94 results found
Cousins S, Cutfield NJ, Kaski D, et al., 2014, Visual Dependency and Dizziness after Vestibular Neuritis, PLOS One, Vol: 9, ISSN: 1932-6203
Symptomatic recovery after acute vestibular neuritis (VN) is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence) was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI). The third of patients showing the worst clinical outcomes (mean DHI score 36–80) had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03). Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.
Lempert T, Olesen J, Furman J, et al., 2014, Vestibular migraine: Diagnostic criteria. Consensus document of the Barany Society and the International headache society, REVUE NEUROLOGIQUE, Vol: 170, Pages: 401-406, ISSN: 0035-3787
Kaski DM, Tahtis VM, Seemungal BM, 2014, The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke, EUROPEAN JOURNAL OF NEUROLOGY, Vol: 21, Pages: 239-239, ISSN: 1351-5101
Nigmatullina Y, Hellyer PM, Nachev P, et al., 2014, The neuroanatomical correlates of vestibular adaptation in ballet dancers, Joint Congress of European Neurology, Publisher: WILEY-BLACKWELL, Pages: 278-278, ISSN: 1351-5101
Kaski D, Quadir S, Nigmatullina Y, et al., 2014, Human angular path integration, timing and temporoparietal junction, Joint Congress of European Neurology, Publisher: WILEY-BLACKWELL, Pages: 283-283, ISSN: 1351-5101
Nada Y, Hetvi B, Bain P, et al., 2014, Pedunculopontine nucleus DBS modulates visual-vestibular integration, Joint Congress of European Neurology, Publisher: WILEY-BLACKWELL, Pages: 280-280, ISSN: 1351-5101
Nigmatullina Y, Ferguson V, Yousif N, et al., 2014, The cortical mechanisms of oscillopsia and its suppression in asymptomatic infantile nystagmus and symptomatic nystagmus in neurological patients, Joint Congress of European Neurology, Publisher: WILEY-BLACKWELL, Pages: 74-74, ISSN: 1351-5101
Nigmatullina Y, Hellyer PM, Nachev P, et al., 2014, The neuroanatomical correlates of vestibular adaptation in ballet dancers, Joint Congress of European Neurology, Publisher: SPRINGER HEIDELBERG, Pages: S190-S191, ISSN: 0340-5354
Kaski D, Quadir S, Nigmatullina Y, et al., 2014, Human angular path integration, timing and the temporoparietal junction, Joint Congress of European Neurology, Publisher: SPRINGER HEIDELBERG, Pages: S194-S194, ISSN: 0340-5354
Nada Y, Hetvi B, Bain P, et al., 2014, Pedunculopontine nucleus DBS modulates visual-vestibular integration, Joint Congress of European Neurology, Publisher: SPRINGER HEIDELBERG, Pages: S192-S192, ISSN: 0340-5354
Nigmatullina Y, Ferguson V, Yousif N, et al., 2014, The cortical mechanisms of oscillopsia and its suppression in asymptomatic infantile nystagmus and symptomatic nystagmus in neurological patients, Joint Congress of European Neurology, Publisher: SPRINGER HEIDELBERG, Pages: S55-S55, ISSN: 0340-5354
Kaski DM, Tahtis VM, Seemungal BM, 2014, The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in subacute stroke, Joint Congress of European Neurology, Publisher: SPRINGER HEIDELBERG, Pages: S165-S165, ISSN: 0340-5354
Seemungal BM, 2014, The cognitive neurology of the vestibular system, CURRENT OPINION IN NEUROLOGY, Vol: 27, Pages: 125-132, ISSN: 1350-7540
Tahtis V, Kaski D, Seemungal BM, 2014, The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke: A pilot study, RESTORATIVE NEUROLOGY AND NEUROSCIENCE, Vol: 32, Pages: 527-532, ISSN: 0922-6028
Patel M, Nigmatullina Y, Seemungal BM, et al., 2013, Effects of Prochlorperazine on Normal Vestibular Ocular and Perceptual Responses: A Randomised, Double-Blind, Crossover, Placebo-Controlled Study, Audiology and Neuro-Otology, Vol: 19, Pages: 91-96, ISSN: 1421-9700
Background: The present study investigated whether prochlorperazine affects vestibulo-ocular reflex (VOR) and vestibulo-perceptual function. Methods: We studied 12 healthy naïve subjects 3 h after a single dose of oral prochlorperazine 5 mg in a randomised, placebo-controlled, double-blind, crossover study in healthy young subjects. Two rotational tests in yaw were used: (1) a threshold task investigating perceptual motion detection and nystagmic thresholds (acceleration steps of 0.5°/s2) and (2) suprathreshold responses to velocity steps of 90°/s in which vestibulo-ocular and vestibuloperceptual time constants of decay, as well as VOR gain, were measured. Results: Prochlorperazine had no effect upon any measure of nystagmic or perceptual vestibular function compared to placebo. This lack of effects on vestibular-mediated motion perception suggests that the drug is likely to act more as an anti-emetic than as an antivertiginous agent.
