Neurovestibular analysis and falls in Parkinson's disease and atypical parkinsonism

Contains fulltext : 183430.pdf (publisher's version ) (Open Access)Radboud University, 20 maart 2018Promotor : Bloem, B.R. Co-promotores : Verhagen, W.I.M., Meulstee, J.164 p

Neurovestibular analysis and falls in Parkinson's disease and atypical parkinsonism

Contains fulltext : 183430.pdf (publisher's version ) (Open Access)Radboud University, 20 maart 2018Promotor : Bloem, B.R. Co-promotores : Verhagen, W.I.M., Meulstee, J.164 p

Acute vestibular syndrome: a critical review and diagnostic algorithm concerning the clinical differentiation of peripheral versus central aetiologies in the emergency department

Contains fulltext : 165785.pdf (publisher's version ) (Closed access)Almost 20 % of cerebral ischaemic strokes occur in the posterior circulation. Estimates are that 20 % of these patients present with isolated vertigo. In approximately one-sixth to one-third of these patients, this symptom is wrongly diagnosed to be peripheral vestibular in origin. As a result, these missed stroke patients are withheld from therapeutic and secondary prophylactic treatment, which may result in unnecessary morbidity and mortality. We therefore propose a diagnostic algorithm concerning the clinical differentiation of acute vestibular syndrome (AVS) patients based on a critical review of the available literature

Neurovestibular analysis and falls in Parkinson's disease and atypical parkinsonism

Contains fulltext : 167985.pdf (publisher's version ) (Closed access)The primary aim of our study was to determine the extent of vestibular dysfunction in patients with Parkinson's disease (PD). Our secondary aim was to determine if vestibular dysfunction in PD is a risk factor for falling. The tertiary aim was to determine both the extent of vestibular dysfunction and if this dysfunction is a risk factor for falling in patients with atypical parkinsonism (AP). Twenty-five healthy subjects, 30 PD patients and 14 AP patients were matched for age and gender in a case-control study design. All subjects underwent clinical neurological and neurotological assessments, cervical and ocular vestibular evoked myogenic potentials (VEMPs), brainstem auditory evoked potentials (BAEPs), subjective visual vertical measurements, and videonystagmography with caloric and rotatory chair stimulation. Ninety per cent of PD patients (27 of 30) and all 14 AP patients had signs of vestibular dysfunction on laboratory examinations. The evoked potential (VEMPs and BAEPs) test results of PD patients showed significant prolongation of the p13, n1 and interpeak III-V latencies on the symptomatic brainstem side (0.003 </= P </= 0.019) compared with healthy subjects. Also, vestibular testing abnormalities were correlated with an increased risk for falling when fallers among PD and AP patients were compared with the non-fallers (P </= 0.001). To conclude, vestibular dysfunction on vestibular laboratory testing is highly prevalent in both PD and AP patients compared with healthy subjects, and is associated with an increased risk for falling.11 p

Review of urban traffic management and the impacts of new vehicle technologies

Traffic congestion is a growing problem in most urban areas across the world. In recent years, the problem has often been tackled by management of existing capacity rather than the traditional concept of more road building. This requires efficient traffic management tools and has led to widespread implementation of advanced traffic control systems integrated within a wider urban traffic management (UTM) environment. UTM systems collect data from various sources, process and manage the data and use this information to implement various measures to manage traffic. While infrastructure-based UTM systems continue to develop, there is now also a rapid market-driven development of vehicle technologies and in-vehicle driver support systems. Driver information and satellite navigation (sat-nav) systems are two examples already in widespread use, whereas other applications under research and development include intelligent speed adaptation (ISA), adaptive cruise control (ACC) and various other safety-related applications. This study will firstly present state-of-the-art reviews of UTM and in-vehicle systems. It will then discuss the potential impacts of new in-vehicle systems on UTM and opportunities for beneficial cooperation between the two. The research described in the study has been undertaken within a collaborative project FUTURES, funded by the Engineering and Physical Sciences Research Council (EPSRC