vestibular compensation

前庭代偿
  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/freur.2024.1382196。].
    [This corrects the article DOI: 10.3389/fneur.2024.1382196.].
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  • 文章类型: Journal Article
    长链非编码RNA(lncRNAs)已经成为中枢神经系统的关键调节因子,然而,它们在前庭补偿中的作用仍然难以捉摸。为了解决这个知识差距,我们采用大鼠单侧迷路切除术(UL)建立外周前庭功能障碍的动物模型。利用核糖核酸测序(RNA-seq),我们全面分析了这些大鼠在不同时间点的前庭内侧核(MVN)中失调的基因的表达谱:4小时,4天,UL后14天。通过跨靶标预测分析整合差异共表达的信使RNA(mRNAs)和lncRNAs,我们构建了lncRNA-mRNA调控网络。使用RT-qPCR进行选择的mRNA和lncRNA的验证。我们的RNA-seq分析揭示了与对照样品相比3054个lncRNAs和1135个mRNAs的显著异常表达。通过应用加权基因共表达网络分析(WGCNA),我们确定了11个包含所有基因的共表达模块。值得注意的是,在MEmagenta模块内,我们观察到差异表达基因(DEGs)在4小时的初始上调,随后在UL后4天和14天下调。我们的发现表明,3068个lncRNAs正调控1259个DEGs,而1482个lncRNAs在MVN中负调控433个DEGs。RT-qPCR结果证实了RNA-seq数据,验证我们的发现。这项研究为前庭代偿期间的lncRNA-mRNA表达景观提供了新的见解,为在这种情况下进一步探索lncRNA功能铺平了道路。
    Long non-coding RNAs (lncRNAs) have emerged as crucial regulators in the central nervous system, yet their role in vestibular compensation remains elusive. To address this knowledge gap, we employed unilateral labyrinthectomy (UL) in rats to establish animal models of peripheral vestibular dysfunction. Utilizing ribonucleic acid sequencing (RNA-seq), we comprehensively analysed the expression profiles of genes dysregulated in the medial vestibular nucleus (MVN) of these rats at distinct time points: 4 h, 4 days, and 14 days post-UL. Through trans-target prediction analysis integrating differentially co-expressed messenger RNAs (mRNAs) and lncRNAs, we constructed lncRNA-mRNA regulatory networks. Validation of selected mRNAs and lncRNAs was performed using RT-qPCR. Our RNA-seq analysis revealed significant aberrant expression of 3054 lncRNAs and 1135 mRNAs compared to control samples. By applying weighted gene co-expression network analysis (WGCNA), we identified 11 co-expressed modules encompassing all genes. Notably, within the MEmagenta module, we observed an initial upregulation of differentially expressed genes (DEGs) at 4 h, followed by downregulation at 4- and 14-days post-UL. Our findings indicated that 3068 lncRNAs positively regulated 1259 DEGs, while 1482 lncRNAs negatively regulated 433 DEGs in the MVN. The RT-qPCR results corroborated the RNA-seq data, validating our findings. This study offers novel insights into the lncRNA-mRNA expression landscape during vestibular compensation, paving the way for further exploration of lncRNA functions in this context.
