Research in Vestibular Science

Original Articles

Clinical Characteristics of Benign Paroxysmal Positional Vertigo Positive on Bilateral Dix-Hallpike Test: Youngrok Jo, Gun Min Lee, Youn Jin Cho, Mi Joo Kim, Minbum Kim; Res Vestib Sci. 2023;22(1):14-18. Published online March 13, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.1.14

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Abstract PDF: Objectives
The purpose of this study is to investigate the clinical characteristics of benign paroxysmal positional vertigo (BPPV) which showed torsional nystagmus on bilateral Dix-Hallpike test, and to analyze the clinical features of pseudo-bilateral BPPV.
Methods
This study is a retrospective chart review of a total of 341 patients diagnosed with BPPV of posterior canal (PC-BPPV). Among them, patients who showed torsional nystagmus on bilateral Dix-Hallpike test were defined as “bilateral DixHallpike positive patients,” who were classified into true- and pseudo-bilateral PC-BPPV group through analysis of nystagmus direction. And pseudo-bilateral PC-BPPV were categorized into two subtypes according to their pathomechanisms. Clinical characteristics including sex, age, underlying vestibular disorders, recurrence and the number of Epley maneuvers were analyzed. Student t-test and Mann-Whitney U-test were used for statistical analysis.
Results
Among 341 patients, 27 patients (7.9%) were “bilateral Dix-Hallpike positive patients”. They received more Epley maneuvers than the group of unilateral PC-BPPV until the resolution of nystagmus (2.3 vs. 1.4, p＜0.001). Fifteen patients out of 27 were diagnosed with pseudo-bilateral PC-BPPV, who were classified into two subtypes according to their pathomechanisms. The number of Epley maneuvers was not different between true- and pseudo-bilateral PC-BPPV.
Conclusions
Patients with pseudo-bilateral PC-BPPV were common among “bilateral Dix-Hallpike positive patients.” For their better treatment, understanding of possible pathophysiology, accurate Dix-Hallpike test and detailed analysis of nystagmus direction are necessary.

Effect of Korean Red Ginseng on Early Vestibular Function Restoration after Unilateral Labyrinthectomy: Jiyeon Lee, Mi Joo Kim, Gyu Cheol Han; Res Vestib Sci. 2020;19(3):79-88. Published online September 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.3.79

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Abstract PDF: Objectives
Vertigo is a common condition. Definitive treatment is to induce vestibular compensation. Currently, no medications have been discovered that enhance vestibular functional restoration. The current study was conducted to evaluate the ability of ordinary Korean red ginseng (KRG) to induce vestibular compensation.
Methods
Twelve Sprague-Dawley rats were divided into two groups. Five rats (KRG group) were fed KRG extract (100 mg/kg) for 2 weeks before undergoing unilateral labyrinthectomy (ULx). The remaining seven rats (control group) were untreated before ULx. After surgery, all animals were housed in the same environment without being fed additional extract. To evaluate vestibular function, gain of the horizontal nystagmus to 0.2 Hz with a peak velocity of 100°/second sinusoidal rotation was compared and analyzed before ULx as well as 3 and 7 days after surgery.
Results
Before the operation, gain of the control and KRG group were 0.81±0.05 and 0.88±0.08, respectively, with 0.2-Hz stimulation. This value decreased to 0.43±0.08 and 0.53±0.08, respectively on 3 days after operation (p=0.047), and it was 0.40±0.06 and 0.68±0.11, respectively on 7 days after surgery. The difference of gain between the two groups was statistically significant at each 3 and 7 days (p＜0.05). By confirming c-Fos protein expression in medial vestibular nuclei, the functional effect of KRG causing vestibular modulation was confirmed.
Conclusions
Rats treated with KRG showed more rapid and complete recovery after acute vestibular loss compared to untreated animals. Therefore, KRG could be one of candidate for the useful medication of vestibular diseases.

