The otoliths of the vestibular system are seen as the primary gravitational sensors and are respo... more The otoliths of the vestibular system are seen as the primary gravitational sensors and are responsible for a compensatory eye torsion called the ocular counter-roll (OCR). The OCR ensures gaze stabilization and is sensitive to a lateral head roll with respect to gravity and the Gravito-Inertial Acceleration (GIA) vector during e.g., centrifugation. This otolith-mediated reflex will make sure you will still be able to maintain gaze stabilization and postural stability when making sharp turns during locomotion. To measure the effect of prolonged spaceflight on the otoliths, we measured the OCR induced by off-axis centrifugation in a group of 27 cosmonauts before and after their 6-month space mission to the International Space Station (ISS). We observed a significant decrease in OCR early post-flight, with first- time flyers being more strongly affected compared to frequent or experienced flyers. Our results strongly suggest that experienced space crew have acquired the ability to ada...
Humans undergo extreme physiological changes when subjected to long periods of weightlessness, an... more Humans undergo extreme physiological changes when subjected to long periods of weightlessness, and as we continue to become a space-faring species, it is imperative that we fully understand the physiological changes that occur in the human body, including the brain. In this study, we present findings of brain structural changes associated with long-duration spaceflight based on diffusion magnetic resonance imaging (dMRI) data. Twelve cosmonauts who spent an average of six months aboard the International Space Station (ISS) were scanned in an MRI scanner pre-flight, ten days after flight, and at a follow-up time point seven months after flight. We performed differential tractography, a technique that confines white matter fiber tracking to voxels showing microstructural changes. We found significant microstructural changes in several large white matter tracts, such as the corpus callosum, arcuate fasciculus, corticospinal, corticostriatal, and cerebellar tracts. This is the first pap...
Objective: The purpose of this retrospective study was to determine the vocal characteristics of ... more Objective: The purpose of this retrospective study was to determine the vocal characteristics of a treatment-seeking population with the primary complaint of vocal fatigue (VF). Methods: Forty-three men (mean age 42 years, range 19-69) and 145 women (mean age 34 years, range 18-68) were included. None of the subjects had received voice therapy or previous laryngeal surgery. A questionnaire, laryngeal and perceptual evaluations, aerodynamic and acoustic parameters, and the Dysphonia Severity Index (DSI) were used to determine vocal characteristics. Results: In 74% of the subjects, flexible laryngeal videostroboscopic evaluation revealed a vocal pathology, with vocal nodules and muscle tension dysphonia as the most frequently diagnosed pathologies. Vocal abuse/misuse was present in 65% of the subjects. A median DSI value of -0.4 and -0.8 was found in female and male patients, respectively. Aerodynamic and acoustic parameters and DSI scores were significantly different from normative d...
Objective: The purpose of this paper was to provide an extensive description of a case of sopite ... more Objective: The purpose of this paper was to provide an extensive description of a case of sopite syndrome, a manifestation of motion sickness scarcely described in the literature. Design: The following questionnaires were used to assess sopite syndrome symptoms pre, during and post parabolic flight; Misery Scale rate, Positive and Negative Affect Scale, the Motion Sickness Assessment Questionnaire and the Epworth Sleepiness Scale. Study sample: Case report of a 35-year old female compared to a control group (n=26). Results: We describe of sopite syndrome during parabolic flight. The subject reported drowsiness and she noted mood changes such as irritation and annoyance. Furthermore, she was not able to perform her assigned task. Her symptoms escalated into extreme fatigue and the inability to stay awake. Nauseogenic symptoms improved, but soporific symptoms persisted for several hours after the motion stimulus (i.e. parabolic flight). Conclusions: This case points towards the need for controlled studies to assess the prevalence of this syndrome among the general population and select groups. Future research should focus on developing tests for personnel screening and explore treatment options.
