管理慢性前庭障碍患者的创新方法:研究前庭误差信号的随访指标和预测标记。

IF 1.3 Q3 REHABILITATION
Frontiers in rehabilitation sciences Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI:10.3389/fresc.2024.1414198
Frédéric Xavier, Emmanuelle Chouin, Brahim Tighilet, Christian Chabbert, Stéphane Besnard
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引用次数: 0

摘要

导言:尽管在了解前庭病变的生化、解剖和功能影响方面取得了重大进展,但为对传统疗法无反应的患者制定标准化的有效康复策略仍是一项挑战。慢性前庭障碍的特点是永久性或反复发作的失衡和视力模糊或震荡,这给非药物治疗带来了极大的复杂性。外周前庭损伤及其对中枢神经系统(CNS)的影响之间复杂的相互作用引发了有关神经可塑性和前庭代偿能力的问题。尽管基础研究已对前庭系统病变的后果进行了研究,但对慢性外周前庭误差信号(VES)对中枢神经系统的影响的研究仍然不足。VES 指的是前庭系统的感官预期与感知之间的差异,最近的工程学研究已经澄清了这一点。加深对 VES 的理解不仅对前庭生理学和病理学至关重要,而且对设计有效的前庭康复措施和方法也至关重要,它揭示了补偿机制和感觉统合的重要性:这项回顾性研究以对标准治疗无效的慢性单侧外周性前庭病变患者为对象,旨在排除任何原有疾病的干扰。在综合前庭探索和康复计划实施前后,研究人员通过问卷调查、姿势测试和视频眼震图对参与者进行了评估:结果:结果表明,姿势稳定性和生活质量有了明显改善,显示出中枢神经系统的积极调节和前庭代偿的改善:讨论:成功的前庭康复可能需要采取多方面的方法,结合神经可塑性和感觉统合的最新见解,并根据每位患者的具体需求和临床进展情况量身定制。这种方法的重点是补偿前庭功能障碍和加强感觉-知觉-运动的整合,其目的不仅在于定制干预措施,还在于加强前庭、视觉和神经系统之间的一致性,从而提高慢性前庭功能障碍患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Innovative approaches for managing patients with chronic vestibular disorders: follow-up indicators and predictive markers for studying the vestibular error signal.

Introduction: Despite significant advancements in understanding the biochemical, anatomical, and functional impacts of vestibular lesions, developing standardized and effective rehabilitation strategies for patients unresponsive to conventional therapies remains a challenge. Chronic vestibular disorders, characterized by permanent or recurrent imbalances and blurred vision or oscillopsia, present significant complexity in non-pharmacological management. The complex interaction between peripheral vestibular damage and its impact on the central nervous system (CNS) raises questions about neuroplasticity and vestibular compensation capacity. Although fundamental research has examined the consequences of lesions on the vestibular system, the effect of a chronic peripheral vestibular error signal (VES) on the CNS remains underexplored. The VES refers to the discrepancy between sensory expectations and perceptions of the vestibular system has been clarified through recent engineering studies. This deeper understanding of VES is crucial not only for vestibular physiology and pathology but also for designing effective measures and methods of vestibular rehabilitation, shedding light on the importance of compensation mechanisms and sensory integration.

Methods: This retrospective study, targeting patients with chronic unilateral peripheral vestibulopathy unresponsive to standard treatments, sought to exclude any interference from pre-existing conditions. Participants were evaluated before and after a integrative vestibular exploratory and rehabilitation program through questionnaires, posturographic tests, and videonystagmography.

Results: The results indicate significant improvements in postural stability and quality of life, demonstrating positive modulation of the CNS and an improvement of vestibular compensation.

Discussion: Successful vestibular rehabilitation likely requires a multifaceted approach that incorporates the latest insights into neuroplasticity and sensory integration, tailored to the specific needs and clinical progression of each patient. Focusing on compensating for the VES and enhancing sensory-perceptual-motor integration, this approach aims not just to tailor interventions but also to reinforce coherence among the vestibular, visual, and neurological systems, thereby improving the quality of life for individuals with chronic vestibular disorders.

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