Optimising And Applying Ocular Vestibulat Evoked Myogenic Potentials (oVEMPs)
Funder
National Health and Medical Research Council
Funding Amount
$228,931.00
Summary
This project seeks to optimise techniques for a new method of assessing the balance organs (vestibular organs) and then apply these techniques. Three conditions will be studied: vestibular neuritis - a condition causing acute and severe dizziness; Parkinson's disease, in which disorders of balance are common and superior canal dehiscence (SCD) in which there is a hole in the bone overlying one of the semicircular canals, leading to sensitivity to sound.
Sound And Vibration-Evoked Vestibular Potentials In The Differential Diagnosis Of Common Vestibulopathy.
Funder
National Health and Medical Research Council
Funding Amount
$261,016.00
Summary
Vertigo is a debilitating symptom that is a significant burden to the community. This project utilizes a simple test of balance function called the Vestibular Evoked Myogenic Potential (VEMP), to differentiate between the four most common balance disorders causing vertigo. Using sound and vibration to stimulate different parts of the balance organs, we will extract useful discriminators for each disorder and develop a neural network that predicts the likelihood of each condition.
Ictal Characteristics Of Common Vestibular Diseases
Funder
National Health and Medical Research Council
Funding Amount
$281,573.00
Summary
vertigo is a disabling symptom affecting 1 million Australians at any given time. Acute vertigo is associated with abnormal eye movements or nystagmus, the pattern of which points to its origin. In this project, we extract the unique characteristics of distinct vertigo syndromes to enable their separation
Acute Vertigo In Emergency Departments: Distinguishing Between Central And Peripheral Causes By Objective Measure Of Oculomotor Examination (HINTS)
Funder
National Health and Medical Research Council
Funding Amount
$181,065.00
Summary
The goal of this work is to provide a quantitative objective measure of HINTS for developing an automatic diagnostic decision tool to differentiate vestibular neuritis (peripheral) and stroke (central) in patients presenting in emergency department for acute vestibular syndrome. Video oculography makes interpretation of the results more reliable. Video oculography goggles will be used as part of a systematic training program to enhance frontline clinician skills in eye movement examination.
The aim of my project grant is to develop a portable electrodiagnostic test to classify balance disorders by compiling a statistically validated database of eye movement patterns associated with specific balance disorders. What is unique about this electrodiagnostic balance disorder test, which distinguishes it from but also complement conventional balance function tests, is its ability not only to show an impairment of balance function, but it can differentiate between balance disorders.
I am a neuroscientist specializing in human balance disorders. Over the past 17 years my research has focused on developing innovative, objective and accessible measurements of semicircular canal and otolith function of the vestibular system in three dime
Combined linear and angular head movements are integral components of our natural head movements. The vestibular sensory apparatus in the labyrinth of the inner ear, which comprises three semicircular canals and two otoliths acts as an inertial guidance system during head motion. The vestibular sensors mediate the angular and linear vestibulo-ocular reflexive eye movements imperative to stabilise vision during the head motions. However, it is unclear how these responses to sudden linear and angu ....Combined linear and angular head movements are integral components of our natural head movements. The vestibular sensory apparatus in the labyrinth of the inner ear, which comprises three semicircular canals and two otoliths acts as an inertial guidance system during head motion. The vestibular sensors mediate the angular and linear vestibulo-ocular reflexive eye movements imperative to stabilise vision during the head motions. However, it is unclear how these responses to sudden linear and angular motion in three dimensions are combined and processed. Diseases of the inner ear can produce incapacitating visual and balance disturbances, yet the normal function of some of the inner ears receptors, in particular the otoliths, cannot be easily tested. Clinical evidence has shown that patients with incapacitating attacks of vertigo can have impairment of either or both the semicircular canals and the otoliths. The aim of this project is to measure quantitatively the semicircular canal-otolith response to transient, high-acceleration combined linear-angular head movements to find a reliable way to test the otolith function. Based on physiological principles and my preliminary experiment, we plan to use an off-axis head rotation procedure, a three-dimensional eye movement recordings and vector analysis technique to assess the linear and angular vestibulo-ocular reflex response from the otoliths and semicircular canals in the labyrinth. The practical significance of answers to these questions is that they will characterise the combined linear and angular vestibulo-ocular reflex responses that stabilise vision during transient head movements. It will provide us with a greater understanding of the visual disturbance that patients experienced during these kinds of head movements following vestibular disease or surgery. Measurement of the linear vestibulo-ocular reflex may also provide a diagnostic test of otolith function clinically in disease states.Read moreRead less