The reported study investigated the effect of 7 rate control methods (RCM) on running speech inte... more The reported study investigated the effect of 7 rate control methods (RCM) on running speech intelligibility, speaking rate (SR), articulation rate (AR) and pause characteristics in 27 individuals with dysarthria. The data reveal that with the exception of slower on demand, each RCM resulted in lower mean SRs and ARs (p < 0.05). Clinically significant improvements in intelligibility were found in half of the participants with different types of dysarthria. The majority of them had normal or decreased ARs and SRs. The most effective methods were: alphabet board, hand tapping and pacing board. For the majority of speakers, the maximal decrease in speech rate was not associated with the maximal increase in intelligibility.
Purpose: This study investigated the effect of rate control methods (RCMs) on speaking rate (SR),... more Purpose: This study investigated the effect of rate control methods (RCMs) on speaking rate (SR), articulation rate (AR), and intelligibility in dysarthric speakers. Method: Nineteen dysarthric patients (7 unilateral upper motor neuron dysarthria, 6 hypokinetic, 3 flaccid, 3 ataxic) participated. SR, AR and intelligibility ratings were determined on the basis of 1-min recorded reading passages. Seven RCMs were applied: voluntary rate control, hand tapping, alphabet board, pacing board and delayed auditory feedback with a delay of 50, 100 and 150 ms. Results: Almost all methods resulted in lower mean SRs and ARs (p < 0.05). Rate control did not improve overall intelligibility of the dysarthric population. However, a meaningful increase of intelligibility was found in 5 participants. This study indicates that the effect of rate control on intelligibility is independent of habitual speech rate and type of dysarthria. Degree of intelligibility may be an influencing factor. The most e...
Background. Sitting balance and the ability to perform selective truncal movements are important ... more Background. Sitting balance and the ability to perform selective truncal movements are important predictors of functional outcome after stroke. However, few clinical trials have evaluated the effect of truncal exercises. Objective. The authors assessed the effect of additional truncal exercises on truncal function, standing balance, and mobility. Methods. An assessor-blinded randomized controlled trial was carried out at a stroke rehabilitation hospital. A total of 33 participants (mean 35 days post onset) were randomly assigned to an experimental group (n = 18) or a control group (n = 15). In addition to conventional therapy, the experimental group received 16 hours of truncal exercises. The control group received 16 hours of sham treatment. Truncal function was evaluated by the Trunk Impairment Scale (TIS) and standing balance and mobility by the Tinetti Test. The Romberg with eyes open and eyes closed, Four Test Balance Scale (FTBS), Berg Balance Scale (BBS), Rivermead Motor Asse...
The purpose of the present study is to measure the effectiveness of two treatment techniques-voca... more The purpose of the present study is to measure the effectiveness of two treatment techniques-vocalization with abdominal breath support and manual circumlaryngeal therapy (MCT)-in patients with muscle tension dysphonia (MTD). The vocal quality before and after the two treatment techniques was measured by means of the dysphonia severity index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following set of voice measurements: maximum phonation time (MPT), highest frequency, lowest intensity, and jitter. The repeated-measures analysis of variance (ANOVA) revealed a significant difference between the objective overall vocal quality before and after MCT. No significant differences were measured between the objective overall vocal quality before and after vocalization with abdominal breath support. This study showed evidence that MCT is an effective treatment technique for patients with elevated laryngeal position, increased laryngeal muscle tension, and MTD. The precise way in which MCT has an effect on vocal quality has not been addressed in this experiment, but merits study. Further research into this topic could focus on electromyography (EMG) recordings in relation to vocal improvements with larger sample of subjects.
This case report describes convulsions and hemiparesis after retrobulbar injection with good outc... more This case report describes convulsions and hemiparesis after retrobulbar injection with good outcome in a patient undergoing outpatient cryocoagulation of his right eye. Case Report: We report a young man in which localized convulsions of the ipsilateral face occurred 9 minutes after retrobulbar injection followed shortly by convulsions of the contralateral arm and leg. After the convulsions, the patient experienced left-sided hemiparesis resolving approximately 1 hour after the injection. There was no hemodynamic instability during this period. It was difficult to determine the exact cause of convulsions and hemiparesis. Conclusions: We believe these complications occurred because of unintentional injection of local anesthetic agent into the subarachnoid space without affecting the brainstem. Possible mechanisms of spread of local anesthetic agent into the central nervous system after retrobulbar block are discussed.