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  • 文章类型: Journal Article
    目的本研究旨在使用视频头脉冲测试(vHIT)评估无眼球震颤的周围前庭疾病患者的半规管功能。方法本研究纳入接受vHIT的患者,并调查了无眼球震颤患者中vHIT异常发现的比例。此外,在没有眼球震颤的患者中同时进行vHIT和热量测试的情况下,对前庭测试的结果进行了调查.结果197例患者中46例(23.4%)眼球震颤试验未见异常,包括凝视眼球震颤测试,位置性眼球震颤试验,定位眼球震颤测试,在vHIT上显示至少一个半规管功能障碍。最常见的诊断是前庭神经鞘瘤(14/46,30.4%),还包括双侧前庭功能障碍的病例(12/46,26.1%)。与没有主观症状的患者相比,在具有头晕/眩晕的主观症状的患者中,更频繁地观察到杂乱无章的追赶扫视模式。尽管与热量测试相比,vHIT的灵敏度较低,vHIT可以检测到热量测试未检测到的孤立的垂直管功能障碍。结论vHIT被认为是对无眼球震颤患者有用的测试,因为vHIT可以在大约四分之一的无眼震患者中检测到异常。vHIT被认为是眼球震颤测试后进行的首批测试之一,包括凝视眼球震颤测试,位置性眼球震颤试验,和定位眼球震颤测试。另一方面,在某些情况下,vHIT未显示异常,而热量测试显示耳道麻痹。有必要执行vHIT,请记住,有一些异常无法单独通过vHIT检测到。
    Objectives This study aims to evaluate semicircular canal function using video head impulse test (vHIT) in patients with peripheral vestibular disorders without nystagmus. Methods Patients who underwent vHIT were enrolled in this study, and the proportion of abnormal findings on vHIT in patients without nystagmus was investigated. In addition, the results of vestibular testing were investigated in cases in which both vHIT and caloric testing were performed in patients without nystagmus. Results Forty-six patients (23.4%) of 197 patients who had no abnormal findings on the nystagmus tests, including the gaze nystagmus test, positional nystagmus test, and positioning nystagmus test, showed dysfunction in at least one semicircular canal on vHIT. The most frequent diagnosis was vestibular schwannoma (14/46, 30.4%), and cases with bilateral vestibular dysfunction were also included (12/46, 26.1%). A disorganized pattern of catch-up saccade was observed more frequently in patients with subjective symptoms of dizziness/vertigo compared to those without subjective symptoms. Although the sensitivity of vHIT was low compared to caloric testing, vHIT could detect isolated vertical canal dysfunction not detected by caloric testing. Conclusions vHIT is considered to be a useful test for patients without nystagmus, as vHIT could detect abnormalities in approximately one-quarter of patients without nystagmus. vHIT is considered to be one of the first tests to be performed following nystagmus testing, including the gaze nystagmus test, the positional nystagmus test, and the positioning nystagmus test. On the other hand, there are some cases in which vHIT shows no abnormality while caloric testing shows canal paresis. It is necessary to perform vHIT, bearing in mind that there are abnormalities that cannot be detected by vHIT alone.
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  • 文章类型: Journal Article
    急性单侧前庭病(AUVP)是引起外周性前庭性眩晕的第二大原因。AUVP的完全恢复与足够的中央前庭代偿有关。现已证实,前庭核和前庭皮质介入了AUVP患者的前庭代偿进程。然而,很少有研究关注AUVP患者的丘脑功能代偿。本研究旨在探讨AUVP患者使用功能磁共振成像(fMRI)对丘脑静息状态功能连接(FC)的改变。
    从40名AUVP患者和35名健康对照(HC)收集3D-T1和静息状态fMRI数据。分析基于种子的(双侧丘脑)FC,以调查两组之间FC的变化。此外,我们使用Pearson的部分相关性评估了AUVP患者丘脑FC改变与临床特征之间的关联.
    与HC相比,AUVP患者显示双侧丘脑和左岛之间的FC降低。我们还观察到右丘脑和左缘上回之间的FC降低。此外,我们发现左丘脑和右中央后回(PCG)之间的FC增加,以及右丘脑和双侧PCG区域之间的FC增加,AUVP患者的右中额回和右中枕回。此外,AUVP患者左丘脑和左岛之间的FC与管麻痹值呈负相关(p=0.010,r=-0.434)。
    我们的结果为丘脑-前庭皮质通路减少提供了第一个证据,以及AUVP患者的丘脑-体感和丘脑-视觉皮层通路增加。这些发现有助于我们更好地了解急性单侧外周前庭损伤后中枢动态代偿的潜在机制。
    UNASSIGNED: Acute unilateral vestibulopathy (AUVP) is the second leading cause of peripheral vestibular vertigo. Full recovery of AUVP is related to sufficient central vestibular compensation. It has been confirmed that the vestibular nucleus and vestibular cortex are involved in the process of vestibular compensatory in AUVP patients. However, few studies have focused on the functional compensation of thalamus in patients with AUVP. This study aimed to explore the alterations of resting-state functional connectivity (FC) focused on thalamus using functional magnetic resonance imaging (fMRI) in AUVP patients.