Characteristics of Nystagmus during Attack of Vestibular Migraine: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Res Vestib Sci. 2019;18(2):38-42. Published online June 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.2.38

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Abstract PDF

Objectives
The purpose of this study is to investigate characteristics of nystagmus during attacks of vestibular migraine (VM), and to find a distinct clinical feature compared to other migraine and peripheral vestibular disorders.
Methods
This study is a retrospective chart review of 82 patients satisfied with VM criteria, which is formulated by the new Bárány Society. Spontaneous and positional nystagmus provoked by various head positions were examined with video-nystagmography in all patients. Bithermal caloric test and cervical vestibular evoked myogenic potential test (cVEMP) were also performed. The direction and peak slow-phase velocity (SPV) of nystagmus, unilateral caloric weakness and interaural difference of cVEMP were analyzed. Control groups were lesion side in acute VN for nystagmus results and healthy side in the patients with benign paroxysmal positional vertigo of posterior semicircular canal for caloric and cVEMP results. Chi-square test and Mann-Whitney U-test were used for statistical analysis.
Results
During the acute attack, nystagmus was seen in 71.9% (59 of 82) of patients. Horizontal nystagmus was the predominant type. Peak SPV in VM patients was much slower than in the control group (2.37±1.73 °/sec vs. 17.05±12.69 °/sec, p＜0.0001). There was no significant difference on the result of both caloric and cVEMP test, compared to those of control groups.
Conclusion
Nystagmus with horizontal directions and low SPV was dominant form in the attack of VM. Close observation of nystagmus can be helpful to make a correct diagnosis and to understand the pathomechanism of vertigo in VM.

Citations

Citations to this article as recorded by

Vestibular Migraine: A Recent Update on Diagnosis and Treatment
Young Seo Kim, Hak Seung Lee
Research in Vestibular Science.2022; 21(3): 67. CrossRef

Laboratory Management Status of Vestibular Function Test in Korea: Tae Su Kim, Mi Joo Kim, Byung-Kun Kim, Hyun Ah Kim, Dae Woong Bae, Miran Bae, Seong-Cheon Bae, Eeksung Lee, Eun-Ju Jeon; Res Vestib Sci. 2018;17(4):160-166. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.160

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Abstract PDF Supplementary Material

Objectives
This study was conducted to assess the current management status of the vestibular function test laboratories in Korea.
Methods
Questionnaire about the management status of the vestibular function test laboratories was sent by email to the entire members of the Korean Balance Society. The contents of questionnaire included situation of employees who perform the tests, the types of vestibular function tests and equipment, frequency of the test and types of dizziness related questionnaires.
Results
Forty-nine hospitals and clinics responded. All the 49 respondents answered that they have videonystagmography. Spontaneous nystagmus analysis by videonystagmogrphy was the most frequently tests for patients with dizziness. Questionnaires for dizziness were used by 27 respondents (55.1%) for initial evaluation of the dizziness patients. The Korean version of dizziness handicap inventory was the most frequently used dizziness related questionnaire. Conclusions: We analyzed the current management status of vestibular function test laboratories to comprehend the present condition of the vestibular function test. We think that these results will help to provide a standard for laboratory operations and prepare for the education, focusing on high-demand tests.

Citations

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The impact examination of the head tilt size on the subjective visual vertical (SVV) among the normal individuals with ages ranged from 18 to 35 years
Mahmoud Rezvani Amin, Hadi Behzad
Hearing, Balance and Communication.2022; 20(2): 129. CrossRef

Identification of Vestibular Organ Originated Information on Spatial Memory in Mice: Gyu Cheol Han, Minbum Kim, Mi Joo Kim; Res Vestib Sci. 2018;17(4):134-141. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.134