JT. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial chara... more JT. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse.
Archives of Otolaryngology–Head & Neck Surgery, 2000
Interventions: A commercially available navigation system with infrared optical tracking was used... more Interventions: A commercially available navigation system with infrared optical tracking was used for computer navigation on the face and within the nose of the subjects after matching with external fiducials or with 3 different configurations of anatomical landmarks. Navigation errors were measured and correlated to matching strategies and compared through statistical analysis. Results: Matching with external fiducials on the face results in smaller navigation error than matching with anatomical landmarks. The configuration of matching strategies with anatomical landmarks also significantly determines the accuracy of computer navigation, especially when different locations of accuracy measurement are considered. Conclusion: Statistically significant findings have shown that the choice of a matching strategy is a major factor in the accuracy of computer navigation for ear, nose, throat surgery.
Journal of Musculoskeletal & Neuronal Interactions, 2016
Objectives: We review the studies that have evaluated intermittent short-radius centrifugation as... more Objectives: We review the studies that have evaluated intermittent short-radius centrifugation as a potential countermeasure for cardiovascular, musculoskeletal, and sensorimotor deconditioning in simulated weightlessness. Methods: The findings from 18 experimental protocols that have used bed rest and dry immersion for comparing the protective effects of centrifugation versus standing upright or walking, and the effects of continuous vs. periodic exposure to centrifugation are discussed. Results: Centrifugation for as little as 30 min per day was found to be effective in mitigating orthostatic intolerance and strength in postural muscle after 5 days of bed rest, but it was not effective in mitigating plasma volume loss. Conclusion: To determine the optimal prescription for centrifugation as a countermeasure, we recommend further studies using (a) bed rest of longer duration, (b) individualized prescriptions of centrifugation combined with exercise, and (c) functional performance te...
The prospect of continued manned space missions warrants an in-depth understanding of how prolong... more The prospect of continued manned space missions warrants an in-depth understanding of how prolonged microgravity affects the human brain. Functional magnetic resonance imaging (fMRI) can pinpoint changes reflecting adaptive neuroplasticity across time. We acquired resting-state fMRI data of cosmonauts before, shortly after, and eight months after spaceflight as a follow-up to assess global connectivity changes over time. Our results show persisting connectivity decreases in posterior cingulate cortex and thalamus and persisting increases in the right angular gyrus. Connectivity in the bilateral insular cortex decreased after spaceflight, which reversed at follow-up. No significant connectivity changes across eight months were found in a matched control group. Overall, we show that altered gravitational environments influence functional connectivity longitudinally in multimodal brain hubs, reflecting adaptations to unfamiliar and conflicting sensory input in microgravity. These resul...
Mal de debarquement syndrome (MdDS) is a neurological condition typically characterized by a sens... more Mal de debarquement syndrome (MdDS) is a neurological condition typically characterized by a sensation of motion, which in most cases manifests after disembarking from a vehicle (e.g., boat, plane, and car). However, the same symptoms can also occur spontaneously. Two main theories of the pathophysiology of MdDS are briefly summarized here. In this perspective, we aimed to report the most recent findings on neuroimaging studies related to MdDS, as well as to suggest further potential research questions that could be addressed with the use of neuroimaging techniques. A detailed analysis of previous work on MdDS has led to five main research questions that could be addressed in new neuroimaging studies. Furthermore, in this perspective, we propose new stepping-stones to addressing critical research questions related to MdDS and its pathophysiology. We propose considerations for new studies, as well as a detailed analysis of the current limitations and challenges present when studying MdDS patients. We hope that our examination of the nuances of MdDS as a neurological disorder will contribute to more directed research on this topic.
