Quantifying head acceleration during vestibular rehabilitation

Dizziness can often be a serious and confounding condition that ranges in severity from annoying to debilitating and affects many people. The most common and effective treatment for persistent dizziness is vestibular rehabilitation therapy, which falls into three categories: adaptation, sensory substitution, and habituation. While more is known about adaptation and sensory substitution, questions remain regarding the exact mechanisms of recovery for habituation. Precisely, the optimal stimulation to the vestibular system, as measured in intensity of head accelerations, is unknown for habituation treatment. In this dissertation are drafts of two manuscripts. The first explores the average intensity of linear and angular head accelerations in non-symptomatic and symptomatic subjects across age and self-reports of dizziness and imbalance during four commonly-used habituation exercises. The second paper presents a mathematical formula for transposing angular displacement in the traditional anatomical planes to the planes of the semicircular canal pairs for collected data on angular displacement of the head. This mathematical model allows for conversion of measurement from overall head accelerations into angular acceleration in the planes of each paired set of semicircular canals, and increases research and clinical knowledge of vestibular stimulation during head-movement exercises

Multimodal neuroimaging of vestibular and postural networks: Investigating the pathophysiology of idiopathic dizziness in older adults

Successful ageing - the preservation of good performance into old age, is an aspiration for many and a challenge for society. Modifiable factors which account for ageing-related functional decline should thus be identified and reduced. As life expectancy increases, brain ageing and its functional consequences become an increasingly important target for research and intervention. Cerebral small vessel disease, largely driven by vascular risk factors, has emerged as a strong contributor to cognitive and balance decline in late life. Though the early effects of cerebral small vessel disease on cognition are increasingly better understood, its symptomatic effects on other functional systems are not well characterised. In this thesis, I investigated the long recognised, but pathophysiologically enigmatic syndrome of dizziness in older adults, not accounted for by neurological disease or vestibular dysfunction. I considered the hypothesis that this ‘idiopathic dizziness’ is secondary to cerebral small vessel disease through its deleterious effects on white matter networks which subserve vestibular perceptual processes and/or the control of balance. I first defined the functional anatomy of the core human vestibular cortex by its functional connectivity (Chapter 3). I related the resulting anatomical subregions to behavioural and task neuroimaging data to define a vestibular network involved in self-motion perception. I proceeded to characterise the syndrome of idiopathic dizziness using clinical, cognitive and behavioural (vestibular function, balance and gait) data from patients and controls (Chapter 4). I combined this data with structural and diffusion magnetic resonance imaging data to investigate the pathophysiology of idiopathic dizziness. I found that frontal white matter tracts relevant to the control of balance had lower integrity in patients with idiopathic dizziness than controls. These findings occurred in the context of excess vascular risk, and markers of cerebral small vessel disease. Additionally, I found vestibular function and perception were normal in patients with idiopathic dizziness. The results suggest disrupted balance control may underpin idiopathic dizziness in cerebral small vessel disease. I proceeded to investigate whether neural correlates of balance control were altered in idiopathic dizziness as a model for mild balance impairment in cerebral small vessel disease (Chapter 5). To do this, I applied electroencephalography during quiet standing and related brain activity to spontaneous sway. I showed idiopathic dizziness was linked to altered cortical activity in relation to balance control, and this cortical activity was influenced by the burden of cerebral small vessel disease. Additionally, patients with idiopathic dizziness uniquely engaged a low frequency postural connectivity network, consistent with a different mode of postural control. Overall, the results within this thesis show a relationship between idiopathic dizziness and vascular injury to frontal tracts involved in the control of balance in cerebral small vessel disease. Small vessel disease may disrupt the cortical control of balance as a basis for symptoms in this syndrome.Open Acces

Aerospace Medicine and Biology: A continuing supplement 180, May 1978

This special bibliography lists 201 reports, articles, and other documents introduced into the NASA scientific and technical information system in April 1978

Effect of Aging on Human Postural Control and the Interaction with Attention

The ability to stand upright and walk is generally taken for granted, yet control of balance utilizes many processes involving the neuromuscular and sensory systems. As we age, balance function begins to decline and can become problematic for many older adults. In particular, adults 65 years of age and older exhibit a higher incidence of falls than younger adults, and falls are a leading cause of injury in older adults, contributing to significant medical costs. Without better understanding of the impact of aging on balance and means to ameliorate those effects, this problem is expected to grow as life expectancy continues to increase.In addition to sensori-motor declines with age that impact balance, another factor known to affect balance, particularly in older adults, is attention, meaning the amount of cognitive resources utilized for a particular task. When two or more tasks vie for cognitive resources, performance in one or more tasks can be compromised (a common example today is driving while talking on a cell phone). Attention has been observed to be a critical factor in many falls reported by older adults. However, it is still not fully understood how aging and attentional demand affect balance and how they interact with each other.In this dissertation, we conducted dual-task experiments and model-based analyses to study upright standing and the interaction of the effects of age and attention on postural control. The effect of age was investigated by testing two age groups (young and older adults) with no evident balance and cognitive impairment and by comparing results of the two groups. The effect of attention and its interaction with age was studied by comparing body sway in the two age groups in response to a moving platform, while either concurrently performing a cognitive task (dual-task) or not (single-task). Our findings highlight postural control differences between young and older adults, as quantified by experimental measures of body motion as well as by model parameter values, such as stiffness, damping and processing delay

