Relevant bibliographies by topics / Vestibular

Academic literature on the topic 'Vestibular'

Author: Grafiati
Published: 4 June 2021
Last updated: 9 March 2023

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Journal articles on the topic "Vestibular"

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Panichi, R., M. Faralli, R. Bruni, A. Kiriakarely, C. Occhigrossi, A. Ferraresi, A. M. Bronstein, and V. E. Pettorossi. "Asymmetric vestibular stimulation reveals persistent disruption of motion perception in unilateral vestibular lesions." Journal of Neurophysiology 118, no. 5 (November 1, 2017): 2819–32. http://dx.doi.org/10.1152/jn.00674.2016.

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Self-motion perception was studied in patients with unilateral vestibular lesions (UVL) due to acute vestibular neuritis at 1 wk and 4, 8, and 12 mo after the acute episode. We assessed vestibularly mediated self-motion perception by measuring the error in reproducing the position of a remembered visual target at the end of four cycles of asymmetric whole-body rotation. The oscillatory stimulus consists of a slow (0.09 Hz) and a fast (0.38 Hz) half cycle. A large error was present in UVL patients when the slow half cycle was delivered toward the lesion side, but minimal toward the healthy side. This asymmetry diminished over time, but it remained abnormally large at 12 mo. In contrast, vestibulo-ocular reflex responses showed a large direction-dependent error only initially, then they normalized. Normalization also occurred for conventional reflex vestibular measures (caloric tests, subjective visual vertical, and head shaking nystagmus) and for perceptual function during symmetric rotation. Vestibular-related handicap, measured with the Dizziness Handicap Inventory (DHI) at 12 mo correlated with self-motion perception asymmetry but not with abnormalities in vestibulo-ocular function. We conclude that 1) a persistent self-motion perceptual bias is revealed by asymmetric rotation in UVLs despite vestibulo-ocular function becoming symmetric over time, 2) this dissociation is caused by differential perceptual-reflex adaptation to high- and low-frequency rotations when these are combined as with our asymmetric stimulus, 3) the findings imply differential central compensation for vestibuloperceptual and vestibulo-ocular reflex functions, and 4) self-motion perception disruption may mediate long-term vestibular-related handicap in UVL patients. NEW & NOTEWORTHY A novel vestibular stimulus, combining asymmetric slow and fast sinusoidal half cycles, revealed persistent vestibuloperceptual dysfunction in unilateral vestibular lesion (UVL) patients. The compensation of motion perception after UVL was slower than that of vestibulo-ocular reflex. Perceptual but not vestibulo-ocular reflex deficits correlated with dizziness-related handicap.
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Tien, Hui-Chi, and Fred H. Linthicum. "Histopathologic Changes in the Vestibule after Cochlear Implantation." Otolaryngology–Head and Neck Surgery 127, no. 4 (October 2002): 260–64. http://dx.doi.org/10.1067/mhn.2002.128555.

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OBJECTIVE: The study goal was to determine the histopathologic changes of the vestibular end organs after cochlear implantation and to relate them to clinical performance. STUDY DESIGN: To differentiate the effect of implantation from the disease process that originally destroyed the hearing, 11 pairs of temporal bones from unilateral implantees were studied with light microscopy to compare the vestibular damage in the implanted ears with that in the nonimplanted ears. RESULTS: Significant histopathologic damage of the vestibular end organs was noted in 6 patients (54.5%). The major histopathologic findings were fibrosis in the vestibule, saccule membrane distortion, new bone formation, and reactive neuromas. The scala vestibuli involvement, as a result of damage to the osseous spiral lamina or basilar membrane in cochlear basal turn, was highly correlated with vestibular damage (75%). CONCLUSIONS: Although the clinical incidence of balance disturbance after cochlear implantation is low, damage of the vestibular end organs may occur and be asymptomatic. Keeping the electrode array in the scala tympani will minimize vestibular damage.
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Sudhoff, Holger, Hans Björn Gehl, Ercan Boga, Stefan Müller, Katharina Wilms, Sven Mutze, and Ingo Todt. "Stapes Prosthesis Length: One Size Fits All?" Audiology and Neurotology 24, no. 1 (2019): 1–7. http://dx.doi.org/10.1159/000494915.

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Background: The insertion of the stapes piston into the vestibule provides the physical basis for a successful stapedotomy. In routine clinical practice, two different ways to handle prosthesis length are performed: (1) an individualized measurement of the stapes prosthesis length or (2) a standard prosthesis length for all cases. Objective: The objective of this study was to compare both ways of handling prosthesis length and the effect of these methods on insertional prosthesis depth. Material and Method: We retrospectively evaluated 39 patients after performing a stapedotomy for radiologically estimated vestibular stapes prosthesis insertion depth. The individual measured length data were hypothetically changed to a standard length of 4.75, 5, 5.25, and 5.5 mm, and the insertion depths were compared. Results: The individually measured prosthesis lengths led to an insertion depth between 0.2 and 1.6 mm (mean 0.74 mm). The ratio of insertion depth/vestibular depth was between 8 and 59.1% (mean 26.6%). The different assumed standard lengths led to different rates of the vestibulum positions and possible bony contacts at the vestibulum floor. Conclusion: The individual measurement led to a zero rate of the vestibulum positions of stapes prosthesis pistons with a low insertion depth/vestibular depth ratio.
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Lee, Ju-Young, and Jeong-Yoon Choi. "Anatomic and Physiologic Properties and Clinical Manifestations ofVestibulo-Autonomic Reflexes." Journal of the Korean Neurological Association 40, no. 4 (November 1, 2022): 287–95. http://dx.doi.org/10.17340/jkna.2022.4.1.