Artificial gravity through centrifugation is currently seen as countermeasure with potential agai... more Artificial gravity through centrifugation is currently seen as countermeasure with potential against negative effects of spaceflight. However, side effects like increased motion sickness need to be investigated. Habituation protocols abate conflicts by reducing response to rotation with prolonged exposure to mismatches. Visually reinforced habituation may induce less reduction of oculomotor response to rotation than classical habituation.
Background Dizziness and imbalance are common symptoms that are often inadequately diagnosed or m... more Background Dizziness and imbalance are common symptoms that are often inadequately diagnosed or managed, due to a lack of dedicated specialists. Decision Support Systems (DSS) may support first-line physicians to diagnose and manage these patients based on personalised data. Aim To examine the diagnostic accuracy and application of the EMBalance DSS for diagnosis and management of common vestibular disorders in primary care. Methods Patients with persistent dizziness were recruited from primary care in Germany, Greece, Belgium and the UK and randomised to primary care clinicians assessing the patients with (+ DSS) versus assessment without (− DSS) the EMBalance DSS. Subsequently, specialists in neuro-otology/audiovestibular medicine performed clinical evaluation of each patient in a blinded way to provide the “gold standard” against which the + DSS, − DSS and the DSS as a standalone tool (i.e. without the final decision made by the clinician) were validated. Results One hundred nine...
Background: The peripheral vestibular end organ is considered to consist of semi-circular canals ... more Background: The peripheral vestibular end organ is considered to consist of semi-circular canals (SCC) for detection of angular accelerations and the otoliths for detection of linear accelerations. However, otoliths being phylogenetically the oldest part of the vestibular sensory organs are involved in detection of all motions. Summary: This study elaborates on this property of the otolith organ, as this concept can be of importance for the currently designed vestibular implant devices. Key Message: The analysis of the evolution of the inner ear and examination of clinical examples shows the robustness of the otolith system and inhibition capacity of the SCC. The otolith system must be considered superior to the SCC system as illustrated by evolution, clinical evidence, and physical principles.
The otoliths of the vestibular system are seen as the primary gravitational sensors and are respo... more The otoliths of the vestibular system are seen as the primary gravitational sensors and are responsible for a compensatory eye torsion called the ocular counter-roll (OCR). The OCR ensures gaze stabilization and is sensitive to a lateral head roll with respect to gravity and the Gravito-Inertial Acceleration (GIA) vector during e.g., centrifugation. This otolith-mediated reflex will make sure you will still be able to maintain gaze stabilization and postural stability when making sharp turns during locomotion. To measure the effect of prolonged spaceflight on the otoliths, we measured the OCR induced by off-axis centrifugation in a group of 27 cosmonauts before and after their 6-month space mission to the International Space Station (ISS). We observed a significant decrease in OCR early post-flight, with first- time flyers being more strongly affected compared to frequent or experienced flyers. Our results strongly suggest that experienced space crew have acquired the ability to ada...
Humans undergo extreme physiological changes when subjected to long periods of weightlessness, an... more Humans undergo extreme physiological changes when subjected to long periods of weightlessness, and as we continue to become a space-faring species, it is imperative that we fully understand the physiological changes that occur in the human body, including the brain. In this study, we present findings of brain structural changes associated with long-duration spaceflight based on diffusion magnetic resonance imaging (dMRI) data. Twelve cosmonauts who spent an average of six months aboard the International Space Station (ISS) were scanned in an MRI scanner pre-flight, ten days after flight, and at a follow-up time point seven months after flight. We performed differential tractography, a technique that confines white matter fiber tracking to voxels showing microstructural changes. We found significant microstructural changes in several large white matter tracts, such as the corpus callosum, arcuate fasciculus, corticospinal, corticostriatal, and cerebellar tracts. This is the first pap...