Lempert T, Olesen J, Furman J, et al., 2013, Vestibular migraine: Diagnostic criteria. Consensus document of the Bárány Society and the International Headache Society, Acta Otorrinolaringologica Espanola, Vol: 64, Pages: 428-433, ISSN: 0001-6519
This work presents the diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society. The classification includes vestibular migraine and probable vestibular migraine. Vestibular migraine will feature in an appendix of the third edition of the International Classification of Headache Disorders as a first step for new entities, in accordance with the usual procedures of the International Headache Society. Probable vestibular migraine may be included in a later version of the International Classification of Headache Disorders, when further evidence has been gathered. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and on the exclusion of other causes of vestibular symptoms. The symptoms required for a diagnosis of vestibular migraine include various types of vertigo, as well as head motion-induced dizziness with nausea. Symptoms must be of moderate or severe intensity. The duration of acute episodes is limited to a window of between 5. min and 72. h. © 2013 Elsevier España, S.L.
Nigmatullina Y, Hellyer PJ, Nachev P, et al., 2013, The Neuroanatomical Correlates of Training-Related Perceptuo-Reflex Uncoupling in Dancers, Cerebral Cortex, Vol: 25, Pages: 554-562
Sensory input evokes low-order reflexes and higher-order perceptual responses. Vestibular stimulation elicits vestibular-ocular reflex (VOR) and self-motion perception (e.g., vertigo) whose response durations are normally equal. Adaptation to repeated whole-body rotations, for example, ballet training, is known to reduce vestibular responses. We investigated the neuroanatomical correlates of vestibular perceptuo-reflex adaptation in ballet dancers and controls. Dancers' vestibular-reflex and perceptual responses to whole-body yaw-plane step rotations were: (1) Briefer and (2) uncorrelated (controls' reflex and perception were correlated). Voxel-based morphometry showed a selective gray matter (GM) reduction in dancers' vestibular cerebellum correlating with ballet experience. Dancers' vestibular cerebellar GM density reduction was related to shorter perceptual responses (i.e. positively correlated) but longer VOR duration (negatively correlated). Contrastingly, controls' vestibular cerebellar GM density negatively correlated with perception and VOR. Diffusion-tensor imaging showed that cerebral cortex white matter (WM) microstructure correlated with vestibular perception but only in controls. In summary, dancers display vestibular perceptuo-reflex dissociation with the neuronatomical correlate localized to the vestibular cerebellum. Controls' robust vestibular perception correlated with a cortical WM network conspicuously absent in dancers. Since primary vestibular afferents synapse in the vestibular cerebellum, we speculate that a cerebellar gating of perceptual signals to cortical regions mediates the training-related attenuation of vestibular perception and perceptuo-reflex uncoupling.
