Dizzy Patients Research Articles

Effect of Interventional Therapy Unexplained Dizziness and Relationship Between Dizziness Handicap Inventory and Right-to-Left Shunt Grading.

Unexplained dizziness remains a clinical challenge. Our previous studies have shown that unexplained dizziness may be related to patent foramen ovale (PFO). This study aims to explore whether the degree of shunt is correlated with the degree of unexplained dizziness and looking for the possible clinical intervention for patients with unexplained dizziness. This study was a large single-center, prospective, controlled study. From March 2019 to March 2022, patients with unexplained dizziness and explained dizziness and healthy controls were recruited. Contrast-enhanced transcranial Doppler sonography (c-TCD) was performed to detect the existence of right-to-left shunt (RLS) and shunt grading. The dizziness handicap inventory (DHI) was completed to evaluate the dizziness. Unexplained dizziness patients with large amount of PFO were volunteered to receive medication treatment and transcatheter PFO closure and followed up six months. A total of 387 patients (132 unexplained, 123 explained and 132 controls) were enrolled. There was a statistical difference in the RLS grading with three groups (p < 0.001). The Spearman correlation coefficient of RLS grading and DHI scores in unexplained dizziness patients (r=0.122, p=0.163) and explained dizziness patients (r=0.067, p=0.460). In the unexplained group, there were 49 cases with massive grading RLS. Of which 25 patients received percutaneous PFO closure treatment and 24 cases received medication treatment. Followed up six months after treatment, the amount of DHI scores change in patients who received the percutaneous PFO closure was significantly higher than that in the medication treatment group (p < 0.001). RLS may play an important role in unexplained dizziness. For unexplained dizziness patients, PFO closure may contribute to better outcomes. In the future, large-scale randomized controlled studies are still needed.

Clinical Findings in a Pati ent with Large B-Cell Lymphoma andNeuroniti s: A Case Study.

Given the multifaceted nature of the balance system, an interdisciplinary approach to patient care is imperative. For surgical patients with complex medical histories, comprehensive vestibular evaluations provide information on baseline vestibular function and identify possible surgical risks and outcomes. This case study follows a patient diagnosed with probable right vestibular neuronitis immediately preceding surgical resection of a left brainstem lesion, later diagnosed as a B cell lymphoma (BCL) and provides details regarding pre- and postsurgical outcomes. This case study expands on the importance of the inclusion of vestibular audiologists on the interdisciplinary team for related surgical procedures to provide insight into possible surgical risks and subsequent effects on patients' postsurgical quality of life. Case report. A 68-year-old female patient evaluated within the Henry Ford Health System for management of diffuse large BCL. Standard neuro-otology, neuro-surgical, audiological, and vestibular evaluations were conducted to evaluate the patient's complex symptomology. This case report outlines a patient hospitalized for a left brainstem mass, later diagnosed as an aggressive form of lymphoma, with a concurrent episode of vestibular neuronitis on the contralesional side. Functional outcomes are discussed following surgical intervention to remove the mass. Postsurgical vestibular testing revealed a bilateral vestibular hypofunction. Vestibular audiology plays an essential role in the multidisciplinary team for complex dizzy patients with related surgical procedures, as this subset of the field can offer critical insight into postsurgical recommendations and patient expectations.

“The Pupillary (Hippus) Nystagmus”: A Possible Clinical Hallmark to Support the Diagnosis of Vestibular Migraine

(1) Background: Hippus (which in this paper will be called "Pupillary nystagmus") is a well-known phenomenon which has never been related to any specific pathology, so much so that it can be considered physiological even in the normal subject, and is characterized by cycles of dilation and narrowing of the pupil under constant lighting conditions. The aim of this study is to verify the presence of pupillary nystagmus in a series of patients suffering from vestibular migraine. (2) Methods: 30 patients with dizziness suffering from vestibular migraine (VM), diagnosed according to the international criteria, were evaluated for the presence of pupillary nystagmus and compared with the results obtained in a group of 50 patients complaining of dizziness that was not migraine-related. (3) Results: Among the 30 VM patients, only two cases were found to be negative for pupillary nystagmus. Among the 50 non-migraineurs dizzy patients, three had pupillary nystagmus, while the remaining 47 did not. This resulted in a test sensitivity of 0.93% and a specificity of 0.94%. (4) Conclusion: we propose the consideration of the presence of pupillary nystagmus as an objective sign (present in the inter-critical phase) to be associated with the international diagnostic criteria for the diagnosis of vestibular migraine.

