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"Dizziness, imbalance, and falls—which result in an increased burden on both patients and the healthcare system—are seen at higher rates in older, compared to younger, adults and may stem from age-related vestibular degeneration. Currently, there is a lack of diagnostic tests capable of accurately identifying the age-related changes in vestibular function that may underlie these symptoms and, therefore, older adults may experience delays in diagnosis and treatment leading to reduced quality of life and increased healthcare utilization. The objective of the present study was to investigate alternate diagnostic stimulus parameters of current vestibular tests that may be better able to effectively differentiate between healthy younger and normal-aging older adults and, therefore, better assay age-related vestibular changes. To achieve this objective, the present study employed a non-experimental, group-comparisons design including 15 younger (M = 26.7 years of age, range = 22–38) and 15 older (M = 70.0 years of age, range = 60–83) healthy adults. The three rotational vestibular tests used for between-group comparisons were: constant angular acceleration (CAA), sinusoidal harmonic acceleration (SHA), and the computerized rotational head impulse test (crHIT). Each test was completed at varying stimulus magnitudes and recorded outcomes related to vestibulo-ocular reflex (VOR) function. Results from linear mixed effects models (LMEM) analyses showed statistically significant effects related to age group for both VOR gain and phase for the SHA test but not for the CAA or crHIT tests. For SHA VOR gain, there were statically significant effects for the two-way interaction of age group (younger vs. older) and frequency (0.01 vs. 0.16 Hz) as well as the three-way interaction of age group, frequency, and velocity (60 vs. 250 deg/s). For SHA phase, there was a statistically significant effect for the two-way interaction of age group and velocity. The magnitude of the effects were qualitatively compared, following standardization of the outcome parameters, and the two-way interaction effect of age group and velocity for the SHA phase outcome was larger than either interactions for the SHA VOR gain outcome; however, fit of the LMEM examining SHA phase was poorer than that for SHA VOR gain. Results suggest that the effect of age on VOR function is apparent at high velocity and mid-frequency SHA tests. Furthermore, the magnitude of these effects are larger for SHA phase than for SHA VOR gain; however, the magnitudes are somewhat similar and LMEM fit may impede this interpretation. These findings add important information to our understanding of how VOR function is affected by age for SHA, CAA, and crHIT tests. Additionally, these results provide direction for future research, especially for studies that seek to further investigate diagnostic tests that may better elucidate age-related changes in vestibular function to help decrease the burden of dizziness, imbalance, and falls on older adults as the findings suggest that SHA presented at a high velocity and mid-frequency may elucidate the effects of age on vestibular function. "--Abstract.
Progress in Brain Research is the most acclaimed and accomplished series in neuroscience, firmly established as an extensive documentation of the advances in contemporary brain research. The volumes, some of which are derived from important international symposia, contain authoritative reviews and original articles by invited specialists. The rigorous editing of the volumes assures that they will appeal to all laboratory and clinical brain research workers in the various disciplines: neuroanatomy, neurophysiology, neuropharmacology, neuroendocrinology, neuropathology, basic neurology, biological psychiatry, and the behavioral sciences. This volume, The Cerebellum and Memory Formation: Structure, Computation and Function, covers topics including feedback control of cerebellar learning; cortico-cerebellar organization and skill acquisition; cerebellar plasticity and learning in the oculomotor system, and more. Leading authors review the state-of-the-art in their field of investigation, and provide their views and perspectives for future research The volume reflects current thinking about the ways in which the cerebellum can engage in learning, and the contributors come from a variety of research fields The chapters express perspectives from different levels of analysis that range from molecular and cellular mechanisms through to long-range systems that allow the cerebellum to communicate with other brain areas
In The Vestibular System: A Sixth Sense, leading experts present an integrative, comprehensive and innovative look at the sense that Aristotle missed. The vestibular system plays a vital role in everyday life, contributing to a surprising range of functions from reflexes to the highest levels of perception and consciousness. This text not only offers a thorough and fresh review of the basic sensory transduction, the neurophysiology of peripheral and central pathways and how vestibular signals are processed in the control of gaze and posture; it significantly moves the discussion forward with its attention to the current research and the field's revolutionary advances, such as the understanding of neural correlates of self-motion and the basis of clinical disorders. In addition, the objective presentation of existing controversies is exciting reading and an extremely important contribution to the text's completeness. Dynamic, intellectually challenging, and unique in its level of integration of the material, this book is essential for anyone interested in understanding the vestibular system.
This volume reviews clinically relevant studies of the vestibulo-ocular reflex, the otolithic-ocular reflex, and related eye movements and highlights the practical applications of these findings in the management of patients with vertigo (dizziness and/or balance disturbance) and the design of exercise programmes for vestibular rehabillitation. The section on diagnosis and treatment of vertigo addresses conerns such as psychogenic dizziness, imbalance and falls in the aged, and perilymph fistula, and includes descriptions of outpatient and postoperative vestibular rehabilitation programmes and surgical treatment of benign postural vertigo. Nystagmus, a cardinal physical sign of vestibular disorder, is also discussed in detail. Other contributors describe new approaches to testing the vestibulo-ocular reflex and otolithic function.
There is perhaps no area of neuro-ophthalmology that is advancing more rapidly with respect to an understanding of its anatomy and physiology than the ocular motor system. For this reason, it is difficult not only to keep up with the latest information concerning the basic mechanisms involved in the control of eye movements but also to remain up to date regarding the pathophysiology of specific disorders of eye movement. The material in this book is derived from a two-day course on eye movements held in The Netherlands in 1986. The course was designed as an introduction to the normal ocular motor system and to disorders of eye movements and was aimed toward orthoptists, ophthalmolo gists, optometrists, neurologists, and neurosurgeons. The chapters in this book were compiled by a trio of experts in the field of eye movements and contain discussions of anatomy and physiology of the ocular motor system, techniques of examination of patients with diplopia, and pathophysiology of specific disorders of ocular motility. Many of the authors of these chapters are among the most active investigators of eye movements in the world today, and their comments thus reflect the latest information in the field. This text is both basic and com prehensive and thus has something for everyone, from the student just beginning a study of the ocular motor system to the seasoned 'veteran' who wishes to know the latest information regarding central ocular motor control mechanisms. Neil R.