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The vestibular nervous system senses linear and angular acceleration upon the head during postural change and generates vestibular nerve activity changes. The autonomic nervous system regulates involuntary physiologic processes throughout the peripheral and central nervous systems. The vestibular and autonomic systems interplay throughout several brain regions to maintain homeostasis during the postural changes, called vestibulo-autonomic reflex. In this review, we first contemplated the anatomic and physiologic properties of vestibulo-autonomic reflex, focusing on the relationship between vestibular and cardiovascular systems and between the vestibular and respiratory systems and the role of the brainstem and cerebellum on the vestibulo-autonomic reflex. Then, we summarized the autonomic dysfunction reported in patients with various vestibular disorders, such as acute unilateral vestibulopathy, benign paroxysmal positional vertigo, Meniere’s disease, and persistent perceptual postural dizziness. Finally, we described the mechanism of autonomic manifestation in vestibular disorders in detail using the recently proposed mechanism of vestibular syncope integrating the vestibular system, brainstem and cerebellum, and autonomic system functions.
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Wang, Yue, and Qi Guo. "Progress in Research on Vestibular Rehabilitation Therapy." Infection International 5, no. 4 (December 1, 2016): 119–24. http://dx.doi.org/10.1515/ii-2017-0142.

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AbstractThe deterioration of vestibular function is a side effect of numerous diseases of the inner ear. Vertigo is the most common symptom of vestibular dysfunction. Vestibule-suppressing drugs can control symptoms but impede the rehabilitation of vestibular function. Surgical treatment can effectively resolve vestibular dysfunction associated with some progressive diseases, including tumors. However, unilateral vestibular function remains permanently damaged after surgery, causing problems like vertigo and imbalance. To enhance the understanding of Vestibular rehabilitation therapy, this paper presents a summary of the progress in research on Vestibular rehabilitation therapy for patients with vestibular dysfunction.
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Saadat, Daryoush, Dennis P. O'Leary, Jack L. Pulec, and Hiroya Kitano. "Comparison of Vestibular Autorotation and Caloric Testing." Otolaryngology–Head and Neck Surgery 113, no. 3 (September 1995): 215–22. http://dx.doi.org/10.1016/s0194-5998(95)70109-5.

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The two most common stimuli of the vestibular system for diagnostic purposes are caloric and rotational head movements. Caloric stimulation, by delivering thermal energy to the lateral semicircular canal, is a well-studied method of vestibular testing, and its clinical usefulness has been established. Vestibular autorotation testing uses high-frequency (2 to 6 Hz), active head movements to stimulate the horizontal and vertical vestibulo-ocular reflex to produce measurable eye movements that can be used to calculate gain and phase. We compared the alternate bilateral bithermal caloric results with the vestibular autorotation test results obtained from 39 patients with peripheral vestibular disorders and from 10 patients with acoustic neuroma. In the peripheral disorder group, only 2 of 14 patients with equal caloric response (<20% reduced vestibular response) had a normal vestibular autorotation test result. No patients with a reduced vestibular response greater than 21% had a normal vestibular autorotation test result. In the acoustic neuroma group, four patients had a normal reduced vestibular response, but all patients had an abnormal vestibular autorotation test result. We conclude that testing both the horizontal and vertical vestibulo-ocular reflexes in their physiologic frequency range with the vestibular autorotation test provides additional information that could be missed by conventional caloric testing. Therefore high-frequency rotational testing is a valuable addition to the vestibular test battery.
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Abe, Chikara, Kunihiko Tanaka, Chihiro Awazu, and Hironobu Morita. "Galvanic vestibular stimulation counteracts hypergravity-induced plastic alteration of vestibulo-cardiovascular reflex in rats." Journal of Applied Physiology 107, no. 4 (October 2009): 1089–94. http://dx.doi.org/10.1152/japplphysiol.00400.2009.

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Recent data from our laboratory demonstrated that, when rats are raised in a hypergravity environment, the sensitivity of the vestibulo-cardiovascular reflex decreases. In a hypergravity environment, static input to the vestibular system is increased; however, because of decreased daily activity, phasic input to the vestibular system may decrease. This decrease may induce use-dependent plasticity of the vestibulo-cardiovascular reflex. Accordingly, we hypothesized that galvanic vestibular stimulation (GVS) may compensate the decrease in phasic input to the vestibular system, thereby preserving the vestibulo-cardiovascular reflex. To examine this hypothesis, we measured horizontal and vertical movements of rats under 1-G or 3-G environments as an index of the phasic input to the vestibular system. We then raised rats in a 3-G environment with or without GVS for 6 days and measured the pressor response to linear acceleration to examine the sensitivity of the vestibulo-cardiovascular reflex. The horizontal and vertical movement of 3-G rats was significantly less than that of 1-G rats. The pressor response to forward acceleration was also significantly lower in 3-G rats (23 ± 1 mmHg in 1-G rats vs. 12 ± 1 mmHg in 3-G rats). The pressor response was preserved in 3-G rats with GVS (20 ± 1 mmHg). GVS stimulated Fos expression in the medial vestibular nucleus. These results suggest that GVS stimulated vestibular primary neurons and prevent hypergravity-induced decrease in sensitivity of the vestibulo-cardiovascular reflex.
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Silva, Tatiana Rocha, Luciana Macedo de Resende, and Marco Aurélio Rocha Santos. "Potencial evocado miogênico vestibular ocular e cervical simultâneo em indivíduos normais." CoDAS 28, no. 1 (February 2016): 34–40. http://dx.doi.org/10.1590/2317-1782/20162015040.

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RESUMO Objetivo: Caracterizar o registro e analisar os resultados do potencial evocado miogênico vestibular cervical e ocular combinado em indivíduos sem queixas auditivas e vestibulares. Métodos: Participaram da pesquisa 30 indivíduos sem queixa auditiva e com audição dentro dos padrões de normalidade. A coleta de dados foi realizada por meio do potencial evocado miogênico vestibular cervical e ocular registrados simultaneamente. Resultados: Houve diferença entre as orelhas direita e esquerda para a amplitude das ondas P13 e N23 do potencial evocado miogênico vestibular cervical e para a latência da onda N10 do potencial evocado miogênico vestibular ocular. No gênero feminino não houve diferença entre as orelhas direita e esquerda para a amplitude das ondas P13, N23, N10, P15, interamplitude no potencial evocado miogênico vestibular cervical e interamplitude no potencial evocado miogênico vestibular ocular e para a latência das ondas P13, N23, N10 e P15. No gênero masculino houve diferença entre as orelhas direita e esquerda para a amplitude da onda P13. Conclusão: Os resultados do potencial evocado miogênico vestibular cervical e ocular combinado foram consistentes, uma vez que as respostas geradas pelos potenciais evocados miogênicos vestibulares apresentaram morfologia, latência e amplitude adequadas, o que permite a avaliação da via vestibular ipsilateral descendente e da via vestibular contralateral ascendente.
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Böhmer, Andreas, and Ugo Fisch. "Clinical Pathophysiology of Vestibular Neurectomy." Otolaryngology–Head and Neck Surgery 112, no. 1 (January 1995): 183–88. http://dx.doi.org/10.1016/s0194-59989570318-7.

