PDF(Pubmed)
Abstract：
Maintaining balance comes naturally to healthy people. In subjects with vestibulopathy, even when compensated, and especially if it is bilateral, maintaining balance requires cognitive effort. Pupillometry is an established method of quantifying cognitive effort. Background/Objectives: We hypothesized that pupillometry would be able to capture the increased effort required to maintain posture in subjects with bilateral vestibulopathy in increasingly difficult conditions. Additionally, we hypothesized that the cognitive workload during balance tasks, indexed by pupil size, would decrease with the activation of the BionicVEST cochleo-vestibular implants. Methods: Subjects with a cochleo-vestibular implant as of March 2023 were recruited, excluding those with ophthalmological issues that precluded pupillometry. Pupillometry was performed using a validated modified videonystagmography system. Computed dynamic posturography and a Modified Clinical Test of Sensory Integration on Balance were performed while the pupil was recorded. Tests were first performed after 24 h of deactivating the vestibular component of the implant. Thereafter, it was reactivated, and after 1 h of rest, the tests were repeated. The pupil recording was processed using custom software and the mean relative pupil diameter (MRPD) was calculated. Results: There was an average of 10.7% to 24.2% reduction in MRPD when the vestibular implant was active, with a greater effect seen in tasks of moderate difficulty, and lesser effect when the task was easy or of great difficulty. Conclusions: Despite technical challenges, pupillometry appears to be a promising method of quantifying the cognitive effort required for maintaining posture in subjects with bilateral vestibulopathy before and after vestibular implantation.
摘要：
保持平衡对健康人来说很自然。在患有前庭病的受试者中，即使得到补偿，尤其是如果是双边的，保持平衡需要认知努力。瞳孔测量是一种量化认知努力的既定方法。背景/目标：我们假设瞳孔测量能够在日益困难的条件下捕获双侧前庭病患者维持姿势所需的更多努力。此外,我们假设在平衡任务期间的认知工作量，按瞳孔大小索引，会随着BionicVEST耳蜗前庭植入物的激活而降低。方法：招募截至2023年3月接受耳蜗前庭植入物的受试者，排除那些排除瞳孔测量的眼科问题。使用经过验证的改良的视频眼震描记术系统进行瞳孔测量。在记录瞳孔的同时，进行了计算机动态姿势造影和改良的平衡感觉统合临床测试。首先在停用植入物的前庭组件24小时后进行测试。此后,它被重新激活，休息1小时后，重复测试。使用定制软件处理瞳孔记录,并计算平均相对瞳孔直径(MRPD)。结果：前庭植入物活动时，MRPD平均减少10.7％至24.2％，在中等难度的任务中看到更大的效果，当任务很容易或很困难时，效果较小。结论：尽管存在技术挑战，瞳孔测量法似乎是一种有前途的方法，可以量化前庭植入前后双侧前庭病变患者维持姿势所需的认知努力。
