Abstract
Objectives: In this study, based on the known vestibulo-hippocampal connections, we asked whether mild chronic vestibulopathy leads only to vestibular-related deficits or whether there are effects on hippocampal function, structure, and cognition in general. In more detail, we assessed whether chronic vestibulopathy leads to (a) deficits in vestibular tasks without cognitive demand (balancing), (b) deficits in spatial cognitive tasks that require vestibular input (path integration, rotational memory), (c) deficits in spatial cognitive tasks that do not rely on vestibular input, (d) deficits in general cognitive function, and (e) atrophy in the brain. Methods: A total of 15 patients with chronic uni- or bilateral vestibulopathy (56.8 ± 10.1 years; 4 females) were included in this study and were age- and gender-matched by the control participants (57.6 ± 10.5) in a pairwise manner. Given their clinical symptoms and their deficits of the vestibulo-ocular reflex (VOR) the patients could be classified as being mildly affected. All participants of the underwent the following tests: clinical balance (CBT), triangle completion (TCT) for path integration, rotational memory (RM), the visuo-spatial subset of the Berlin intelligence structure test (BIS-4) and d2-R for attention and concentration, and a structural MRI for gray matter analysis using voxel-based morphometry (VBM). Results: Compared to the healthy controls, the vestibulopathy patients performed significantly worse in terms of CBT, TCT, and RM but showed no differences in terms of the BIS-4 and d2-R. There were also no significant volumetric gray matter differences between the two groups. Conclusions: This study provides evidence that both non-cognitive and cognitive functions that rely on vestibular input (balancing, path integration, rotational memory) are impaired, even in mild chronic vestibulopathy, while other cognitive functions, which rely on visual input (visuo-spatial memory, attention), are unimpaired in this condition, together with an overall intact brain structure. These findings may reflect a segregation between vestibular- and visual-dependent processes in the medial temporal lobe on the one hand and a structure–function dissociation on the other.
Highlights
Peripheral vestibular disorders are common in the older population, with rates of around 7% in people who are above 70 years of age [1]
Chronic vestibulopathy—a chronic vestibular syndrome that is characterized by unsteadiness when walking or standing due to vestibular hypofunction [3]—may lead to far more additional effects
The patients performed significantly worse in the wheelchair condition for the triangle completion test (TCT) (Figure 5), demonstrating a decreased ability to return to the starting point, which was represented by a larger distance from the point where they ended up to the original starting point
Summary
(when assumptions not fulfilled) with the between-group factor group and Bonferroni or. As presented, the patients’ performance on the rotational chair was overall significantly worse than it was in the controls Their ability to detect rotational movements based on inputs from the vestibular system and to recall this movement immediately thereafter was decreased on conditions with one and two rotations. The patients performed significantly worse in the wheelchair (vestibular) condition for the triangle completion test (TCT) (Figure 5), demonstrating a decreased ability to return to the starting point, which was represented by a larger distance from the point where they ended up to the original starting point
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