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This study attempts to characterize the residual vestibular function remaining after incomplete supralabyrinthine vestibular neurectomy performed for disabling vertigo. Patients with bilateral vestibular neurectomy had preserved horizontal vestibulo-ocular reflexes in response to high angular accelerations with gain enhancement over time. A torsional down-beating spontaneous nystagmus and an important tilt of the subjective vertical were observed when the remaining eighth nerve was sectioned after homolateral incomplete supralabyrinthine vestibular neurectomy. These findings suggest that a reorganization of vestibular reflexes may occur after incomplete supralabyrinthine vestibular neurectomy if afferents of the inferior vestibular branch are partially spared. The vestibular function after incomplete supralabyrinthine vestibular neurectomy does not affect the postoperative control of vertiginous attacks and may have positive effects in case of deterioration of the contralateral inner ear.
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Furman, Joseph M., Li-Chi Hsu, Susan L. Whitney, and Mark S. Redfern. "Otolith-ocular responses in patients with surgically confirmed unilateral peripheral vestibular loss." Journal of Vestibular Research 13, no. 2-3 (October 1, 2003): 143–51. http://dx.doi.org/10.3233/ves-2003-132-309.

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The chronic effects of unilateral peripheral vestibular loss (UPVL) are influenced by vestibular compensation. This study documents the balance-related symptoms and quantitative vestibular laboratory testing of 20 patients with surgically confirmed UPVL. Included are measures of the semicircular canal-ocular reflex, the otolith-ocular reflex, and both static and dynamic semicircular canal-otolith-interaction. This study differs from previous studies of patients with UPVL in that a large number of patients with surgically confirmed lesions were tested with three types of off-vertical axis rotation, several of the patients had anatomically preserved superior vestibular nerves, and self-perceived level of disability related to dizziness and imbalance were available. Results confirmed previously reported changes in the vestibulo-ocular reflex of patients with UPVL. Also, there was no apparent effect of anatomically preserving the superior vestibular nerve during surgical resection of vestibular schwannomas based on either subjective or objective measures of vestibular dysfunction. Further, there were no apparent correlations between subjective measures of dizziness and imbalance and objective measures of vestibulo-ocular function. These results have clinical implications for the management of patients with unilateral vestibular loss and provide insights into the process of vestibular compensation especially with respect to the otolith-ocular reflex.
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Dissertations / Theses on the topic "Vestibular"

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Sato, Silvana Rodrigues de Souza. "Concurso vestibular." Florianópolis, SC, 2011. http://repositorio.ufsc.br/xmlui/handle/123456789/95324.

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Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Educação, Programa de Pós-Graduação em Educação, Florianópolis, 2011
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A partir deste estudo propomo-nos analisar o concurso vestibular como dispositivo meritocrático de ingresso na Universidade Federal de Santa Catarina. A base empírica é constituída por uma amostra de universitários das primeiras fases de todos os seus cursos, aprovados no vestibular do ano de 2010. Para alcançar esse objetivo, buscamos compreender diferentes exames para acessar os níveis escolares, principalmente, os referentes ao ensino superior, compomos o atual perfil socioeconômico dos ingressantes da universidade federal catarinense e estudamos o modo como a aprovação ou reprovação no vestibular é explicada e sentida, a partir do entendimento dos candidatos aprovados no concurso do ano de 2010. Além disso, realizamos um levantamento das pesquisas sobre a temática e empreendemos estudos sobre as diferentes denominações atribuídas aos exames, juntamente com a análise de orientações oficiais que regulamentaram e/ou estão em vigor na legislação brasileira. Aprofundamos estudos em algumas teorias sociológicas contemporâneas de Michel Foucault, Pierre Bourdieu, Jean-Claude Passeron e François Dubet, desejando entender a importância que os dispositivos de seleção e de classificação assumem no desenvolvimento das sociedades modernas. Identificamos os significados dos termos vestibular, concurso e exame, vocábulos de objetivos diferentes, embora inter-relacionados. A tabulação e a análise das informações contidas nos questionários aplicados aos acadêmicos nos levaram a concluir que a herança familiar, em todas as suas dimensões e com uma alta reconversão de capitais, tem pesado a favor dos jovens vindos das camadas sociais mais favorecidas. Fica evidente que as famílias utilizam variadas estratégias para que seus descendentes construam trajetórias escolares bem sucedidas. Os percursos escolares dos calouros são marcados por iniciativas que fizeram a diferença no momento do ritual de passagem do ensino médio para o ensino superior. A se destacar a respeito da expressiva maioria: cursou educação infantil; migrou do ensino fundamental público para o ensino médio privado; disponibilizou de mais de um turno para a preparação para o vestibular (85%); não trabalhava no começo dos estudos acadêmicos (71%) e mantinha a perspectiva de prosseguimento dos estudos em nível de pós-graduação. O mérito escolar é legitimado pela maioria dos calouros, que atribui o sucesso no concurso vestibular ao esforço de cada candidato.
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Taylor, Rachael Louise. "Vestibular Evoked Myogenic Potential Characteristics in Common Vestibular Disorders." Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/15856.

