Vestibular Physiology Research Articles

The pioneers of vestibular physiology in the 19th century.

The pioneers of vestibular physiology in the 19th century.

Innovative approaches for managing patients with chronic vestibular disorders: follow-up indicators and predictive markers for studying the vestibular error signal.

Despite significant advancements in understanding the biochemical, anatomical, and functional impacts of vestibular lesions, developing standardized and effective rehabilitation strategies for patients unresponsive to conventional therapies remains a challenge. Chronic vestibular disorders, characterized by permanent or recurrent imbalances and blurred vision or oscillopsia, present significant complexity in non-pharmacological management. The complex interaction between peripheral vestibular damage and its impact on the central nervous system (CNS) raises questions about neuroplasticity and vestibular compensation capacity. Although fundamental research has examined the consequences of lesions on the vestibular system, the effect of a chronic peripheral vestibular error signal (VES) on the CNS remains underexplored. The VES refers to the discrepancy between sensory expectations and perceptions of the vestibular system has been clarified through recent engineering studies. This deeper understanding of VES is crucial not only for vestibular physiology and pathology but also for designing effective measures and methods of vestibular rehabilitation, shedding light on the importance of compensation mechanisms and sensory integration. This retrospective study, targeting patients with chronic unilateral peripheral vestibulopathy unresponsive to standard treatments, sought to exclude any interference from pre-existing conditions. Participants were evaluated before and after a integrative vestibular exploratory and rehabilitation program through questionnaires, posturographic tests, and videonystagmography. The results indicate significant improvements in postural stability and quality of life, demonstrating positive modulation of the CNS and an improvement of vestibular compensation. Successful vestibular rehabilitation likely requires a multifaceted approach that incorporates the latest insights into neuroplasticity and sensory integration, tailored to the specific needs and clinical progression of each patient. Focusing on compensating for the VES and enhancing sensory-perceptual-motor integration, this approach aims not just to tailor interventions but also to reinforce coherence among the vestibular, visual, and neurological systems, thereby improving the quality of life for individuals with chronic vestibular disorders.

Evaluation and assessment of roles of neurootological examinations, vestibular tests, and videonystagmography in patients with dizziness

BackgroundVertigo and dizziness are frequent clinical symptoms. Peripheral vertigo and central vertigo are two different types of vertigo that result from a disrupted vestibular system. Imbalance and dizziness are frequent initial complaints. It is common for improper diagnosis and subpar treatment to result from a lack of a systematic approach to the examination and laboratory evaluation of the vestibular system. A correct diagnosis can be made with a fundamental knowledge of vestibular physiology and the right examination methods.ObjectivesThe current study was done to evaluate and assess the roles of neuro-otological examinations, vestibular tests, and videonystagmography among patients with dizziness visiting a tertiary care centre.MethodologyAn analytical cross-sectional study was conducted among patients complaining of vertigo at a tertiary care centre for the duration of 18 months. A total of 64 patients were included according to inclusion and exclusion criteria. Various diagnostic tests were applied and correlated with the complaints of the patients.ResultForty-two percent of patients with dizziness had hearing loss, and 26.5% had tinnitus. 57.8% had the PTA test within the normal limit, and the head shake test (videonystagmography) was positive among 39.1%. Caloric test abnormality was seen in 53.1% of patients with dizziness. Neuro-otological examination of the head shake test was found positive in 29.7% of cases. 79.7% of cases show a positive Fukuda test. SP > AP is seen among 9.4% of cases in EchoG. 67.1% show a positive Romberg test. The Dix-Hallpike test was positive among 31.2% of dizziness patients.ConclusionIn conclusion, history and neuro-otological testing can aid in the diagnosis of vertigo, but they cannot be relied on if the vertigo is complex. Only symptomatic history and neuro-otological tests are helpful in cases like a simple unilateral posterior canal BPPV, but in a complex case with tinnitus, aural fullness, Romberg positivity, or Fukuda positivity, we need the assistance of additional investigations such as vestibular tests such as ECochG and VNG.