Evaluation of Types of Vertigo With Electronystagmography: An Experience From a Tertiary Care Hospital in West Bengal, India.

Background Electronystagmography (ENG) is a diagnostic test that measures the electrical activity of the muscles that control eye movements. ENG has the potential to identify the cause of vertigo by assessing the function of the vestibular system. Vertigo can be of two types - peripheral or central. In addition, a combination of peripheral and central types may coexist. Peripheral vertigo is caused by pathology in the inner ear and central vertigo is caused by pathology in the brainstem or cerebellum. Objective This study aimed to evaluate the applicability of ENG in assisting the diagnosis of the type of vertigo in a remote tertiary care center in West Bengal, India. Materials and methods This cross-sectional study was conducted in tertiary care hospital in West Bengal, India. Any patient presenting first time with a complaint of vertigo was approached and recruited for the study after taking written informed consent. We collected demographics and conducted a complete ear, nose, and throat examination, including otoscopy and audiological evaluation. A consensus between two expert otorhinolaryngologists was reached for the categorization of vertigo. Then, ENG was performed to assess the vestibular function to help aid the categorization. Magnetic resonance imaging (MRI) and computed tomography (CT) scans were done in central vertigo patients according to the necessity to diagnose the cause. Data were presented in descriptive statistical terms and categorical data were compared by Chi-square test. Result A total of 84 patients (male 31, female 53) with a median age of 25 years (Q1-Q3: 21-30.25) participated in the study. We found 75% of the patients were complaining of instability, 50% rotatory objective vertigo, 29.76% falling tendency, 22.62% blackout, and 2.38% sinking sensation. The majority of the patients (63%) had two or more symptoms. A total of 68 (80.95%) patients could be categorized into peripheral (46 [54.76%]) and central (22 [26.19%]) types. When we added ENG to the tests, we could categorize all the patients and found that 48 (57.14%) had peripheral, 27 (32.14%) had central, and nine (10.71%) had mixed lesions. Conclusion ENG when used in conjunction with clinical examination, otoscopy, and an audiological examination can help to categorize all patients into peripheral, central, or mixed lesion types of vertigo. Hence, ENG can be an important tool in identifying the type of vertigo and can aid in appropriate treatment decisions.

An evaluation of trace elements and oxidative stress in patients with benign paroxysmal positional vertigo.

Vertigo and Dizziness are a common complaint among the reasons for applying to the ear nose throat clinic. Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of perpheric vertigo. Oxidative stress is caused by the formation of hydroxyl radicals, superoxide anions and hydrogen peroxide, which are reactive oxygen derivatives (ROS). The aim of this study is to investigate the relationship between complaints and serum trace element and oxidative stress levels in patients with BPPV. This study was conducted with 66 adult patients who presented to the ENT policlinic with the complaint of vertigo and were diagnosed with BPPV between May 2020 and September 2020. Blood samples were taken from patients diagnosed with BPPV to measure serum Zn and Cu levels and oxidative stress levels during an attack. The mean ages of the study patients and healthy controls were 45.7 ± 15.1 and 44.7±13.2. Female / Male ratio were 28(42.5%)/38(57.5%) and 32(48.5%)/34(51.5%) in study and control group. We found serum Cu levels were lower in the patient group (p <0.05). Serum Total Thiol and Native Thiol values were lower in patients with BPPV. Total Thiol results were statistically significant.(p<0.05) Disulfide values were significantly higher in the disease group. (P <0.05). Thiol Oxidized / Thiol Reduced ratio (2243.6±6.7/343.8±125.3) was higher in control group. (p<0.05). Serum oxidative stress and trace elements play a role in the pathophysiology of BPPV. We present the cut-off values for Cu and Zn in vertigo patients for the first time in the literature. We think that these cut-off values of the trace elements and thiol/disulfide hemostasis can be used clinically by physicians in the etiology, diagnosis and treatment of vertigo.

Vestibular Disorders and Hormonal Dysregulations: State of the Art and Clinical Perspectives.