Behavioural And Physiological Tests Of Clinical Indicators Of Vestibular Function.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Part of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture. Recurring vertigo attacks and persistent imbalance can disrupt the most productive years of patients' lives and balance-related falls account for more the half of accidental deaths in the elderly. Despite this most doctors find dizziness difficult to diagnose and impossible to treat, so specialist Balance Disorders Clinics see many patients a year but still have very long waiting ti ....Part of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture. Recurring vertigo attacks and persistent imbalance can disrupt the most productive years of patients' lives and balance-related falls account for more the half of accidental deaths in the elderly. Despite this most doctors find dizziness difficult to diagnose and impossible to treat, so specialist Balance Disorders Clinics see many patients a year but still have very long waiting times. There is then clearly a major need to improve the understanding and the treatment of dizzy patients and improvement will come about through scientific understanding of vestibular dysfunction, and technological realization of improvements in the assessment and treatment of patients. This project seeks to identify whether 3 simple new indicators of balance function are valid, using tests on guinea pigs to understand the way in which they work.Read moreRead less
Vestibulo-ocular Responses To Bone Conducted Vibration
Funder
National Health and Medical Research Council
Funding Amount
$282,772.00
Summary
This project is about an entirely new way of clinically evaluating balance function of the inner ear by using bone conducted vibration (BCV). We will make measures of the BCV stimulus in order to specify the stimulus at the receptors, and relate this stimulus to the eye-movement responses it causes. Measuring the exact stimulus and the response will give us a much better understanding of why this stimulus works, allowing us to optimize the clinical tests of balance function.
The Neural Basis Of Clinical Vestibular Testing By Bone Conducted Sound
Funder
National Health and Medical Research Council
Funding Amount
$260,986.00
Summary
Dysfunction of the balance system of the inner ear (the vestibular system) causes recurring dizzy attacks and persistent unsteadiness which can disrupt the most productive years of some people's lives. Balance-related falls account for more than half of accidental deaths in the elderly (Marchetti and Whitney 2005). Despite this, most doctors find dizziness difficult to diagnose and almost impossible to treat in part because of the subjective nature of the patients' reports. Fast, simple, safe, o ....Dysfunction of the balance system of the inner ear (the vestibular system) causes recurring dizzy attacks and persistent unsteadiness which can disrupt the most productive years of some people's lives. Balance-related falls account for more than half of accidental deaths in the elderly (Marchetti and Whitney 2005). Despite this, most doctors find dizziness difficult to diagnose and almost impossible to treat in part because of the subjective nature of the patients' reports. Fast, simple, safe, objective clinical tests are needed to diagnose these patients' problems and to identify which of the 10 vestibular sensory regions is affected. A new way of testing balance function is to use sound because sound can activate the vestibular system as well as the auditory system. We are using that fact to develop a whole new way of clinical testing of vestibular function and this largely Australian development has been very rapidly accepted by the international vestibular community. In a recent NHMRC project (253620) we discovered 1) that bone conducted vibration specifically activates some sensory nerves from one of the gravity sensing regions of the balance system (the otoliths) and 2) that air-conducted (AC) sound and bone-conducted vibration (BCV) appear to probe the function of different vestibular sensory regions 3) most importantly that BCV causes an eye movement response in alert guinea pigs (as it does in alert human subjects). This seems to be the objective response for testing otolith function which we are seeking. In this project we plan to extend these results by recording single vestibular nerve cells in guinea pigs, testing hypotheses about their responses to various types of sound and then injecting the neurons with stains which will allow us to confirm definitely the location of the receptors activated by the sound stimuli. The outcome will be the physiological basis of a new clinical test of balance using bone conducted vibration.Read moreRead less