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Semin Hear 2009; 30(4): 231-241
DOI: 10.1055/s-0029-1241124
© Thieme Medical Publishers

Anatomical and Physiological Considerations in Vestibular Dysfunction and Compensation

Sherri M. Jones1 , Timothy A. Jones1 , Kristal N. Mills1 , G. Christopher Gaines1
  • 1Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina
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Publication History

Publication Date:
21 October 2009 (online)

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ABSTRACT

Sensory information from the vestibular, visual, and somatosensory/proprioceptive systems are integrated in the brain in complex ways to produce a final motor output to muscle groups for maintaining gaze, head and body posture, and controlling static and dynamic balance. The balance system is complex, which can make differential diagnosis of dizziness quite challenging. However, this complex system is organized anatomically in a variety of pathways, and some of these pathways have been documented. The vestibulo-ocular reflex (VOR) is one such pathway. Understanding the anatomy and physiology of the VOR facilitates our understanding of normal and abnormal eye movements, and research is advancing our understanding of the plasticity of the vestibular system. This review highlights anatomical and physiological features of the normal vestibular system, applies these concepts to explain some clinical findings in some common peripheral vestibular disorders, and discusses some of the research investigating the anatomical and physiological basis for vestibular compensation.

KEYWORDS

Vestibular - anatomy - physiology - dysfunction - compensation - vestibular nuclei - cerebellum