The interaction between endocrine and vestibular systems remains poorly documented so far, despite numerous observations in humans and animals revealing direct links between the two systems. For example, dizziness or vestibular instabilities often accompany the menstrual cycle and are highly associated with the pre-menopause period, while sex hormones, together with their specific receptors, are expressed at key places of the vestibular sensory network. Similarly, other hormones may be associated with vestibular disorders either as causal/inductive factors or as correlates of the pathology. This review was carried out according to the PRISMA method, covering the last two decades and using the MEDLINE and COCHRANE databases in order to identify studies associating the terms vestibular system and/or vestibular pathologies and hormones. Our literature search identified 646 articles, 67 of which referred directly to vestibular dysfunction associated with hormonal variations. While we noted specific hormonal profiles depending on the pathology considered, very few clinical studies attempted to establish a direct link between the expression of the vestibular syndrome and the level of circulating hormones. This review also proposes different approaches to shed new light on the link between hormones and vestibular disorders, and to improve both the diagnosis and the therapeutic management of dizzy patients.

Research Progress of Chinese and Western Medicine in the Pathogenesis and Treatment of Vertigo

In recent years, with the progress of society and the change of lifestyle, the incidence of vertigo is gradually increasing. However, the current understanding of the pathogenesis and treatment of vertigo is limited, which leads to poor clinical diagnosis and treatment effect. The author analyzed the pathogenesis and treatment methods of vertigo from the perspectives of Western medicine and traditional Chinese medicine respectively, and summarized the related factors of vertigo, the research progress of traditional Chinese and western medicine treatment methods of vertigo, and the latest application research status of new ideas and new ideas for vertigo treatment. Based on the incidence types of vertigo, the overall concept and dialectical thinking of traditional Chinese medicine are put forward to guide the clinical treatment. The objective is to explore the advantages and disadvantages of Western medicine and traditional Chinese medicine in the treatment of vertigo, and integrate their advantages and disadvantages, in order to provide the best treatment plan for more vertigo patients, so as to improve the quality of life of patients.

Effects of saccade delay, side of deficit, and training on detection of catch-up saccades during head-impulse test in virtual-reality-enhanced mannequin

In this study, a training simulator for the examination of dizzy patients based on a virtual-reality-enhanced mannequin (VREM) was developed to evaluate the detection of catch-up saccades during head impulse test (HIT) and the effect of training in VREM. For novices (n = 35), 2 trials were conducted before and after a training session. Experts (n = 7) were submitted to an evaluation session. In each trial, a left or a right horizontal canal deficit with an overt catch-up saccade (delay between 110 and 320 ms) was randomly presented. Participants scored the difficulty in performing the maneuver, in recognizing the saccades, and the self-confidence in the diagnosis using a visual analogue scale (VAS). Saccade delay significantly influenced the performance. Training significantly improved the sensitivity in the residents (69.1% before to 97.9% after the training, p < 0.001, Fisher's exact test, n = 560 tests), surpassing experts’ performances (p < 0.001, versus 87% in experts, Fisher's exact test). The specificity also increased to the expert level (78% before to 95% after the training, and 95% in experts, p < 0.001, Fisher’s exact test). The VAS showed a decrease difficulty to execute the HIT, with an increase in the confidence after training. VREM improved the HIT execution performance and the confidence in novice practitioners.

Assessment of psychological parameters and cognitive parameters in peripheral vertigo patients

Background: Assessment of the psychological and cognitive functions will give an indication of the development of vertigo. However, to support this view, there is very less literature available. Aim and Objective: The present study assesses the psychological and cognitive parameters in patients with vertigo. Materials and Methods: Sixty cases of vertigo within the 50 and 70 years and 60 age-matched non-controls were part of the study. A spatial and verbal memory test was administered to assess cognitive functions. DASS 42 was used to assess the psychological parameters. Results: Negative psychological emotions are significantly higher in vertigo patients. Spatial memory was significantly lower in the cases. Verbal memory was significantly lower in the cases. Conclusion: The study results suggest that there were higher levels of depression, anxiety, and stress and significantly lower levels of cognitive functions in the patients with vertigo when compared with healthy controls. The study suggests considering the psychological and cognitive parameters in diagnosing and managing vertigo.

