Approximately 18 million people develop symptoms associated with inner ear (vestibular) disorders each year; a number that increases with age. It is estimated that more than 70% of individuals with vestibular loss will not have a resolution of symptoms after two weeks. Given the rate of growth of the elderly population in the United States, it is likely that the incidence and prevalence of the dizziness due to vestibular disorders will increase. One disabling symptom is the inability to see clearly during head motion (poor gaze stability), as when driving a car. For a majority of these individuals, vestibular rehabilitation remains the only treatment option. Unfortunately, vestibular rehabilitation strategies to improve gaze stability have not been adequately investigated. Persons with vestibular hypofunction use different strategies to improve their ability to see clearly during a head motion. The strategies employed are improved when the head motion can be predicted, as in self-generated head rotations. Although many studies have demonstrated the adaptive capacity of the vestibular system to passive head motion, self-generated head motion - which represents a more functional aspect of daily living and is congruent with the vestibular rehabilitation tactics provided by clinicians - has not been thoroughly investigated. In addition, studies of the auditory and optokinetic systems provide compelling evidence that neural plasticity is enhanced when the error signal driving adaptation is adjusted incrementally throughout training. Few studies, however, have investigated the effect of using an incrementally adjusted error signal for vestibulo-ocular reflex (VOR) adaptation in people with unilateral vestibular hypofunction (UVH). We hypothesize that the efficacy of vestibular rehabilitation can be enhanced by presenting an incrementally adjusted error signal during training. We will compare the rate and magnitude of VOR adaptation for self-generated head motion when using an incremental versus a sudden-task demand. The saccadic oculomotor system is also highly modifiable and has been shown to enhance a deficient VOR, yet it is unknown whether saccade adaptation is a useful means to assist gaze stability during head motion. We hypothesize and that the saccadic system can be modified to assist with gaze stability during head rotation and will investigate this in people with UVH. Finally, we will model the various error signals used in the VOR and saccade adaptation paradigms. This is important for the long-term goals of this project, which are to determine the adaptive preferences that individuals with vestibular loss use to improve gaze stability.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DC007926-02
Application #
7121606
Study Section
Communication Disorders Review Committee (CDRC)
Program Officer
Sklare, Dan
Project Start
2005-09-12
Project End
2009-08-31
Budget Start
2006-09-01
Budget End
2007-08-31
Support Year
2
Fiscal Year
2006
Total Cost
$134,448
Indirect Cost
Name
Johns Hopkins University
Department
Biomedical Engineering
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
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Janky, Kristen L; Zuniga, M Geraldine; Ward, Bryan et al. (2014) Canal plane dynamic visual acuity in superior canal dehiscence. Otol Neurotol 35:844-9
Janky, Kristen L; Zuniga, M Geraldine; Carey, John P et al. (2012) Balance dysfunction and recovery after surgery for superior canal dehiscence syndrome. Arch Otolaryngol Head Neck Surg 138:723-30
Scherer, Matthew R; Shelhamer, Mark J; Schubert, Michael C (2011) Characterizing high-velocity angular vestibulo-ocular reflex function in service members post-blast exposure. Exp Brain Res 208:399-410
Schubert, Michael C; Zee, David S (2010) Saccade and vestibular ocular motor adaptation. Restor Neurol Neurosci 28:9-18
Scherer, Matthew; Schubert, Michael C (2010) High-velocity angular vestibulo-ocular reflex adaptation to position error signals. J Neurol Phys Ther 34:82-6
Scherer, Matthew; Migliaccio, Americo A; Schubert, Michael C (2008) Effect of vestibular rehabilitation on passive dynamic visual acuity. J Vestib Res 18:147-57
Schubert, Michael C; Migliaccio, Americo A; Minor, Lloyd B et al. (2008) Retention of VOR gain following short-term VOR adaptation. Exp Brain Res 187:117-27
Schubert, Michael C; Della Santina, Charles C; Shelhamer, Mark (2008) Incremental angular vestibulo-ocular reflex adaptation to active head rotation. Exp Brain Res 191:435-46
Schubert, Michael C; Migliaccio, Americo A; Clendaniel, Richard A et al. (2008) Mechanism of dynamic visual acuity recovery with vestibular rehabilitation. Arch Phys Med Rehabil 89:500-7

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