Imperial College London

ProfessorAdolfoBronstein

Faculty of MedicineDepartment of Medicine

Clinical Professor Head of Neuro-otology Unit
 
 
 
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Contact

 

+44 (0)20 3313 5525a.bronstein

 
 
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Assistant

 

Miss Lorna Stevenson +44 (0)20 3313 5525

 
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Location

 

10 L15bLab BlockCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
to

396 results found

Minakaran N, Soorma T, Bronstein AM, Plant GTet al., 2019, Charles Bonnet syndrome and periodic alternating nystagmus: Moving visual hallucinations., Neurology, Vol: 92, Pages: e1072-e1075

OBJECTIVE: To describe and discuss potential mechanisms for modulation of visual hallucinations by nystagmus. METHODS: We present 2 patients with coexistent Charles Bonnet syndrome and periodic alternating nystagmus in the context of acquired visual loss. RESULTS: The combination has given rise to a rare phenomenon: visual hallucinations that move in a manner governed by the nystagmus, specifically by the direction and velocity of the slow phase. The perceived modulation of movement is selective for a surface in one case and a landscape in the other but not present for hallucinated individual objects and people separate from the hallucinated background visual scene. CONCLUSIONS: The collision of Charles Bonnet syndrome and periodic alternating nystagmus in these 2 patients has demonstrated that some visual hallucinations can be modulated by, or collaterally with, ocular movements. We propose 2 potential mechanisms based on ocular proprioceptive input from extraocular muscles projecting to either extrastriate processing of visual scene, or to higher-order visual cortical areas involved in analysis of motion signals across the whole visual field.

JOURNAL ARTICLE

Bednarczuk NF, Bonsu A, Ortega MC, Fluri A-S, Chan J, Rust H, de Melo F, Sharif M, Seemungal BM, Golding JF, Kaski D, Bronstein AM, Arshad Qet al., 2019, Abnormal visuo-vestibular interactions in vestibular migraine: a cross sectional study., Brain, Vol: 142, Pages: 606-616

Vestibular migraine is among the commonest causes of episodic vertigo. Chronically, patients with vestibular migraine develop abnormal responsiveness to both vestibular and visual stimuli characterized by heightened self-motion sensitivity and visually-induced dizziness. Yet, the neural mechanisms mediating such symptoms remain unknown. We postulate that such symptoms are attributable to impaired visuo-vestibular cortical interactions, which in turn disrupts normal vestibular function. To assess this, we investigated whether prolonged, full-field visual motion exposure, which has been previously shown to modulate visual cortical excitability in both healthy individuals and avestibular patients, could disrupt vestibular ocular reflex and vestibular-perceptual thresholds of self-motion during rotations. Our findings reveal that vestibular migraine patients exhibited abnormally elevated reflexive and perceptual vestibular thresholds at baseline. Following visual motion exposure, both reflex and perceptual thresholds were significantly further increased in vestibular migraine patients relative to healthy controls, migraineurs without vestibular symptoms and patients with episodic vertigo due to a peripheral inner-ear disorder. Our results provide support for the notion of altered visuo-vestibular cortical interactions in vestibular migraine, as evidenced by vestibular threshold elevation following visual motion exposure.

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Khan AN, Bronstein A, Bain P, Pavese N, Nandi Det al., 2019, Pedunculopontine and subthalamic nucleus stimulation's effect on saccades in Parkinson's disease., World Neurosurg

BACKGROUND: Recently, deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been explored as a target to treat the axial motor symptoms of advanced Parkinson's disease (PD). In this paper, we consider the relative effects of bilateral STN (subthalamic nucleus) and PPN DBS on both initiation and inhibition of saccades in advanced PD. METHODS: Five patients with advanced PD performed two different oculomotor tasks whilst OFF- stimulation, with bilateral STN-DBS, bilateral PPN-DBS and simultaneous bilateral STN & PPN DBS. The first task involved visually guided saccades and the second, antisaccades. Saccadic latency, accuracy and velocity were recorded for both the visually guided and antisaccade tasks, while prosaccades were measured for the antisaccade task alone. Patients with advanced PD without DBS, age-matched healthy subjects and young healthy subjects all acted as controls (twelve each). RESULTS: Simultaneous bilateral STN and PPN DBS produced the greatest improvement in the mean latencies, velocities and accuracies for the visually guided saccades and antisaccades compared to OFF-DBS (p < 0.001). Interestingly, bilateral STN and PPN DBS caused a significant additional improvement compared to STN DBS alone by reducing the number of prosaccades (p<0.01). CONCLUSIONS: We know that the frontal lobe is involved in saccadic inhibition during AS tasks. Hence, our novel finding of an improvement in the antisaccadic task suggests an ascending, frontally mediated effect of PPN DBS. This implies that there may be PPN to frontal lobe connections which may partly explain the benefits of PPN DBS in axial motor function.

