience to guide navigation.
简介空间导航是指在周围环境中移动的能力，是日常生活中一项复杂的技能。特定的前庭末梢器官功能障碍和听力障碍对空间导航的影响很少受到关注。我们假设听力障碍会对空间导航产生不利影响，而双模态障碍（前庭和听力）会进一步损害导航能力：我们对巴尔的摩老龄化纵向研究（Baltimore Longitudinal Study of Aging）中 182 名参与者的数据进行了回顾性分析，这些参与者在视频头脉冲测试（vHIT）、颈部（cVEMP）和眼部（oVEMP）前庭诱发肌源性电位、听力测试和三角形完成测试（TCT）中都有可解释的结果。在控制年龄、性别和认知能力的情况下，采用多元线性回归法确定了TCT成绩在终点误差、角度偏差和行走距离方面的预测因素。结果：oVEMP异常与较大的终点误差（p=0.008）和较大的角度偏差（p=0.002）有关，但与行走距离无关（p=0.392）。cVEMP和vHIT异常与步行距离（p=0.835，p=0.300）、终点误差（p=0.256，p=0.808）或角度偏差（p=0.192，p=0.966）无关。与听力正常的成年人相比，听力受损的成年人在 TCT 期间行走的距离较短（p=0.049），但终点误差（p=0.302）和角度偏差（p=0.466）相似。在预测空间导航能力方面，前庭功能和听力功能之间没有相互作用：在这项队列分析中，前庭功能障碍和听力障碍与较差的空间导航能力有关。我们推测，听力障碍会对一个人利用实时、内在听觉线索和/或先前经验指导导航的能力产生负面影响。
期刊介绍：
''Audiology and Neurotology'' provides a forum for the publication of the most-advanced and rigorous scientific research related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear. This journal seeks submission of cutting edge research opening up new and innovative fields of study that may improve our understanding and treatment of patients with disorders of the auditory and vestibular systems, their central connections and their perception in the central nervous system. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines.
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