    UNASSIGNED: Data of 3D-T1 and resting-state fMRI were collected from 40 AUVP patients and 35 healthy controls (HC). Seeds-based (bilateral thalamus) FC was analyzed to investigate the changes in FC between the two groups. Furthermore, we evaluated the associations between altered thalamus FC and clinical features in AUVP patients using Pearson\'s partial correlation.
    UNASSIGNED: Compared with HC, AUVP patients showed decreased FC between bilateral thalamus and left insula. We also observed decreased FC between right thalamus and left supramarginal gyrus. Additionally, we found increased FC between left thalamus and right postcentral gyrus (PCG), as well as increased FC between right thalamus and regions of bilateral PCG, right middle frontal gyrus and right middle occipital gyrus in AUVP patients. Furthermore, the FC between left thalamus and left insula was negatively correlated with values of canal paresis in patients with AUVP (p = 0.010, r = -0.434).
    UNASSIGNED: Our results provided first evidence for the decreased thalamo-vestibular cortex pathway, as well as increased thalamo-somatosensory and thalamo-visual cortex pathway in AUVP patients. These findings help us better understand the underlying mechanisms of central dynamic compensatory following an acute unilateral peripheral vestibular damage.
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  • 文章类型: Journal Article
    目的:本研究的目的是评估前庭神经切除术后严重梅尼埃病患者的功能结局和平衡补偿。方法:分析20例单侧梅尼埃病患者前庭神经切除术前和术后2年的手术前后结果。使用美国耳鼻咽喉头颈外科学会提出的主观分级量表和头晕障碍量表进行临床评估。分析感觉组织测试结果,以评估手术前后的平衡系统。结果:所有患者报告前庭神经切除术后眩晕发作完全缓解;根据美国耳鼻咽喉头颈外科学会提出的量表,95%的患者报告功能水平改善,平均评分从4.5降至1.6。临床改善,用头晕障碍清单评估,存在于所有患者中,平均结果从81.7降至16.4。分析两种分级系统,术前和术后结果之间的差异有统计学意义.前庭神经切除术前后的感觉组织测试结果无统计学差异。患者的年龄与头晕障碍量表和姿势造影的术后结果之间存在显着相关性。结论:前庭神经切断术是治疗重度梅尼埃病的有效方法,经保守治疗,临床症状无改善。它导致主观身体,功能,和情绪的改善,使患者能够恢复日常活动和工作。适当的患者资格和全面的术前评估对于获得满意的临床结果至关重要。
    Objectives: The aim of this study was to evaluate the functional outcomes and balance compensation in patients with severe Meniere\'s disease after vestibular neurectomy. Methods: Pre- and postoperative results were analyzed in twenty patients with unilateral Meniere\'s disease before and two years after vestibular neurectomy. Clinical evaluation was performed using a subjective grading scale proposed by the American Academy of Otolaryngology-Head and Neck Surgery and the Dizziness Handicap Inventory. Sensory organization test results were analyzed to assess the balance system before and after the surgery. Results: All patients reported a complete resolution of vertigo attacks after the vestibular neurectomy; 95% of patients reported functional level improvement according to a scale proposed by the American Academy of Otolaryngology-Head and Neck Surgery, and the average score decreased from 4.5 to 1.6. Clinical improvement, evaluated with the Dizziness Handicap Inventory, was present in all patients, with the average result decreasing from 81.7 to 16.4. Analyzing both grading systems, differences between pre- and postoperative results were statistically significant. No statistically significant differences were found between the sensory organization test results before and after vestibular neurectomy. Significant correlations were found between a patient\'s age and postoperative results of the Dizziness Handicap Inventory and posturography. Conclusions: Vestibular neurectomy is an effective vertigo treatment in patients with severe Meniere\'s disease with no clinical improvement despite conservative treatment. It results in subjective physical, functional, and emotional improvement, enabling patients to return to daily activities and work. An appropriate qualification of patients and comprehensive preoperative evaluation are essential to obtaining satisfactory clinical outcomes.
