Perceived Vertical and Lateropulsion: Clinical Syndromes, Localization, and Prognosis

We present a clinical classification of central vestibular syndromes according to the three major planes of action of the vestibulo-ocular reflex: yaw, roll, and pitch. The plane-specific syndromes are determined by ocular motor, postural, and percep tual signs. Yaw plane signs are horizontal nystagmus, past pointing, rotational and lat eral body falls, deviation of perceived straight-ahead to the left or right. Roll plane signs are torsional nystagmus, skew deviation, ocular torsion, tilts of head, body, and perceived vertical in a clockwise or counterclockwise direction. Pitch plane signs are upbeat/downbeat nystagmus, forward/backward tilts and falls, deviations of the per ceived horizon. The thus defined vestibular syndromes allow a precise topographic analysis of brainstem lesions according to their level and side. Special emphasis is placed on the vestibular roll plane syndromes of ocular tilt reaction, lateropulsion in Wallenberg's syndrome, thalamic and cortical astasia and their association with roll plane tilt of perceived vertical. Recovery is based on a functionally significant central compensation of a vestibular tone imbalance, the mechanism of which is largely un known. Physical therapy may facilitate this central compensation, but this has not yet been proven in prospective studies

HSV-1 not only in human vestibular ganglia but also in the vestibular labyrinth

Reactivation of herpes simplex virus type 1 (HSV-1) in the vestibular ganglion (VG) is the suspected cause of vestibular neuritis (VN). Recent studies reported the presence of HSV-1 DNA not only in human VGs but also in vestibular nuclei, a finding that indicates the possibility of viral migration to the human vestibular labyrinth. Distribution of HSV-1 DNA was determined in geniculate ganglia, VGs, semicircular canals, and macula organs of 21 randomly obtained human temporal bones by nested PCR. Viral DNA was detected in 48% of the labyrinths, 62% of the VGs, and 57% of the geniculate ganglia. The potential significance of this finding is twofold: (1) Inflammation in VN could also involve the labyrinth and thereby cause acute unilateral vestibular deafferentation. (2) As benign paroxysmal positional vertigo often occurs in patients who have had VN, it could also be a sequel of viral labyrinthitis. Copyright (C) 2001 S. Karger AG, Basel

Reproductive and Social Dynamics of a Lek Breeding Bird

Sociality and the unequal apportionment of reproductive success among social individuals is a common characteristic of many vertebrate taxa. To date, our understanding of what factors drive high variance in reproductive success (i.e., intra vs. inter-sexual selection) and which male attributes contribute to that variance, are still fragmentary for most species. Moreover, how social structure interacts with individual behavior and fitness remains understudied despite its potential importance to the evolution of cooperation. This dissertation research focused on understanding this complex synergistic interplay between social and reproductive dynamics in a lek-breeding bird, the wire-tailed manakin. The first chapter examines the complex display ritual of this species of manakin (Pipra filicauda). More specifically, it quantifies and compares the frequency of individual behavior among males of different age and social status. In addition, the first chapter examines in detail the genetic relatedness of male partnerships to test the kin selection hypothesis. The second chapter uses these complex reticulate interactions to build social networks. This chapter details the emergent properties of these networks and examines their role in determining male social ascendancy and access to reproduction. The third chapter uses a combination of molecular tools and network analysis to create a synthetic understanding of variance in male reproductive success. This chapter presents molecular estimates of reproductive skew and examines the social correlates of male reproductive success. Our primary results show 1) that males within leks are not more related than expected by chance, enabling us to reject the role of kin selection in the lek evolution of wire-tailed manakins; 2) that the complex networks of social interactions among males contain the ingredients needed for the evolution of cooperation; 3) that social connectivity of young males was predictive of their later social ascendancy; 4) that the number of male affiliations was strongly predictive of the number of offspring he sired. Overall our findings greatly advance our understanding of social relationships and the role they play in the evolution of cooperation and reproductive variance

