Visuo-vestibular biofeedback in patients with peripheral vestibular disorders

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Otolaryngology

Background:

• Diseases of the vestibular system can impair balance and quality of life.
• Compensation for vestibular disorders involves increased activity in proprioceptive and visual systems.
• Multisensory stimulation is considered optimal for achieving vestibular compensation.

Purpose of the Study:

• To evaluate the effectiveness of vestibular rehabilitation therapy (VRT).
• To assess VRT's impact on posturography measurements in patients with specific vestibular disorders.
• To compare VRT outcomes across different vestibular conditions: Ménière's disease, vestibular neuronitis, and vertebrobasilar insufficiency.

Main Methods:

• A cohort of 72 patients with diagnosed vestibular disorders participated.
• Patients underwent a comprehensive battery of tests including electronystagmography, various vestibular function tests (caloric, rotatory, optokinetic), computed posturography, craniocorpography, and audiological assessments (pure-tone, speech audiometry, tinnitometry).
• Posturography, specifically measuring the area of sway, was used to quantify balance changes over time during VRT.

Main Results:

• Patients with Ménière's disease showed an initial decrease in postural sway area after 3 weeks of VRT, but this improvement was transient, with values increasing by 6 weeks, particularly with eyes closed.
• Vestibular neuronitis patients exhibited continuous improvement, with significant decreases in both postural sway area and movement velocity.
• Patients with vertebrobasilar insufficiency demonstrated continuous improvement in postural sway, although absolute values remained in the pathological range.

Conclusions:

• Vestibular rehabilitation therapy shows differential effects depending on the underlying vestibular disorder.
• While VRT can lead to significant balance improvements in vestibular neuronitis and some improvement in vertebrobasilar insufficiency, its long-term efficacy in Ménière's disease may be limited without continued intervention.
• Posturography is a valuable tool for objectively measuring the impact of VRT on balance control in various vestibular pathologies.