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Abstract PDF

Objectives
We aimed to study the role of vestibular input on spatial memory performance in mice that had undergone bilateral surgical labyrinthectomy, semicircular canal (SCC) occlusion and 4G hypergravity exposure.
Methods
Twelve to 16 weeks old ICR mice (n=30) were used for the experiment. The experimental group divided into 3 groups. One group had undergone bilateral chemical labyrinthectomy, and the other group had performed SCC occlusion surgery, and the last group was exposed to 4G hypergravity for 2 weeks. The movement of mice was recorded using camera in Y maze which had 3 radial arms (35 cm long, 7 cm high, 10 cm wide). We counted the number of visiting arms and analyzed the information of arm selection using program we developed before and after procedure.
Results
The bilateral labyrinthectomy group which semicircular canal and otolithic function was impaired showed low behavioral performance and spacial memory. The semicircular canal occlusion with CO2 laser group which only semicircular canal function was impaired showed no difference in performance activity and spatial memory. However the hypergravity exposure group in which only otolithic function impaired showed spatial memory function was affected but the behavioral performance was spared. The impairment of spatial memory recovered after a few days after exposure in hypergravity group.
Conclusions
This spatial memory function was affected by bilateral vestibular loss. Space-related information processing seems to be determined by otolithic organ information rather than semicircular canals. Due to otolithic function impairment, spatial learning was impaired after exposure to gravity changes in animals and this impaired performance was compensated after normal gravity exposure.

Citations

Citations to this article as recorded by

Galvanic Vestibular Stimulation Improves Spatial Cognition After Unilateral Labyrinthectomy in Mice
Thanh Tin Nguyen, Gi-Sung Nam, Jin-Ju Kang, Gyu Cheol Han, Ji-Soo Kim, Marianne Dieterich, Sun-Young Oh
Frontiers in Neurology.2021;[Epub] CrossRef
The Differential Effects of Acute Right- vs. Left-Sided Vestibular Deafferentation on Spatial Cognition in Unilateral Labyrinthectomized Mice
Thanh Tin Nguyen, Gi-Sung Nam, Jin-Ju Kang, Gyu Cheol Han, Ji-Soo Kim, Marianne Dieterich, Sun-Young Oh
Frontiers in Neurology.2021;[Epub] CrossRef

Review

Posttraumatic Peripheral Vertigo: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Res Vestib Sci. 2018;17(4):125-129. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.125

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Abstract PDF: Posttraumatic vertigo can be defined as the vertiginous disorder occurred after head and neck trauma without other pre-existing vestibular disorder. Central, peripheral, and combined deficits might cause this condition. Especially, various peripheral vestibulopathies are possible causes of posttraumatic vertigo; benign paroxysmal positional vertigo, temporal bone fracture, perilymphatic fistula, labyrinthine concussion, posttraumatic hydrops, and cervical vertigo. Since the differential diagnosis of the posttraumatic vertigo is often difficult, it is essential to acquire knowledge of their pathophysiology and clinical features. In this review, peripheral vestibulopathy as the possible causes of posttraumatic vertigo were described according to the current literature.

마우스 공간지각과 기억 형성에 미치는 전정 유래 정보의 규명: Mi Joo Kim, Minbum Kim, Gyu Cheol Han; Received November 5, 2018 Accepted December 3, 2018 Published online December 3, 2018; [Accepted]

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Abstract: Objectives
: We aimed to study the role of vestibular input on spatial memory performance in mice that had undergone bilateral surgical labyrinthectomy, SCC occlusion and 4G hypergravity exposure.
Methods
: ICR mice(n=30) were used for the experiment. The experimental group divided into 3 groups. One group had undergone bilateral chemical labyrinthectomy, and the other group had performed SCC occlusion surgery and the last group was exposed to 4G hypergravity for two weeks. The movement of mice were recorded using camera in Y maze which had 3 radial arms. We counted the number of visiting arms and analyzed the information of arm selection using program we developed before and after procedure.
Results
: The bilateral labyrinthectomy group which semicircular canal & otolithic function was impaired showed low behavioral performance and spacial memory. The semicircular canal occlusion with CO2 laser group which only semicircular canal function was impaired showed no difference in performance activity and spatial memory. However the hypergravity exposure group in which only otolithic function impaired showed spatial memory function was affected but the behavioral performance was spared. The impairment of spatial memory recovered after a few days after exposure in hypergravity group.
Conclusion
: This spatial memory function was affected by bilateral vestibular loss. Space-related information processing seems to be determined by otolithic organ information rather than semicircular canals. Due to otolithic function impairment, spatial learning was impaired after exposure to gravity changes in animals and this impaired performance was compensated after normal gravity exposure.

