Journal of Vestibular Research-Equilibrium & Orientation最新文献

Dizziness significantly impairs health-related quality of life, yet its specific impact remains underexplored. Gaining insight into this relationship is essential for providing optimal care. Thus, this study aimed to explore the impact of dizziness-related quality of life (DRQOL) and develop a conceptual framework to inform patient-centered care. Participants with documented complaints of dizziness, vertigo, or unsteadiness were identified via medical record review. Those with severe medical illness or disability were excluded. 30 adults (12 males and 18 females), diagnosed with vestibular (n = 10), neurological (n = 10), or nonspecific-related dizziness (n = 10) were recruited. Semi-structured interviews were conducted using Zoom to examine the effects of dizziness on daily life. Interviews were transcribed, de-identified, and analyzed using thematic content analysis. Findings revealed that dizziness and imbalance affect multiple domains, including physical health (functioning, symptoms, and vision), social health (impact and support), cognitive health, and mental health (both positive and negative). These impacts were consistent across all diagnostic subgroups. Despite challenges, many participants reported adaptive responses, including coping strategies and resilience. The study highlights the broad and debilitating effects of dizziness, while also recognizing the role of positive outcomes.

IntroductionThe advent and growth of social media platforms have dramatically altered the landscape of health information sharing, particularly for conditions like Meniere's disease. This study delves into the nature and impact of shared experiences and peer support concerning Meniere's disease on social media, underscoring the critical need for analyzing this content for its influence and accuracy. This study aims to analyze the portrayal of Meniere's disease across social media platforms, focusing on content accuracy and misinformation, to provide vestibular care professionals with insights for improving patient education and fostering more effective patient engagement.Materials and methodsEmploying a comprehensive qualitative approach, our study scrutinized 1108 social media posts about Meniere's disease from Facebook, Instagram, and TikTok-over 3 months. Analysis included authorship identification, examination of the subject matter, tone assessment, and evaluation of post popularity and engagement metrics.Results and analysisA significant portion of the analyzed posts were predominantly image-driven, with a majority authored by patients or their family members. Instagram was the most utilized for Meniere's disease discussions, followed by Facebook and then TikTok. The content analysis revealed that personal experiences comprised 40% of the posts, followed by informational posts, and queries or advice-seeking posts. Sentiment analysis showcased a diverse range of emotions: 45% of posts displayed a positive tone, 35% were neutral, and 20% expressed negative sentiments.DiscussionThe findings from this study highlight a significant demand for accurate and authoritative educational resources on social media regarding Meniere's disease. They offer vestibular care providers, including otolaryngologists, audiologists, physical therapists, speech-language pathologists, and others valuable insights into improving patient-centered care by developing and implementing effective communication strategies. Emphasizing patient empowerment, these strategies should cater to a patient population that is increasingly turning to social media for health-related information. The study also points to the necessity of addressing misinformation and guiding patients towards reliable sources of medical information online.

Mastoid vibration (MV) is a non-invasive way to induce vestibular illusions. However, the influence of MV on gait kinetics during different visual conditions has not been well-established. The purpose of this study was to examine the influence of different types of MV (bilateral vs unilateral) on vertical ground reaction force (vGRF) during walking under both vision-available (VA) and vision-deprived (VD) conditions. Twenty healthy adults walked at their preferred speed on a pressure-sensor treadmill and vGRF characteristics (peak forces, impulses, loading/unloading rates, and variability) were recorded under VA and VD conditions, with and without MV. Vision deprivation increased magnitude and variability of most vGRF variables, suggesting more cautious gait. Bilateral MV (but not unilateral MV) significantly increased the components of vGRF and their variabilities in push-off phase, likely as part of a consistent "press forward" motor response to the vestibular illusion. These results show that MV systematically modulates kinetics, particularly when applied bilaterally and with no visual input. This interaction between vestibular and visual afferents in these young adults may lay a foundation and should be considered in the clinical assessment of gait patterns (GRF profiles) in the future, particularly when using pressure sensor embedded treadmills.