Cousins S, Kaski D, Cutfield N, et al., 2013, Vestibular perception following acute unilateral vestibular lesions, JOURNAL OF NEUROLOGY, Vol: 260, Pages: S27-S27, ISSN: 0340-5354
Kaski D, Nigmatullina Y, Malhotra P, et al., 2013, A temporoparietal junction timing mechanism mediates human path integration, JOURNAL OF NEUROLOGY, Vol: 260, Pages: S106-S106, ISSN: 0340-5354
Cousins S, Kaski D, Cutfield N, et al., 2013, Vestibular Perception following Acute Unilateral Vestibular Lesions, PLOS One, Vol: 8, ISSN: 1932-6203
Little is known about the vestibulo-perceptual (VP) system, particularly after a unilateral vestibular lesion. We investigatedvestibulo-ocular (VO) and VP function in 25 patients with vestibular neuritis (VN) acutely (2 days after onset) and aftercompensation (recovery phase, 10 weeks). Since the effect of VN on reflex and perceptual function may differ at thresholdand supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5u/s2 and velocity steps of90u/s (acceleration 180u/s2). We hypothesised that the vestibular lesion or the compensatory processes could dissociate VOand VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute andrecovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory thisindicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesioninducedbias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any‘perceptual noise’ added by the vertigo does not disrupt the cognitive decision-making processes inherent to theperceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing andsuggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, asignificant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VPresponses were reduced – asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VPresponses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-thresholdresponses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. Weprovide evidence of perceptual process
Lempert T, Olesen J, Furman J, et al., 2013, Vestibular Migraine: diagnostic Criteria Consensus document of the Barany Society and the International Headache Society, NERVENARZT, Vol: 84, Pages: 511-+, ISSN: 0028-2804
Kaski D, Davies N, Seemungal BM, 2012, Varicella-zoster virus meningo-rhombencephalitis presenting as Ramsey Hunt, NEUROLOGY, Vol: 79, Pages: 2291-2292, ISSN: 0028-3878
Kaski D, Malhotra P, Bronstein AM, et al., 2012, TEMPOROPARIETAL CORTEX AFFORDS SELF-LOCATION PERCEPTION BY A TEMPORAL INTEGRATION OF SENSORY SIGNALS OF MOTION, Annual Meeting of the Association-of-British-Neurologists, Publisher: BMJ PUBLISHING GROUP, ISSN: 0022-3050
Seemungal B, Guzman-Lopez J, Arshad Q, et al., 2012, VESTIBULAR ACTIVATION DIFFERENTIALLY MODULATES HUMAN EARLY VISUAL CORTEX AND V5/MT EXCITABILITY AND RESPONSE ENTROPY, Annual Meeting of the Association-of-British-Neurologists, Publisher: BMJ PUBLISHING GROUP, ISSN: 0022-3050
Seemungal BM, Guzman-Lopez J, Arshad Q, et al., 2012, Vestibular Activation Differentially Modulates Excitability and Response Entropy in Human V5/MT and Early Visual Cortex., Cerebral Cortex, Vol: 23, Pages: 12-19, ISSN: 1047-3211
Head movement imposes the additional burdens on the visual system of maintaining visual-acuity and determining the origin of retinal image motion (i.e. self-motion versus object-motion). Although maintaining visual acuity during self-motion is effected by minimising retinal slip via the brainstem vestibular-ocular reflex, higher-order visuo-vestibular mechanisms also contribute. Disambiguating self-motion versus object-motion also invokes higher-order mechanisms and a cortical visuo-vestibular reciprocal antagonism is propounded. Hence one prediction is of a vestibular modulation of visual cortical excitability and indirect measures have variously suggested none, focal or global effects of activation or suppression in human visual cortex. Using transcranial magnetic stimulation-induced phosphenes to probe cortical excitability, we observed decreased V5/MT excitability versus increased Early Visual Cortex (EVC) excitability, during vestibular activation. In order to exclude non-specific effects (e.g. arousal) on cortical excitability, response specificity was assessed using information theory, specifically response entropy. Vestibular activation significantly modulated phosphene response entropy for V5/MT but not EVC, implying a specific vestibular effect on V5/MT responses. This is the first demonstration that vestibular activation modulates human visual cortex excitability. Furthermore, using information theory, not previously used in phosphene response analysis, we could distinguish between a specific vestibular modulation of V5/MT excitability from a non-specific effect at EVC.
Arshad Q, Kaski D, Buckwell D, et al., 2012, A New Device to Quantify Ocular Counterroll Using Retinal Afterimages, AUDIOLOGY AND NEURO-OTOLOGY, Vol: 17, Pages: 20-24, ISSN: 1420-3030
Murdin L, Seemungal BM, Bronstein AM, 2012, Dizziness, Medicine (United Kingdom), Vol: 40, Pages: 431-434, ISSN: 1357-3039
Dizziness and vertigo are common symptoms. In the acute setting, it is most important to make an accurate diagnosis, particularly to distinguish peripheral from central causes of vertigo and to determine which patients require urgent neuro-imaging for suspected stroke. Although the history and physical examination usually yield the diagnosis, on occasion there is diagnostic ambiguity and the clinician must have to hand a list of likely diagnoses in order to decide rationally which specific investigations (e.g. brain imaging) are required. This article outlines the diagnostic approach to common and important conditions that present with acute dizziness, and their management. © 2012 Elsevier Ltd. All rights reserved.
Seemungal BM, Barraclough K, 2012, Vestibular symptoms in general medical disorders, Vertigo and Imbalance
Seemungal BM, Barraclough K, 2012, Vestibular symptoms in general medical disorders., Publisher: OUP
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