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  • 文章类型: Journal Article
    尽管在良性阵发性位置性眩晕(BPPV)的治疗中,耳石重新定位动作(CRM)的成功率很高,越来越多的患者报告残留的头晕症状可能会持续很长时间。虽然大多数BPPV病例可以解释为牙管炎,病因复杂。考虑个体患者的病史和潜在的BPPV病理生理学可能为补充CRM的治疗方法提供潜力。对于禁用CRM的患者,也是一种有希望的替代方法。本文总结了BPPV和残留头晕的可能潜在原因,以及可能被考虑减轻残留症状负担的潜在管理方案的建议。
    Despite the high success rate of canalith repositioning maneuvers (CRMs) in the treatment of benign paroxysmal positional vertigo (BPPV), a growing number of patients report residual dizziness symptoms that may last for a significant time. Although the majority of BPPV cases can be explained by canalolithiasis, the etiology is complex. Consideration of the individual patient\'s history and underlying pathophysiology of BPPV may offer the potential for treatment approaches supplementary to CRMs, as well as a promising alternative for patients in whom CRMs are contraindicated. This article provides a summary of the possible underlying causes of BPPV and residual dizziness, along with suggestions for potential management options that may be considered to relieve the burden of residual symptoms.
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  • 文章类型: Journal Article
    前庭代偿是内耳内前庭器官的生理反应。这种适应表现在持续暴露于加速或减速期间,前庭器官逐渐适应这种变化。前庭代偿的分子基础仍有待充分阐明,然而,新兴的研究暗示与神经可塑性和信号转导通路的关联。在整个补偿过程中,前庭感觉神经元维持信号传递到中央平衡系统,通过突触传递和神经元兴奋性的改变促进适应性。在这个过程中涉及的值得注意的分子候选包括离子通道和神经递质谱的变化,以及神经元和突触可塑性,代谢过程,和电生理修饰。本研究巩固了当前对前庭代偿中分子事件的理解,扩大现有的研究环境,并评估当代治疗策略。此外,这篇综述提出了未来研究的潜在途径,这些途径可以增强我们对前庭补偿机制的理解。
    Vestibular compensation is a physiological response of the vestibular organs within the inner ear. This adaptation manifests during consistent exposure to acceleration or deceleration, with the vestibular organs incrementally adjusting to such changes. The molecular underpinnings of vestibular compensation remain to be fully elucidated, yet emerging studies implicate associations with neuroplasticity and signal transduction pathways. Throughout the compensation process, the vestibular sensory neurons maintain signal transmission to the central equilibrium system, facilitating adaptability through alterations in synaptic transmission and neuronal excitability. Notable molecular candidates implicated in this process include variations in ion channels and neurotransmitter profiles, as well as neuronal and synaptic plasticity, metabolic processes, and electrophysiological modifications. This study consolidates the current understanding of the molecular events in vestibular compensation, augments the existing research landscape, and evaluates contemporary therapeutic strategies. Furthermore, this review posits potential avenues for future research that could enhance our comprehension of vestibular compensation mechanisms.
