School of Psychology, University of Kent, Canterbury, UK.
Neuropsychiatry Service, Kent & Medway NHS and Social Care Partnership Trust, UK.
J Neuropsychol. 2019 Sep;13(3):417-431. doi: 10.1111/jnp.12157. Epub 2018 Apr 19.
Vestibular dysfunction is associated with visual short-term memory impairment; however, it remains unclear if this impairment arises as a direct result of the vestibular dysfunction or is a consequence of comorbid changes in mood, affect, fatigue, and/or sleep. To this end, we assessed the concurrence and interdependence of these comorbidities in 101 individuals recruited from a tertiary balance clinic with a neuro-otological diagnosis. Over fifty per cent of the sample showed reduced visuospatial short-term memory, 60% and 37% exceeded cut-off on the Beck Anxiety and Depression Inventories, respectively, 70% exceeded cut-off on the Fatigue Severity Scale, 44% reported daytime sleepiness on the Epworth Sleepiness Scale, and 78% scored above cut-off on the Pittsburgh Sleep Quality Index. The high concurrence of these symptoms gives reason to infer the existence of a vestibular cognitive affective syndrome. Structural equation modelling indicated that the significant statistical association between general unassisted posture (a marker of chronic vestibular dysfunction and strong predictor of falls risk) and short-term memory was not mediated by mood and wakefulness. Instead, the memory impairment related more directly to vestibular dysfunction. From a rehabilitation perspective, the implication is that if the vestibular disorder is treated successfully then the memory problem will likewise improve.
前庭功能障碍与视觉短期记忆障碍有关;然而，目前尚不清楚这种损害是直接由前庭功能障碍引起的，还是情绪、情感、疲劳和/或睡眠等共病变化的结果。为此，我们评估了从一家三级平衡诊所招募的 101 名具有神经耳科诊断的个体中这些共病的同时发生和相互依赖性。超过一半的样本表现出视觉空间短期记忆减退，60%和 37%分别超过贝克焦虑和抑郁量表的临界值，70%超过疲劳严重程度量表的临界值，44%在嗜睡量表上报告白天嗜睡，78%在匹兹堡睡眠质量指数上得分超过临界值。这些症状的高度共存使得我们有理由推断存在前庭认知情感综合征。结构方程模型表明，一般非辅助姿势（慢性前庭功能障碍的标志物和跌倒风险的强预测因子）与短期记忆之间的显著统计学关联不受情绪和觉醒的影响。相反，记忆障碍与前庭功能障碍的关系更为直接。从康复的角度来看，这意味着如果前庭障碍得到成功治疗，那么记忆问题也会得到改善。
