Research in Vestibular Science

Original Articles

Unilateral Vestibulopathy Mimicking Inner Ear Ischemia Modeling Using Photothrombosis and Behavioral Assessment Using EthoVision: Min Seok Song, Min Young Lee, Ji Eun Choi, So-Young Chang, Jae-Hun Lee, John Patrick Cuenca, Nathaniel T. Carpena, Jae Yun Jung; Res Vestib Sci. 2023;22(4):112-119. Published online December 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.4.112

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Abstract PDF: Objectives
Inner ear ischemic animal models using photochemical reactions have been devised in various ways. Localized vascular ischemia occurs with 532-nm laser irradiation after systemic rose bengal injection, a known photothrombotic mechanism. The aim of this study is to evaluate a photothrombosis-induced vestibulopathy mimicking behavioral changes in the inner ear ischemia model.
Methods
Seven-week-old male Spraque-Dawley rats were used. Animals were divided into three groups: control group (n=6), sham laser group (n=9), and laser group (n=9). To induce the photothrombosis, animals were injected with rose bengal into the femoral vein and then were irradiated with a 532-nm laser (175 mW for 900 seconds) via transtympanic membrane. To investigate the vestibulopathy after photothrombosis, the behavior tests (tail lift reflex test, air righting reflex test, rotarod test) were performed on the 1st, 3rd, and 7th days after surgery. Additionally, an open field test was conducted and analyzed using EthoVision XT (Noldus).
Results
The laser group exhibited significant behavioral change to mimic vestibulopathy in all assessments. Inducing photothrombosis with rose bengal caused severe gait instability, which precluded rotarod testing. In the tail lift reflex test, the laser group displayed vestibular dysfunction with a lower angle formation compared to the control rats. During the open field test, the laser group exhibited reduced mobility, a condition that persisted in the laser groups for 7 days.
Conclusions
Noninvasive laser irradiation using rose bengal and a 532-nm laser induces photothrombosis in the inner ear of animals, leading to the development of vestibulopathy mimicking imbalanced behavior.

A Comparative Analysis of the Vestibulocochlear Function in Patients with Isolated Semicircular Canal Hypofunction Using a Video Head Impulse Test: Yu Jung Park, Min Young Lee, Ji Eun Choi, Jae Yun Jung, Jung Hwa Bahng; Res Vestib Sci. 2023;22(2):34-45. Published online June 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.2.34

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Abstract PDF: Objectives
The objective of this study was to analyze vestibulocochlear function results in patients identified with isolated semicircular canal (SCC) hypofunction using the video head impulse test (vHIT).
Methods
A retrospective review was conducted on the clinical records of 123 patients diagnosed with isolated SCC hypofunction based on vHIT results. Among these patients, 72 had isolated posterior SCC (PSCC) hypofunction, 25 had isolated lateral SCC (LSCC) hypofunction, and 26 had isolated anterior SCC (ASCC) hypofunction. Descriptive analyses were performed on various vestibulocochlear tests including pure tone audiometry, sinusoidal harmonic acceleration (SHA), spontaneous nystagmus (SN), head-shaking nystagmus (HSN), caloric testing, and cervical vestibular evoked myogenic potential, with results analyzed separately for each SCC hypofunction group.
Results
The study found that 66.0% of the evaluated patients exhibited abnormal results in at least one vestibulocochlear function test. PSCC hypofunction patients showed a significantly higher incidence of hearing loss compared to ASCC and LSCC hypofunction patients. LSCC hypofunction patients exhibited higher rates of corrective saccade, phase asymmetry of SHA, and SN abnormalities compared to other SCC hypofunction patients. Additionally, the rates of corrective saccade and phase asymmetry of SHA were also higher in LSCC hypofunction patients. ASCC hypofunction patients demonstrated significantly higher rates of normal corrective saccade, phase lead of SHA, and SN.
Conclusions
The analysis of this study suggests that even in cases where vHIT indicates isolated SCC hypofunction, additional vestibulocochlear function tests should be conducted to identify any associated vestibulocochlear dysfunctions. This highlights the importance of comprehensive evaluation to accurately diagnose and manage patients with SCC hypofunction.