Objective: The purpose of this retrospective study was to determine the vocal characteristics of ... more Objective: The purpose of this retrospective study was to determine the vocal characteristics of a treatment-seeking population with the primary complaint of vocal fatigue (VF). Methods: Forty-three men (mean age 42 years, range 19-69) and 145 women (mean age 34 years, range 18-68) were included. None of the subjects had received voice therapy or previous laryngeal surgery. A questionnaire, laryngeal and perceptual evaluations, aerodynamic and acoustic parameters, and the Dysphonia Severity Index (DSI) were used to determine vocal characteristics. Results: In 74% of the subjects, flexible laryngeal videostroboscopic evaluation revealed a vocal pathology, with vocal nodules and muscle tension dysphonia as the most frequently diagnosed pathologies. Vocal abuse/misuse was present in 65% of the subjects. A median DSI value of -0.4 and -0.8 was found in female and male patients, respectively. Aerodynamic and acoustic parameters and DSI scores were significantly different from normative d...
Objective: The purpose of this paper was to provide an extensive description of a case of sopite ... more Objective: The purpose of this paper was to provide an extensive description of a case of sopite syndrome, a manifestation of motion sickness scarcely described in the literature. Design: The following questionnaires were used to assess sopite syndrome symptoms pre, during and post parabolic flight; Misery Scale rate, Positive and Negative Affect Scale, the Motion Sickness Assessment Questionnaire and the Epworth Sleepiness Scale. Study sample: Case report of a 35-year old female compared to a control group (n=26). Results: We describe of sopite syndrome during parabolic flight. The subject reported drowsiness and she noted mood changes such as irritation and annoyance. Furthermore, she was not able to perform her assigned task. Her symptoms escalated into extreme fatigue and the inability to stay awake. Nauseogenic symptoms improved, but soporific symptoms persisted for several hours after the motion stimulus (i.e. parabolic flight). Conclusions: This case points towards the need for controlled studies to assess the prevalence of this syndrome among the general population and select groups. Future research should focus on developing tests for personnel screening and explore treatment options.
The reported study investigated the effect of 7 rate control methods (RCM) on running speech inte... more The reported study investigated the effect of 7 rate control methods (RCM) on running speech intelligibility, speaking rate (SR), articulation rate (AR) and pause characteristics in 27 individuals with dysarthria. The data reveal that with the exception of slower on demand, each RCM resulted in lower mean SRs and ARs (p < 0.05). Clinically significant improvements in intelligibility were found in half of the participants with different types of dysarthria. The majority of them had normal or decreased ARs and SRs. The most effective methods were: alphabet board, hand tapping and pacing board. For the majority of speakers, the maximal decrease in speech rate was not associated with the maximal increase in intelligibility.
Purpose: This study investigated the effect of rate control methods (RCMs) on speaking rate (SR),... more Purpose: This study investigated the effect of rate control methods (RCMs) on speaking rate (SR), articulation rate (AR), and intelligibility in dysarthric speakers. Method: Nineteen dysarthric patients (7 unilateral upper motor neuron dysarthria, 6 hypokinetic, 3 flaccid, 3 ataxic) participated. SR, AR and intelligibility ratings were determined on the basis of 1-min recorded reading passages. Seven RCMs were applied: voluntary rate control, hand tapping, alphabet board, pacing board and delayed auditory feedback with a delay of 50, 100 and 150 ms. Results: Almost all methods resulted in lower mean SRs and ARs (p < 0.05). Rate control did not improve overall intelligibility of the dysarthric population. However, a meaningful increase of intelligibility was found in 5 participants. This study indicates that the effect of rate control on intelligibility is independent of habitual speech rate and type of dysarthria. Degree of intelligibility may be an influencing factor. The most e...
Background. Sitting balance and the ability to perform selective truncal movements are important ... more Background. Sitting balance and the ability to perform selective truncal movements are important predictors of functional outcome after stroke. However, few clinical trials have evaluated the effect of truncal exercises. Objective. The authors assessed the effect of additional truncal exercises on truncal function, standing balance, and mobility. Methods. An assessor-blinded randomized controlled trial was carried out at a stroke rehabilitation hospital. A total of 33 participants (mean 35 days post onset) were randomly assigned to an experimental group (n = 18) or a control group (n = 15). In addition to conventional therapy, the experimental group received 16 hours of truncal exercises. The control group received 16 hours of sham treatment. Truncal function was evaluated by the Trunk Impairment Scale (TIS) and standing balance and mobility by the Tinetti Test. The Romberg with eyes open and eyes closed, Four Test Balance Scale (FTBS), Berg Balance Scale (BBS), Rivermead Motor Asse...