Explicitly linking field- and satellite- derived measurements for improved vegetation quantification and disturbance detection

Arid and semi-arid ecosystems have been recognized as critical in supporting over one-third of the world's populations, notably those more dependent on the natural resource base for their livelihoods. These systems, and especially savannas within them, are highly vulnerable to predicted fluctuations in climatic change, disturbances, and management regimes. This research posits these areas in a social-ecological system (SES) framework that encompasses human, governance, and recourse units. A challenge in both SES and CHANS (coupled human and natural systems) research is how to explicitly and empirically link the social and the ecological, and further how to extrapolate from sets of case studies to the greater region, supra-system, or SES / CHANS theory and practice. This work leverages Landsat and IKONOS imagery as well as field-based vegetation sampling (structure and species) through the use of IDL (interactive data language) visualizations, both pixel- and object-based classifications, and CART (classification and regression tree) analysis. The longer term goal of this work is to produce a protocol and classification scheme modified from the 1976 Anderson scheme to include both structure and disturbance explicitly in processing, mapping, monitoring, and management. In creating SVCs (Structural Vegetation Categories) built from field data there is strong potential for extracting 3-D data from 2-D imagery once the protocol produces robust results with high enough accuracies. As hypothesized, the object-based classifications produced higher overall accuracy (70.83%), though the pixel-based classification performed better in the detection of woodlands (90.91%). Given the spatial scales of the imagery as compared to the size of the field plots and transect spacing, it is important to remember that when extrapolating to other areas a critical part of spatial scale is extent (not just grain). That is, the inherent clumping of trees versus shrubs may be driving the better performance of pixel-based for woodlands but not so for shrublands. Sensitivity to placement of plots and especially plot sizes across future sites will help explore this question and move SES research into a realm whereby remote sensing and vegetation sampling can provide improved empirical linkages among the subsystems and their feedbacks.Geography and the Environmen

Bedside differentiation of vestibular neuritis from central "vestibular pseudoneuritis".

Acute unilateral peripheral and central vestibular lesions can cause similar signs and symptoms, but they require different diagnostics and management. We therefore correlated clinical signs to differentiate vestibular neuritis (40 patients) from central ‘‘vestibular pseudoneuritis’’ (43 patients) in the acute situation with the final diagnosis assessed by neuroimaging. Skew deviation was the only specific but non-sensitive (40%) sign for pseudoneuritis. None of the other isolated signs (head thrust test, saccadic pursuit, gaze evoked nystagmus, subjective visual vertical) were reliable; however, multivariate logistic regression increased their sensitivity and specificity to 92%

Peripheral vestibular disorders

Purpose of review First, to update the diagnosis, pathophysiology, and treatment of the most frequent peripheral vestibular disorders. Second, to identify those disorders for which the diagnostic criteria are still deficient and treatment trials are still lacking. Recent findings Bilateral vestibulopathy can be reliably diagnosed by the head-impulse test, caloric irrigation, and vestibular-evoked myogenic potentials. A new frequent subtype has been described: cerebellar ataxia, neuropathy, and vestibular areflexia syndrome. Benign paroxysmal positioning vertigo can be easily diagnosed and effectively treated. Vestibular neuritis is most likely caused by the reactivation of a herpes simplex type 1 infection; the inferior vestibular nerve subtype is now well established. More evidence is needed that the recovery can be improved by corticosteroids. Endolymphatic hydrops in Meniere's disease can be depicted by high-resolution MRI after transtympanic gadolinium injection; a high-dosage and long-term prophylactic treatment with betahistine is evidently effective. Its mechanism of action is most likely an increase in the inner-ear blood flow. Vestibular paroxysmia is now a well established entity; carbamazepine is the treatment of first choice. Superior canal dehiscence syndrome can be reliably diagnosed; the best current treatment option is canal plugging. Summary Although progress has been made in the diagnosis and treatment of most peripheral vestibular disorders, more state-of-the-art trials are needed on the treatment of bilateral vestibulopathy to prove the efficacy of balance training, of vestibular neuritis (in terms of recovery of peripheral vestibular function and central compensation), of vestibular paroxysmia to prove the effects of carbamazepine, and of Meniere's disease to find the optimal dosage of betahistine