Retraction

Retraction of “Factors Associated with Patient Satisfaction in Customized Vestibular Exercise: A Pilot Study”: Hye Soo Ryu, Min Young Lee, Jae Yun Jung, Ji Eun Choi; Res Vestib Sci. 2020;19(4):149-149. Published online December 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.4.149; Retracts: Res Vestib Sci 2019;18(3):71

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PDF

Original Articles

Can Cupulolithiasis Affect the Time Constant or Gain of the Velocity Step Test?: Min Tae Kim, Ji Eun Choi, Min Young Lee, Jae Yun Jung; Res Vestib Sci. 2019;18(4):98-102. Published online December 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.4.98

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Abstract PDF

Objectives
The nystagmus evoked by an angular velocity step is influenced by the cupula dynamics and the status of velocity storage mechanisms. This study questioned whether the cupulolithiasis of horizontal canal benign paroxysmal positional vertigo (HC-BPPV) affects the time constant or gain of the velocity step test.
Methods
We performed a retrospective study of 30 patients who diagnosed with HC-BPPV and performed rotary chair test at Dankook University Hospital from June 2010 to May 2017. All patients had normal vestibular function on the sinusoidal harmonic acceleration test. According to the direction of nystagmus on the head roll test, we further divided the patients into “geotrophic” (canalolithiasis) and “apogeotrophic” (cupulolithiasis) groups. We compared the time constant (Tc), gain, and directional preponderance (DP) between the 2 groups. We also compared the time constant and gain between lesion side of BPPV and normal side in each group.
Results
In the supine head roll, geotrophic nystagmus observed in 14 patients and apogeotrophic nystagmus observed in 16 patients. When parameters of the velocity step test compared according to lesion side of BPPV (per-rotary of lesion side, postrotary of lesion side, per-rotary of normal side, and postrotary of normal side), there were no significant differences in Tc, gain, and DP between the 2 groups. There were also no significant differences in Tc and gain between lesion side and normal side in each group.
Conclusions
We assumed that cupulolithiasis of HC-BPPV could affect the cupular deflection evoked by an angular velocity step, but there were no significant differences in Tc and gain between patients with cupulolithiasis and canalolithiasis.

Citations

Citations to this article as recorded by

Influence of Otoliths on the Vestibulo-Ocular Reflex in Horizontal Canal Benign Paroxysmal Positional Vertigo
Hee Soo Yoon, Jae Yeong Jeong, Jae Ho Chung, Ha Young Byun, Chul Won Park, Seung Hwan Lee
Research in Vestibular Science.2020; 19(2): 49. CrossRef

Factors Associated with Patient Satisfaction in Customized Vestibular Exercise: A Pilot Study: Hye Soo Ryu, Min Young Lee, Jae Yun Jung, Ji Eun Choi; Res Vestib Sci. 2019;18(3):71-77. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.71; Retraction in: Res Vestib Sci 2020;19(4):149

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Factors associated with patient satisfaction in customized vestibular exercise : pilot study: Hye Soo Ryu, Min Young Lee, Jae Yun Jung, Ji Eun Choi; Received June 20, 2019 Accepted August 26, 2019 Published online August 26, 2019; [Accepted]

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Abstract: Numerous studies have been reported on the effect of customized vestibular exercise (VE), but little study has been reported on the satisfaction of customized VE. Therefore, this study aims to investigate the factors that affect the satisfaction of customized VE. A telephone survey was conducted on 37 patients who underwent customized vestibular exercise from January to November 2018. The questionnaire consisted of a total of 10 items, including subjective symptom, compliance and satisfaction of exercise, preferred methods of exercise, and appropriate costs. Based on the questionnaire of satisfaction, the clinical features, improvement of symptom, compliance, preferred methods of exercise were compared between satisfactory and unsatisfactory groups. Of the 20 patients who responded to the telephone survey (response rate 57%), 10 patients were included in the satisfactory group and the remaining ten were included in the unsatisfactory group. There were not significant differences between two groups in age, sex, severity of subjective symptom before customized VE, preferred methods of exercise. subjective dizziness after customized VE was significantly decreased in the satisfactory group, but there was no significant difference in the unsatisfactory group. The satisfaction of customized VE was significantly lower in patients with chronic uncompensated vestibulopathy, postural instability, less improvement of dizziness, or poor compliance. The satisfaction of the customized vestibular movement is thought to be closely related to the treatment effect and compliance. Thus, in addition to prescribing appropriate customized exercise, it is necessary to educate the patients and to provide a variety of ways to improve compliance.