Implementation and effects of low stakes quiz feedback on exam performance in a health professional program

Introduction: The inclusion of interactive learning approaches in graduate education including mobile polling, game-based learning, physiology apps, eLearning activities and tablet use to supplement course content is an established means to improve student engagement. Strategies that continue to support learning asynchronously with the purpose of driving deeper critical thinking and reasoning has the potential to further advance course outcomes. The purpose of this investigation was to assess whether the incorporation of detailed asynchronous feedback to low stakes quizzes as an additional learning tool translates into improved exam performance in the Foundational Sciences. Methods: ExamSoft assessment data was collected across 2 semesters from 101 Doctor of Physical Therapy students enrolled in a Foundational Sciences course series encompassing cardiopulmonary, pediatrics and neuro blocked content. Exam performance was compared between 2 cohorts (non-feedback, n=53 and feedback group, n=48) following the implementation of detailed question feedback on low stakes semester quizzes with the second cohort. Exam performance on specific subject areas was also reviewed for select exam questions that directly aligned with quiz questions. Results: Independent samples t-test analyses indicated that learners in the feedback group demonstrated consistently improved exam performance for midterm (p < 0.001 for summer midterm and p < 0.01 for fall midterm) and final exams (p < 0.01 for both summer and fall final exams) across the 2 semesters when compared to the non-feedback group. Similar results were observed when specific exam questions were reviewed across physiology content areas. Vestibular physiology exam performance was significantly (p = 0.05) improved in the feedback group, while basal ganglia physiology showed a trend but was not significant. Pharmacology exam performance was significantly improved for the fall final exam (p < 0.001), but not for the fall midterm. Conclusions: Instructor tailored quiz question feedback, which requires student review to view the correct answer choice is an additional learning opportunity that results in improved course outcomes. This approach to providing feedback to low stakes assessments focuses the in-class time on new material because the quiz feedback can be reviewed asynchronously as needed by the learner. Using the learning management system quiz feedback feature provides a valuable strategy to further support learning outside of the classroom and provides an opportunity for students to synthesize and apply content at a deeper level. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Vestibular physiology and function in zebrafish.

The vestibular system of the inner ear provides information about head motion and spatial orientation relative to gravity to ensure gaze stability, balance, and postural control. Zebrafish, like humans, have five sensory patches per ear that serve as peripheral vestibular organs, with the addition of the lagena and macula neglecta. The zebrafish inner ear can be easily studied due to its accessible location, the transparent tissue of larval fish, and the early development of vestibular behaviors. Thus, zebrafish are an excellent model for studying the development, physiology, and function of the vestibular system. Recent work has made great strides to elucidate vestibular neural circuitry in fish, tracing sensory transmission from receptors in the periphery to central computational circuits driving vestibular reflexes. Here we highlight recent work that illuminates the functional organization of vestibular sensory epithelia, innervating first-order afferent neurons, and second-order neuronal targets in the hindbrain. Using a combination of genetic, anatomical, electrophysiological, and optical techniques, these studies have probed the roles of vestibular sensory signals in fish gaze, postural, and swimming behaviors. We discuss remaining questions in vestibular development and organization that are tractable in the zebrafish model.

Noise-induced Vestibular Dysfunction

Noise pollution is an ever-increasing menace and affects the general and the mental well-being. The auditory effects of noise are well documented. However, noise induced vestibular dysfunction has received little attention and is an unexplored and an under-diagnosed entity. We review the effects of noise on the balance function. Various studies have shown the detrimental effects of noise on the vestibular end organs. Such changes may take place by various mechanisms and that noise induced vestibular dysfunction may occur in the absence of hearing loss. The long-term effects of noise on the vestibular physiology are not known and is an area for further research particularly in the setting of occupational noise exposure. It is imperative to understand the response of the vestibular system to noise at the molecular levels so that therapeutic measures can be adopted. At the same time, it is important to identify vestibular dysfunction at an early stage clinically so that further exposure can be prevented and permanent damage is averted.