The purpose of the present study is to measure the effectiveness of two treatment techniques-voca... more The purpose of the present study is to measure the effectiveness of two treatment techniques-vocalization with abdominal breath support and manual circumlaryngeal therapy (MCT)-in patients with muscle tension dysphonia (MTD). The vocal quality before and after the two treatment techniques was measured by means of the dysphonia severity index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following set of voice measurements: maximum phonation time (MPT), highest frequency, lowest intensity, and jitter. The repeated-measures analysis of variance (ANOVA) revealed a significant difference between the objective overall vocal quality before and after MCT. No significant differences were measured between the objective overall vocal quality before and after vocalization with abdominal breath support. This study showed evidence that MCT is an effective treatment technique for patients with elevated laryngeal position, increased laryngeal muscle tension, and MTD. The precise way in which MCT has an effect on vocal quality has not been addressed in this experiment, but merits study. Further research into this topic could focus on electromyography (EMG) recordings in relation to vocal improvements with larger sample of subjects.
This case report describes convulsions and hemiparesis after retrobulbar injection with good outc... more This case report describes convulsions and hemiparesis after retrobulbar injection with good outcome in a patient undergoing outpatient cryocoagulation of his right eye. Case Report: We report a young man in which localized convulsions of the ipsilateral face occurred 9 minutes after retrobulbar injection followed shortly by convulsions of the contralateral arm and leg. After the convulsions, the patient experienced left-sided hemiparesis resolving approximately 1 hour after the injection. There was no hemodynamic instability during this period. It was difficult to determine the exact cause of convulsions and hemiparesis. Conclusions: We believe these complications occurred because of unintentional injection of local anesthetic agent into the subarachnoid space without affecting the brainstem. Possible mechanisms of spread of local anesthetic agent into the central nervous system after retrobulbar block are discussed.
JT. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial chara... more JT. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse.
Archives of Otolaryngology–Head & Neck Surgery, 2000
Interventions: A commercially available navigation system with infrared optical tracking was used... more Interventions: A commercially available navigation system with infrared optical tracking was used for computer navigation on the face and within the nose of the subjects after matching with external fiducials or with 3 different configurations of anatomical landmarks. Navigation errors were measured and correlated to matching strategies and compared through statistical analysis. Results: Matching with external fiducials on the face results in smaller navigation error than matching with anatomical landmarks. The configuration of matching strategies with anatomical landmarks also significantly determines the accuracy of computer navigation, especially when different locations of accuracy measurement are considered. Conclusion: Statistically significant findings have shown that the choice of a matching strategy is a major factor in the accuracy of computer navigation for ear, nose, throat surgery.
Journal of Musculoskeletal & Neuronal Interactions, 2016
Objectives: We review the studies that have evaluated intermittent short-radius centrifugation as... more Objectives: We review the studies that have evaluated intermittent short-radius centrifugation as a potential countermeasure for cardiovascular, musculoskeletal, and sensorimotor deconditioning in simulated weightlessness. Methods: The findings from 18 experimental protocols that have used bed rest and dry immersion for comparing the protective effects of centrifugation versus standing upright or walking, and the effects of continuous vs. periodic exposure to centrifugation are discussed. Results: Centrifugation for as little as 30 min per day was found to be effective in mitigating orthostatic intolerance and strength in postural muscle after 5 days of bed rest, but it was not effective in mitigating plasma volume loss. Conclusion: To determine the optimal prescription for centrifugation as a countermeasure, we recommend further studies using (a) bed rest of longer duration, (b) individualized prescriptions of centrifugation combined with exercise, and (c) functional performance te...
