Popp Pauline, Wulff Melanie, Finke Kathrin, Rühl Maxine, Brandt Thomas, Dieterich Marianne
Department of Neurology, Ludwig-Maximilians University, Klinikum Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany.
Graduate School of Systemic Neurosciences, Ludwig-Maximilians University, Munich, Germany.
J Neurol. 2017 Mar;264(3):554-563. doi: 10.1007/s00415-016-8386-7. Epub 2017 Jan 10.
Behavioral studies in rodents and humans have demonstrated deficits of spatial memory and orientation in bilateral vestibular failure (BVF). Our aim was to explore the functional consequences of chronic vestibular failure on different cognitive domains including spatial as well as non-spatial cognitive abilities. Sixteen patients with a unilateral vestibular failure (UVF), 18 patients with a BVF, and 17 healthy controls (HC) participated in the study. To assess the cognitive domains of short-term memory, executive function, processing speed and visuospatial abilities the following tests were used: Theory of Visual Attention (TVA), TAP Alertness and Visual Scanning, the Stroop Color-Word, and the Corsi Block Tapping Test. The cognitive scores were correlated with the degree of vestibular dysfunction and the duration of the disease, respectively. Groups did not differ significantly in age, sex, or handedness. BVF patients were significantly impaired in all of the examined cognitive domains but not in all tests of the particular domain, whereas UVF patients exhibited significant impairments in their visuospatial abilities and in one of the two processing speed tasks when compared independently with HC. The degree of vestibular dysfunction significantly correlated with some of the cognitive scores. Neither the side of the lesion nor the duration of disease influenced cognitive performance. The results demonstrate that vestibular failure can lead to cognitive impairments beyond the spatial navigation deficits described earlier. These cognitive impairments are more significant in BVF patients, suggesting that the input from one labyrinth which is distributed into bilateral vestibular circuits is sufficient to maintain most of the cognitive functions. These results raise the question whether BVF patients may profit from specific cognitive training in addition to physiotherapy.
对啮齿动物和人类的行为研究表明，双侧前庭功能丧失（BVF）会导致空间记忆和定向能力缺陷。我们的目的是探讨慢性前庭功能丧失对包括空间认知能力和非空间认知能力在内的不同认知领域的功能影响。16名单侧前庭功能丧失（UVF）患者、18名BVF患者和17名健康对照者（HC）参与了该研究。为评估短期记忆、执行功能、处理速度和视觉空间能力等认知领域，使用了以下测试：视觉注意理论（TVA）、TAP警觉性和视觉扫描、斯特鲁普颜色-文字测试以及科西方块敲击测试。认知得分分别与前庭功能障碍程度和疾病持续时间相关。各组在年龄、性别或利手方面无显著差异。BVF患者在所有检查的认知领域均有显著受损，但并非在特定领域的所有测试中都如此，而UVF患者与HC独立比较时，其视觉空间能力和两项处理速度任务中的一项有显著受损。前庭功能障碍程度与一些认知得分显著相关。病变侧别和疾病持续时间均未影响认知表现。结果表明，前庭功能丧失可导致超出先前描述的空间导航缺陷的认知障碍。这些认知障碍在BVF患者中更为显著，表明来自一个内耳的输入分布到双侧前庭回路中足以维持大多数认知功能。这些结果提出了一个问题，即BVF患者除了物理治疗外，是否可能从特定的认知训练中获益。