Investigation of the Relationship between Vestibular Disorders and Sleep Disturbance.

Introduction Vestibular pathologies cause physical and psychological symptoms, as well as cognitive problems. Objective To evaluate the deterioration in sleep quality associated with vestibular pathologies. Methods The Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), the Pittsburgh Sleep Quality Index (PSQI), and the Limits of Stability test (LOS) were applied to the participants. Results We included 25 patients with Meniere's disease (MD), 22 patients with benign paroxysmal positional vertigo (BPPV), 21 patients with unilateral peripheral vestibular loss (UPVL), 23 patients with vestibular migraine (VM), and 43 controls. The total PSQI scores of the controls were better than those of the MD ( p = 0.014), VM ( p < 0.001), BPPV ( p = 0.003), and UPVL ( p = 0.001) groups. The proportion of poor sleepers in the MD ( p = 0.005), BPPV ( p = 0.018), and UPVL ( p < 0.001) groups was significantly higher than that of the controls. The highest total DHI score (45.68 ± 25.76) was found among the MD group, and it was significantly higher than the scores of the BPPV ( p = 0.007) and control ( p < 0.001) groups. The highest BDI score was obtained in the VM group, and it was significantly higher than the scores of the BPPV ( p = 0.046) and control ( p < 0.001) groups. Moreover, the BDI scores of the MD ( p = 0.001) and UPVL groups were also significantly worse than the score of the controls ( p = 0.001). Conclusion The present study showed thatpatients with vestibular symptoms have physical and functional complaints, as well as increased psychosocial stress and decreased sleep quality. Evaluating multiple parameters of quality of life may contribute to a better understanding of vestibular physiology and symptoms, and may help establish a more effective therapeutic approach.

Caloric stimulation of the labyrinth and some forgotten pioneers

Introduction Understanding the physiology of the caloric stimulation of the vestibular end organ was a seminal discovery in the history of neurotology. Robert Barany has been traditionally credited with this (1906). However, well before Barany, three scientists observed, qualified and quantified a similar phenomenon with different explanations. They were Charles Edouard Brown Sequard (1858), A Bornhardt (1876) and Benno Baginsky (1881). Materials and methods Articles with key words containing ‘caloric test’ and the ‘vestibular system’ were searched and studied from a historical perspective in scientific research repositories and journals on the history of medicine. Contemporaneous articles of the three scientists were analysed and inferences drawn. Results and discussion Charles Edouard Brown Sequard noticed the caloric effect on the ear causing giddiness in 1853, A Bornhardt observed nystagmus on application of ice cold water/hot iron rod to the semicircular canals in 1876 and Benno Baginsky in 1881 identified the correct pressure/temperature on the external/middle ear to elicit a caloric response. They also stumbled across key observations of vestibular physiology which were later confirmed in the 20th century. Conclusions This paper resurrects the works of these three forgotten pioneers and their contributions to our understanding of the physiology of the vestibular system.

Anatomy and Physiology of Vestibular System

A comprehensive understanding of vestibular anatomy and physiology is essential to interpreting and treating vestibular disorders. The otolithic organs and semicircular canals are the major components of the vestibular system. Each contains hair cells, mechanosensory cells responsible for converting mechanical signals produced by the body into electrical signals. Each hair cell produces a resting discharge rate. This rate can be increased or decreased as a result of head motion, with the magnitude of change dependent on the direction and strength of the motion. These signals are sent to the vestibulocochlear nerve which interprets and integrates the information with input from other sensory organs. The main role of the vestibular system is to maintain balance and detect angular and linear acceleration. Angular acceleration is detected by the semicircular canal via interpretation of endolymph flow caused by head movement. Linear acceleration is detected by the otolith organs through gravity-dependent otoconia movement. This article serves as a review for the structure and function of the major vestibular organs. This review contains, 9 figures, 1 table, and 8 references Keywords: Vestibular physiology, Hair cells, Otolith organs, Macule, Semicircular canals, Ampulla, Crista, Vestibulocochlear nerve, Angular acceleration, Linear acceleration