Post-traumatic peripheral vertigo: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Received November 28, 2018 Accepted December 1, 2018 Published online December 1, 2018; [Accepted]

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Abstract: Post-traumatic vertigo can be defined as the vertiginous disorder occurred after head and neck trauma without other pre-existing vestibular disorder. Central, peripheral and combined deficits might cause this condition. Especially, various peripheral vestibulopathies are possible causes of post-traumatic vertigo; benign paroxysmal positional vertigo (BPPV), temporal bone fracture, perilymphatic fistula, labyrinthine concussion, post-traumatic hydrops and cervical vertigo. Since the differential diagnosis of the post-traumatic vertigo is often difficult, it is essential to acquire knowledge of their pathophysiology and clinical features. In this review, peripheral vestibulopathy as the possible causes of post-traumatic vertigo were described according to the current literature.

Post-traumatic peripheral vertigo: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Received November 28, 2018 Accepted December 1, 2018 Published online December 1, 2018; [Accepted]

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Abstract: Post-traumatic vertigo can be defined as the vertiginous disorder occurred after head and neck trauma without other pre-existing vestibular disorder. Central, peripheral and combined deficits might cause this condition. Especially, various peripheral vestibulopathies are possible causes of post-traumatic vertigo; benign paroxysmal positional vertigo (BPPV), temporal bone fracture, perilymphatic fistula, labyrinthine concussion, post-traumatic hydrops and cervical vertigo. Since the differential diagnosis of the post-traumatic vertigo is often difficult, it is essential to acquire knowledge of their pathophysiology and clinical features. In this review, peripheral vestibulopathy as the possible causes of post-traumatic vertigo were described according to the current literature.

Original Article

Hyper-response of Cervical Vestibular Evoked Myogenic Potential in Patients with Meniere Disease: A Preliminary Study: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Res Vestib Sci. 2018;17(2):44-48. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.44

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Abstract PDF

Objectives
The purpose of this study is to investigate the hyper-responsiveness of cervical vestibular-evoked myogenic potential (cVEMP) in patients with Meniere disease (MD), and to compare the result of cVEMP between probable and definite MD group.
Methods
A total of 110 patients satisfied with probable MD and definite MD criteria, which is recently formulated by the Classification Committee of the Bárány Society, were included. An interpeak amplitude and interaural amplitude difference (IAD) ratio of both ears was measured. The abnormal response of ipsi-lesional cVEMP was categorized into 2 groups; hyper-response and hypo-response. Chi-square test and Mann-Whitney U-test were used for statistical analysis.
Results
In the probable MD and definite MD group, the mean IAD was 25.24%±17.79% and 53.82%±34.98%, respectively (p＜0.01). The abnormal response of cVEMP at the affected ear was more frequent in the definite MD group, compared to the probable MD group (32/40 vs. 13/36, p＜0.01). However, hyper-response was more frequently observed in the patients with probable MD, compared to the patients with definite MD (13/36 vs. 3/40, p＜0.01).
Conclusion
Hyper-response of cVEMP was more frequently observed in the early probable MD patients. It might be an early sign of MD, related with the saccular hydrops, which can help the early detection and treatment.

Citations

Citations to this article as recorded by

Superior Semicircular Canal Dehiscence Syndrome Manifested as Menière’s Disease: A Case Report
Byeong Jin Kim, Yun Na Yang, Chan Mi Lee, Eun Jung Lee
Research in Vestibular Science.2021; 20(3): 108. CrossRef
Characteristics of Nystagmus during Attack of Vestibular Migraine
Soyeon Yoon, Mi Joo Kim, Minbum Kim
Research in Vestibular Science.2019; 18(2): 38. CrossRef

Hyper-response of cVEMP (cervical vestibular evoked myogenic potential) in patients with Meniere disease : a preliminary study: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Received May 16, 2018 Accepted June 5, 2018 Published online June 5, 2018; [Accepted]

