Recovery of vestibular ocular reflex function and balance control after a unilateral peripheral vestibular deficit.

Frontiers in Neurology

John eAllum¹ 

[1] University Hospital Basel;

关键词: Gait;    Balance control;    unilateral peripheral vestibular deficit;    vestibulo-spinal reflexes;    vestibulo-ocular reflexes;    stance;   

DOI  :  10.3389/fneur.2012.00083

来源: DOAJ

【 摘 要 】

This review describes the effect of unilateral peripheral vestibular deficit (UPVD) on balance control as observed in stance and gait tests. Normally, a UPVD is defined based on vestibular ocular reflex (VOR) function. Therefore, we compare recovery observed in balance control over time with similar patterns of recovery or lack thereof in VOR function. Three types of UPVD are considered; acute vestibular neuritis, vestibular loss prior to and after cerebellar pontine angle tumor (CPAT) surgery during which a vestibular neurectomy was performed, and vestibular loss following neurectomy to eliminate disabling Ménière’s disease.To measure balance control, body-worn gyroscopes, mounted near the body’s centre of mass, were used for stance and gait tests. Measurement variables were the pitch (anterior-posterior) and roll (lateral) sway angles and angular velocities of the lower trunk-pelvis. All three groups showed balance deficits during stance tasks on foam, especially with eyes closed when stable control is highly dependent on vestibular inputs. Deficits in balance control during gait were present but were more profound for complex gait tasks such as tandem gait. Differences emerged between the groups concerning the severity of the deficit and its recovery. Generally, the effects of acute neuritis were more severe but recovered rapidly, deficits due to vestibular neurectomy were less severe but longer lasting. These results paralleled deficits in VOR function and raise questions about two modes of neural plasticity occurring in the vestibular system following vestibular loss: one mode being the limited central compensation for the loss, and the second mode being some restoration of peripheral vestibular function. Future work will need to correlate deficits in balance control during stance and gait more exactly with VOR deficits and carefully consider the differences between insufficient central compensation compared to inadequate peripheral restoration of function.

【 授权许可】

Unknown