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Intense sound and vibration evokes small reflexes from the neck and eye muscles, reflecting activation of vestibular-otolith receptors. These responses provide the basis for two clinical tests of balance function, referred to as cervical- and ocular- vestibular evoked myogenic potentials (cVEMPs and oVEMPs). As relatively new tests, their diagnostic role has not been fully explored. The primary aim of this thesis was to identify test and stimulus combinations that improve the sensitivity and specificity of VEMP testing, whilst differentiating between different causes of vertigo and imbalance. Patients with Ménière’s disease, vestibular migraine, superior canal dehiscence, vestibular schwannoma, and vestibular neuritis were recruited from neurology outpatient clinics at the Royal Prince Alfred Hospital in Sydney, Australia from 2009-2015. Each study identified specific stimulus/VEMP combinations that enhanced the sensitivity of VEMP testing, as well as revealing patterns of otolith dysfunction that characterised each disorder. Ménière’s disease was characterised by impaired saccular and largely preserved utricular function, whereas in vestibular migraine otolith function was usually preserved and symmetrical. Superior canal dehiscence was unique with its high frequency augmentation effects and prolonged oVEMP latencies to skull-tap stimulation. For vestibular schwannoma larger than 14 mm, impaired function of both otolith organs was common. Abnormal utricular, but spared saccular function, was most often observed in patients with vestibular neuritis. The findings of this thesis provide new insight into how test parameters can be manipulated to enhance the sensitivity of VEMP testing in the clinical setting. The different patterns of saccular and utricular involvement contribute significantly to the clinician’s ability to separate different vestibular disorders.
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Hijano, Esqué Rafael. "Valor diagnóstico de los potenciales vestibulares evocados miogénicos (VEMPs) en el schwannoma vestibular." Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/325410.

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Introducción: El schwannoma vestibular (SV) es un tumor benigno con origen en el VIII par craneal. La prueba diagnóstica de referencia del SV es la resonancia magnética (RM), si bien existen una serie de pruebas de funcionalidad cócleo-vestibular que, junto con el grado de sospecha dado por determinadas manifestaciones clínicas, pueden poner sobre la pista del SV. Entre éstas pruebas se encuentran los potenciales evocados vestibulares miogénicos de registro cervical (cVEMPs) que ha ganado popularidad en los últimos años como prueba de funcionalidad del sáculo y del nervio vestibular inferior. Los objetivos del presente estudio son determinar cuál es la bondad diagnóstica de los cVEMPs , establecer qué variables demográficas, clínicas (síntomas, signos, inicio) y de resultados en pruebas otoneurológicas (audiometría, pruebas vestibulares calóricas, potenciales auditivos de tronco –PEATC-, cVEMPs) pueden predecir tamaño, grado de penetración y localización tumorales (fundamentales para establecer la modalidad terapéutica adecuada y para la valoración de la funcionalidad auditivo-vestibular residual que, sin duda, marcan la calidad de vida de estos pacientes). Material y métodos: Para establecer la bondad diagnóstica de los cVEMPs se analizó retrospectivamente una cohorte de 585 pacientes visitados consecutivamente en una consulta de otoneurología, en un período de 4 años, con síntomas-signos auditivo-vestibulares (93 con SV, 492 sin SV). A todos ellos se les realizó cVEMPs y RM. Se calculó sensibilidad, especificidad, valores predictivos y razones de verosimilitud; así mismo se usó una cohorte retrospectiva de 157 pacientes con diagnóstico confirmado de SV en el mismo hospital en un período de 10 años, recogiendo datos demográficos, síntomas (hipoacusia, acúfenos, desequilibrio, vértigo, signos no otológicos) y resultados en audiometría, pruebas calóricas, PEATC y cVEMPs, para realizar análisis multivariado referente a la predicción de tamaño, localización –intra o extracanalicular- y grado de penetración en el conducto auditivo interno (CAI) del SV. Resultados: La prueba índice usada en la serie (cVEMPs) para el diagnóstico de SV, cuando fue comparada con la prueba de referencia (RM CAI), presentó una sensibilidad de 81.72% y una especificidad del 37.60%. Mucho más bajas fueron la sensibilidad (58%) y especificidad (52%) de las pruebas vestibulares calóricas. El valor predictivo negativo de los cVEMPs fue del 92%. La afectación de las frecuencias bajas en la audiometría, una alteración del intervalo III-V en el lado sano en los PEATC y presentar signos no otológicos y desequilibrio fueron las variables predictivas que se relacionaron significativamente con el tamaño del SV, en un modelo de regresión lineal múltiple. Los pacientes con afectación en la audiometría de frecuencias graves y penetración del SV más allá de la mitad del CAI tuvieron más probabilidad de presentar SV extracanaliculares. La pérdida en la audiometría de > 40 dB se mostró como la única variable explicativa del mayor grado de penetración de los SV en el CAI. Conclusiones: Los cVEMPs no son una buena herramienta diagnóstica de detección, debido a su baja especificidad, pero sí de exclusión dado su alto valor predictivo negativo. Presentar desequilibrio, signos no otológicos, afectación de las frecuencias bajas en la audiometría y un incremento en el intervalo III-V del lado sano en los PEATC son las variables que predicen mejor el tamaño en mm de los SV. Los cVEMPs no son una buena herramienta para discernir entre un tumor intra o extracanalicular, ni tampoco el grado de penetración tumoral en el CAI.
Introduction: Vestibular schwannoma (VS) is a benign tumor arising from the eighth cranial nerve. The current gold standard for diagnosing SV is magnetic resonance imaging (MRI), although many tests which evaluate cochleovestibular functionality, together with the degree of suspicion given by certain clinical manifestations, can put on the track of the diagnostic of VS. These tests include cervical vestibular evoked myogenic potentials (cVEMPs), that has gained popularity in recent years as a diagnostic tool to evaluate the saccule and the inferior vestibular nerve functionality. The aims of this study are to determine what is the diagnostic accuracy of the cVEMPs, to establish which demographic, clinical (symptoms, signs, onset) and otoneurological tests (audiometry, caloric tests, auditory brainstem potentials -ABR-, cVEMPs) variables can predict size, degree of tumor penetration and location (they are fundamental for establishing the proper therapeutic modality and for the assessment of the residual auditory-vestibular functionality, which undoubtedly predict the quality of life of these patients). Material and methods: A cohort of 585 patients visited consecutively over a period of 4 years, in an otoneurology clinic, suffering from audiovestibular signs and symptoms (93 with VS, 492 without VS) was retrospectively analyzed to establish the diagnostic accuracy of cVEMPs. cVEMPs and MRI was performed in all of them. Sensitivity, specificity, predictive values, and likelihood ratios were calculated; a retrospective cohort of 157 patients with confirmed diagnosis of VS, at the same hospital in a period of 10 years, was also analyzed, collecting demographic data, symptoms (hearing loss, tinnitus, vertigo, imbalance non-otological signs) and results in audiometry, caloric testing, ABR and cVEMPs in order to perform a multivariate analysis to predict the size, location - intra vs. extracanalicular- and degree of penetration into the internal auditory canal (IAC) of the VS. Results: The index test for the diagnosis of SV used in this series (cVEMPs) -when compared to the reference standard test (MRI) - presented a sensitivity of 81.72% and a specificity of 37.60%. The caloric test showed both low sensitivity (58%) and specificity (52%). The negative predictive value of cVEMPs was 92%. The involvement of low frequencies on audiometry, an alteration of the III-V interval in the ipsilateral side in the ABR, non-otological signs and imbalance were predictive variables that were significantly related to the size of the SV in a multiple linear regression model. Patients with involvement of low-frequencies in the audiometric test and penetration of the VS beyond half of the IAC were more likely to have an extracanalicular VS. A loss > 40 dB in the audiometry was established as the single explanatory variable of a higher penetration degree of VS in the IAC. Conclusions: cVEMPs are not a good diagnostic detection tool, due to its low specificity. Conversely, given its high negative predictive value, they are a good diagnostic tool of exclusion. Having imbalance, non-otological signs, involvement of low frequencies in the audiometry and an increased III-V interval in the healthy side in ABR are the variables which best predict the size of VS in millimeters. cVEMPs are not a good tool to discern between intracanalicular and extracanalicular tumors, nor the degree of tumor penetration in the IAC.
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Silva, André Luis dos Santos. "EL EQUILIBRIO, LA MARCHA Y LA EFICACIA DE UM TRATAMIENTO KINESITERAPICO EN ANCIANOS PORTADORES DE DESÓRDENES VESTIBULARES." Centro Universitário de Caratinga, 2005. http://bibliotecadigital.unec.edu.br/bdtdunec/tde_busca/arquivo.php?codArquivo=74.