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Harcourt JP, Lambert A, Wong PY, Patel M, Agarwal K, Golding JF, Bronstein AMet al., 2019, Long-Term Follow-Up of Intratympanic Methylprednisolone Versus Gentamicin in Patients With Unilateral Menière's Disease., Otol Neurotol

OBJECTIVES: To determine whether long term (>48 months) symptomatic vertigo control is sustained in patients with Menière's disease from a previous comparative trial of intratympanic methylprednisolone versus gentamicin, and if the two treatments remain nonsignificantly different at long-term follow-up. STUDY DESIGN: Mail survey recording vertigo frequency in the previous one and six months, further intratympanic treatment received, and validated symptom questionnaires. SETTING: Outpatient hospital clinic setting. PATIENTS: Adult patients with definite unilateral refractory Menière's disease, who previously received intratympanic treatment in a comparative trial. INTERVENTION: A survey of trial participants who received intratympanic gentamicin (40 mg/mL) or methylprednisolone (62.5 mg/mL). OUTCOME MEASURES: Primary: number of vertigo attacks in the 6 months prior to receiving this survey compared with the 6 months before the first trial injection. Secondary number of vertigo attacks over the previous 1 month; validated symptom questionnaire scores of tinnitus, dizziness, vertigo, aural fullness, and functional disability. RESULTS: Forty six of the 60 original trial patients (77%) completed the survey, 24 from the gentamicin and 22 from the methylprednisolone group. Average follow-up was 70.8 months (standard deviation 17.0) from the first treatment injection. Vertigo attacks in the 6 months prior to receiving the current survey reduced by 95% compared to baseline in both drug groups (intention-to-treat analysis, both p < 0.001). No significant difference between drugs was found for the primary and secondary outcomes. Eight participants (methylprednisolone = 5 and gentamicin = 3) required further injections for relapse after completing the original trial. CONCLUSION: Intratympanic methylprednisolone treatment provides effective long-lasting relief of vertigo, without the known inner-ear toxicity associated with gentamicin. There are no significan

JOURNAL ARTICLE

Castro P, Kaskia D, Schieppati M, Furman M, Arshad Q, Bronstein Aet al., 2019, Subjective stability perception is related to postural anxiety in older subjects, GAIT & POSTURE, Vol: 68, Pages: 538-544, ISSN: 0966-6362

JOURNAL ARTICLE

Bronstein AM, Dieterich M, 2019, Long-term clinical outcome in vestibular neuritis., Curr Opin Neurol, Vol: 32, Pages: 174-180

PURPOSE OF REVIEW: To review recent work on clinical and imaging aspects of vestibular neuritis (or acute vestibular syndrome), in particular with a view to identifying factors predicting long-term clinical outcome. RECENT FINDINGS: Evidence for a role of inflammation in the vestibular nerve, and the presence of Gadolinium enhancement acutely in vestibular neuritis, is accruing. Visual dependence, anxiety and somatization traits predict the development of chronic dizziness after acute vestibular neuritis. Adaptation to asymmetric rotation is impaired in vestibular neuritis and this may indicate insufficient central compensation in chronic dizzy patients. Corticosteroids appear ineffective at improving long-term clinical outcome. Functional imaging changes during the central compensation period lead to structural brain changes; both processes correlate with clinical recovery. SUMMARY: Vestibular neuritis appears to be the result of postviral neuroinflammation of the vestibular nerve. However, long-term prognosis is not dependent on the magnitude of the peripheral residual damage (as measured with caloric and video head-impulse test). Instead, a combination of visuovestibular psychophysical factors (visual dependence), psychological traits and dysfunctional vestibular perception are relevant. Several functional and structural neuroimaging changes develop after vestibular neuritis, which reflect and underlie the aforementioned psychophysiological and psychological features.