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Abstract: Objective: The purpose of this study is to investigate the hyper-responsiveness of cervical vestibular-evoked myogenic potential (cVEMP) in patients with Meniere’s disease (MD) , and to compare the result of cVEMP between probable and definite MD group.
Methods
A total of 110 patients satisfied with “Definite” and “Probable MD” criteria, which is recently formulated by the Classification Committee of the Bárány Society, were included. An inter-peak amplitude and interaural amplitude difference (IAD) ratio of both ears was measured. The abnormal response of ipsi-lesional cVEMP was categorized into two groups; “hyper-response” and “hypo-response”. Chi-square test and Mann-Whitney U test were used for statistical analysis.
Results
In the “Probable MD” and “Definite MD” group, the mean IAD was 25.24±17.79% and 53.82±34.98% , respectively (p<0.01). The abnormal response of cVEMP at the affected ear was more frequent in the “Definite MD” group, compared to the “Probable MD” group (32/40 vs. 13/36, p<0.01). However, hyper-response was more frequently observed in the patients with “Probable MD” , compared to the patients with “Definite MD” (13/36 vs. 3/40, p<0.01).
Conclusion
Hyper-response of cVEMP was more frequently observed in the early “probable MD” patients. It might be an early sign of MD, related with the saccular hydrops, which can help the early detection and treatment.

Hyper-response of cVEMP (cervical vestibular evoked myogenic potential) in patients with Meniere disease : a preliminary study: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Received May 16, 2018 Accepted June 5, 2018 Published online June 5, 2018; [Accepted]

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Abstract: Objective: The purpose of this study is to investigate the hyper-responsiveness of cervical vestibular-evoked myogenic potential (cVEMP) in patients with Meniere’s disease (MD) , and to compare the result of cVEMP between probable and definite MD group.
Methods
A total of 110 patients satisfied with “Definite” and “Probable MD” criteria, which is recently formulated by the Classification Committee of the Bárány Society, were included. An inter-peak amplitude and interaural amplitude difference (IAD) ratio of both ears was measured. The abnormal response of ipsi-lesional cVEMP was categorized into two groups; “hyper-response” and “hypo-response”. Chi-square test and Mann-Whitney U test were used for statistical analysis.
Results
In the “Probable MD” and “Definite MD” group, the mean IAD was 25.24±17.79% and 53.82±34.98% , respectively (p<0.01). The abnormal response of cVEMP at the affected ear was more frequent in the “Definite MD” group, compared to the “Probable MD” group (32/40 vs. 13/36, p<0.01). However, hyper-response was more frequently observed in the patients with “Probable MD” , compared to the patients with “Definite MD” (13/36 vs. 3/40, p<0.01).
Conclusion
Hyper-response of cVEMP was more frequently observed in the early “probable MD” patients. It might be an early sign of MD, related with the saccular hydrops, which can help the early detection and treatment.

Hyper-response of cVEMP (cervical vestibular evoked myogenic potential) in patients with Meniere disease : a preliminary study: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Received May 16, 2018 Accepted June 5, 2018 Published online June 5, 2018; [Accepted]

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Abstract: Objective: The purpose of this study is to investigate the hyper-responsiveness of cervical vestibular-evoked myogenic potential (cVEMP) in patients with Meniere’s disease (MD) , and to compare the result of cVEMP between probable and definite MD group.
Methods
A total of 110 patients satisfied with “Definite” and “Probable MD” criteria, which is recently formulated by the Classification Committee of the Bárány Society, were included. An inter-peak amplitude and interaural amplitude difference (IAD) ratio of both ears was measured. The abnormal response of ipsi-lesional cVEMP was categorized into two groups; “hyper-response” and “hypo-response”. Chi-square test and Mann-Whitney U test were used for statistical analysis.
Results
In the “Probable MD” and “Definite MD” group, the mean IAD was 25.24±17.79% and 53.82±34.98% , respectively (p<0.01). The abnormal response of cVEMP at the affected ear was more frequent in the “Definite MD” group, compared to the “Probable MD” group (32/40 vs. 13/36, p<0.01). However, hyper-response was more frequently observed in the patients with “Probable MD” , compared to the patients with “Definite MD” (13/36 vs. 3/40, p<0.01).
Conclusion
Hyper-response of cVEMP was more frequently observed in the early “probable MD” patients. It might be an early sign of MD, related with the saccular hydrops, which can help the early detection and treatment.