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lt;p align="justify"gt;Propuesta: El objectivo de esta investigación fue el de determinar el significado de un tratamiento kinesiterápico a través de un programa personalizado de rehabilitación vestibular en el control de los trastornos vestibulares con la asociación de la reeducación del equilíbrio y de la marcha en la población anciana. Metodología: La pesquisa desarrollada fue analítica, caracterizada como un estudio clínico prospectivo casi experimental con el grupo-control. Se optó por la aplicación de un control diario el cúal los sujetos rellenaron por todo el período de la investigación, demostrando así una característica longitudinal al trabajo. El tratamiento estadístico fue constituido de estadística descriptiva y la inferencial, a través de la cúal se realizó la aplicación de los testes de hipótesis con test t de Student y el Chi-cuadrado que constituyeron la base del proceso comparativo de los valores medios y distribuciones de frecuencias calculadas, de acuerdo a las variables descritas consideradas. El nivel de significancia fue plt;0,05. Sujetos: de un total de 235 pacientes, fueron seleccionados 62 (55 de sexo femenino y 7 del sexo masculino), no institucionalizados, en el Hospital Publico de Buenos Aires. El grupo seleccionado quedo constituido por sujetos con disfunción vestibular, con edad entre 58 a 87 años (aproximado de 67 a 45 años; DP: 6,34), siendo que 31 quedarón en el grupo experimental y 31 en el grupo control. Resultados: el tratamiento kinesitertapico propuesto debe ser aceptado como instrumento de alteración significativa en el cuadro de los pacientes sometidos. Los resultados combinados denotarón que la respuesta clínica y la auto evaluación fueron concordantes en la percepción de mejora del grupo sometido al tratamiento experimental. Hubo diferencias estadísticamente significativas a lo largo de tres meses para los parámetros analisados. Conclusiones: Los resultados de este estudio indican que programas personalizados y supervisados para el control de las vestibulopatias sin eficazes y su oferta debería ser considerada rutineramente en servicios publicos y privados.lt;/pgt;
Proposal: The objective of this investigation was the one to determine the meaning of a kinesitherapy treatment through a customized program in the control of the vestibular disorders with the association of the vestibular rehabilitation and reeducation of the balance and the gait in the elderly. Methodology: The developed search analytical was characterized as quasi experimental design a prospective clinical study with the group-control. It was decided on the application of a daily control which the subjects filled up by all the period of the investigation, demonstrating therefore a longitudinal characteristic to the work. The statistical treatment was constituted of descriptive statistic and the inferencial, through which it was made the application of the tests of hypothesis with test t of Student and the Chi-square that constituted the base of the comparative process of the values average and calculated frequency allocations, according to the described variables considered. The significance level was plt;0,05. Subjects: of a total of 235 patients, noninstitutionalized ones were selected 62 (55 female and 7 male), in the publish hospital of Buenos Aires. The selected group was constituted by subjects with vestibular disorders, with age between 58 to 87 years (approximated of 67 to 45 years; SD 6,34), being that 31 in experimental group and 31 in the control group. Outcomes: the kinesitherapy treatment proposed must be accepted like instrument of significant alteration in the vestibulopath patients. The combined results exposes that clinical answer and the self-evaluation were concordant in the perception of improvement of the group submited of the experimental treatment. There were statistically significant differences throughout three months for the analized parameters. Conclusions: The outcomes of this study indicate that supervisioned physical therapy programs for the control of vertigo is considered efficacy and its supply would be considered in public and private services.
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Nigmatullina, Yuliya. "Visual-vestibular interactions." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/25086.

