scholarly journals Measuring optokinetic after-nystagmus: potential for detecting patients with signs of visual dependence following concussion

2020 ◽  
Author(s):  
Giovanni Bertolini ◽  
Fausto Romano ◽  
Dominik Straumann ◽  
Katharine Keller ◽  
Antonella Palla ◽  
...  
Keyword(s):  
Time Constant ◽  
Visual Cues ◽  
Clinical Signs ◽  
Area Under The Curve ◽  
Velocity Storage ◽  
Eye Position ◽  
Healthy Individuals ◽  
Storage Mechanism ◽  
Persistent Symptoms ◽  
Visual Dependence

AbstractConcussed patients with chronic symptoms commonly report dizziness during exposure to environments with complex visual stimuli (e.g. supermarket aisles, busy crossroads). Such visual induced dizziness is well-known in patients with vestibular deficits, in whom it indicates an overreliance on visual cues in sensory integration. Considering that optokinetic after-nystagmus (OKAN) reflects the response of the central network integrating visual and vestibular self-motion signals (velocity storage network), we investigated OKAN in 71 patients [17 (23.9%) females, 30.36 ± 9.05 years old] who suffered from persistent symptoms after a concussion and presented clinical signs suggesting visual dependence. Data were retrospectively compared with 21 healthy individuals [13 (61.9%) females, 26.29 ± 10.00 years old]. The median values of the slow cumulative eye position and of the time constant of OKAN were significantly higher in patients than in healthy individuals (slow cumulative eye position: 124.15 ± 55.61° in patients and 77.87 ± 45.63° in healthy individuals—p = 0.012; time constant: 25.17 ± 10.27 s in patients and 13.95 ± 4.92 s in healthy individuals—p = 0.003). The receiving operating curve (ROC) estimated on the time constant had an overall area under the curve of 0.73. Analysis of the ROC suggests that a test measuring the OKAN time constant could obtain a sensitivity of 0.73 and specificity of 0.72 in determining the origin of the visual-related disturbances in those patients (threshold 16.6 s). In a subset of 43 patients who also performed the Sensory Organization Test (SOT), the proposed OKAN test was twice as sensitive as the SOT. This study suggests that concussed patients with persisting visual symptoms may have an underlying impairment of the velocity storage mechanism and that measuring the OKAN time constant can objectify such impairment.

scholarly journals Self-motion perception is sensitized in vestibular migraine: pathophysiologic and clinical implications

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Susan King ◽  
Adrian J. Priesol ◽  
Shmuel E. Davidi ◽  
Daniel M. Merfeld ◽  
Farzad Ehtemam ◽  
...  
Keyword(s):  
Time Constant ◽  
Symptom Severity ◽  
Vestibular Nuclei ◽  
Vestibular Migraine ◽  
Velocity Storage ◽  
Otolith Organs ◽  
Storage Mechanism ◽  
Vestibulo Ocular Reflex ◽  
Headache Symptom ◽  
Self Motion

Abstract Vestibular migraine (VM) is the most common cause of spontaneous vertigo but remains poorly understood. We investigated the hypothesis that central vestibular pathways are sensitized in VM by measuring self-motion perceptual thresholds in patients and control subjects and by characterizing the vestibulo-ocular reflex (VOR) and vestibular and headache symptom severity. VM patients were abnormally sensitive to roll tilt, which co-modulates semicircular canal and otolith organ activity, but not to motions that activate the canals or otolith organs in isolation, implying sensitization of canal-otolith integration. When tilt thresholds were considered together with vestibular symptom severity or VOR dynamics, VM patients segregated into two clusters. Thresholds in one cluster correlated positively with symptoms and with the VOR time constant; thresholds in the second cluster were uniformly low and independent of symptoms and the time constant. The VM threshold abnormality showed a frequency-dependence that paralleled the brain stem velocity storage mechanism. These results support a pathogenic model where vestibular symptoms emanate from the vestibular nuclei, which are sensitized by migraine-related brainstem regions and simultaneously suppressed by inhibitory feedback from the cerebellar nodulus and uvula, the site of canal-otolith integration. This conceptual framework elucidates VM pathophysiology and could potentially facilitate its diagnosis and treatment.

scholarly journals Individual motion perception parameters and motion sickness frequency sensitivity in fore-aft motion

2021 ◽  
Author(s):  
Tugrul Irmak ◽  
Ksander N. de Winkel ◽  
Daan M. Pool ◽  
Heinrich H. Bülthoff ◽  
Riender Happee
Keyword(s):  
Motion Sickness ◽  
Motion Perception ◽  
Time Constant ◽  
Storage Time ◽  
Velocity Storage ◽  
Strong Positive Correlation ◽  
Subjective Vertical ◽  
Time Constants ◽  
Frequency Sensitivity ◽  
Observer Model