BackgroundThe vestibular system is essential for balance and visual stability and relies on the ocular counter-roll (OCR) reflex to regulate torsional eye movements during head tilt.ObjectiveThis study aimed to investigate how different tilt angles (15° and 45°) and tilt positions (head and body) influence static video Ocular Counter-Rolling (vOCR) responses in healthy individuals.MethodsA total of 30 healthy volunteers (17 females and 13 males), aged between 18 and 30 years, participated in the study. vOCR testing was conducted using the Interacoustics VisualEyes™ 525 video-oculography (VOG) system. Torsional eye movements were recorded at 15° and 45° during both lateral head tilt and body block tilt. Torsion degree, asymmetry, and gain values were analyzed and compared across all conditions.ResultsGain values did not significantly differ based on tilt angle or position (p > 0.05). The degree of torsional eye movement was significantly higher at 45° tilts compared to 15°, and greater during body tilt than head tilt (p < 0.0001). Asymmetry values remained within normal limits under all conditions and showed no significant differences (p > 0.05).ConclusionsThese findings indicate that the angle and position of tilt affect the magnitude of the rotational response, but that gain and asymmetry values remain consistent across conditions. This suggests that comparable gains can be obtained at different angles, such as 15° and 45°, and that low-angle tilts may be sufficient for evaluating otolith-ocular gain.

BackgroundCerebellopontine angle (CPA) tumors commonly cause audiovestibular symptoms due to eighth cranial nerve involvement. While vestibular schwannoma (VS) is the most frequently observed CPA tumor, vestibular outcomes following surgery for non-VS CPA tumors remain underreported.ObjectivesTo compare post-operative vestibular function, as assessed by the video Head Impulse Test (vHIT), between patients with VS and non-VS CPA tumors.MethodsA retrospective review was conducted on 37 patients (23 VS, 14 non-VS) who underwent CPA tumor resection and had vHIT evaluations pre- and post-operatively. Changes in vestibulo-ocular reflex (VOR) gain across the three semicircular canals were analyzed at 1 and 6 months after surgery.ResultsAlthough pre-operative VOR gains were comparable, the non-VS group demonstrated significantly better VOR gain recovery at 6 months in the horizontal and posterior semicircular canals (p = 0.0055, p = 0.0019, respectively). Notably, VOR gains in these canals improved beyond pre-operative levels in the non-VS group. No significant improvement was observed in the anterior semicircular canal.ConclusionsvHIT outcomes indicate more favorable spontaneous vestibular recovery in non-VS CPA tumor than in VS tumor patients. These findings emphasize the importance of vestibular nerve preservation during non-VS tumor surgery and suggest differences in neural involvement between tumor types.

BackgroundPersistent postural-perceptual dizziness (PPPD) is a common yet challenging functional vestibular disorder. The Niigata PPPD Questionnaire (NPQ) is a simple diagnostic tool developed to assess the severity and presence of PPPD.ObjectiveTo validate the Korean version of the NPQ and to evaluate its reliability and diagnostic performance in differentiating PPPD from other vestibular disorders in comparison to Dizziness Handicap Inventory (DHI).MethodsWe recruited 255 patients, 150 with PPPD, 64 with peripheral vestibular disorders, and 41 with central vestibulopathy at a tertiary dizziness center in South Korea from January to December 2024. The NPQ was translated into Korean with a forward-backward translation procedure. In addition, all participants completed DHI, the Beck Depression Inventory-II (BDI-II), the State-Trait Anxiety Inventory (STAI), and the Perceived Stress Scale (PSS) to assess dizziness-related disability and psychological symptoms. Internal consistency was assessed using Cronbach's alpha. Discriminative ability was evaluated through between-group comparisons, correlation analyses, and receiver operating characteristic (ROC) curve analyses.ResultsThe Korean NPQ demonstrated excellent internal consistency (Cronbach's α = 0.93). The total and subscale scores of the NPQ were significantly higher in PPPD than in other vestibular disorder groups. ROC analysis yielded an area under the curve of 0.670 with a cut-off score at 15.5 (sensitivity 59.3%, specificity 71.4%). The visual stimulation subscale showed the highest AUC (0.703). A logistic regression combined model using NPQ visual stimulation and dizziness handicap inventory (DHI) emotional subscales achieved the best diagnostic accuracy (AUC = 0.756). The NPQ total score was moderately correlated with the DHI (ρ = 0.65) and modestly correlated with psychological symptoms.ConclusionThe Korean NPQ is reliable and provides acceptable diagnostic utility for distinguishing PPPD. Combining NPQ and DHI subscales enhances diagnostic accuracy, supporting its use as a screening tool in diverse clinical settings, including telemedicine.