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Following repeated exposure to vestibular stimulation, the vestibular response as measured by the vestibular-ocular reflex and perception of self-motion is reduced. Similarly, prolonged viewing of a visual motion stimulus results in a reduced sensitivity to the adapting motion stimulus. These phenomena of visual-vestibular desensitisation are utilised as part of treatment of patients with peripheral or central vestibular disorders. Patients typically receive vestibular rehabilitation therapy, which involves exposure to repeated visual and/or vestibular stimulation. Whilst the effects of vestibular rehabilitation at the behavioural level have been widely studied, the neural mechanism of how it works is unclear. In this thesis, asymptomatic subjects were recruited to investigate the neural mechanisms underlying visual and vestibular desensitisation. In the first study, the effect of long term vestibular training was investigated on the vestibular psychophysical measures and on the structure of the brain. To this aim, a group of high level dancers and a group of non-dancers were recruited with both groups undergoing a battery of vestibular tests and neuroimaging brain scans. Compared to controls, dancers showed a significant reduction in both vestibular ocularmotor response and perception of self-motion. Moreover, in controls a significant correlation was found between ocularmotor and perceptual measures, which was absent in dancers. This uncoupling of the vestibular measures was also seen at the neuroanatomical level in the locus of the vestibular-cerebellum, as revealed by voxel based morphometry (VBM) analysis of the dancers' brain grey matter. Using diffusion tensor imaging (DTI), a widespread cortical white matter (WM) network was found to correlate with vestibular perception in the control group only. The findings suggest that in dancers, a cerebellar gating of perceptual signals to cortical regions takes place that may mediate the training-related resistance to vertigo. The second study of the thesis looked at the effect of a single prolonged exposure to unilateral visual motion stimulus in healthy untrained subjects. This involved using transcranial magnetic stimulation (TMS) induced phosphenes to assess early visual cortical excitability. Following visual motion adaptation, excitability of visual cortex (V1) was significantly reduced when viewing motion in the adapted direction and significantly increased when viewing motion in the non-adapted direction. This suggests that reciprocal inhibition takes place between oppositely tuned directionally selective neurones in V1 to facilitate motion perception. The visual cortical excitability returned to its prior-adaptation state after five minutes suggesting that a single exposure to visual motion stimulus is not sufficient to cause a long-term adaptive effect. The final study of the thesis investigated potential neural mechanisms involved in suppressing visual symptom of oscillopsia (perception of the world oscillating/moving), a potentially distressing condition that occurs in some vestibular and ocularmotor disorders. The study recruited participants with nystagmus and they were divided into two groups according to their experience of oscillopsia: symptomatic (with oscillopsia) and asymptomatic (no oscillopsia). TMS induced phosphenes were used to assess (1) whether visual cortical spatial updating takes place according to the eye position and (2) whether modulation of visual cortical excitability takes place during nystagmus. In the asymptomatic group only, evidence for both visual cortical updating and modulation of visual cortical excitability was found, which was absent in the symptomatic group. The findings suggest that spatial updating of eye position and changes in visual cortical excitability are implicated in the suppression of oscillopsia. In particular, the work presented in the thesis provides neuroanatomical imaging basis for vestibular adaptation and provides evidence for a direct cortical involvement in visual motion adaptation. Both of these mechanisms are likely to be involved in the clinical recovery process of patients with vestibular and ocularmotor disorders. Greater understanding of the neural mechanisms involved in long lasting visual-vestibular desensitisation will bring us closer to developing personalised treatments that are more effective in improving symptoms of patients with visuo-vestibular disorders.
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Junkes, Terezinha Kuhn. "Redação no vestibular." reponame:Repositório Institucional da UFSC, 1987. https://repositorio.ufsc.br/handle/123456789/106282.

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Dissertação (mestrado) - Universidade Federal de Santa Catarina, Florianópolis, 1987.
Made available in DSpace on 2013-12-05T19:58:38Z (GMT). No. of bitstreams: 1 98673.pdf: 3478366 bytes, checksum: 223123bde5e75936fa63acfeeb272dc0 (MD5) Previous issue date: 1987
A partir da dificuldade de expressão verbal constatada nas redações de alunos de 2o. grau e dos vestibulandos, a presente dissertação objetiva estudar o assunto. Analisa sobretudo, os aspectos da coesão e da coerência textuais, dando um enfoque teórico, conforme vários autores, como Beugrande e Dressler, Halliday e Hasan, Marcuschi, Schmidt, centralizando a discussão em torno de elementos substitutivos. Numa visão micro e macroestrutural, analisam-se os problemas de remissão: as relações anafóricas e a referência exofórica - dêitica, além de serem trabalhados os elementos não contextualizados. O corpus para estudo prático dessas questões é constituído por 281 redações do vestibular de 1986 da UFSC. Constata-se baixo número de redações fluentes, confirmando tais resultados a problemática do ensino de redação na grande maioria das escolas brasileiras, tanto da rede particular quanto da oficial, problemática agravada ainda mais nos estudantes de nível sócio-econômico menos favorecido e nos que fazem o 2o. grau supletivo. A origem dos problemas enfrentados pelos alunos pode ser detectada no uso inadequado de gramáticas normativas e na organização do conteúdo didático de alguns livros-texto, além das técnicas ineficientes de manuais próprios de redação. Conclui-se que a solução para a problemática só será viável quando houver mudanças de princípios e métodos, em relação ao ensino da redação, principalmente por parte dos autores de livros didáticos e dos professores.
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Akin, Faith W. "Vestibular Grand Rounds." Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/2445.

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Akin, Faith W. "Bilateral Vestibular Loss." Digital Commons @ East Tennessee State University, 1997. https://dc.etsu.edu/etsu-works/2459.

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Akin, Faith W. "Vestibular Grand Rounds." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/2440.

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Akin, Faith W. "Vestibular Grand Rounds." Digital Commons @ East Tennessee State University, 2008. https://dc.etsu.edu/etsu-works/2449.

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Books on the topic "Vestibular"

1

M, Highstein Stephen, Fay Richard R, and Popper Arthur N, eds. The vestibular system. New York: Springer, 2004.

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1934-, Honrubia Vicente, ed. Clinical neurophysiology of the vestibular system. 2nd ed. Philadelphia: F.A. Davis Co., 1990.

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Japan) International Symposium on Vestibular Disorders (1994 Hiroshima-shi. International Symposium on Vestibular Disorders, Hiroshima, January, 1994. Edited by Harada Yasuo 1931-. Stockholm, Sweden: Scandinavian University Press, 1995.

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O, Barber Hugh, and Sharpe James A, eds. Vestibular disorders. Chicago: Year Book Medical Publishers, 1988.