JOURNAL ARTICLE

Edwards AE, Guven O, Furman MD, Arshad Q, Bronstein AMet al., 2018, Electroencephalographic Correlates of Continuous Postural Tasks of Increasing Difficulty, NEUROSCIENCE, Vol: 395, Pages: 35-48, ISSN: 0306-4522

JOURNAL ARTICLE

Balint B, Antelmi E, Mencacci NE, Batla A, Eriksson SH, Walker MC, Bronstein AM, Bhatia KPet al., 2018, Oculomotor apraxia and disrupted sleep with nocturnal ballistic bouts in ADCY5-related disease, PARKINSONISM & RELATED DISORDERS, Vol: 54, Pages: 103-106, ISSN: 1353-8020

JOURNAL ARTICLE

Kaski D, Haider S, Male A, Radunovich A, Liu F, Cordivari C, Bhatia KP, Bronstein AMet al., 2018, Adult Periodic Alternating Nystagmus Masked by Involuntary Head Movements, FRONTIERS IN NEUROLOGY, Vol: 9, ISSN: 1664-2295

JOURNAL ARTICLE

Ortega MC, Bednarczuk NF, Fluri A-S, Chan J, Rust H, de Melo F, Kaski D, Seemungal BM, Bronstein AM, Arshad Qet al., 2018, Abnormal Visuo-vestibular Interactions in Vestibular Migraine, 70th Annual Meeting of the American-Academy-of-Neurology (AAN), Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0028-3878

CONFERENCE PAPER

Ahmad H, Requena T, Frejo L, Cobo M, Gallego-Martinez A, Martin F, Lopez-Escamez JA, Bronstein AMet al., 2018, Clinical and Functional Characterization of a Missense ELF2 Variant in a CANVAS Family, FRONTIERS IN GENETICS, Vol: 9, ISSN: 1664-8021

JOURNAL ARTICLE

Castro P, Esteves SS, Lerchundi F, Buckwell D, Gresty MA, Bronstein AM, Arshad Qet al., 2018, Viewing Target Distance Influences the Vestibulo-Ocular Reflex Gain when Assessed Using the Video Head Impulse Test, AUDIOLOGY AND NEURO-OTOLOGY, Vol: 23, Pages: 285-289, ISSN: 1420-3030

JOURNAL ARTICLE

Roberts RE, Ahmad H, Patel M, Dima D, Ibitoye R, Sharif M, Leech R, Arshad Q, Bronstein AMet al., 2018, An fMRI study of visuo-vestibular interactions following vestibular neuritis, NEUROIMAGE-CLINICAL, Vol: 20, Pages: 1010-1017, ISSN: 2213-1582

JOURNAL ARTICLE

Arshad Q, Nigmatullina Y, Siddiqui S, Franka M, Mediratta S, Ramachandaran S, Lobo R, Malhotra PA, Roberts RE, Bronstein AMet al., 2017, Influence of biases in numerical magnitude allocation on human prosocial decision making, JOURNAL OF NEUROPHYSIOLOGY, Vol: 118, Pages: 3007-3013, ISSN: 0022-3077

JOURNAL ARTICLE

Panichi R, Faralli M, Bruni R, Kiriakarely A, Occhigrossi C, Ferraresi A, Bronstein AM, Pettorossi VEet al., 2017, Asymmetric vestibular stimulation reveals persistent disruption of motion perception in unilateral vestibular lesions, JOURNAL OF NEUROPHYSIOLOGY, Vol: 118, Pages: 2819-2832, ISSN: 0022-3077

JOURNAL ARTICLE

Bronstein A, 2017, Clinical neuro-otology of spatial orientation, 23rd World Congress of Neurology (WCN), Publisher: ELSEVIER SCIENCE BV, Pages: 15-15, ISSN: 0022-510X