Characterizing the Access of Cholinergic Antagonists to Efferent Synapses in the Inner Ear

Stimulation of cholinergic efferent neurons innervating the inner ear has profound, well-characterized effects on vestibular and auditory physiology, after activating distinct ACh receptors (AChRs) on afferents and hair cells in peripheral endorgans. Efferent-mediated fast and slow excitation of vestibular afferents are mediated by α4β2*-containing nicotinic AChRs (nAChRs) and muscarinic AChRs (mAChRs), respectively. On the auditory side, efferent-mediated suppression of distortion product otoacoustic emissions (DPOAEs) is mediated by α9α10nAChRs. Previous characterization of these synaptic mechanisms utilized cholinergic drugs, that when systemically administered, also reach the CNS, which may limit their utility in probing efferent function without also considering central effects. Use of peripherally-acting cholinergic drugs with local application strategies may be useful, but this approach has remained relatively unexplored. Using multiple administration routes, we performed a combination of vestibular afferent and DPOAE recordings during efferent stimulation in mouse and turtle to determine whether charged mAChR or α9α10nAChR antagonists, with little CNS entry, can still engage efferent synaptic targets in the inner ear. The charged mAChR antagonists glycopyrrolate and methscopolamine blocked efferent-mediated slow excitation of mouse vestibular afferents following intraperitoneal, middle ear, or direct perilymphatic administration. Both mAChR antagonists were effective when delivered to the middle ear, contralateral to the side of afferent recordings, suggesting they gain vascular access after first entering the perilymphatic compartment. In contrast, charged α9α10nAChR antagonists blocked efferent-mediated suppression of DPOAEs only upon direct perilymphatic application, but failed to reach efferent synapses when systemically administered. These data show that efferent mechanisms are viable targets for further characterizing drug access in the inner ear.

Selective optogenetic stimulation of glutamatergic, but not GABAergic, vestibular nuclei neurons induces immediate and reversible postural imbalance in mice.

Glutamatergic and GABAergic neurons represent the neural components of the medial vestibular nuclei. We assessed the functional role of glutamatergic and GABAergic neuronal pathways arising from the vestibular nuclei (VN) in the maintenance of gait and balance by optogenetically stimulating the VN in VGluT2-cre and GAD2-cre mice. We demonstrate that glutamatergic, but not GABAergic VN neuronal subpopulation is responsible for immediate and strong posturo-locomotor deficits, comparable to unilateral vestibular deafferentation models. During optogenetic stimulation, the support surface dramatically increased in VNVGluT2+ mice, and rapidly fell back to baseline after stimulation, whilst it remained unchanged during similar stimulation of VNGAD2+ mice. This effect persisted when vestibular tactilo kinesthesic plantar inputs were removed. Posturo-locomotor alterations evoked in VNVGluT2+ animals were still present immediately after stimulation, while they disappeared 1 h later. Overall, these results indicate a fundamental role for VNVGluT2+ neurons in balance and posturo-locomotor functions, but not for VNGAD2+ neurons, in this specific context. This new optogenetic approach will be useful to characterize the role of the different VN neuronal populations involved in vestibular physiology and pathophysiology.