Reviews

Experiemental Model for Ménière’s Disease Using Surgical Ablation of Endolymphatic Sac: Minbum Kim, Mi Joo Kim; Res Vestib Sci. 2016;15(4):95-100. Published online December 12, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.4.95

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Abstract PDF: Endolymphatic hydrops is a representing pathologic finding of Ménière's disease. For the induction of endolymphatic hydrops in an animal model, surgical ablation of endolymphatic sac has been used. Although traditional model with the blockage of endolymphatic sac induced severe hydrops, it has several limitations for the study of pathophysiology of Ménière's disease. Recently, modified experimental models have been introduced, in which additional procedure was performed to induce the acute aggravation of hydrops after the surgical ablation. These new models could be helpful to elucidate the mechanism and develop a new treatment of Ménière's disease. In this review, we introduce the characteristics of animal models using surgical ablation of endolymphatic sac from the classical model to novel modified models.

Acute Vestibular Neuritis and Ramsay-Hunt Syndrome: Mi Joo Kim, Minbum Kim; Res Vestib Sci. 2016;15(4):112-120. Published online December 12, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.4.112

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Abstract PDF: Acute vestibular neuritis is the disorder characterized by acute, spontaneous vertigo with the unilateral vestibular loss. Reactivation of herpes simplex virus is considered as its cause. Its management consists of symptomatic therapy in the acute phase and following rehabilitation exercise to improve central compensation. The differential diagnosis should include central vestibular disorders mimicking peripheral vertigo. Ramsay-Hunt syndrome, which defined as a herpes zoster oticus with facial paresis, is also a disorder frequently accompanied with vestibular deficit. Combination therapy of acyclovir and corticosteroid is recommended for the treatment. In this review, diagnosis and management of the two disorders are described.

전정신경염과 램지헌트 증후군: Mi Joo Kim, Minbum Kim; Received November 14, 2016 Accepted November 20, 2016 Published online November 20, 2016; [Accepted]

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Abstract: Acute vestibular neuritis is the disorder characterized by acute, spontaneous vertigo with the unilateral loss of vestibular loss. Reactivation of herpes simplex virus is considered as its cause. Its management consists of symptomatic therapy in the acute phase and following rehabilitation exercise to improve central compensation. The differential diagnosis should include central vestibular disorders mimicking peripheral vertigo. Ramsay-Hunt syndrome, which defined as a herpes zoster oticus with facial paresis, is also a disorder frequently accompanied with vestibular deficit. Combination therapy of acyclovir and corticosteroid is recommended for the treatment. In this review, the diagnosis and management of the two disorders are described.

Original Articles

Vestibulo-Ocular Reflex Recordings of Small Rodents using a Novel Marker Array: Mi Joo Kim, Jiyeon Lee, Eui Jae Hong, Eun Ji Lee, Yu Jin Min, Dong Ju Lee, Nam Beom Kim, Gyu Cheol Han; Res Vestib Sci. 2016;15(1):11-16.

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Abstract PDF: Objective: Recording the nystagmus of small experimental rodents is an integral technique in vestibular research. Theoretically, the size and the shape of markers strongly affect the analysis of 3 dimensional nystagmus.
Methods
The nystagmus of 6 healthy ICR mice were recorded and their gain values were compared using 200 μm, 300 μm, 400 μm, and 600 μm isosceles triangle markers at the peak velocity of 60o/sec and 100o/sec with the rotational stimulations of 0.1 Hz, 0.2 Hz, and 0.5 Hz.
Results
The gain values of 3 different sizes of the markers showed no significant differences in horizontal- vertical-torsional component. However, it was unable to record the nystagmus with 200 μm markers since the markers were too small to be placed and stayed on the center of the pupils.
Conclusion
Technicians can decide the size of the markers from 200 to 600 ?m to record the nystagmus of mice, depending on the technicians’ skills.