An Optimal Control Model for Human Postural Regulation

Human upright stance is inherently unstable without a balance control scheme. Many biological behaviors are likely to be optimal with respect to some performance measure that involves energy. It is reasonable to believe that the human is (unconsciously) optimizing some performance measure as he regulates his balance posture. In experimental studies, a notable feature of postural control is a small constant sway. Specifically, there is greater sway than would occur with a linear feedback control without delay. A second notable feature of the human postural control is that the response to perturbations varies with their amplitude. Small disturbances produce motion only at the ankles with the hip and knee angles unchanging. Large perturbation evoke ankle and hip angular movement only. Still larger perturbation result in movement of all three joint angles. Inspired by these features, a biomechanical model resembling human balance control is proposed. The proposed model consists of three main components which are the body dynamics, a sensory estimator for delay and disturbance, and an optimal nonlinear control scheme providing minimum required corrective response. The human body is modeled as a multiple segment inverted pendulum in the sagittal plane and controlled by ankle and hip joint torques. A series of nonlinear optimal control problems are devised as mathematical models of human postural control during quiet standing. Several performance criteria that are high even orders in the body state or functions of these states (such as joint angle, Center of Pressure COP or Center of Mass COM) and quadratic in the joint control are utilized. This objective function provides a trade-off between the allowed deviations of the position from its nominal value and the neuromuscular energy required to correct for these deviations. Note that this performance measure reduces the actuator energy used by penalizing small postural errors very lightly. By using the Model Predictive Control (MPC) technique, the discrete-time approximation to each of these problems can be converted into a nonlinear programming problem and then solved by optimization methods. The solution gives a control scheme that agrees with the main features of the joint kinematics and its coordination process. The derived model is simulated for different scenarios to validate and test the performance of the proposed postural control architecture

Behavioural, Electrophysiological and Neurostimulatory Investigations into Developmental Prosopagnosia

Developmental prosopagnosia (DP) is the difficulty or inability to recognise a face and may affect up to 2.9 percent of the population. There is controversy over whether these impairments are perceptual or memorial in nature, and uncertainty about their stability over time and how to remediate symptoms. In the first stage, a battery of ten tests was assembled to assess a wide range of face recognition skills in DP (n = 11) and compared to a control group (Chapter Two). The majority of DPs showed no signs of impaired face perception but profound face memory deficits. To seek electrophysiological corroboration of these impairments, the DPs (n = 8) were given three behavioural tasks known to elicit specific event related potentials (Chapter Three), assessing face perception (N170), face familiarity (N250r) and semantic access (N400). During the experiment, caloric vestibular stimulation (CVS) was also administered to see if it could reduce symptoms. The tasks revealed intact face perception and impaired accuracy in both memory based tasks, corroborated by an atypical N400. Subtle effects of CVS were observed in all measures of the face familiarity task but not at a level that was clinically relevant. To establish, for the first time, whether the impairments in DP are consistent over time, the effects in Chapter Three were replicated (n = 7)(Chapter Four). A similar pattern emerged and test-retest correlations showed high reliability overtime in the familiarity task but not the semantic access task. This implies that reliable 'diagnosis' of developmental prosopagnosia should be based on judgements of face familiarity and not associated with semantic activity. The beneficial effects of CVS were again present in the N250r behavioural measures and were limited to familiar faces only. This implies that CVS is optimising memory recall for face representations. The source of impairments was consistently shown to be memorial in nature and future studies may wish to explore further divisions of memory in DP such as whether impairments are associated with encoding or recall. The thesis also demonstrates the potential for CVS as both a therapeutic tool and cognitive enhancer, and justify more robust trials investigation

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 243)

This bibliography lists 282 reports, articles and other documents introduced into the NASA scientific and technical information system in February 1983

Natural Computing and Beyond

This book contains the joint proceedings of the Winter School of Hakodate (WSH) 2011 held in Hakodate, Japan, March 15–16, 2011, and the 6th International Workshop on Natural Computing (6th IWNC) held in Tokyo, Japan, March 28–30, 2012, organized by the Special Interest Group of Natural Computing (SIG-NAC), the Japanese Society for Artificial Intelligence (JSAI). This volume compiles refereed contributions to various aspects of natural computing, ranging from computing with slime mold, artificial chemistry, eco-physics, and synthetic biology, to computational aesthetics

Aerospace Medicine and Biology: A continuing bibliography with indexes (supplement 238)

This bibliography lists 583 reports, articles and other documents introduced into the NASA scientific and technical information system in October 1982