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Vestibular compensation: the neuro-otologist’s best friend

Why vestibular compensation (VC) after an acute unilateral vestibular loss is the neuro-otologist’s best friend is the question at the heart of this paper. The different plasticity mechanisms underlying VC are first reviewed, and the authors present thereafter the dual concept of vestibulo-centric v...

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Autores principales: Lacour, Michel, Helmchen, Christoph, Vidal, Pierre-Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833803/
https://www.ncbi.nlm.nih.gov/pubmed/27083885
http://dx.doi.org/10.1007/s00415-015-7903-4
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author Lacour, Michel
Helmchen, Christoph
Vidal, Pierre-Paul
author_facet Lacour, Michel
Helmchen, Christoph
Vidal, Pierre-Paul
author_sort Lacour, Michel
collection PubMed
description Why vestibular compensation (VC) after an acute unilateral vestibular loss is the neuro-otologist’s best friend is the question at the heart of this paper. The different plasticity mechanisms underlying VC are first reviewed, and the authors present thereafter the dual concept of vestibulo-centric versus distributed learning processes to explain the compensation of deficits resulting from the static versus dynamic vestibular imbalance. The main challenges for the plastic events occurring in the vestibular nuclei (VN) during a post-lesion critical period are neural protection, structural reorganization and rebalance of VN activity on both sides. Data from animal models show that modulation of the ipsilesional VN activity by the contralateral drive substitutes for the normal push–pull mechanism. On the other hand, sensory and behavioural substitutions are the main mechanisms implicated in the recovery of the dynamic functions. These newly elaborated sensorimotor reorganizations are vicarious idiosyncratic strategies implicating the VN and multisensory brain regions. Imaging studies in unilateral vestibular loss patients show the implication of a large neuronal network (VN, commissural pathways, vestibulo-cerebellum, thalamus, temporoparietal cortex, hippocampus, somatosensory and visual cortical areas). Changes in gray matter volume in these multisensory brain regions are structural changes supporting the sensory substitution mechanisms of VC. Finally, the authors summarize the two ways to improve VC in humans (neuropharmacology and vestibular rehabilitation therapy), and they conclude that VC would follow a “top-down” strategy in patients with acute vestibular lesions. Future challenges to understand VC are proposed.
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spelling pubmed-48338032016-04-25 Vestibular compensation: the neuro-otologist’s best friend Lacour, Michel Helmchen, Christoph Vidal, Pierre-Paul J Neurol Review Why vestibular compensation (VC) after an acute unilateral vestibular loss is the neuro-otologist’s best friend is the question at the heart of this paper. The different plasticity mechanisms underlying VC are first reviewed, and the authors present thereafter the dual concept of vestibulo-centric versus distributed learning processes to explain the compensation of deficits resulting from the static versus dynamic vestibular imbalance. The main challenges for the plastic events occurring in the vestibular nuclei (VN) during a post-lesion critical period are neural protection, structural reorganization and rebalance of VN activity on both sides. Data from animal models show that modulation of the ipsilesional VN activity by the contralateral drive substitutes for the normal push–pull mechanism. On the other hand, sensory and behavioural substitutions are the main mechanisms implicated in the recovery of the dynamic functions. These newly elaborated sensorimotor reorganizations are vicarious idiosyncratic strategies implicating the VN and multisensory brain regions. Imaging studies in unilateral vestibular loss patients show the implication of a large neuronal network (VN, commissural pathways, vestibulo-cerebellum, thalamus, temporoparietal cortex, hippocampus, somatosensory and visual cortical areas). Changes in gray matter volume in these multisensory brain regions are structural changes supporting the sensory substitution mechanisms of VC. Finally, the authors summarize the two ways to improve VC in humans (neuropharmacology and vestibular rehabilitation therapy), and they conclude that VC would follow a “top-down” strategy in patients with acute vestibular lesions. Future challenges to understand VC are proposed. Springer Berlin Heidelberg 2016-04-15 2016 /pmc/articles/PMC4833803/ /pubmed/27083885 http://dx.doi.org/10.1007/s00415-015-7903-4 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Lacour, Michel
Helmchen, Christoph
Vidal, Pierre-Paul
Vestibular compensation: the neuro-otologist’s best friend
title Vestibular compensation: the neuro-otologist’s best friend
title_full Vestibular compensation: the neuro-otologist’s best friend
title_fullStr Vestibular compensation: the neuro-otologist’s best friend
title_full_unstemmed Vestibular compensation: the neuro-otologist’s best friend
title_short Vestibular compensation: the neuro-otologist’s best friend
title_sort vestibular compensation: the neuro-otologist’s best friend
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833803/
https://www.ncbi.nlm.nih.gov/pubmed/27083885
http://dx.doi.org/10.1007/s00415-015-7903-4
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