AbstractPrevious literature suggests a relationship between individual characteristics of motion perception and the peak frequency of motion sickness sensitivity. Here, we used well-established paradigms to relate motion perception and motion sickness on an individual level. We recruited 23 participants to complete a two-part experiment. In the first part, we determined individual velocity storage time constants from perceived rotation in response to Earth Vertical Axis Rotation (EVAR) and subjective vertical time constants from perceived tilt in response to centrifugation. The cross-over frequency for resolution of the gravito-inertial ambiguity was derived from our data using the Multi Sensory Observer Model (MSOM). In the second part of the experiment, we determined individual motion sickness frequency responses. Participants were exposed to 30-minute sinusoidal fore-aft motions at frequencies of 0.15, 0.2, 0.3, 0.4 and 0.5 Hz, with a peak amplitude of 2 m/s2 in five separate sessions, approximately 1 week apart. Sickness responses were recorded using both the MIsery SCale (MISC) with 30 s intervals, and the Motion Sickness Assessment Questionnaire (MSAQ) at the end of the motion exposure. The average velocity storage and subjective vertical time constants were 17.2 s (STD = 6.8 s) and 9.2 s (STD = 7.17 s). The average cross-over frequency was 0.21 Hz (STD = 0.10 Hz). At the group level, there was no significant effect of frequency on motion sickness. However, considerable individual variability was observed in frequency sensitivities, with some participants being particularly sensitive to the lowest frequencies, whereas others were most sensitive to intermediate or higher frequencies. The frequency of peak sensitivity did not correlate with the velocity storage time constant (r = 0.32, p = 0.26) or the subjective vertical time constant (r = − 0.37, p = 0.29). Our prediction of a significant correlation between cross-over frequency and frequency sensitivity was not confirmed (r = 0.26, p = 0.44). However, we did observe a strong positive correlation between the subjective vertical time constant and general motion sickness sensitivity (r = 0.74, p = 0.0006). We conclude that frequency sensitivity is best considered a property unique to the individual. This has important consequences for existing models of motion sickness, which were fitted to group averaged sensitivities. The correlation between the subjective vertical time constant and motion sickness sensitivity supports the importance of verticality perception during exposure to translational sickness stimuli.

Malondialdehyde Assay in the Evaluation of Aspirin Antiplatelet Effects

Pharmacology ◽  
2018 ◽  
Vol 103 (1-2) ◽  
pp. 23-29 ◽  
Author(s):  
Amin Polzin ◽  
Lisa Dannenberg ◽  
Theresa Schneider ◽  
Betül Knoop ◽  
David Naguib ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Operating Characteristic ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
Area Under The Curve ◽  
Healthy Individuals ◽  
Antibody Assay ◽  
Light Transmission Aggregometry ◽  
Artery Disease

Aspirin is essential in secondary prevention of patients after myocardial infarction and with coronary artery disease. However, impaired pharmacodynamic response to aspirin is frequent (high on-treatment platelet reactivity [HTPR]). This leads to an enhanced prevalence of cardiovascular events and to an impaired clinical outcome. The current specific assays to evaluate aspirin antiplatelet effects are complex, time-consuming and demand for a high laboratory expertise. Therefore, we developed a potentially bedside assay based on the determination of malondialdehyde (MDA). MDA is a by-product of the thromboxane (TX) formation, which is synthesized in equimolar concentrations. In this study, we compared this MDA assay to the conventional assays in determination of pharmacodynamic aspirin response. For this, aspirin antiplatelet effects were measured in 22 healthy individuals and 63 aspirin treated patients using TX B2 formation enzyme-linked antibody assay, arachidonic acid induced light transmission aggregometry (LTA) and the new fluorometric MDA assay. In patients, MDA levels correlated well with TX formation (R = 0.81; 95% CI 0.69–0.88; p < 0.001) and LTA (R = 0.84; CI 0.74–0.91; p < 0.001). Receiver operating characteristic analyses revealed that the MDA assay does detect HTPR to aspirin sufficiently (area under the curve: 0.965; p < 0.001). The optimal cut-off was > 128 nmol/L (sensitivity of 100%, specificity of 91%). The new MDA assay is reliable in detecting HTPR. It is highly specific in the evaluation of antiplatelet effects by aspirin. This promising and potential bedside assay needs to be evaluated in clinical practice.

scholarly journals Expression Analysis of Circulating miR-22, miR-122, miR-217 and miR-367 as Promising Biomarkers of Acute Lymphoblastic Leukemia

