The human vestibulo-ocular reflex and compensatory saccades in schwannoma patients before and after vestibular nerve section.

Autor: Pogson JM; Sydney Medical School, The University of Sydney, Sydney, Australia; Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia; Otolaryngology, Head, Neck and Skull Base Surgery Department, St Vincent's Hospital, Sydney, Australia., Taylor RL; Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia; Department of Physiology, University of Auckland, Auckland, New Zealand., Bradshaw AP; Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia., McGarvie L; School of Psychology, The University of Sydney, Sydney, Australia; Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia., D'Souza M; Sydney Medical School, The University of Sydney, Sydney, Australia; Clinical Research Centre, Royal Prince Alfred Hospital, Sydney, Australia., Flanagan S; Otolaryngology, Head, Neck and Skull Base Surgery Department, St Vincent's Hospital, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia., Kong J; Neurosurgery Department, Royal Prince Alfred Hospital, Sydney, Australia; Otolaryngology Head and Neck Surgery Department, Royal Prince Alfred Hospital, Sydney, Australia., Biggs N; Otolaryngology, Head, Neck and Skull Base Surgery Department, St Vincent's Hospital, Sydney, Australia., Shivalingam B; Otolaryngology Head and Neck Surgery Department, Royal Prince Alfred Hospital, Sydney, Australia., Greenberg S; Ear Nose and Throat Department, St George Private Hospital, Sydney, Australia., Croxson G; Otolaryngology Head and Neck Surgery Department, Royal Prince Alfred Hospital, Sydney, Australia., Halmagyi GM; Sydney Medical School, The University of Sydney, Sydney, Australia; Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia., Welgampola MS; Sydney Medical School, The University of Sydney, Sydney, Australia; Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia. Electronic address: miriam@icn.usyd.edu.au.
Jazyk: angličtina
Zdroj: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2022 Jun; Vol. 138, pp. 197-213. Date of Electronic Publication: 2022 Mar 01.
DOI: 10.1016/j.clinph.2022.02.014
Abstrakt: Objective: To examine the vestibulo-ocular reflex (VOR) and compensatory-saccades before and after complete unilateral vestibular deafferentation (UVD).
Methods: Forty patients were studied before and after surgery for vestibular or facial schwannoma using the video head-impulse test (vHIT) and multivariable regression.
Results: Prior to UVD (median(IQR), 14(58.4) days), the average VOR-gain towards the lesioned-ear was lower than in normal for all semicircular canals (lateral, anterior, posterior: 0.69, 0.72, 0.49). One-week after UVD (5(3.0) days) VOR gains were further reduced (0.22, 0.37, 0.27), however, within one-year after UVD (171(125.0) days) the lesioned-ear VOR gains had slightly increased (+0.08, +0.11, +0.03), maximally for the anterior-canal. After UVD, the VOR gain asymmetry (gain towards minus away from intact-ear) was lower for the intact posterior-canal plane (0.56, 0.56, 0.22). For the lesioned canals, the frequency and amplitude of the first compensatory-saccade increased from 61-93% and 1.9-3.6° pre-surgery, to 98-99% and to 3.1-5.9° one-week post-surgery and remained unchanged over one-year; second saccade frequency and amplitude decreased over the same timespan.
Conclusions: After UVD the high-acceleration VOR for the intact posterior-canal plane is more symmetrical than the other canals. First compensatory-saccades adapt within one week and subsequently change only marginally.
Significance: Saccade compensation from surgical UVD is near complete by one-week.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022. Published by Elsevier B.V.)
Databáze: MEDLINE
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