[Research Grant] Mechanisms Determining Chronic Vestibular Symptoms
Ente: Medical Research Council
Scadenza: 2012-07-30
Paese: GB
Descrizione
Dizziness and balance disorders are extremely common medical problems. Patients with dizziness are seen by GPs, neurologists, ear specialists, cardiologists and old age physicians. This is so because dizziness can come from the brain, the ear or the heart and it is more common in the elderly. An extremely common from of sudden onset (acute) dizziness is a condition called vestibular neuritis or labyrinthitis, a viral infection of the inner ear. Although initially freightening at least half of the patients recover within weeks. However, the other half go on to develop various degrees of long term (chronic) dizzy symptoms, with considerable impact for the sufferer, his/her family and the economy (working days lost). The main thrust of our research proposals deals with this question: what are the reasons why some patients with vestibular neuritis do well but others don’t? Can we identify different causes interfering with the recovery? Specifically, we are probing the hypothesis that processing of balance relevant signals by the cerebral cortex may be faulty in these chronic patients. We are confident that understanding of such brain processes in dizzy patients will allow us to set up the basis for rational rehabilitation programs and/or preventive measures.
Patients with diseases of the labyrinth often fail to compensate for the disordered vestibular function and develop chronic symptoms of dizziness, including vertigo, incoordination and nausea, which are provoked particularly in busy environments. These patients are a considerable draw on medical resources as a consequence of their intractability to existing therapies and social costs are also high - 41% of dizzy patients report occupational difficulties and 21% cannot work because of dizziness (Yardley 1998). Although there is some adaptation of reflex vestibular-ocular and spinal functions following labyrinthine lesions, these reflex functions only correlate with dizziness symptoms in the acute stage of vestibular disease and not with chronic symptoms. This suggests the hypothesis that chronically dizzy patients have problems with relearning perceptuo-motor control of spatial functions - using appropriate combinations of other bodily senses and vision to guide balance and orientation. Chronically dizzy patents have not made these compensations adequately because of failures in plasticity of perceptuo-motor control. This hypothesis will be tested in experiments that address the three kinds of symptoms experienced by dizzy patients; comparing symptomatic with well compensated patients to identify how compensation fails. i) The causes of false perceptions of movement and orientation will be studied. Reflex vestibular functions will be compared with patients? ability to use proc
Settori: Dept of Medicine
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