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  • 文章类型: Journal Article
    抑制头部冲动范例(SHIMP)涉及抑制前庭眼反射(VOR)及其产生的反代偿性扫视。SHIMP通过其不同参数(VOR增益/峰值扫视速度PSV/扫视潜伏期)来了解前庭补偿变得越来越重要。SHIMP研究正在成人中出现,但是儿科研究几乎没有进行过。这项研究是在英国三级儿科前庭中心进行的为期2个月的回顾性病例记录审核,以调查SHIMP是否安全/可靠地用于符合正常儿童现行标准/规范的儿童,以及是否产生任何有意义的推论小儿前庭功能减退。这是迄今为止规模最大的儿科SHIMP研究。共有44名转诊儿童(6-18岁,女童>男童)有一系列头晕的抱怨,不平衡,电机不协调,姿势不稳定,听力损失也包括在内,并测量了它们的SHIMP参数。所有儿童都接受了全面的功能/客观的听觉前庭评估。分为前庭功能正常的A组和前庭功能异常的B组。正常人群的平均SHIMPVOR增益为0.98/-0.08,明显的扫视延迟为215.68/-46.16毫秒,与已发表的证据一致。明显扫视的PSV为315.39+/-56.30/s,双方之间存在7.42+/-4.68的增益不对称性。在VOR增益和PSV方面,两组之间观察到中等/较大效应大小的统计学差异,但在扫视潜伏期没有。秘密扫视在SHIMP很少见,而在100%的儿童中观察到明显的扫视。头部脉冲范例(HIMP)和SHIMP之间的VOR增益差异也很显着。我们观察到两组之间VOR增益的侧不对称性具有统计学上的显着差异。此外,我们确定了一组患有小脑病变的儿童,SHIMP中明显扫视的数量相当少.建议进一步研究以调查小儿PSV,不对称,无法产生公开的扫视,这可能是评估补偿和中心功能的有用手段。我们得出的结论是,SHIMP产生有价值的信息,易于执行,以及应用于儿童补充HIMP的可靠测试。
    The suppression head impulse paradigm (SHIMP) involves suppression of the vestibulo-ocular reflex (VOR) and anticompensatory saccades generated thereof. SHIMP is gaining importance to understand vestibular compensation with its different parameters (VOR gain/peak saccadic velocity PSV/latency of saccades). SHIMP studies are emerging in adults, but pediatric studies have hardly been performed. This study is a retrospective case note audit over a period of 2 months in a tertiary pediatric vestibular center in the United Kingdom to investigate whether SHIMP is safe/robust to be used in children conforming to existing standards/norms in normal children and whether it yields any meaningful inferences in pediatric vestibular hypofunction. This is the largest pediatric SHIMP study to date. A total of 44 referred children (6-18 years, female children>male children) with a range of complaints from dizziness, imbalance, motor incoordination, postural instability, and hearing loss were included, and their SHIMP parameters were measured. All children underwent comprehensive functional/objective audiovestibular assessments. Two groups were defined-Group A with normal vestibular function and Group B with abnormal vestibular function. The normal population showed an average SHIMP VOR gain of 0.98+/-0.08 and latency of overt saccades at 215.68+/-46.16 milliseconds agreeing with published evidence. The PSV of overt saccades was 315.39+/-56.30/s, and there was a gain asymmetry of 7.42+/-4.68 between the sides. Statistically significant differences with moderate/large effect sizes were observed between the groups in terms of VOR gain and PSV but not in saccade latencies. Covert saccades were rare in SHIMP, while overt saccades were observed in 100% of children. VOR gain difference between the head impulse paradigm (HIMP) and the SHIMP was significant as well. We observed statistically significant differences in side asymmetry of VOR gain between the groups. Furthermore, we identified a group of children with cerebellar lesions where overt saccades in SHIMP were rather low in number. Further research is recommended to investigate pediatric PSV, asymmetry, and inability to generate overt saccades that may suggest useful means to assess compensation and central function. We conclude that SHIMP yields valuable information and is a safe, easy to perform, and a reliable test that should be used in children to supplement HIMP.