CONFERENCE PAPER

Arshad Q, Bonsu A, Lobo R, Fluri A-S, Sheriff R, Bain P, Pavese N, Bronstein AMet al., 2017, Biased numerical cognition impairs economic decision-making in Parkinson's disease, ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY, Vol: 4, Pages: 739-748, ISSN: 2328-9503

JOURNAL ARTICLE

Ahmad H, Roberts RE, Patel M, Lobo R, Seemungal B, Arshad Q, Bronstein Aet al., 2017, Downregulation of early visual cortex excitability mediates oscillopsia suppression, NEUROLOGY, Vol: 89, Pages: 1179-1185, ISSN: 0028-3878

JOURNAL ARTICLE

Bednarczuk NF, Ortega MC, Fluri A-S, Bronstein AM, Arshad Qet al., 2017, Inter-hemispheric control of vestibular thresholds, BRAIN STIMULATION, Vol: 10, Pages: 988-991, ISSN: 1935-861X

JOURNAL ARTICLE

Roberts RE, Ahmad H, Arshad Q, Patel M, Dima D, Leech R, Seemungal BM, Sharp DJ, Bronstein AMet al., 2017, Functional neuroimaging of visuo-vestibular interaction, BRAIN STRUCTURE & FUNCTION, Vol: 222, Pages: 2329-2343, ISSN: 1863-2653

JOURNAL ARTICLE

Geraghty AWA, Essery R, Kirby S, Stuart B, Turner D, Little P, Bronstein A, Andersson G, Carlbring P, Yardley Let al., 2017, Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care, ANNALS OF FAMILY MEDICINE, Vol: 15, Pages: 209-216, ISSN: 1544-1709

JOURNAL ARTICLE

Kaski D, Bronstein AM, 2017, Ocular Tremor in Parkinson's Disease: Discussion, Debate, and Controversy, FRONTIERS IN NEUROLOGY, Vol: 8, ISSN: 1664-2295

JOURNAL ARTICLE

Lubeck AJA, Van Ombergen A, Ahmad H, Bos JE, Wuyts FL, Bronstein AM, Arshad Qet al., 2017, Differential effect of visual motion adaption upon visual cortical excitability, JOURNAL OF NEUROPHYSIOLOGY, Vol: 117, Pages: 903-909, ISSN: 0022-3077

JOURNAL ARTICLE

Lyon S, Goodkin DA, Bronstein AM, Tatem AJ, Bown Met al., 2017, Clinical News., Br J Hosp Med (Lond), Vol: 78, Pages: 8-11, ISSN: 1750-8460

JOURNAL ARTICLE

Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, Bronstein Aet al., 2017, Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Barany Society, JOURNAL OF VESTIBULAR RESEARCH-EQUILIBRIUM & ORIENTATION, Vol: 27, Pages: 191-208, ISSN: 0957-4271

JOURNAL ARTICLE

Patel M, Agarwal K, Arshad Q, Hariri M, Rea P, Seemungal BM, Golding JF, Harcourt JP, Bronstein AMet al., 2016, Intratympanic methylprednisolone versus gentamicin in patients with unilateral Meniere's disease: a randomised, double-blind, comparative effectiveness trial, LANCET, Vol: 388, Pages: 2753-2762, ISSN: 0140-6736

JOURNAL ARTICLE

Kaski D, Pradhan V, Bronstein A, 2016, THE CLINICAL FEATURES OF FUNCTIONAL (PSYCHOGENIC) EYE MOVEMENTS, Annual Meeting of the Association-of-British-Neurologists (ABN), Publisher: BMJ PUBLISHING GROUP, ISSN: 0022-3050

CONFERENCE PAPER

Kaski D, Pradhan V, Bronstein AM, 2016, Clinical features of functional (psychogenic) eye movement disorders, JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, Vol: 87, Pages: 1389-+, ISSN: 0022-3050

JOURNAL ARTICLE

Kaski D, Pradhan V, Bronstein AM, 2016, Clinical features of functional (psychogenic) eye movement disorders., J Neurol Neurosurg Psychiatry, Vol: 87, Pages: 1389-1392

JOURNAL ARTICLE

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