Sensorimotor postural rearrangement after unilateral vestibular deafferentation in patients with acoustic neuroma

Unilateral vestibular lesion, as acoustic neuroma and its surgical removal, leads to impaired balance control. After initial vertigo and postural instability corresponding to unilateral vestibular deafferentation, improvement in symptoms and global balance functions occurs by a process called vestib...

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Bibliographic Details
Published in:Neuroscience research 2006-06, Vol.55 (2), p.171-181
Main Authors: Parietti-Winkler, Cécile, Gauchard, Gérome C., Simon, Claude, Perrin, Philippe P.
Format: Article
Language:English
Subjects:
Adult
Analysis of Variance
Balance control
Compensation
Denervation
Female
Functional Laterality
Humans
Male
Middle Aged
Neuroma
Neuroma, Acoustic - physiopathology
Neuroma, Acoustic - surgery
Nonlinear Dynamics
Otologic Surgical Procedures - methods
Postural Balance - physiology
Posture - physiology
Prospective Studies
Sensory organization
Surgery
Vestibular Function Tests
Vestibular nuclei
Vestibule, Labyrinth - innervation
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Summary:Unilateral vestibular lesion, as acoustic neuroma and its surgical removal, leads to impaired balance control. After initial vertigo and postural instability corresponding to unilateral vestibular deafferentation, improvement in symptoms and global balance functions occurs by a process called vestibular compensation. In this respect, this prospective study aimed to assess the differential contribution of sensory inputs to the regulation of posture during the recovery process after acoustic neuroma removal. Twenty-seven patients with acoustic neuroma underwent vestibular and posturographic testings, shortly before and 8 days, 1 month and 3 months after surgical removal of the tumour. Immediately after vestibular deafferentation, vestibular function was asymmetrical, postural performances were altered, especially in eyes closed conditions and in sensory challenged situations. One month, and more particularly 3 months after surgery, restoration and even improvement of vestibular and balance performances occurred, associated with a lower number of falls, development of more appropriate sensorimotor strategies and better resolution of sensorial conflicts. Postural perturbations are related to erroneous vestibular afferences, leading to incoherence in information about head position and interference with somatosensory and visual pathways. The time-course implementation of central adaptive mechanisms, characterized by substitution by other sensory afferences and new behavioural strategies, leads to an improvement of balance performance.
ISSN:0168-0102
1872-8111
DOI:10.1016/j.neures.2006.02.016