BackgroundPatients with dizziness and unsteadiness are commonly prescribed gaze stability exercises at varying target distances to manage vestibular impairments but lack objective tools to monitor progress. Maintaining gaze stability during head motion at near distances demands greater eye velocity relative to head velocity due to vergence and increased translational eye rotation demands.ObjectivesThis study compared dynamic visual acuity (DVA) during yaw and pitch at both near and far distances in patients and healthy controls.MethodsThis study includes individuals with unilateral vestibular deafferentation (UVD), veterans with dizziness yet healthy vestibular function, and healthy controls. The computerized DVA at near (50 cm) and far (200 cm) distances were collected. Data analysis included comparisons of near and far DVA in yaw and pitch planes.ResultsA total of 94 participants (34 UVD, 24 veterans with dizziness, 36 controls) were included. Near-distance DVA was significantly worse than far-distance DVA for the entire sample and within each group (p < 0.001).ConclusionsNear-distance DVA is more challenging than far-distance DVA across populations and planes of head rotation. Near-distance DVA may serve as a robust measure of vestibulo-ocular reflex function and offers a practical means for patients to self-monitor the effects of gaze stability training.

BackgroundBenign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, and its prevalence is substantial. While primary BPPV has been well studied, the understanding of secondary BPPV is still limited.ObjectiveTo investigate the prevalence and clinical characteristics of secondary BPPV in a national multicenter retrospective analysis.MethodsThe study involved a retrospective analysis of medical records from 17 institutions across South Korea, between January and June 2022. We evaluated clinical features, presumed etiologies, involvement of semicircular canals, response to canalith repositioning procedures (CRPs), presence of residual dizziness, recurrence, and results of auditory and vestibular function tests for both primary and secondary BPPV cases.ResultsOf the total 1363 BPPV cases, 14.5% (198 patients) were categorized as secondary BPPV. The most prevalent etiology for secondary BPPV was head trauma. Secondary BPPV was associated with a higher prevalence of comorbidities including diabetes and inner ear diseases. Patients with secondary BPPV demonstrated more frequent involvement of multiple semicircular canals, necessitated a greater number of CRPs for resolution, and experienced a higher incidence of residual dizziness compared to primary BPPV cases. Furthermore, secondary BPPV patients exhibited more frequent abnormalities in auditory and vestibular function tests.ConclusionsSecondary BPPV accounts for a significant proportion of BPPV cases, with distinct clinical characteristics compared to primary BPPV.

BackgroundIn Ménière's disease (MD), impaired sleep worsens the quality of life and triggers episodes, perpetuating a vicious cycle. The intricate connection between vestibular function and sleep regulation is poorly understood.ObjectiveWe aimed to investigate this link by studying sleep in confirmed MD patients.MethodsIn a single-center observational study, 26 consecutive patients with MD were enrolled. Sleep characterization included thorough symptom inquiry, questionnaires (PSQI, ESS, PFS, STOP-Bang, and AAO-HNS), and respiratory polygraphy (RP) or polysomnography (PSG).ResultsDespite 42% of patients reporting overall sleep satisfaction, further inquiry revealed 76% experiencing sleep disturbances per PSQI. STOP-Bang indicated 56% with a moderate-to-severe risk of OSAS. OSAS defined by apnea hypopnea index (AHI) ≥ 5/h was present in 75%. OSAS severity was categorized as mild (5/h ≤ AHI < 15/h, 33%), moderate (15/h ≤ AHI < 30/h, 21%), and severe (AHI ≥ 30/h, 21%). In patients with AAO-HNS score >3, migraines and insomnia were more prevalent. Patients with moderate-to-severe OSAS had poorer hearing. All recently diagnosed patients with moderate-to-severe OSAS had undergone more than one medical treatment compared to others (32%).ConclusionsThe high prevalence of sleep disorders in MD patients underscores the need for thorough screening, even without spontaneous complaints. Instrumental sleep exploration via RP or PSG is essential, as OSAS treatment could aid vestibular function.

BackgroundThe vestibular implant is an experimental device that may provide treatment to patients suffering from bilateral vestibulopathy who do not benefit from standard vestibular rehabilitation.ObjectiveThe objective is to identify the various methodology regarding device designs and surgical approaches in addition to assessing subjective and objective vestibular and clinical outcomes in order to evaluate the future and possible limitations of the vestibular implant.MethodsA systematic search of Medline and Embase was conducted according to the PRISMA guidelines using pre-defined inclusion and exclusion criteria. 350 hits were found, which after 2 rounds of screening by 2 independent reviewers resulted in 21 studies eligible for full-text review.ResultsA total of 36 recipients of a vestibular implant across four centres world-wide were identified. Both surgical approach and devices as well as vestibular and functional outcomes varied greatly across centres and from patient to patient, evaluated using a variety of objective and subjective tests.ConclusionSeveral promising results in vestibular implantation were found using both subjective and objective measurements. However, some questions with regards to hearing preservation and long-term, continuous use of the vestibular implant remain to be answered, and more studies are needed to assess the efficacy and cost-utility of the implant.