Perception of Verticality and Vestibular Disorders of Balance and Falls

Objective: To review current knowledge of the perception of verticality, its normal function and disorders. This is based on an integrative graviceptive input from the vertical semicircular canals and the otolith organs. Methods: The special focus is on human psychophysics, neurophysiological and imaging data on the adjustments of subjective visual vertical (SVV) and the subjective postural vertical. Furthermore, examples of mathematical modeling of specific vestibular cell functions for orientation in space in rodents and in patients are briefly presented. Results: Pathological tilts of the SVV in the roll plane are most sensitive and frequent clinical vestibular signs of unilateral lesions extending from the labyrinths via the brainstem and thalamus to the parieto-insular vestibular cortex. Due to crossings of ascending graviceptive fibers, peripheral vestibular and pontomedullary lesions cause ipsilateral tilts of the SVV; ponto-mesencephalic lesions cause contralateral tilts. In contrast, SVV tilts, which are measured in unilateral vestibular lesions at thalamic and cortical levels, have two different characteristic features: (i) they may be ipsi- or contralateral, and (ii) they are smaller than those found in lower brainstem or peripheral lesions. Motor signs such as head tilt and body lateropulsion, components of ocular tilt reaction, are typical for vestibular lesions of the peripheral vestibular organ and the pontomedullary brainstem (vestibular nucleus). They are less frequent in midbrain lesions (interstitial nucleus of Cajal) and rare in cortical lesions. Isolated body lateropulsion is chiefly found in caudal lateral medullary brainstem lesions. Vestibular function in the roll plane and its disorders can be mathematically modeled by an attractor model of angular head velocity cell and head direction cell function. Disorders manifesting with misperception of the body vertical are the pusher syndrome, the progressive supranuclear palsy, or the normal pressure hydrocephalus; they may affect roll and/or pitch plane. Conclusion: Clinical determinations of the SVV are easy and reliable. They indicate acute unilateral vestibular dysfunctions, the causative lesion of which extends from labyrinth to cortex. They allow precise topographical diagnosis of side and level in unilateral brainstem or peripheral vestibular disorders. SVV tilts may coincide with or differ from the perception of body vertical, e.g., in isolated body lateropulsion

Descriptions of vestibular migraine and Meniere's disease in Greek and Chinese antiquity

Background: Vestibular migraine and Meniere's disease are two types of episodic vertigo syndromes that were already observed in Greek and Chinese antiquity. Descriptions first appeared in the work of the classical Greek physician Aretaeus of Cappadocia, who lived in the 2nd century AD, and in Huangdi Neijing, a seminal medical source in the Chinese Medical Classics, written between the 2nd century BC and the 2nd century AD. Aim: The aim of this paper is to search in Aretaeus' book De causis et signis acutorum et chronicorum morborum and in Huangdi Neijing for descriptions of vertigo co-occurring with headache or ear symptoms that resemble current classifications of vestibular migraine or Meniere's disease. Results: Aretaeus describes a syndrome combining headache, vertigo, visual disturbance, oculomotor phenomena, and nausea that resembles the symptoms of vestibular migraine. In the Chinese book Huangdi Neijing the Yellow Thearch mentions the co-occurrence of episodic dizziness and a ringing noise of the ears that recalls an attack of Meniere's disease. Conclusions: The descriptions of these two conditions in Greek and Chinese antiquity are similar to the vertigo syndromes currently classified as vestibular migraine and Meniere's disease. In clinical practice it may be difficult to clearly differentiate between them, and they may also co-occur