2021 ◽  
Author(s):  
Fatemeh hosseinpour-soleimani ◽  
Gholamreza Khamisipour ◽  
Zahra Derakhshan ◽  
Bahram Ahmadi
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Lymphoblastic Leukemia ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Healthy Individuals ◽  
Quantitative Real Time Pcr ◽  
Expression Levels

Abstract Background Currently, the role of serum-based biomarkers such as microRNAs in cancer diagnosis has been extensively established. This study aimed to determine expression levels of bioinformatically selected miRNAs and whether they can be used as biomarkers or a new therapeutic target in patients with Acute Lymphoblastic Leukemia (ALL). Materials and Methods The expression levels of serum miR-22, miR-122, miR-217, and miR-367 in 21 ALL patients and 21 healthy controls were measured using quantitative real-time PCR. The receiver operating characteristic (ROC) curve and the associated area under the curve (AUC) was used to assess candidate miRNAs' diagnostic value as a biomarker. Results The results showed that miR-217 was markedly decreased in patients with ALL compared to controls. Moreover, miR-22, miR-122, and miR-367 were found to be upregulated. Furthermore, ROC analysis showed that serum miR-217 and miR-367 could differentiate ALL patients from the healthy individuals, while miR-22 has approximate discriminatory power that requires further investigation. Conclusion Collectively, the results suggested that miR-217 may play a tumor suppressor role in ALL, whereas miR-22, miR-122, and miR-367 could function as an oncogene. Overall, miR-22, miR-217, and miR-367 could be considered possible biomarkers for the early diagnosis of ALL.

scholarly journals The Oral Microbiome in Periodontal Health

2021 ◽  
Vol 11 ◽  
Author(s):  
Magdalena Lenartova ◽  
Barbora Tesinska ◽  
Tatjana Janatova ◽  
Ondrej Hrebicek ◽  
Jaroslav Mysak ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Clinical Signs ◽  
Aggressive Periodontitis ◽  
Taxonomic Composition ◽  
Oral Microbiome ◽  
Healthy Individuals ◽  
Microbial Succession ◽  
Periodontal Health ◽  
Severe Periodontitis ◽  
Older Subjects

The estimation of oral microbiome (OM) taxonomic composition in periodontally healthy individuals can often be biased because the clinically periodontally healthy subjects for evaluation can already experience dysbiosis. Usually, they are included just based on the absence of clinical signs of periodontitis. Additionally, the age of subjects is used to be higher to correspond well with tested groups of patients with chronic periodontitis, a disorder typically associated with aging. However, the dysbiosis of the OM precedes the clinical signs of the disease by many months or even years. The absence of periodontal pockets thus does not necessarily mean also good periodontal health and the obtained image of “healthy OM” can be distorted.To overcome this bias, we taxonomically characterized the OM in almost a hundred young students of dentistry with precise oral hygiene and no signs of periodontal disease. We compared the results with the OM composition of older periodontally healthy individuals and also a group of patients with severe periodontitis (aggressive periodontitis according to former classification system). The clustering analysis revealed not only two compact clearly separated clusters corresponding to each state of health, but also a group of samples forming an overlap between both well-pronounced states. Additionally, in the cluster of periodontally healthy samples, few outliers with atypical OM and two major stomatotypes could be distinguished, differing in the prevalence and relative abundance of two main bacterial genera: Streptococcus and Veillonella. We hypothesize that the two stomatotypes could represent the microbial succession from periodontal health to starting dysbiosis. The old and young periodontally healthy subjects do not cluster separately but a trend of the OM in older subjects to periodontitis is visible. Several bacterial genera were identified to be typically more abundant in older periodontally healthy subjects.

scholarly journals Predicting the future development of mild cognitive impairment in the cognitively healthy elderly

2020 ◽  
Author(s):  
Bryan Strange ◽  
Linda Zhang ◽  
Alba Sierra-Marcos ◽  
Eva Alfayate ◽  
Jussi Tohka ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Verbal Memory ◽  
Statistical Tests ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Predictive Performance ◽  
Healthy Individuals ◽  
Healthy Elderly ◽  
Out Of Sample

Identifying measures that predict future cognitive impairment in healthy individuals is necessary to inform treatment strategies for candidate dementia-preventative and modifying interventions. Here, we derive such measures by studying converters who transitioned from cognitively normal at baseline to mild-cognitive impairment (MCI) in a longitudinal study of 1213 elderly participants. We first establish reduced grey matter density (GMD) in left entorhinal cortex (EC) as a biomarker for impending cognitive decline in healthy individuals, employing a matched sampling control for several dementia risk-factors, thereby mitigating the potential effects of bias on our statistical tests. Next, we determine the predictive performance of baseline demographic, genetic, neuropsychological and MRI measures by entering these variables into an elastic net-regularized classifier. Our trained statistical model classified converters and controls with validation Area-Under-the-Curve>0.9, identifying only delayed verbal memory and left EC GMD as relevant predictors for classification. This performance was maintained on test classification of out-of-sample converters and controls. Our results suggest a parsimonious but powerful predictive model for MCI development in the cognitively healthy elderly.