Quantification of Vestibulospinal Reflex Under the Stress Condition on Both Soleus Muscles: Mi Joo Kim, Seo Jin Jang, Eun Ji Lee, Ah Ram Yu, Jong Hyun Hwang, Gyu Cheol Han, Ju Kang Lee; Res Vestib Sci. 2012;11(1):14-22.

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Abstract PDF: Therefore, by establishing method that enables to track and observe quantified VSR, the reliability of experiment is attempted to be increased. Materials and Methods:On five SD Rats to measure electromyogram (EMG), electrodes, in the form of stranded cables composed of seven wires, are chronically implanted on both sides of the soleus muscles. Pre and post operative condition of sitting still, standing, and ladder step walking was compared before, and six and twenty four hours after a unilateral labyrinthectomy with quantified muscle activity in maximal voluntary activity. Simultaneously by using multi modality electric potential plus package, the muscle activity between the two legs was tracked and compared. Results: In the sitting still position, the left/right soleus muscle activities were 25.7/26.0 μV before a unilateral labyrinthectomy which was changed after the surgery with the value of 23.1/8.1 μV and 23.4/14.3 μV when six and twenty four hours passed respectively. In the standing position, 92.8/124.0 μV of preoperative value was changed to 89.6/37.3 μV six hours after the unilateral labyrinthectomy, and it was 97.0/54.7 μV 24 hours after. The preoperative value in ladder step walking test was 56.2/86.0 μV, and postoperative ones were 54.9/21.2 μV and 55.7/38.0 μV after six and twenty four hours respectively. Conclusion: VSR assessment method by using quantitative EMG well reflects the process of vestibular compensation, and to maintain the tension of extensor muscles, ladder step walking test is shown to be useful.

Review

Diagnostic Dehydration Testings for Endolymphatic Hydrops: Mi Joo Kim, Gyu Cheol Han; Res Vestib Sci. 2011;10(2):47-51.

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Original Articles

C-fos Expression of Vestibular Nucleus in C57BL/6 Mouse Under the 7 Tesla Ultra High Magnetic Field: Mi Joo Kim, Min Joo Jung, Ji Hye Bae, Eun Ji Lee, Duk Hyun Kim, Gyu Cheol Han; Res Vestib Sci. 2011;10(1):26-29.

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Abstract PDF: Background and Objectives: A typical side effect of super high magnetic field is dizziness and it is expected that 7 Tesla (T) super high magnetic field will have temporary influence on vestibular nucleus. Prevalence rate of dizziness generally increases with advancing years, so this study discusses whether the influence of 7 T super high magnetic field differs depending on the age. Materials and Methods: C57BL/6 mice weighting from 10-40 g were categorized into 4-week-old and 16-week-old groups. They were exposed to 7 T magnetic field and immunohistochemical staining was done to observe expression of c-fos protein in vestibular nucleus of mice. Results: Control group with normal vestibular system did not show c-fos protein. However, mice exposed to 7 T magnetic field showed c-fos expression selectively on medial and lateral parts of vestibular nucleus and there was no significant difference of c-fos expression between both sides (p<0.05). There was statistically significant difference between the different age group: 16-week-old mice group showed higher number of cells expressing c-fos protein than 4-week-old mice group did (p<0.05). Conclusion: It is statistically significant that 7 T super high magnetic field is more influential to older age group.

Measuring the Behavioral Parameters of Mouse Following Unilateral Labyrinthectomy in Round Free Field Using an Infrared Lamp and a Simple Webcam Camera: Mi Joo Kim, Hyun Jung Hwang, Seung Won Chung, Gyu Cheol Han; Res Vestib Sci. 2011;10(1):12-18.