REFERENCES

  • 1 Fuller P M, Fuller C A. Genetic evidence for a neurovestibular influence on the mammalian circadian pacemaker.  J Biol Rhythms. 2006;  21 177-184
    CrossrefPubMedGoogle Scholar
  • 2 Fuller P M, Jones T A, Jones S M, Fuller C A. Neurovestibular modulation of circadian and homeostatic regulation: vestibulohypothalamic connection?.  Proc Natl Acad Sci U S A. 2002;  99(24) 15723-15728
    CrossrefPubMedGoogle Scholar
  • 3 Yates B J, Bronstein A M. The effects of vestibular system lesions on autonomic regulation: observations, mechanisms, and clinical implications.  J Vestib Res. 2005;  15(3) 119-129
    PubMedGoogle Scholar
  • 4 Asher D L. Vestibular anatomy and physiology. In: Northern JL Hearing Disorders. 2nd edition. Boston, MA; Little, Brown 1984: 195-204
    PubMedGoogle Scholar
  • 5 Buttner-Ennever J A. Overview of the vestibular system: Anatomy. In: AJ Beitz, JH Anderson Neurochemistry of the Vestibular System. Boca Raton, FL; CRC Press 2000: 3-24
    PubMedGoogle Scholar
  • 6 Luxon L M. The anatomy and physiology of the vestibular system. In: Dix MR, Hood JD Vertigo. Chichester, United Kingdom; John Wiley 1984: 1-33
    PubMedGoogle Scholar
  • 7 Lysakowski A, McCrea R A, Tomlinson R D. Anatomy of vestibular end organs and neural pathways. In: Cummings CW Otolaryngology: Head and Neck Surgery. 2nd ed. St. Louis, MO; Mosby 1993: 2525-2547
    PubMedGoogle Scholar
  • 8 Lysakowski A, Goldberg J M. Morphophysiology of the vestibular periphery. In: Highstein SM, Fay RR, Popper AN The Vestibular System. New York, NY; Springer-Verlag 2004: 57-151
    PubMedGoogle Scholar
  • 9 Purves D, Augustine G J, Fitzpatrick D et al.. The vestibular system. In: Purves D, Augustine GJ, Fitzpatrick D, et al Neuroscience. Sunderland, MA; Sinauer Associates 2008: 343-362
    PubMedGoogle Scholar
  • 10 Schubert M C, Shepard N T. Practical anatomy and physiology of the vestibular system. In: Jacobsen GP, Shepard NT Balance Function Assessment and Management. San Diego, CA; Plural Publishing 2008: 1-11
    PubMedGoogle Scholar
  • 11 Hain T C, Rudisill H. Practical anatomy and physiology of the ocular motor system. In: Jacobsen GP, Shepard NT Balance Function Assessment and Management. San Diego, CA; Plural Publishing 2008: 13-26
    PubMedGoogle Scholar
  • 12 Highstein S M, Holstein G R. The anatomy of the vestibular nuclei.  Prog Brain Res. 2006;  151 157-203
    PubMedGoogle Scholar
  • 13 Carter J R, Ray C A. Sympathetic responses to vestibular activation in humans.  Am J Physiol Regul Integr Comp Physiol. 2008;  294(3) R681-R688
    PubMedGoogle Scholar
  • 14 Balaban C D, Thayer J F. Neurological bases for balance-anxiety links.  J Anxiety Disord. 2001;  15(1-2) 53-79
    CrossrefPubMedGoogle Scholar
  • 15 Hanes D A, McCollum G. Cognitive-vestibular interactions: a review of patient difficulties and possible mechanisms.  J Vestib Res. 2006;  16(3) 75-91
    PubMedGoogle Scholar
  • 16 Redfern M S, Talkowski M E, Jennings J R, Furman J M. Cognitive influences in postural control of patients with unilateral vestibular loss.  Gait Posture. 2004;  19(2) 105-114
    CrossrefPubMedGoogle Scholar
  • 17 Smith P F, Zheng Y, Horii A, Darlington C L. Does vestibular damage cause cognitive dysfunction in humans?.  J Vestib Res. 2005;  15(1) 1-9
    PubMedGoogle Scholar
  • 18 Gittis A H, du Lac S. Intrinsic and synaptic plasticity in the vestibular system.  Curr Opin Neurobiol. 2006;  16(4) 385-390
    CrossrefPubMedGoogle Scholar
  • 19 Smith P F, Horii A, Russell N et al.. The effects of vestibular lesions on hippocampal function in rats.  Prog Neurobiol. 2005;  75(6) 391-405
    CrossrefPubMedGoogle Scholar
  • 20 Rabbitt R D, Damiano E R, Grant J W. Biomechanics of the semicircular canals and otolith organs. In: Highsten SM, Fay RR, Popper AN The Vestibular System. New York, NY; Springer-Verlag 2004: 153-201
    PubMedGoogle Scholar
  • 21 Herdman S J, Tusa R J. Physical therapy management of benign positional vertigo. In: Herdman SJ Vestibular Rehabilitation. Philadelphia, PA; FA Davis 2000: 233-260
    PubMedGoogle Scholar
  • 22 Baloh R W, Honrubia V. Clinical Neurophysiology of the Vestibular System. 2nd ed. Philadelphia, PA; FA Davis 1990
    PubMed
  • 23 Rajguru S M, Ifediba M A, Rabbitt R D. Biomechanics of horizontal canal benign paroxysmal positional vertigo.  J Vestib Res. 2005;  15(4) 203-214
    PubMedGoogle Scholar
  • 24 Cakir B O, Ercan I, Cakir Z A, Civelek S, Sayin I, Turgut S. What is the true incidence of horizontal semicircular canal benign paroxysmal positional vertigo?.  Otolaryngol Head Neck Surg. 2006;  134(3) 451-454
    CrossrefPubMedGoogle Scholar
  • 25 Honrubia V, Baloh R W, Harris M R, Jacobson K M. Paroxysmal positional vertigo syndrome.  Am J Otol. 1999;  20(4) 465-470
    PubMedGoogle Scholar
  • 26 Curthoys I S, Halmagyi M. Vestibular compensation: Clinical changes in vestibular function with time after unilateral vestibular loss. In: Herdman SJ Vestibular Rehabilitation. Philadelphia, PA; FA Davis 2000: 76-97
    PubMedGoogle Scholar
  • 27 Gacek R R, Schoonmaker J E. Morphologic changes in the vestibular nerves and nuclei after labyrinthectomy in the cat: a case for the neurotrophin hypothesis in vestibular compensation.  Acta Otolaryngol. 1997;  117(2) 244-249
    CrossrefPubMedGoogle Scholar
  • 28 Campos Torres A, Vidal P P, de Waele C. Evidence for a microglial reaction within the vestibular and cochlear nuclei following inner ear lesion in the rat.  Neuroscience. 1999;  92 1475-1490
    CrossrefPubMedGoogle Scholar
  • 29 de Waele C, Campos Torres A, Josset P, Vidal P P. Evidence for reactive astrocytes in rat vestibular and cochlear nuclei following unilateral inner ear lesion.  Eur J Neurosci. 1996;  8(9) 2006-2018
    CrossrefPubMedGoogle Scholar
  • 30 Cawthorne T. Vestibular injuries.  Proc R Soc Med. 1946;  39 270-273
    PubMedGoogle Scholar
  • 31 Cooksey F S. Rehabilitation in vestibular injuries.  Proc R Soc Med. 1946;  39 273-278
    PubMedGoogle Scholar
  • 32 Leigh R J, Zee D S. The Neurology of Eye Movements. 4th ed. New York, NY; Oxford University Press 2006: 53-62
    PubMedGoogle Scholar
  • 33 Darlington C L, Smith P F. Molecular mechanisms of recovery from vestibular damage in mammals: recent advances.  Prog Neurobiol. 2000;  62(3) 313-325
    CrossrefPubMedGoogle Scholar
  • 34 Smith P F, Curthoys I S. Neuronal activity in the contralateral medial vestibular nucleus of the guinea pig following unilateral labyrinthectomy.  Brain Res. 1988;  444(2) 295-307
    CrossrefPubMedGoogle Scholar
  • 35 Smith P F, Curthoys I S. Neuronal activity in the ipsilateral medial vestibular nucleus of the guinea pig following unilateral labyrinthectomy.  Brain Res. 1988;  444(2) 308-319
    CrossrefPubMedGoogle Scholar
  • 36 Ris L, Godaux E. Neuronal activity in the vestibular nuclei after contralateral or bilateral labyrinthectomy in the alert guinea pig.  J Neurophysiol. 1998;  80(5) 2352-2367
    PubMedGoogle Scholar
  • 37 Ris L, de Waele C, Serafin M, Vidal P P, Godaux E. Neuronal activity in the ipsilateral vestibular nucleus following unilateral labyrinthectomy in the alert guinea pig.  J Neurophysiol. 1995;  74(5) 2087-2099
    PubMedGoogle Scholar
  • 38 Graham B P, Dutia M B. Cellular basis of vestibular compensation: analysis and modelling of the role of the commissural inhibitory system.  Exp Brain Res. 2001;  137(3-4) 387-396
    CrossrefPubMedGoogle Scholar
  • 39 Beraneck M, McKee J L, Aleisa M, Cullen K E. Asymmetric recovery in cerebellar-deficient mice following unilateral labyrinthectomy.  J Neurophysiol. 2008;  100(2) 945-958
    CrossrefPubMedGoogle Scholar
  • 40 McElligott J G, Spencer R F. Neuropharmacological aspects of the vestibule-ocular reflex. In: Beitz AJ, Anderson JH Neurochemistry of the Vestibular System. Boca Raton, FL; CRC Press 2000: 199-222
    PubMedGoogle Scholar

Sherri M JonesPh.D. 

Associate Professor, Department of Communication Sciences and Disorders, East Carolina University

Room 3310 Health Sciences Bldg., Greenville, NC 27858

Email: jonessh@ecu.edu

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