Dizziness

Dizziness is the quintessential symptom presentation in all of clinical medicine. It is a common reason that patients present to a physician. This chapter provides background information about the vestibular system, then reviews key aspects of history-taking and examination of the patient, then discusses specific disorders and common presentation types. Throughout the chapter the focus is on neurologic and vestibular disorders. Normal vestibular anatomy and physiology are discussed, followed by recommendations for history-taking and the physical examination. Specific disorders that cause dizziness are explored, along with common causes of non-specific dizziness. Common presentations are discussed, including acute severe dizziness, recurrent attacks, and recurrent positional vertigo. Finally, the chapter looks at laboratory investigations in diagnosis and management. Figures include population prevalence of dizziness symptoms, the anatomy of inner structures, primary afferent vestibular nerve activity, the head thrust test, the Dix-Hallpike maneuver, the supine positional test, the canalith repositioning procedure, and the barbecue roll maneuver. Tables list physiologic properties and clinical features of the components of the peripheral vestibular system, information to be acquired from history of the present illness, common symptoms patients report as dizziness, examination components, distinguishing among common peripheral and central vertigo syndromes, common causes of nonspecific dizziness, types of dizziness presentations, relevant imaging abnormalities on neuroimaging studies, vestibular testing components, and medical therapy for symptomatic dizziness. This review contains 8 highly rendered figures, 10 tables, and 68 references.

Dizziness

Dizziness is the quintessential symptom presentation in all of clinical medicine. It is a common reason that patients present to a physician. This chapter provides background information about the vestibular system, then reviews key aspects of history-taking and examination of the patient, then discusses specific disorders and common presentation types. Throughout the chapter the focus is on neurologic and vestibular disorders. Normal vestibular anatomy and physiology are discussed, followed by recommendations for history-taking and the physical examination. Specific disorders that cause dizziness are explored, along with common causes of non-specific dizziness. Common presentations are discussed, including acute severe dizziness, recurrent attacks, and recurrent positional vertigo. Finally, the chapter looks at laboratory investigations in diagnosis and management. Figures include population prevalence of dizziness symptoms, the anatomy of inner structures, primary afferent vestibular nerve activity, the head thrust test, the Dix-Hallpike maneuver, the supine positional test, the canalith repositioning procedure, and the barbecue roll maneuver. Tables list physiologic properties and clinical features of the components of the peripheral vestibular system, information to be acquired from history of the present illness, common symptoms patients report as dizziness, examination components, distinguishing among common peripheral and central vertigo syndromes, common causes of nonspecific dizziness, types of dizziness presentations, relevant imaging abnormalities on neuroimaging studies, vestibular testing components, and medical therapy for symptomatic dizziness. This review contains 8 highly rendered figures, 11 tables, and 69 references.

Dizziness

Dizziness is the quintessential symptom presentation in all of clinical medicine. It is a common reason that patients present to a physician. This chapter provides background information about the vestibular system, then reviews key aspects of history-taking and examination of the patient, then discusses specific disorders and common presentation types. Throughout the chapter the focus is on neurologic and vestibular disorders. Normal vestibular anatomy and physiology are discussed, followed by recommendations for history-taking and the physical examination. Specific disorders that cause dizziness are explored, along with common causes of non-specific dizziness. Common presentations are discussed, including acute severe dizziness, recurrent attacks, and recurrent positional vertigo. Finally, the chapter looks at laboratory investigations in diagnosis and management. Figures include population prevalence of dizziness symptoms, the anatomy of inner structures, primary afferent vestibular nerve activity, the head thrust test, the Dix-Hallpike maneuver, the supine positional test, the canalith repositioning procedure, and the barbecue roll maneuver. Tables list physiologic properties and clinical features of the components of the peripheral vestibular system, information to be acquired from history of the present illness, common symptoms patients report as dizziness, examination components, distinguishing among common peripheral and central vertigo syndromes, common causes of nonspecific dizziness, types of dizziness presentations, relevant imaging abnormalities on neuroimaging studies, vestibular testing components, and medical therapy for symptomatic dizziness. This review contains 8 highly rendered figures, 10 tables, and 68 references.

