Coto Jennifer, Alvarez Carmen L, Cejas Ivette, Colbert Brett M, Levin Bonnie E, Huppert Joshua, Rundek Tatjana, Balaban Carey, Blanton Susan H, Lee David J, Loewenstein David, Hoffer Michael, Liu Xue Zhong
University of Miami Miller School of Medicine, Department of Otolaryngology, Miami, FL, USA.
San Juan Bautista Medical School, Caguas, PR, USA.
J Otol. 2021 Oct;16(4):258-265. doi: 10.1016/j.joto.2021.06.001. Epub 2021 Jun 11.
Given the interdependence of multiple factors in age-related vestibular loss (e.g., balance, vision, cognition), it is important to examine the individual contributions of these factors with ARVL. While the relationship between the vestibular and visual systems has been well studied (Bronstein et al., 2015), little is known about the association of the peripheral vestibular system with neurodegenerative disorders (Cronin et al., 2017). Further, emerging research developments implicate the vestibular system as an opportunity for examining brain function beyond balance, and into other areas, such as cognition and psychological functioning. Additionally, the bidirectional impact of psychological functioning is understudied in ARVL. Recognition of ARVL as part of a multifaceted aging process will help guide the development of integrated interventions for patients who remain at risk for decline. In this review, we will discuss a wide variety of characteristics of the peripheral vestibular system and ARVL, how it relates to neurodegenerative diseases, and correlations between ARVL and balance, vision, cognitive, and psychological dysfunction. We also discuss clinical implications as well as future directions for research, with an emphasis on improving care for patients with ARVL.
鉴于年龄相关性前庭功能丧失（ARVL）中多种因素相互依存（如平衡、视力、认知），研究这些因素对ARVL的个体影响很重要。虽然前庭系统与视觉系统之间的关系已得到充分研究（布朗斯坦等人，2015年），但关于外周前庭系统与神经退行性疾病之间的关联却知之甚少（克罗宁等人，2017年）。此外，新出现的研究进展表明，前庭系统是一个研究大脑功能的契机，不仅限于平衡功能，还可涉及其他领域，如认知和心理功能。此外，心理功能在前庭功能丧失中的双向影响尚未得到充分研究。认识到ARVL是多方面衰老过程的一部分，将有助于为仍有衰退风险的患者制定综合干预措施。在本综述中，我们将讨论外周前庭系统和ARVL的各种特征、它与神经退行性疾病的关系以及ARVL与平衡、视力、认知和心理功能障碍之间的相关性。我们还将讨论临床意义以及未来的研究方向，重点是改善对ARVL患者的护理。