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Wetmore, Stephen, and Allan Rubin, eds. Vestibular Migraine. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-14550-1.

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Susan, Herdman, ed. Vestibular rehabilitation. Philadelphia: F.A. Davis Co., 1994.

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Clendaniel, Richard A. Vestibular rehabilitation. 4th ed. Philadelphia: F.A. Davis, 2014.

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A, Kerber Kevin, ed. Clinical neurophysiology of the vestibular system. 4th ed. New York: Oxford University Press, 2011.

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Baskaya, Mustafa K., G. Mark Pyle, and Joseph P. Roche. Vestibular Schwannoma Surgery. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-99298-3.

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Highstein, Stephen M., Richard R. Fay, and Arthur N. Popper, eds. The Vestibular System. New York, NY: Springer New York, 2004. http://dx.doi.org/10.1007/b97280.

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Book chapters on the topic "Vestibular"

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Alpini, Dario Carlo, Antonio Cesarani, and Guido Brugnoni. "Vestibular Ataxia (Bilateral Vestibular Hypofunctionpathy)." In Vertigo Rehabilitation Protocols, 97–108. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-14782-6_7.

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Goldberg, Jay M. "Vestibular Inputs: The Vestibular System." In Neuroscience in the 21st Century, 1007–54. New York, NY: Springer New York, 2016. http://dx.doi.org/10.1007/978-1-4939-3474-4_30.

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Goldberg, Jay M. "Vestibular Inputs: The Vestibular System." In Neuroscience in the 21st Century, 1291–338. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-88832-9_30.

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Goldberg, Jay M. "Vestibular Inputs: The Vestibular System." In Neuroscience in the 21st Century, 883–929. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-1997-6_30.

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von Brevern, Michael. "Vestibular Migraine: Vestibular Testing and Pathophysiology." In Vestibular Migraine and Related Syndromes, 83–90. Cham: Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-07022-3_7.

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Brandt, Thomas. "Vestibular epilepsy." In Vertigo, 233–39. London: Springer London, 1999. http://dx.doi.org/10.1007/978-1-4471-0527-5_14.

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Schubert, Michael C. "Vestibular, Rehabilitation." In Encyclopedia of Computational Neuroscience, 3050–54. New York, NY: Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4614-6675-8_14.

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Badakhshi, Harun. "Vestibular Schwannoma." In Image-Guided Stereotactic Radiosurgery, 63–80. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-39189-2_6.

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Zaidi, Shabih H., and Arun Sinha. "Vestibular Migraine." In Vertigo, 91–102. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-36485-3_5.

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Merchant, Randall E. "Vestibular Nuclei." In Encyclopedia of Clinical Neuropsychology, 3585–86. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-57111-9_376.

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Conference papers on the topic "Vestibular"

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Elsner, Ann E., C. Wall, and J. Johnson. "Aging in visual-vestibular interactions." In OSA Annual Meeting. Washington, D.C.: Optica Publishing Group, 1986. http://dx.doi.org/10.1364/oam.1986.wf4.

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To search rapidly for information in a scene, it is critical to make quick, accurate saccadic eye movements. Often, while making these movements, a body or head movement is required. Thus, vestibular and saccadic eye movements must be coordinated. It is known that the vestibular system can change with age; e.g., the gain of the system can decrease with age, particularly at low frequencies. However, the effects on saccadic eye movements are not understood. Using a pseudorandom vestibular stimulus (rotation about the vertical) with frequencies from 0.02 to 1.67 Hz, we have measured (a) the gain and phase of the vestibulo-ocular reflex and (b) saccade parameters. Saccade targets were three red LEDs, positioned in the center and 9° to either side. We recruited five observers, 62–69 years, who had been normal on a battery of vestibular tests 2 years prior. There was a slight loss of low frequency relative to high frequency gain, but this trend was not significant. However, the average number of saccade errors doubled while rotating vs remaining stationary. Most errors during rotation were (a) single or multistep saccades of less than half-amplitude or (b) slow eye movements.
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Schendzielorz, P., M. Scheich, K. Rak, J. Völker, A. Lundershausen, M. Bürklein, and R. Hagen. "Preoperative vestibular function of patients with vestibular schwannoma." In Abstract- und Posterband – 89. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Forschung heute – Zukunft morgen. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1640571.

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Silveira, Roberto Leal Da, and Eder Rocha. "Vestibular Schwannomas Guidelines." In 30th Annual Meeting North American Skull Base Society. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1702459.

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Korol, Igor, and Nikolai Silkov. "The regularities of vestibular nystagmus and the influence of vestibular afferentation." In Abstract- und Posterband – 91. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Welche Qualität macht den Unterschied. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1711201.

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Malina, G., D. Heiferman, Loren Riedy, C. Szujewski, E. Rezaii, J. Leonetti, and D. Anderson. "Pediatric Sporadic Vestibular Schwannomas." In 29th Annual Meeting North American Skull Base Society. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1679489.

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Synnott, J., P. J. McCullagh, G. P. Kelly, H. G. McAllister, and H. G. Houston. "Portable virtual vestibular stimulation." In 2009 9th International Conference on Information Technology and Applications in Biomedicine (ITAB 2009). IEEE, 2009. http://dx.doi.org/10.1109/itab.2009.5394316.

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Castro, Isabella Moraes de, and Leticia Moraes de Aquino. "Vestibular rehabilitation by telemonitoring." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.489.