Transition Rates from Benign Paroxysmal Positional Vertigo to Persistent Postural-Perceptual Dizziness

AbstractPersistent postural-perceptual dizziness (PPPD) is a chronic dizziness disorder that is newly listed in the World Health Organization (WHO)'s International Classification of Diseases (ICD-11) revised in 2018. In this study, I selected definite cases of the first occurrence of benign paroxysmal positional vertigo (BPPV) among vertigo patients who visited our clinic in the past 1 year, and retrospectively reviewed the age at the first visit, gender, affected side, previous medical conditions, type of BPPV, and their tendency toward transition to PPPD. Eligible patients were new first-ever cases of BPPV who visited our clinic during the 1-year period from June 1, 2020, to May 31, 2021, and who met the diagnostic criteria for BPPV established by the Japan Society for Equilibrium Research. There were 311 cases, including 120 men and 191 women, with a male:female ratio of 1:1.6; hence, the majority of patients were women. The mean age ± standard deviation was 60.7 ± 17.8 years. Men ranged in age from 14 to 88 years, with a mean age of 64.2 ± 16.3 years. Women ranged in age from 11 to 90 years, with a mean age of 58.5 ± 18.5 years. Thus, the average age of the men was higher. As for the type of BPPV, there were 172 cases of posterior semicircular canal-type BPPV (canalolithiasis), 79 cases of lateral semicircular canal-type BPPV (canalolithiasis), and 60 cases of lateral semicircular canal-type BPPV (cupulolithiasis), with the posterior semicircular canal-type BPPV (canalolithiasis) being the most common. In regard to the affected side, the right side was affected in 164 cases and the left side in 147 cases; thus, involvement of the right side was more common. The time to remission was less than 0.5 months in 86 cases, less than 1 month in 69 cases, less than 2 months in 50 cases, less than 3 months in 22 cases, and more than 3 months in 57 cases. Remission was achieved in less than 3 months in 72.9% of cases. The course remained unknown in 27 cases, as the patients discontinued their clinic visits. There was only one case of a 75-year-old man and one case of a 70-year-old woman who transitioned to PPPD. Both cases had left-sided posterior semicircular canal-type BPPV (canalolithiasis). The man had underlying hypertension, while the woman had underlying hypertension and diabetes mellitus. The rate of transition from BPPV to PPPD was 0.6% when cases with an unknown course were included, and the rate was as low as 0.7% when cases with an unknown course were excluded. Thus, the frequency of transition from BPPV to PPPD is low.

Dizziness in a tertiary neurological department: A cross-sectional study.

Dizziness is a common and challenging symptom, which can be caused by different pathophysiological mechanisms and might affect a large number of population. However, up to now, there have been limited research on the characteristics of dizziness as the chief complaint in hospitalized patients in the Department of Neurology. Thus, the aim of this study was to investigate the hospitalized patients with dizziness as their chief complaint in the Department of Neurology. In this cross-sectional study, we conducted a retrospective document analysis of hospitalized patients admitted to a tertiary neurological department with the symptom of dizziness during the period of September 2019 to December 2020. We included 211 patients with dizziness as their chief complaint from 1841 patients admitted to this tertiary neurological department during that period. Of all 1841 hospitalized patients, those with dizziness as the chief complaint accounted for 11.5% and most of their past medical history included hypertension, diabetes, cerebrovascular diseases, dyslipidemia, and coronary heart disease. Among these 211 patients, dizziness was more common in women than in men (p = .004). More patients presented with vertigo (40.8%) and light-headedness (39.8%) than disequilibrium (17.1%) and pre-syncope (2.4%). Nausea (48.3%), vomiting (34.1%), headache (13.3%), walking unsteadily (13.3%), and ear symptoms (12.8%) were the most common concomitant symptoms. Dix-Hallpike test (24.6%) and Romberg's sign (11.4%) were positive in these dizzy patients. Nystagmus (2.4%), vision changes (1.4%), and hearing disorders (8.5%) were relatively rare symptoms. Common auxiliary examinations were performed, such as magnetic resonance imaging (60.2%), computed tomography (31.8%), carotid duplex ultrasound (30.8%), and echocardiography (28.0%). Benign paroxysmal positional vertigo (24.2%) and stroke/transient ischemic attack (19.0%) were confirmed to be common causes of dizziness. Note that 97.2% of dizzy patients were in improved recovery after treatment. The diagnosis and management of dizziness remain a challenge for clinicians. Vertigo and light-headedness were the most common symptoms among different types of dizziness. Benign paroxysmal positional vertigo and stroke/transient ischemic attack were among the leading causes for common dizziness disorders. The prognosis of most dizzy patients was good.