Dizziness

Dizziness is the quintessential symptom presentation in all of clinical medicine. It is a common reason that patients present to a physician. This chapter provides background information about the vestibular system, then reviews key aspects of history-taking and examination of the patient, then discusses specific disorders and common presentation types. Throughout the chapter the focus is on neurologic and vestibular disorders. Normal vestibular anatomy and physiology are discussed, followed by recommendations for history-taking and the physical examination. Specific disorders that cause dizziness are explored, along with common causes of non-specific dizziness. Common presentations are discussed, including acute severe dizziness, recurrent attacks, and recurrent positional vertigo. Finally, the chapter looks at laboratory investigations in diagnosis and management. Figures include population prevalence of dizziness symptoms, the anatomy of inner structures, primary afferent vestibular nerve activity, the head thrust test, the Dix-Hallpike maneuver, the supine positional test, the canalith repositioning procedure, and the barbecue roll maneuver. Tables list physiologic properties and clinical features of the components of the peripheral vestibular system, information to be acquired from history of the present illness, common symptoms patients report as dizziness, examination components, distinguishing among common peripheral and central vertigo syndromes, common causes of nonspecific dizziness, types of dizziness presentations, relevant imaging abnormalities on neuroimaging studies, vestibular testing components, and medical therapy for symptomatic dizziness. This review contains 8 highly rendered figures, 11 tables, and 69 references.

Dizziness

Dizziness is the quintessential symptom presentation in all of clinical medicine. It is a common reason that patients present to a physician. This chapter provides background information about the vestibular system, then reviews key aspects of history-taking and examination of the patient, then discusses specific disorders and common presentation types. Throughout the chapter the focus is on neurologic and vestibular disorders. Normal vestibular anatomy and physiology are discussed, followed by recommendations for history-taking and the physical examination. Specific disorders that cause dizziness are explored, along with common causes of non-specific dizziness. Common presentations are discussed, including acute severe dizziness, recurrent attacks, and recurrent positional vertigo. Finally, the chapter looks at laboratory investigations in diagnosis and management. Figures include population prevalence of dizziness symptoms, the anatomy of inner structures, primary afferent vestibular nerve activity, the head thrust test, the Dix-Hallpike maneuver, the supine positional test, the canalith repositioning procedure, and the barbecue roll maneuver. Tables list physiologic properties and clinical features of the components of the peripheral vestibular system, information to be acquired from history of the present illness, common symptoms patients report as dizziness, examination components, distinguishing among common peripheral and central vertigo syndromes, common causes of nonspecific dizziness, types of dizziness presentations, relevant imaging abnormalities on neuroimaging studies, vestibular testing components, and medical therapy for symptomatic dizziness. This review contains 8 highly rendered figures, 11 tables, and 69 references.

Alexander Crum Brown: A Forgotten Pioneer in Vestibular Sciences.

Although vestibular anatomy was described in the Renaissance period, research in vestibular physiology began in the 1820s and was spearheaded by Purkinje and Flourens. This was subsequently expanded by Ménière, Helmholtz, Goltz, Mach, Breuer, Ewald, and Hogyes, who are regarded as the early pioneers in research on vestibular physiology in the 19th century. The relationship of endolymphatic flow and semicircular canal function is termed the Mach-Breuer hypothesis. What is less well known is that a Scottish chemist, Alexander Crum Brown, arrived at similar conclusions as Mach and Breuer at the same time quite independently. In fact, he pioneered several concepts in vestibular physiology that included pairing of semicircular canals for function, the vestibular pathway, optic fixation elimination in vestibular experimentation, the theory of motion intolerance, and study in deaf mutes for insights into vestibular pathology and vestibular compensation. This article is a tribute to this forgotten pioneer in vestibular research.

Aging, Vestibular Function, and Balance: Proceedings of a National Institute on Aging/National Institute on Deafness and Other Communication Disorders Workshop.