Original Articles

Cervical Vestibular Evoked Myogenic Potential as a Prognostic Indicator of Benign Paroxysmal Positional Vertigo Recurrence: Min Su Kang, Hyun Ju Han, Min Young Lee, Jae Yung Jung; Res Vestib Sci. 2017;16(2):53-56. Published online June 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.2.53

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Abstract PDF: Objectives
Recently there was hypothesis that relates the otolith dysfunction to the recurrence of benign paroxysmal positional vertigo (BPPV). Therefore in the present study, we assessed relationship between cervical vestibular evoked myogenic potential (cVEMP) and BPPV recurrence and raise the possibility of cVEMP as a recurrence indicator of BPPV. Methods: A retrospective review of patient from November 2009 to June 2014 was carried out. Ninety-four patients who suffered from BPPV were enrolled. Medical record review and telephone survey was done to check BPPV recurrence. Results: In medical record review, normal cVEMP group showed 18.9% recurrence rate and abnormal cVEMP group showed 25%. In telephone survey, normal cVEMP group showed 39.19% recurrence rate and abnormal cVEMP group showed 60%. There was no significant statistical difference. Conclusions: cVEMP abnormality was not a risk factor of BPPV recurrence. Further study with larger number of enrolled subjects is necessary.

Clinical Significance of Spontaneous Nystagmus Frequency in Vestibular Neuronitis: Sang Hyun Park, Min Young Lee, Jae Yun Jung; Res Vestib Sci. 2016;15(2):55-59. Published online June 15, 2016

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Abstract PDF: OBJECTIVE: Spontaneous nystagmus is typical sign in vestibular neuronitis. However, the clinical significance of spontaneous nystagmus frequency remains unclear. The aim of this study is to analyze the spontaneous nystagmus frequency in patients with vestibular neuronitis.
METHODS
Twenty-five patients with vestibular neuronitis were included. Patients were divided good (≥20%) and poor (<20%) group according to change of spontanous nystagmus frequency. Frequency and velocity of spontaneous nystagmus were analyzed by using video-nystagmography. Caloric test and slow harmonic acceleration test were also performed.
RESULTS
There was a positive linear correlation between frequency and velocity in initial and follow test (R²=0.51, 0.43, p<0.01, p<0.01). Also, there was a strong positive linear correlation betweeng change of frequency and change of velocity (R²=0.64, p<0.01). The phase lead of slow harmonic acceleration test of good group was smaller compared with poor group, and this was statistically significant in 0.04 Hz.
CONCLUSION
We suggested that frequency of spontaneous nystagmus may be a useful clinical factor in vestibular neuronitis.

Review

The Principle and Methodology of Vestibular Evoked Myogenic Potential: Min Young Lee, Myung Whan Suh; Res Vestib Sci. 2015;14(1):9-14.

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Abstract PDF: Vestibular evoked myogenic potential (VEMP) has developed as a broadly applied vestibular function test in clinics from its introduction in 1992. In the past, there was only one well known VEMP protocol, which is cervical VEMP, however recently ocular VEMP is also popular. Therefore, clarifying the VEMP recording protocol (cervical VEMP or ocular VEMP) before discussing the VEMP
result
has become essential. There is considerable difference regarding this VEMP test from other vestibular function tests. VEMP is thought to be assessing the functions of the otolith organs (utricle and saccule) which are evoked by acoustic stimulus. Cervical VEMP is valuable since this is the only available test method which could speculate the function of the saccule and inferior vestibular nerve. Still, there’s less clearly understood part regarding the central pathway of VEMP. However, many clinicians and researchers participating in vestibular research speculate that this functional test will have a more dominant role in the near future. Here we describe the basic principles and methodological considerations regarding VEMP recording.