Dizziness Among Population in a Tertiary care Centre in Maduranthagam.

Dizziness is a common chief complaint and there is a broad variety of possible underlying diseases for dizziness. Physicians must distinguish the majority of patients with self-limiting conditions from those with serious illnesses that require acute treatment. Diagnosis can be a challenge sometimes due to lack of dedicated vestibular lab and injudicious use of vestibular suppressant medications. In total of 100 cases were taken into study in which the most common was found to be benign paroxysmal positional vertigo and the most serious was cerebellar infarct and space occupying lesion. Complete evaluation of the patient should be done to arrive at a diagnosis. Therefore, a modification in the assessment methods of the dizzy patients with emphasis on history and clinical presentation seems essential.

Difference of Cervical Vestibular Evoked Myogenic Potentials between Bone-Conduction and Air-Conduction in Patients with Nonspecific Dizziness

Objectives: This study was performed to evaluate the difference of the cervical vestibular evoked myogenic potentials (cVEMP) stimulated by bone-conduction (BC) and air-conduction (AC) in patients with nonspecific dizziness.Methods: Twenty-eight dizzy patients (56 ears) and 15 subjects (30 ears) as normal control was enrolled. Responses of BC- and AC-cVEMP were recorded sequentially in both groups. cVEMP parameters including latencies, inter-latencies intervals, amplitudes, and interaural amplitude asymmetry were analyzed and compared.Results: Among the patients with nonspecific dizziness, AC-cVEMP responses were clearly detected in all 56 ears while BC-cVEMP responses were detected in 32 ears (57.1%). Amplitudes of BC-cVEMP were significantly smaller than those of AC-cVEMP in all patients with BC-cVEMP response. There was no difference in latencies, inter-latencies intervals, and interaural amplitude asymmetry ratios between BC- and AC-cVEMP. There was no significant difference in BCand AC-cVEMP between the dizzy and control groups.Conclusions: BC-cVEMP is not clinically useful in comparison to AC-cVEMP for the evaluation of nonspecific dizziness. An effective stimulation tool for BC is necessary to provoke more reliable responses of BC-cVEMP.

Characteristics of vestibular migraine, probable vestibular migraine, and recurrent vertigo of childhood in caloric and video head impulse tests.

Vertigo is very common in children, but the specific diagnosis and characteristics are not clear. The main objective of this study was to analyze the characteristics of caloric test (CT) and video head impulse test (vHIT) in vestibular migraine of childhood (VMC), probable vestibular migraine of childhood (PVMC), and recurrent vertigo of childhood (RVC), which can provide a reference value for their clinical diagnosis. We selected VMC, PVMC and RVC patients under 18 years of age from the outpatient Department of Otolaryngology-Head and Neck Surgery between May 2021 and August 2022. All patients underwent vestibular function examinations, including eye movement recording CT and vHIT. CT results depended on whether both canal paresis and directional preponderance were under normal limits, and vHIT results depended on the gain values of vestibulo-ocular reflex. The results of both tests were analyzed according to the disease type. Among the 81 pediatric vertigo patients aged 5-17 years, 44 were females and 37 were males. According to the type of vertigo, 29 patients (25.80%) were diagnosed with VMC, 11 (13.58%) with PVMC, and 41 (50.62%) with RVC. The abnormal rates of the CT in VMC, PVMC, and RVC patients were 24.14%, 36.36%, and 17.07%, respectively. There was no significant difference in the abnormal rates among the three groups (P > 0.05). None of the patients showed abnormal vHIT results (all abnormal rates 0.00%). The abnormal CT rates were significantly higher than those of abnormal vHIT rates (P < 0.05). VMC, PVMC, and RVC are more likely to be diagnosed by symptoms, as neither CT nor vHIT are specific to any conditions. Due to different clinical presentations of vertigo in pediatric patients, it is critical to further clarify the diagnosis with medical history and clinical characteristics.

The diagnostic value of the ocular tilt reaction plus head tilt subjective visual vertical (±45°) in patients with acute central vascular vertigo.