Balance impairment and falls are among the most prevalent and morbid conditions affecting older adults. A critical contributor to balance and gait function is the vestibular system; however, there remain substantial knowledge gaps regarding age-related vestibular loss and its contribution to balance impairment and falls in older adults. Given these knowledge gaps, the National Institute on Aging and the National Institute on Deafness and Other Communication Disorders convened a multidisciplinary workshop in April 2019 that brought together experts from a wide array of disciplines, such as vestibular physiology, neuroscience, movement science, rehabilitation, and geriatrics. The goal of the workshop was to identify key knowledge gaps on vestibular function and balance control in older adults and develop a research agenda to make substantial advancements in the field. This article provides a report of the proceedings of this workshop. Three key questions emerged from the workshop, specifically: (i) How does aging impact vestibular function?; (ii) How do we know what is the contribution of age-related vestibular impairment to an older adult's balance problem?; and more broadly, (iii) Can we develop a nosology of balance impairments in older adults that can guide clinical practice? For each of these key questions, the current knowledge is reviewed, and the critical knowledge gaps and research strategies to address them are discussed. This document outlines an ambitious 5- to 10-year research agenda for increasing knowledge related to vestibular impairment and balance control in older adults, with the ultimate goal of linking this knowledge to more effective treatment.

Unilateral vestibular deafferentation impairs embodied spatial cognition.

A growing number of studies indicate that cognitive complaints are common in patients with peripheral vestibular disorders. A better understanding of how vestibular disorders influence cognition in these patients requires a clear delineation of the cognitive domains affected by vestibular disorders. Here, we compared the consequences of left and right vestibular neurectomy on third-person perspective taking-a visuo-spatial task requiring mainly own-body mental imagery, and on 3D objects mental rotation imagery-requiring object-based mental imagery, but no perspective taking. Patients tested 1week after a unilateral vestibular neurectomy and a group of age- and gender-matched healthy participants played a virtual ball-tossing game from their own first-person perspective (1PP) and from the perspective of a distant avatar (third-person perspective, 3PP). Results showed larger response times in the patients with respect to their controls for the 3PP taking task, but not for the 1PP task and the 3D objects mental imagery. In addition, we found that only patients with left vestibular neurectomy presented altered 3PP taking abilities when compared to their controls. This study suggests that unilateral vestibular loss affects mainly own-body mental transformation and that only left vestibular loss seems to impair this cognitive process. Our study also brings further evidence that vestibular signals contribute to the sensorimotor bases of social cognition and strengthens the connections between the so far distinct fields of social neuroscience and human vestibular physiology.

The risk of stroke in patients with dizziness

Primary prevention of cerebrovascular diseases is not realized, developed aspect of the program, such as dietary habits, blood pressure control, lipid concentrations, assessment of metabolic disorders - are not used as a single unit. The first step in the solving of this problem, the main recommendation of the Guide to the primary prevention of CVD which based on the fact that the risk of disease should be evaluated for all patients on the basis of a careful study of medical history, physical examination, and the results of certain lab tests. The determina-tion monitoring purposes of different risk factors with the obligatory account of individual risk factors - it is one of the advantages in identifying those who have a higher risk of developing cerebral accidents.Proved that to the high-risk group of stroke include the patients with vertigo (other neurologic symptoms), especially men of middle and old age. Furthermore, during the imaging of the brain in most patients with dizziness have been identified unexpressed signs of a lesion of the barrel or the cerebellum, which resemble the clinical manifestations of peripheral vestibular disorders. Recent studies have shown that the dizziness is often a basic of vestibular dysfunctions that lead to the development of acute cerebral ischemia. The importance of the influence of vestibular physiology, affective neuroscience and so-cial neuroscience require a correction of manifestations of dizziness, as a factor in the risk of stroke by Citoflavin drug has a pronounced antiischemic and antioxidant effect, significantly preventing the build-up of ischemic damage to brain tissue. Drug, including in biochemical power shunt, helps to prevent unwanted effects that are typical of ischemic tissue to stabilize the work of their own antioxidant systems.