The Velocity Storage Mechanism of the Optokinetic Nystagmus Under Apparent Stimulus Movements in Squirrel Monkeys

1997 ◽  
Vol 7 (6) ◽  
pp. 441-451
Author(s):  
J. Kröller ◽  
F. Behrens ◽  
V.V. Marlinsky
Keyword(s):  
Steady State ◽  
Brain Stem ◽  
Apparent Movement ◽  
Squirrel Monkeys ◽  
Constant Light ◽  
Velocity Storage ◽  
Slow Phase ◽  
Stripe Pattern ◽  
Storage Mechanism ◽  
The Brain

Experiments in two awake untrained squirrel monkeys were performed to study the velocity storage mechanism during fast rise of OKN slow phase velocity. This was done by testing the monkey’s capability to perform OKN in response to a stationary-appearing stroboscopically illuminated stripe pattern of a horizontally rotating drum. Nystagmus was initially elicited during constant illumination lasting between 0.6 and 25 s. The periodicity of the stripe pattern was 2.37°. When after the constant light the flash illumination was switched on again, two types of behavior could occur, depending on the length of the constant light interval (CLI): 1) when the CLI was shorter than a threshold value of 6.2 seconds, the OKN ceased under the flash stimulation. Then a “post-OKN” occurred that increased with the length of the CLIs, indicating that the intermittently illuminated pattern did not provoke fixation suppression of OKN aftereffects. 2) when the CLI was above threshold, the OKN continued under the flash light: it will he called “apparent movement OKN.” The threshold CLI between the type 1 and the type 2 response did not depend on drum velocities between 21.5°/s and 71.3°/s. The average gain of the apparent movement OKN was 0.83 ± 0.04; gain and stability of slow phase eye movement velocity did not deviate systematically from the usually elicited OKN. OKAN after apparent movement OKN did not deviate from OKAN after constantly illuminated moving patterns. In response to the OKN initiation by a constantly illuminated pattern up to pattern velocities of 100°/s, the OKN steady state gain was reached within the first 2 or 3 nystagmus beats. We ascribe the increase of the post-OKN with CLI and the existence of a threshold constant light interval to activity-accumulation in the common velocity-to-position integrator (velocity storage) of the brain stem. Loading of the velocity storage takes place after the OKN gain has already reached the steady-state value. Apparent movement OKN could also be elicited in guinea pigs that lack an effective smooth pursuit system. We suggest that apparent movement OKN is produced by mechanisms located in the brain stem.

Spatial orientation of postrotatory nystagmus during static roll tilt in cats

2002 ◽  
Vol 12 (1) ◽  
pp. 15-23
Author(s):  
Keiko Yasuda ◽  
Hiroaki Fushiki ◽  
Rinnosuke Wada ◽  
Yukio Watanabe
Keyword(s):  
Spatial Orientation ◽  
Vertical Axis ◽  
Longitudinal Axis ◽  
Velocity Storage ◽  
Slow Phase ◽  
Storage Mechanism ◽  
Spatial Disorientation ◽  
Acceleration And Deceleration ◽  
Eye Velocity ◽  
Roll Tilt

While the stimulation of otolith inputs reduces the duration of postrotatory nystagmus (PRN), there is still room for dialogue about the effect of static tilt on the orientation of PRN. We studied one possible influence of static roll tilt on the spatial orientation of PRN in cats. The animal was rotated about an earth-vertical axis (EVA) at a constant velocity of 100 deg/s with an acceleration and deceleration of 120 deg / s 2 . Within two seconds after stopping EVA rotation, the animal was passively tilted at 45 deg/s about its longitudinal axis by as much as ± 90 deg in steps of 15 deg. Eye movements were measured with magnetic search coils. The angle of the PRN plane and its slow phase eye velocity were measured. The time constant of PRN decreased with an increase in roll tilt. The PRN plane remained earth horizontal within a range of ± 30 deg roll tilt. Beyond this range, the velocity of PRN decreased too rapidly to measure any change in orientation. Our results indicate a spatially limited and temporally short interaction of the semicircular canal and otolith signals in the velocity storage mechanism of cat PRN. Our data, along with previous studies, suggest that different species show different solutions to the problem of the imbalance and spatial disorientation during contradictory stimuli.

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