To investigate the localization diagnostic value of the ocular tilt reaction (OTR) plus head tilt subjective visual vertical (SVV) in patients with acute central vascular vertigo (ACVV). We enrolled 40 patients with acute infarction, 20 with unilateral brainstem infarction (BI) and 20 with unilateral cerebellar infarction (CI). We also included 20 patients with unilateral peripheral vestibular disorders (UPVD) as the control group. The participants completed the OTR and SVV during head tilt (±45°) within 1 week of symptom onset. In patients with ACVV, including that caused by lateral medullary infarction (100%, 2/2), partial pontine infarction (21%, 3/14), and cerebellum infarction (35%, 7/20), we observed ipsiversive OTR, similar to that seen in UPVD patients (80.0%, 16/20). Some of the patients with medial medullary infarction (50%, 1/2), partial pons infarction (42%, 6/14), midbrain infarction (100%, 2/2), and partial cerebellum infarction (30.0%, 6/20) showed contraversive OTR. The skew deviation (SD) of the BI group with ACVV was significantly greater than that of the UPVD group (6.60 ± 2.70° vs. 1.80 ± 1.30°, Z = -2.50, P = 0.012), such that the mean SD of the patients with a pons infarction was 9.50° and that of patients with medulla infarction was 5.00°. In ACVV patients with no cerebellar damage, the area under the curve of the receiver operating characteristic curve corresponding to the use of SD to predict brainstem damage was 0.92 (95%CI: 0.73-1.00), with a sensitivity of 100% and a specificity of 80% when SD ≥ 3°. We found no statistical difference in SD between the UPVD and CI groups (1.33 ± 0.58° vs. 1.80 ± 1.30°, Z = -0.344, P = 0.73). Compared with the UPVD patients, the ACVV patients with a partial pons infarction (43%, 6/14, χ2 = 13.68, P = 0.002) or medulla infarction (25%, 1/4, χ2 = 4.94, P = 0.103) exhibited signs of the ipsiversive E-effect with the contraversive A-effect, while those with a partial medulla infarction (50%, 2/4), pons infarction (43%, 6/14), or cerebellar infarction (60%, 12/20) exhibited a pathological symmetrical increase in the E-effect. The evaluation of OTR plus head tilt SVV (±45°) in vertigo patients is helpful for identifying and diagnosing ACVV, especially when SD is ≥ 3° or the E-effect is symmetrically increased.

Posterior circulation stroke diagnosis in unselected group of acutely dizzy patients

BackgroundsDiagnostics of a posterior circulation ischemia (POCI) in patients with acute vertigo is a challenging task. Recently, the combination of HINTS (Head Impulse, Nystagmus and Test of Skew) exam and ABCD2 has been recommended to identify stroke in these patients. Until now, studies regarding HINTS have mostly been tested on preselected patient groups and their results are only partially applicable to real clinical practice. AimsTo compare the sensitivity and specificity of HINTS and ABCD2 and their combination in unselected acutely dizzy patients in the emergency department (ED) toward posterior circulation stroke detection. MethodsA prospective cross-sectional monocentric study in ED patients with acute onset of dizziness lasting less than 72 h. Their clinical characteristics, HINTS, vascular risk factors, ABCD2 scores and neuroimaging data were analyzed. Results140 patients were recruited. Acute stroke was identified by MRI in 39 patients. All patients had central pattern nystagmus, skew deviation or further focal neurological finding. The age (≥60) and arterial hypertension clearly distinguished stroke and non-stroke group (p < 0001). The sensitivity of HINTS, ABCD2 and their combination in the unselected group was high (82,1 - 97,4%), but specificity low. After removing patients with inconclusive diagnosis, including transitory ischemic attack, specificity was much higher and comparable to previously published results. ConclusionsThe sensitivity and specificity of HINTS in previously published studies may vary because of their selection criteria. Even though, our study was performed on the unselected patient cohort, combination of HINTS and ABCD2 remained highly sensitive in detecting POCI and outperformed each of these tests alone.

Pharmacological Properties of Jaeumgeonbi-Tang on Redox System and Stress-Related Hormones in Chronic Subjective Dizziness: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial.

