Ellis Andrew W, Schöne Corina G, Vibert Dominique, Caversaccio Marco D, Mast Fred W
Department of Psychology, University of Bern, Bern, Switzerland.
Center for Cognition, Learning and Memory, University of Bern, Bern, Switzerland.
Front Neurol. 2018 Apr 27;9:286. doi: 10.3389/fneur.2018.00286. eCollection 2018.
There is evidence that vestibular sensory processing affects, and is affected by, higher cognitive processes. This is highly relevant from a clinical perspective, where there is evidence for cognitive impairments in patients with peripheral vestibular deficits. The vestibular system performs complex probabilistic computations, and we claim that understanding these is important for investigating interactions between vestibular processing and cognition. Furthermore, this will aid our understanding of patients' self-motion perception and will provide useful information for clinical interventions. We propose that cognitive training is a promising way to alleviate the debilitating symptoms of patients with complete bilateral vestibular loss (BVP), who often fail to show improvement when relying solely on conventional treatment methods. We present a probabilistic model capable of processing vestibular sensory data during both passive and active self-motion. Crucially, in our model, knowledge from multiple sources, including higher-level cognition, can be used to predict head motion. This is the entry point for cognitive interventions. Despite the loss of sensory input, the processing circuitry in BVP patients is still intact, and they can still perceive self-motion when the movement is self-generated. We provide computer simulations illustrating self-motion perception of BVP patients. Cognitive training may lead to more accurate and confident predictions, which result in decreased weighting of sensory input, and thus improved self-motion perception. Using our model, we show the possible impact of cognitive interventions to help vestibular rehabilitation in patients with BVP.
有证据表明，前庭感觉处理会影响更高层次的认知过程，同时也受其影响。从临床角度来看，这具有高度相关性，因为有证据显示外周前庭功能缺陷患者存在认知障碍。前庭系统执行复杂的概率计算，我们认为理解这些计算对于研究前庭处理与认知之间的相互作用很重要。此外，这将有助于我们理解患者的自我运动感知，并为临床干预提供有用信息。我们提出认知训练是缓解完全双侧前庭丧失（BVP）患者衰弱症状的一种有前景的方法，这些患者仅依靠传统治疗方法时往往不见改善。我们提出了一个概率模型，该模型能够在被动和主动自我运动过程中处理前庭感觉数据。至关重要的是，在我们的模型中，可以使用来自包括更高层次认知在内的多个来源的知识来预测头部运动。这是认知干预的切入点。尽管感觉输入丧失，但BVP患者的处理电路仍然完好，并且当运动是自我产生时，他们仍然可以感知自我运动。我们提供了计算机模拟，展示了BVP患者的自我运动感知。认知训练可能会导致更准确、更自信的预测，从而减少感觉输入的权重，进而改善自我运动感知。使用我们的模型，我们展示了认知干预对帮助BVP患者进行前庭康复的可能影响。
