title: Tonic Investigation Concept of Cervico-vestibular Muscle Afferents.
abstract: IntroductionInterdisciplinary research has contributed greatly to an improved understanding of the vestibular system. To date, however, very little research has focused on the vestibular system's somatosensory afferents. To ensure the diagnostic quality of vestibular somatosensory afferent data, especially the extra cranial afferents, stimulation of the vestibular balance system has to be precluded.ObjectiveSophisticated movements require intra- and extra cranial vestibular receptors. The study's objective is to evaluate an investigation concept for cervico-vestibular afferents with respect to clinical feasibility.MethodsA dedicated chair was constructed, permitting three-dimensional trunk excursions, during which the volunteer's head remains fixed. Whether or not a cervicotonic provocation nystagmus (c-PN) can be induced with static trunk excursion is to be evaluated and if this can be influenced by cervical monophasic transcutaneous electrical nerve stimulation (c-TENS) with a randomized test group. 3D-video-oculography (VOG) was used to record any change in cervico-ocular examination parameters. The occurring nystagmuses were evaluated visually due to the small caliber of nystagmus amplitudes in healthy volunteers.ResultsThe results demonstrate: no influence of placebo-controlled c-TENS on the spontaneous nystagmus; a significant increase of the vertical nystagmus on the 3D-trunk-excursion chair in static trunk flexion with cervical provocation in all young healthy volunteers (n = 49); and a significant difference between vertical and horizontal nystagmuses during static trunk excursion after placebo-controlled c-TENS, except for the horizontal nystagmus during trunk torsion.ConclusionWe hope this cervicotonic investigation concept on the 3D trunk-excursion chair will contribute to new diagnostic and therapeutic perspectives on cervical pathologies in vestibular head-to-trunk alignment.
authors.affiliation: Department of Otorhinolaryngology, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: Linda Josephine
authors.initials: LJ
authors.lastname: Dorn
authors.affiliation: Department of Otorhinolaryngology, Sankt Gertrauden Hospital, Berlin, Germany.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Lappat
authors.affiliation: Institute of Anatomy, Universität Erlangen-Nürnberg, Erlangen-Nürnberg, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Neuhuber
authors.affiliation: Department of Otorhinolaryngology, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Scherer
authors.affiliation: Department of Otorhinolaryngology, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: Heidi
authors.initials: H
authors.lastname: Olze
authors.affiliation: Department of Otorhinolaryngology, Universitätsklinik Magdeburg, Magdeburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hölzl
keywords: TENS; cervical nystagmus; cervical vertigo; neck torsion test; trunk excursion chair; vertical nystagmus