Jaeumgeonbi-Tang (JGT), a traditional herbal medicine, has been used to treat dizziness and vertigo in Korea and China for hundreds of years. The purpose of this study was to evaluate the pharmacological properties of JGT in chronic subjective dizziness (CSD) patients. A randomized, double-blind, parallel-group and placebo-controlled trial was performed with a total of 50 CSD patients. The patients were randomly assigned to one of two groups: JGT or placebo (n = 25 for each). All participants received the treatment (placebo or JGT, 24 g/day) for 4 weeks. We analyzed the serum levels of oxidative stressors, antioxidants, and stress hormones. Serum levels of lipid peroxidation, but not nitric oxide, were significantly decreased in the JGT group. JGT not only prevented the decline of serum total glutathione contents and total antioxidant capacity, but it also increased superoxide dismutase and catalase activities. Serum levels of stress hormones including cortisol, adrenaline, and serotonin were notably normalized by JGT treatment, but noradrenaline levels were not affected. Regarding the safety and tolerability of JGT, we found no allergic, adverse, or side effects in any of the participants. JGT showed beneficial effects on CSD patients by improving redox status and balancing psycho-emotional stress hormones.

The value of circulating lymphocytic subpopulations in the diagnosis and repair of ischemic stroke patients with dizziness.

To determine whether dizziness can contribute to stroke as a main cause still remains challenging. This study aims to explore clinical biomarkers in the identification of ischemic stroke patients from people with dizziness and the prediction of their long-term recovery. From January 2018 to June 2019, 21 ischemic stroke patients with a main complaint of dizziness, 84 non-stroke dizziness patients and 87 healthy volunteers were recruited in this study. Then, their peripheral blood samples were collected, and the percentages of circulating lymphocytes T cells, CD4+ T cells, CD8+ T cells, T-/- cells (DNTs), CD4+ regulatory T cells (Tregs), CD8+ Tregs, B cells and regulatory B cells (Bregs) were examined to identify biomarkers with clinical value. According to our data, a significant difference in the DNTs proportion was detected between non-stroke dizziness and ischemic stroke patients with dizziness (p = 0.0009). The Bregs proportion in ischemic stroke patients with dizziness was lower than that in non-stroke dizziness patients (p = 0.035). In addition, the percentage of Bregs and DNTs within lymphocytes in patients' peripheral blood exhibited a significant negative correlation with stroke occurrence (Bregs, p = 0.039; DNTs, p = 0.046). Moreover, the Bregs and DNTs within lymphocytes were negatively related to participants' age, while presented a weak relationship with clinical risks like smoking, hypertension, and diabetes. Then, area under the receiver operating characteristic curve (AUC) of Bregs and DNTs together was 0.768, the risk factors and Bregs or DNTs ranged from 0.795 and 0.792, respectively, and the AUC value of risk factors, Bregs and DNTs combination was further increased to 0.815. Furthermore, the Bregs percentage within lymphocytes at admission was also a potential predictor of repair at discharge and the following 3 months. Bregs and DNTs could be the clinical biomarkers together in the identification of ischemic stroke patients from people with dizziness.

The integrated optokinetic nystagmus inter-saccadic interval scales statistical different in a group of vertigo patients depended on the stimulation velocity, but not for healthy subjects

The integrated optokinetic nystagmus inter-saccadic interval scales statistical different in a group of vertigo patients depended on the stimulation velocity, but not for healthy subjects

The integrated optokinetic nystagmus inter-saccadic interval scales statistical different in a group of vertigo patients depended on the stimulation velocity, but not for healthy subjects

Optokinetic nystagmus is rhythmic eye movements, back and forth, with a slow and fast phase, when the eyes are presented for full-field visual stimulus. OKN was recorded in 10 healthy subjects and 10 patients suffering from vertigo, for four conditions: stripes moving 30 o/s left and right and 60 o/s left and right. The aim of the present study was to analyze if the optokinetic stimulation intensity, stripes moving with angular velocity of 30 and 60 o/s, below and above the normal threshold for smooth pursuit function, influences the scaling properties of the integrated optokinetic nystagmus inter-saccadic intervals in a group of patients suffering from vertigo and a group of healthy subjects. Calculating the scaling, the spread over time, for the integrated optokinetic nystagmus inter-saccadic intervals, the time intervals between the onsets of consecutive fast components, shows lower Hurst exponent for velocity stimulation of 30o/s compared to 60o/s for both patients and health subjects, but only reach statistical significance for the group of patients. This result is a novel finding.