Case Report

A Case of Bilateral Benign Paroxysmal Positional Vertigo in Bilateral Mondini Malformation With Right Enlarged Vestibular Aqueduct Syndrome: Min Young Lee, Sung Do Jung, Myung Whan Suh, Jae Yun Jung; Res Vestib Sci. 2012;11(2):77-80.

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Abstract PDF: Enlarged vestibular aqueduct syndrome (EVAS) is well known congenital bony ear anomaly. It’s audiologic symptoms and radiological findings are reported in many literatures. However vestibular symptoms of EVAS are rarely reported. A patient with right EVAS developed sudden spinning vertigo on casual observation. He is diagnosed as bilateral benign paroxysmal positional vertigo and recovered by canal repositioning maneuver. We present this case with reviews of previous literatures.

Original Articles

Correlation between Spontaneous Nystagmus and Vestibular Function Test Parameters according to Gender and Age in Vestibular Neuritis: Jae Yun Jung, Eun Seok Lim, Young Saeng Kim, Min Young Lee, Yong Won Chung, Chung Ku Rhee; J Korean Bal Soc. 2006;5(2):248-252.

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Abstract PDF: Background
and Objectives: There are caloric test, SCEP, DP in Step velocity and VOR asymmetry in SHA test as parameters for evaluation in unilateral peripheral vestibulopathy in parameter of vestibular function test. The aim of this study is to assess the correlation between these parameters and intensity of spontaneous nystagmus in vestibular neuritis. Materials and Method: We evaluated 75 patients who were diagnosed as vestibular neuritis with 3 degree spontaneous nystagmus at vestibular function test lab from January 2000 to July 2005 in Dankook university hospital. The correlations between direction and intensity of spontaneous nystagmus and monothermal caloric test, SCEP and DP in step velocity, VOR asymmetry (0.01, 0.04, 0.16 Hz) in SHA test were analysed. And correlations according to sex, age were also analysed.
Results
The correlation coefficient between intensity of spontaneous nystagmus and monothermal caloric test was 0.60. The correlation coefficient between intensity of spontaneous nystagmus and SCEP was 0.35. The correlation coefficient between intensity of spontaneous nystagmus and Tc DP was 0.36 and it showed no significant correlation. The correlation coefficient between intensity of spontaneous nystagmus and VOR asymmetry (0.01, 0.04, 0.16) was 0.57, 0.46, 0.51, respectively and there was higher correlation in man, age under 60.
Conclusion
Intensity of spontaneous nystagmus showed close relations to monothermal caloric test, VOR asymmetry of SHA, Tc DP, SCEP DP in sequence. In addition, young male patients tends to be closely related to intensity of spontaneous nystagmus. Key Words : Spontaneous nystagmus, Vestibular function test, Vestibular neuritis

A Promotive Effect of Low Level Laser on Hair Cell Viability in Postnatal Organotypic Culture of Rat Utricles: Yong Won Chung, Jin Chul Ahn, Eun Seok Lim, Young Saeng Kim, Min Young Lee, Jae Yun Jung, Chung Ku Rhee; J Korean Bal Soc. 2006;5(1):29-34.

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Abstract PDF: Background
and Objectives: To culture and maintain mammalian hair cells is still a big challenge. In this study, long-term organotypic culture of rat utricular maculae was established to study vestibular hair cell. The effects of low level laser on hair cell viability in postnatal organotypic culture of rat utricles were investigated. Materials and Method: Uticular explants were prepared from postnatal 2 to 7 rats and cultured. To improve hair cell survival, the utricles were irradiated daily with low level laser. Whole-mount utricles were stained with FM1-43 which is known to be an efficient marker to identify live hair cells in cultured tissues. Such cells visualized directly through tissue culture dish with cover glass bottom by Confocal laser scanning microscope at specific time points.
Results
The explanted utricular hair cells were cultured for up to 31 days in in vitro culture system. In low level laser irradiation group, utricular hair cells were more survived at 24 DIV and 31 DIV.
Conclusion
These results suggest that low level laser promotes hair cell viability in utricular explants. Key Words : Organotypic culture, Low level laser, FM 1-43, Utricle

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