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  • 文章类型: Journal Article
    目的:通过视频头部脉冲测试(vHIT)评估前庭神经鞘瘤(VS)患者的半规管功能。
    方法:本研究纳入19例VS患者接受手术治疗。VS患者的半规管术前和术后检查了前庭眼反射(VOR)的增加和追赶扫视中的散射程度。
    结果:19例VS患者中有10例(52.6%)被定义为术前vHIT结果同时显示前庭神经(SVN)和前庭神经(IVN)受损。听力水平和主观前庭症状与术前半规管功能显着相关。与术前vHIT结果相比,手术后1个月内的VOR增加在所有三个运河中都显著减少;然而,手术后6个月前半规管和后半规管的显著差异消失。与IVN起源的病例相比,来源不明的病例术后后半规管功能明显减少。
    结论:因为vHIT可以评估术前前庭神经损伤,术后VOR增益降低和前庭代偿程度,与热量测试相比,通过vHIT评估的半规管功能提供了关于VS患者接受手术的大量有用信息,对于VS患者,应在术前和术后进行vHIT。
    OBJECTIVE: To evaluate pre- and post-operative semicircular canal function in patients with vestibular schwannoma (VS) by the video Head Impulse Test (vHIT).
    METHODS: Nineteen patients with VS who underwent surgery were enrolled in this study. The gain in vestibulo-ocular reflex (VOR) and the degree of scatter in catch-up saccades were examined pre- and post-operatively for the semicircular canals in VS patients.
    RESULTS: Ten of 19 cases (52.6 %) with VS were defined as demonstrating both superior vestibular nerve (SVN) and inferior vestibular nerve (IVN) impairment from the results of pre-operative vHIT. Hearing level and subjective vestibular symptoms showed significant correlations with pre-operative semicircular canal function. Compared to pre-operative vHIT results, VOR gains within 1 month after surgery were significantly reduced in all three canals; however, significant differences had disappeared in the anterior and posterior semicircular canals at 6 months after surgery. Cases of unknown origin had a significantly greater reduction in posterior semicircular canal function after surgery compared with those with disease of IVN origin.
    CONCLUSIONS: As vHIT could evaluate pre-operative vestibular nerve impairment, post-operative VOR gain reduction and the degree of vestibular compensation, semicircular canal function evaluated by vHIT provides a good deal of useful information regarding VS patients undergoing surgery compared to caloric testing, and vHIT should be performed pre- and post-operatively for patients with VS.
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  • 文章类型: English Abstract
    Unlike other sensory systems, since the vestibular system maintains the tension balance of the entire system in a\"push-pull\" mode, local dysfunction in the system will cause the balance of the entire system to collapse. Unilateral peripheral vestibular dysfunction will cause severe vestibular symptoms, but it can recover spontaneously within a few days to several weeks. This phenomenon is called \"vestibular compensation\"(VC). Since the peripheral vestibular impact in most cases is irreversible, it is widely believed that the central mechanism plays a key role in the vestibular compensation process. Static symptom is fully compensated within a few weeks, which is in parallel with the restored balance in the resting discharge of the vestibular nucleus on both sides; the incomplete compensation of dynamic deficits takes longer and is achieved mainly through the mechanism of sensory substitution and behavioral substitution. Here we briefly reviewed the mechanism of vestibular compensation and treatment in order to provide an insight into further study and clinical treatment strategies.
    摘要: 与其他感觉系统不同,前庭系统通过“推-拉”的模式维持整个系统的张力平衡,局部功能异常增强或减弱都将导致整个系统的功能障碍。单侧外周前庭受损将引起显著的前庭症状,但其可在数日至数周内逐步自行缓解,该现象被称为“前庭代偿”。由于多数情况下的前庭外周损伤为不可逆性,因此广泛认为中枢机制是前庭代偿的主因。其中,静态症状在数周内消失,代偿较为完全,推测是前庭核团放电再平衡的结果;动态症状的代偿需要更长时间,通过感觉替代、行为替代等方式实现,且代偿不完全。本文简要综述了前庭代偿及治疗机制的研究进展以期为未来的研究工作和临床治疗策略提供参考。.
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