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Introduction: Dizziness is one of the main symptoms of vestibular disorders, with high prevalence and functional impact. Vestibular Physiotherapy (VP) is a part of the treatment in these disorders, targeting functional improvement. Currently, telehealth (TH) appears to expand access, being an immediate solution for COVID-19 pandemic. Objective: To seek evidence of the benefits of VP via TH regarding assessment and interventions for patients with VD. Design and settings: Study carried out at São Camilo University. Methodology: Integrative review of clinical studies, Key words: “Vestibular disorders” and “TH”, in the PubMED and PeDRO databases, with no language or year limit. Results: 10 articles were found, 5 were included after review. Of these, 80% had a TH care protocol guiding adaptations to assessments for acute/ subacute symptoms, considering the severity and need for referrals. 60% of the works highlight the barriers found: devices and the patient’s ability to manage them, data and internet security; but also raise the possibility of greater reach to specialized professionals. One article adapted the Dix-Hallpike test from a distance. Only one study proposed remote interventions by exercise, comparing with face-to-face assistance, demonstrating similar results. Conclusion: Evidence suggests viable use of TH in dizziness, with better evidence in the evaluation processes, considering the barriers to be controlled. Only one study showed results on VF and exercises, showing that it is a possibility to be further investigated.
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Bhargava, Malika, Komal Naeem, and Randall Porter. "Zapping Vestibular Schwannomas: The First Vestibular Schwannoma Treated with the ZAP-X." In Special Virtual Symposium of the North American Skull Base Society. Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1725546.

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Silva, João Vitor Vicente Da, Graziele Da Costa Martins, Verônica Regina Gomes Paes Fernandes, and Edgard De Freitas Vianna. "DISTÚRBIOS VESTIBULARES E A ATUAÇÃO DA FARMÁCIA CLÍNICA: UM RELATO DE CASO CLÍNICO." In III Congresso Brasileiro de Ciências Farmacêuticas On-line. Revista Multidisciplinar em Saúde, 2022. http://dx.doi.org/10.51161/conbracif/69.

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Introdução: Os distúrbios vestibulares apresentam uma gama de classificações e etiologias. A vertigem é a principal queixa relatada por pacientes com estes distúrbios, caracterizada como a sensação ilusória de movimento do corpo ou do ambiente. A neurite vestibular e vertigem posicional paroxística benigna constituem as principais causas de vertigem. Os tratamentos atualmente visam à redução de sintomas e melhora na qualidade de vida. Neste contexto o farmacêutico clínico é capaz de utilizar seus conhecimentos para otimização da farmacoterapia e segurança no cuidado ao paciente. Objetivo: O presente relato de caso tem como objetivo evidenciar a atuação do farmacêutico clínico junto à equipe multidisciplinar no manejo dos distúrbios vestibulares. Materiais e métodos: Paciente do sexo feminino, 45 anos, 90 Kg e 1,75 m, procurou a emergência de um hospital de médio porte do Rio de Janeiro, RJ, referindo vertigem, cefaleia e vômitos com início na madrugada, relatando perda de força generalizada, tontura e episódio de êmese. Resultados: A partir do monitoramento farmacoterapêutico com o objetivo de avaliar a melhor terapia para os diagnósticos dados a esta paciente, o farmacêutico clínico investigou através da literatura opções terapêuticas. Foram realizadas intervenções farmacêuticas junto à equipe multidisciplinar sugerindo a utilização de antieméticos, antinauseantes, bloqueadores de canal de cálcio e benzodiazepínicos, medicamentos com ação supressora vestibular. Além da análise de interações medicamentosas durante o período de internação da paciente. Conclusão: A atuação do farmacêutico clínico nos distúrbios vestibulares possui relevância para a adoção da conduta farmacoterapêutica mais adequada para cada paciente. Os demais profissionais de saúde, em destaque a equipe médica, devem trabalhar em conjunto com o Serviço de Farmácia Clínica visando à melhoria na qualidade do cuidado durante a internação.
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Della Santina, C. C., A. A. Migliaccio, and A. H. Patel. "Electrical Stimulation to Restore Vestibular Function Development of a 3-D Vestibular Prosthesis." In 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference. IEEE, 2005. http://dx.doi.org/10.1109/iembs.2005.1616217.

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Reports on the topic "Vestibular"

1

Kolev, Ognyan I., and Budin B. Mihov. Hormonal Changes Following Prenauseogenic Vestibular Stimulation. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, June 2018. http://dx.doi.org/10.7546/crabs.2018.06.16.

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Walker, Mark. Disequilibrium after Traumatic Brain Injury: Vestibular Mechanisms. Fort Belvoir, VA: Defense Technical Information Center, September 2012. http://dx.doi.org/10.21236/ada576379.

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Walker, Mark. Disequilibrium After Traumatic Brain Injury: Vestibular Mechanisms. Fort Belvoir, VA: Defense Technical Information Center, September 2011. http://dx.doi.org/10.21236/ada559247.

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Guedry, F. E., and C. M. Oman. Vestibular Stimulation during a Simple Centrifuge Run. Fort Belvoir, VA: Defense Technical Information Center, May 1990. http://dx.doi.org/10.21236/ada227285.

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Hansen, Marlan R., J. J. Clark, Wie Y. Yue, Prabhat C. Goswami, and Bruce J. Gantz. ErbB2 Trafficking and Signaling in Human Vestibular Schwannomas. Fort Belvoir, VA: Defense Technical Information Center, October 2008. http://dx.doi.org/10.21236/ada501648.

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Sánchez Legaza, Elena. Neurofibromatosis tipo 2 manifestada como schwannoma vestibular bilateral. Buenos Aires: siicsalud.com, March 2017. http://dx.doi.org/10.21840/siic/154613.

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Hansen, Marlan R., J. J. Clark, Wie Y. Yue, Prabhat C. Goswami, and Bruce J. Gantz. ErbB2 Trafficking and Signaling in Human Vestibular Schwannomas. Fort Belvoir, VA: Defense Technical Information Center, October 2009. http://dx.doi.org/10.21236/ada554580.

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Hansen, Marlan R. ErbB2 Trafficking and Signaling in Human Vestibular Schwannomas. Fort Belvoir, VA: Defense Technical Information Center, October 2010. http://dx.doi.org/10.21236/ada554583.

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Hansen, Marlan R. ERbB2 Trafficking and Signaling in Human Vestibular Schwannomas. Fort Belvoir, VA: Defense Technical Information Center, October 2011. http://dx.doi.org/10.21236/ada554627.

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Eddy, Douglas, John Gibbons, William Storm, Jonathan French, Kenneth Stevens, Emily Barton, Rebecca Cardenas, and Patrick Hickey. An Assessment of Modafinil for Vestibular and Aviation-Related Effects. Fort Belvoir, VA: Defense Technical Information Center, October 2005. http://dx.doi.org/10.21236/ada442742.

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