The prospect of continued manned space missions warrants an in-depth understanding of how prolong... more The prospect of continued manned space missions warrants an in-depth understanding of how prolonged microgravity affects the human brain. Functional magnetic resonance imaging (fMRI) can pinpoint changes reflecting adaptive neuroplasticity across time. We acquired resting-state fMRI data of cosmonauts before, shortly after, and eight months after spaceflight as a follow-up to assess global connectivity changes over time. Our results show persisting connectivity decreases in posterior cingulate cortex and thalamus and persisting increases in the right angular gyrus. Connectivity in the bilateral insular cortex decreased after spaceflight, which reversed at follow-up. No significant connectivity changes across eight months were found in a matched control group. Overall, we show that altered gravitational environments influence functional connectivity longitudinally in multimodal brain hubs, reflecting adaptations to unfamiliar and conflicting sensory input in microgravity. These resul...
Mal de debarquement syndrome (MdDS) is a neurological condition typically characterized by a sens... more Mal de debarquement syndrome (MdDS) is a neurological condition typically characterized by a sensation of motion, which in most cases manifests after disembarking from a vehicle (e.g., boat, plane, and car). However, the same symptoms can also occur spontaneously. Two main theories of the pathophysiology of MdDS are briefly summarized here. In this perspective, we aimed to report the most recent findings on neuroimaging studies related to MdDS, as well as to suggest further potential research questions that could be addressed with the use of neuroimaging techniques. A detailed analysis of previous work on MdDS has led to five main research questions that could be addressed in new neuroimaging studies. Furthermore, in this perspective, we propose new stepping-stones to addressing critical research questions related to MdDS and its pathophysiology. We propose considerations for new studies, as well as a detailed analysis of the current limitations and challenges present when studying MdDS patients. We hope that our examination of the nuances of MdDS as a neurological disorder will contribute to more directed research on this topic.
Artificial gravity through centrifugation is currently seen as countermeasure with potential agai... more Artificial gravity through centrifugation is currently seen as countermeasure with potential against negative effects of spaceflight. However, side effects like increased motion sickness need to be investigated. Habituation protocols abate conflicts by reducing response to rotation with prolonged exposure to mismatches. Visually reinforced habituation may induce less reduction of oculomotor response to rotation than classical habituation.
Background Dizziness and imbalance are common symptoms that are often inadequately diagnosed or m... more Background Dizziness and imbalance are common symptoms that are often inadequately diagnosed or managed, due to a lack of dedicated specialists. Decision Support Systems (DSS) may support first-line physicians to diagnose and manage these patients based on personalised data. Aim To examine the diagnostic accuracy and application of the EMBalance DSS for diagnosis and management of common vestibular disorders in primary care. Methods Patients with persistent dizziness were recruited from primary care in Germany, Greece, Belgium and the UK and randomised to primary care clinicians assessing the patients with (+ DSS) versus assessment without (− DSS) the EMBalance DSS. Subsequently, specialists in neuro-otology/audiovestibular medicine performed clinical evaluation of each patient in a blinded way to provide the “gold standard” against which the + DSS, − DSS and the DSS as a standalone tool (i.e. without the final decision made by the clinician) were validated. Results One hundred nine...
Background: The peripheral vestibular end organ is considered to consist of semi-circular canals ... more Background: The peripheral vestibular end organ is considered to consist of semi-circular canals (SCC) for detection of angular accelerations and the otoliths for detection of linear accelerations. However, otoliths being phylogenetically the oldest part of the vestibular sensory organs are involved in detection of all motions. Summary: This study elaborates on this property of the otolith organ, as this concept can be of importance for the currently designed vestibular implant devices. Key Message: The analysis of the evolution of the inner ear and examination of clinical examples shows the robustness of the otolith system and inhibition capacity of the SCC. The otolith system must be considered superior to the SCC system as illustrated by evolution, clinical evidence, and physical principles.
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Papers by Floris Wuyts