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Abstract PDF: Background and Objectives: In this research, movements of mouse after labyrinthectomy were analyzed to determine the degree of vestibular dysfunction and compensation. Materials and Methods: By using an infrared lamp, mouse movements were recorded for 100 seconds in a dark room. The experimental area was manufactured as a circular space with a diameter of 60 cm. The movements of five mice labyrinthectomized on right side were observed and recorded at 3 hours, 9 hours and 120 hours after the operation, and also the ten mice of control group. Results: The differences between the total moving distances and the rotating angle from the origin that set the center of round field between groups were analyzed with pictures of 1 frame per second. It is concluded that all 4 groups show significant differences between its mean rotation angle and total moving distances statistically. At 9 hours after right labyrinthectomy, mice tended to turn clockwise; but at 120 hours, there was no significant difference between clockwise and counter-clockwise rotation. Conclusion: Measuring the movement of mouse in round free field can be the proper method to determine the degree of vestibular dysfunction and vestibular compensation. This test was time-saving and cost-effective method.

Case Reports

A Case of Multiple Perilymph Fistula Induced by Tympanostomy Tube Insertion: Seung Won Chung, Mi Joo Kim, Gyu Cheol Han; Res Vestib Sci. 2010;9(1):32-37.

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Abstract PDF: This controversial diagnosis centers around the phenomenon of perilymph leaking from the inner ear into the middle ear cleft through the oval window, round window or other fissures in the bony labyrinth that may be abnormally patent. A perilymph fistula may develop after stapedectomy surgery, penetrating middle ear trauma, head trauma, barotrauma, or possibly spontaneously. Uncertainty regarding the clinical criteria for the diagnosis and the inability to document the presence of a microfistula at surgery contribute to the problematic nature of this diagnosis. However, this condition should be seriously considered in the patient with vertigo after head trauma, barotrauma injury, or previous middle ear surgery. It is particularly likely in patients with penetrating middle ear trauma with vertigo. Most authors agree that perilymph fistulas generally heal spontaneously, therefore a few days of bed rest is appropriate in acute cases. Cases suspected after penetrating trauma should be explored early if symptoms persist. Here, authors report a case of multiple perilymph fistula possibly caused by tympanostomy tube insertion in a 48-year-old man with a review of the literature.

The Comparison of the Magnetic Resonance Images in the Patient With Definite Meniere’s Disease Before and After Endolymphatic Sac Decompression: Mi Joo Kim, Gyu Cheol Han, Seung Won Chung; Res Vestib Sci. 2009;8(2):152-155.

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Abstract PDF: Endolymphatic hydrops is believed to be underlying pathophysiology of Meniere’s disease. The degree of endolymphatic hydrops observed by MRI (magnetic resonance imaging) in patients with Meniere’s disease offers a new method to study the progression of Meniere’s disease. There have been multiple attempts to diagnose Meniere’s disease with the help of radiologic tests including MRI in Korea. We describe a case report of a patient with Meniere’s who showed changes of endolymphatic sac in MRI after endolymphatic sac decompression.

Original Article

Autoantibodies and Complements in Acute Peripheral Vestibulopathy: Mi Joo Kim, Joo Hyun Jung, Chang Hyun Cho, Jung Ho Lee; Res Vestib Sci. 2009;8(1):23-26.

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Abstract PDF: Background and Objectives The etiology and pathophysiology of acute peripheral vestibulopathy are largely unknown. The purpose of this study is to evaluate the manifestation of the autoantibodies and complements in patients with acute peripheral vestibulopathy. Materials and Methods We checked anti-ds-DNA, rheumatoid factor, anti phospholipid IgG and IgM, anti nuclear antibody (ANA), C3, C4 in 72 patients who were diagnosed as acute peripheral vestibulopathy on physical examination and the caloric test. The results of the patients with unilateral acute peripheral vestibulopathy were compared to those of the patients with bilateral acute peripheral vestibulopathy. Results Twelve patients (16.6%) in anti-ds-DNA, 4 patients (5.5%) in C3, 10 patients (13.8%) in C4, 2 patients (2.7%) in anti-phospholipid IgG and 13 patients (18%) in antinuclear antibody (ANA) showed abnormal findings among patients with acute peripheral vestibulpahty. There was no difference in the manifestation of the autoantibodies and complements between the patients with unilateral and bilateral acute peripheral vestibulopathy. Conclusion The autoimmune diseases may be one of etiologic factors in acute peripheral vestibulopathy. Key Words: Autoantibodies; Vestibular Neuronitis; Complement System Proteins

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