Effectiveness of Internet Based Treatment Methods for Symptom Management of Vestibular Disorders: A Systematic Review

Introduction: The objective of this systematic review is to investigate the effectiveness of internet-based and blended therapy for patients with peripheral, central, or mixed vestibular dysfunction based on current research. Methods: Medline, CINAHL Complete, PubMed, and The Cochrane Library were searched from September 2022 to January 2023 using the search terms “vestibular,” “internet,” “computer,” “management,” “online,” “self-efficacy,” “vestibular disorder,” “rehabilitation,” “treatment,” “dizziness,” and “phys* ther*.”Studies were included if they used internet-based interventions for patients with diagnosed vestibular dysfunction caused by pure vestibular pathology. Three independent reviewers performed the selection process based on title, abstract, and full-text reading. In total, 8 studies were selected, three reviewers independently extracted data related to intervention technique, duration of intervention, symptoms relief, and overall outcome. The PEDro and hierarchy of evidence scales were used to assess the methodological quality of selected articles. Results: Of 8 articles, seven were randomized controlled trials (RCTs), and one was a qualitative design study. Hierarchy of evidence rating scores ranged from level 2 to level 3. Six of the articles had a level 2 score, and two articles had a level 3 score. PEDro scores ranged from 2/10 to 8/10, including three 8/10, two 7/10, two 2/10, and one 3/10 scores. Primary outcome measures reviewed in this study include the Vertigo Symptom Scale-Short Form and Dizziness Handicap Inventory. Secondary outcome measures include Dynamic Gait Index, Hospital Anxiety and Depression Scale, Visual Analogue Scale, quality of life measures, and subjective reports. Discussion: Although PEDro scores ranged from poor to good, internet vestibular rehabilitation (IVR) was shown to be an effective form of improvement in reported dizziness, anxiety related to symptoms, and dynamic postural stability. IVR did not significantly improve quality of life or severity of symptoms. Conclusion: Based on present findings, IVR can be recommended to patients as a means to reduce chronic symptoms outside of the clinic.https://digitalcommons.misericordia.edu/research_posters2023/1007/thumbnail.jp

Differential Regulation of CASZ1 Protein Expression During Cardiac and Skeletal Muscle Development

BACKGROUND: The zinc-finger transcription factor CASZ1 is required for differentiation of a distinct population of cardiomyocytes during development. However, expression of Casz1 mRNA is detected throughout the developing heart, suggesting the spatial regulation of CASZ1 occurs at the protein level. Relatively little is known about posttranscriptional regulation of Casz1 in the heart. RESULTS: We generated antibodies that specifically recognize CASZ1 in developing Xenopus embryos, and performed immunofluorescence analysis of CASZ1 during cardiac development. CASZ1 was detected throughout the developing myocardium. CASZ1 was restricted to terminally differentiated cardiomyocytes, and was down-regulated in cells that re-enter the cell cycle. We determined that CASZ1 expression correlated with terminal differentiation in cardiac muscle cells, skeletal muscle cells, and lymph-heart musculature. CONCLUSIONS: This study indicates that spatially distinct expression of CASZ1 protein may be due to posttranscriptional control of Casz1 mRNA during cardiac development. The results of this study provide insights into the role of Casz1 in cardiac function and in the differentiation of other cell types, including skeletal muscle and lymph heart

Congenital heart disease protein 5 associates with CASZ1 to maintain myocardial tissue integrity

The identification and characterization of the cellular and molecular pathways involved in the differentiation and morphogenesis of specific cell types of the developing heart are crucial to understanding the process of cardiac development and the pathology associated with human congenital heart disease. Here, we show that the cardiac transcription factor CASTOR (CASZ1) directly interacts with congenital heart disease 5 protein (CHD5), which is also known as tryptophan-rich basic protein (WRB), a gene located on chromosome 21 in the proposed region responsible for congenital heart disease in individuals with Down's syndrome. We demonstrate that loss of CHD5 in Xenopus leads to compromised myocardial integrity, improper deposition of basement membrane, and a resultant failure of hearts to undergo cell movements associated with cardiac formation. We further report that CHD5 is essential for CASZ1 function and that the CHD5-CASZ1 interaction is necessary for cardiac morphogenesis. Collectively, these results establish a role for CHD5 and CASZ1 in the early stages of vertebrate cardiac development