The “broken escalator” phenomenon: Vestibular dizziness interferes with locomotor adaptation
Golding, John F.
Bronstein, Adolfo M.
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AbstractBACKGROUND:Although vestibular lesions degrade postural control we do not know the relative contributions of the magnitude of the vestibular loss and subjective vestibular symptoms to locomotor adaptation. OBJECTIVE:To study how dizzy symptoms interfere with adaptive locomotor learning. METHODS:We examined patients with contrasting peripheral vestibular deficits, vestibular neuritis in the chronic stable phase (n = 20) and strongly symptomatic unilateral Meniere’s disease (n = 15), compared to age-matched healthy controls (n = 15). We measured locomotor adaptive learning using the “broken escalator” aftereffect, simulated on a motorised moving sled. RESULTS:Patients with Meniere’s disease had an enhanced “broken escalator” postural aftereffect. More generally, the size of the locomotor aftereffect was related to how symptomatic patients were across both groups. Contrastingly, the degree of peripheral vestibular loss was not correlated with symptom load or locomotor aftereffect size. During the MOVING trials, both patient groups had larger levels of instability (trunk sway) and reduced adaptation than normal controls. CONCLUSION:Dizziness symptoms influence locomotor adaptation and its subsequent expression through motor aftereffects. Given that the unsteadiness experienced during the “broken escalator” paradigm is internally driven, the enhanced aftereffect found represents a new type of self-generated postural challenge for vestibular/unsteady patients.
CitationPatel, M., Roberts, E., Arshad, Q., Bunday, K., Golding, J.F., Kaski, D. and Bronstein, A.M. 2020. The “broken escalator” phenomenon: vestibular dizziness interferes with locomotor adaptation. Journal of Vestibular Research.
JournalJournal of Vestibular Research
DescriptionThis is an accepted manuscript of an article published by IOS Press in Journal of Vestibular Research on 18/05/2020, available online: doi:10.3233/VES-200693 The accepted version of the publication may differ from the final published version.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0/