Vertigo and Dizziness: Central Vestibular Disorders

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuro-otology and Neuro-ophthalmology".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 8261

Special Issue Editors


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Guest Editor
Department of Otorhinolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile
Interests: hearing loss; audiovestibular disorders; Ménière's disease; vestibular migraine; ototoxicity

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Co-Guest Editor
Department of Neurology, Cesar Milstein Hospital, Buenos Aires, Argentina
Interests: central vestibular pathway; cerebellum; vestibular migraine; central vertigo

Special Issue Information

Dear Colleagues,

Vertigo and dizziness are commonly reported symptoms in neurology and otolaryngology consults. The etiologies of disorders are usually classified from the anatomical perspective. The most common peripheral vestibular disorders affect the vestibular nerve and/or the labyrinth. In contrast, when a lesion involves the vestibular nuclei, cerebellum and accessory vestibular pathways, it is considered a central vestibular disorder. Within the latter group, vestibular migraine is the most common disorder and considered the most frequent form of episodic vertigo. Other central causes of vertigo include head injuries, posterior circulation stroke, paraneoplastic syndrome, central nervous system inflammatory and demyelinating diseases, degenerative disorders, infections, posterior fossa brain tumors and side effects of medications; all are potentially life-threatening conditions.

In this Special Issue, we seek submissions that address the etiologies, pathophysiology, diagnosis and treatment of central vestibular disorders. We invite research articles, reviews and commentaries on these topics.

Dr. Sofia Waissbluth
Dr. Dario Yacovino
Guest Editors

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Keywords

  • vestibular migraine
  • stroke
  • cerebellum
  • brainstem lesions
  • pseudoneuritis
  • multiple sclerosis
  • ataxia
  • downbeat nystagmus
  • degenerative disorders
  • vestibular nuclear complex

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Published Papers (3 papers)

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Research

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23 pages, 3303 KiB  
Article
Functional Dizziness as a Spatial Cognitive Dysfunction
by Hayo A. Breinbauer, Camilo Arévalo-Romero, Karen Villarroel, Claudio Lavin, Felipe Faúndez, Rosario Garrido, Kevin Alarcón, Ximena Stecher, Francisco Zamorano, Pablo Billeke and Paul H. Delano
Brain Sci. 2024, 14(1), 16; https://doi.org/10.3390/brainsci14010016 - 23 Dec 2023
Cited by 1 | Viewed by 2947
Abstract
(1) Background: Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve disrupted spatial cognition processes as a core feature. (2) Methods: A cohort of 19 PPPD patients underwent psycho-cognitive testing, including [...] Read more.
(1) Background: Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve disrupted spatial cognition processes as a core feature. (2) Methods: A cohort of 19 PPPD patients underwent psycho-cognitive testing, including assessments for anxiety, depression, memory, attention, planning, and executive functions, with an emphasis on spatial navigation via a virtual Morris water maze. These patients were compared with 12 healthy controls and 20 individuals with other vestibular disorders but without PPPD. Vestibular function was evaluated using video head impulse testing and vestibular evoked myogenic potentials, while brain magnetic resonance imaging was used to exclude confounding pathology. (3) Results: PPPD patients demonstrated unique impairments in allocentric spatial navigation (as evidenced by the virtual Morris water maze) and in other high-demand visuospatial cognitive tasks that involve executive functions and planning, such as the Towers of London and Trail Making B tests. A factor analysis highlighted spatial navigation and advanced visuospatial functions as being central to PPPD, with a strong correlation to symptom severity. (4) Conclusions: PPPD may broadly impair higher cognitive functions, especially in spatial cognition. We discuss a disruption in the creation of enriched cognitive spatial maps as a possible pathophysiology for PPPD. Full article
(This article belongs to the Special Issue Vertigo and Dizziness: Central Vestibular Disorders)
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9 pages, 251 KiB  
Article
Effectiveness of Vestibular Rehabilitation for Patients with Degenerative Cerebellar Ataxia: A Retrospective Cohort Study
by Lisa L. Heusel-Gillig and Courtney D. Hall
Brain Sci. 2023, 13(11), 1520; https://doi.org/10.3390/brainsci13111520 - 28 Oct 2023
Cited by 1 | Viewed by 2336
Abstract
Many patients with cerebellar ataxia have dizziness caused by oculomotor or peripheral vestibular deficits; however, there is little evidence supporting the use of vestibular rehabilitation for this population. The purpose of this study was to determine whether patients with degenerative cerebellar diseases improve [...] Read more.
Many patients with cerebellar ataxia have dizziness caused by oculomotor or peripheral vestibular deficits; however, there is little evidence supporting the use of vestibular rehabilitation for this population. The purpose of this study was to determine whether patients with degenerative cerebellar diseases improve following rehabilitation including vestibular exercises. A secondary aim was to identify variables associated with the outcomes. A retrospective chart review identified 42 ambulatory patients (23 men and 19 women; mean age = 54.5 ± 14.4 years) with cerebellar degeneration. Fourteen patients had ataxia only, twenty had ataxia and oculomotor abnormalities, and eight had ataxia with oculomotor and peripheral vestibular deficits. Patients received customized physical therapy including balance and gait training, as well as gaze stabilization and habituation exercises for vestibular hypofunction and motion-provoked dizziness. Primary outcome measures (Activities-specific Balance Confidence Scale, Tinetti Performance Oriented Mobility Assessment, Dynamic Gait index, and Sensory Organization Test) were evaluated at baseline and discharge. Patients improved (p < 0.05) on all outcome measures. Patients with vestibular deficits were seen for more visits compared to those with gait ataxia only (7.1 vs. 4.8 visits). This study provides evidence that patients with degenerative cerebellar disease improve in balance confidence, fall risk and sensory integration with therapy that includes vestibular rehabilitation. Full article
(This article belongs to the Special Issue Vertigo and Dizziness: Central Vestibular Disorders)

Review

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15 pages, 1311 KiB  
Review
The Light Cupula Phenomenon: A Scoping Review
by Dong-Han Lee, Tae Hee Kim, Minho Jang and Chang-Hee Kim
Brain Sci. 2024, 14(1), 15; https://doi.org/10.3390/brainsci14010015 - 23 Dec 2023
Cited by 2 | Viewed by 2176
Abstract
Direction-changing positional nystagmus (DCPN), which refers to the change in the direction of nystagmus with different head positions, is a well-known characteristic of horizontal semicircular canal BPPV. The supine head roll test is commonly used to diagnose horizontal canal BPPV. However, persistent geotropic [...] Read more.
Direction-changing positional nystagmus (DCPN), which refers to the change in the direction of nystagmus with different head positions, is a well-known characteristic of horizontal semicircular canal BPPV. The supine head roll test is commonly used to diagnose horizontal canal BPPV. However, persistent geotropic DCPN observed during this test cannot be explained by the conventional explanations of canalolithiasis or cupulolithiasis. To account for this unique nystagmus, the concept of a “light cupula” has been recently introduced. In this review, we provide an overview of the historical background, clinical features and diagnostic methods, proposed mechanisms, and treatment strategies associated with the light cupula phenomenon based on the available literature to date. Full article
(This article belongs to the Special Issue Vertigo and Dizziness: Central Vestibular Disorders)
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