Publications by authors named "Wuehr M"

Imperceptible noisy galvanic vestibular stimulation (nGVS) improves standing balance due to the presence of stochastic resonance (SR). There is, however, a lack of consensus regarding the optimal levels and type of noise used to elicit SR like dynamics. We aimed to confirm the presence of SR behavior in the vestibular system of young healthy adults by examining postural responses to increasing amplitudes of white and pink noise stimulation scaled to individual cutaneous perceptual threshold.

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Article Synopsis
  • * A new portable nGVS device has been developed for everyday use, featuring a simple interface and an automatic motion sensor to optimize stimulation based on the user’s activity level.
  • * Initial testing shows the device is safe with only minor side effects and effectively enhances vestibular perception and balance in healthy users, suggesting it could be a practical therapy for daily life.
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Dizziness is one of the most common reasons for medical consultations. The interdisciplinary range of differential diagnoses often leads to difficulties in proper classification. Artificial Intelligence and machine learning can assist through data-driven algorithms and facilitate the collection of important clinical signs as digital biomarkers.

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Mobile health technologies enable continuous, quantitative assessment of mobility and gait in real-world environments, facilitating early diagnoses of gait disorders, disease progression monitoring, and prediction of adverse events like falls. Traditionally, mobile gait assessment predominantly relied on body-fixed sensors positioned at the feet or lower trunk. Here, we investigate the potential of an algorithm utilizing an ear-worn motion sensor for spatiotemporal segmentation of gait patterns.

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An earlier observational study described selected patients with acute neck pain syndrome, who experienced short bursts of cervical vertigo elicited by rapid head movements. The current study on a larger cohort of 20 patients with chronic or frequently recurring neck pain syndrome and age-matched controls focused on two major questions: (1) Can head movements in subjects with exacerbations of neck pain and restrictions of neck mobility also elicit bursts of vertigo? (2) What is the impact on postural balance measured by analysis of body sway and locomotion? A detailed questionnaire was applied, posture and gait were evaluated by use of instrumented posturography-and gait analysis with and without slow or rapid horizontal head rotations in the yaw plane with and without sight/visual input. All patients reported some or frequent episodes of dizziness in the range of seconds only elicited by rapid, not by slow head movements.

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Background: Physical inactivity and subsequent muscle atrophy are highly prevalent in neurocritical care and are recognized as key mechanisms underlying intensive care unit acquired weakness (ICUAW). The lack of quantifiable biomarkers for inactivity complicates the assessment of its relative importance compared to other conditions under the syndromic diagnosis of ICUAW. We hypothesize that active movement, as opposed to passive movement without active patient participation, can serve as a valid proxy for activity and may help predict muscle atrophy.

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Postural instability is a common complication in advanced Parkinson's disease (PD) associated with recurrent falls and fall-related injuries. The test of retropulsion, consisting of a rapid balance perturbation by a pull in the backward direction, is regarded as the gold standard for evaluating postural instability in PD and is a key component of the neurological examination and clinical rating in PD (e.g.

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Background: Gait impairment is a key feature in later stages of Parkinson's disease (PD), which often responds poorly to pharmacological therapies. Neuromodulatory treatment by low-intensity noisy galvanic vestibular stimulation (nGVS) has indicated positive effects on postural instability in PD, which may possibly be conveyed to improvement of dynamic gait dysfunction.

Objective: To investigate the effects of individually tuned nGVS on normal and cognitively challenged walking in PD patients with mild-to-moderate gait dysfunction.

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Human activity recognition (HAR) technology enables continuous behavior monitoring, which is particularly valuable in healthcare. This study investigates the viability of using an ear-worn motion sensor for classifying daily activities, including lying, sitting/standing, walking, ascending stairs, descending stairs, and running. Fifty healthy participants (between 20 and 47 years old) engaged in these activities while under monitoring.

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Article Synopsis
  • Postural instability in progressive supranuclear palsy (PSP) may result from abnormal vestibulospinal reflexes, and low-intensity noisy galvanic vestibular stimulation (nGVS) has been investigated as a non-invasive treatment to improve balance.* -
  • In a study with 16 PSP patients, nGVS at various intensities was tested for its effects on body sway, specifically looking for a bell-shaped response curve indicative of stochastic resonance (SR).* -
  • Results showed that nGVS significantly reduced body sway in 56% of patients, with some experiencing improvements that were clinically meaningful, suggesting nGVS could be an effective strategy for managing postural symptoms in PSP.*
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Background: The current diagnostic workup for chronic dizziness in elderly patients often neglects neuropsychological assessment, thus missing a relevant proportion of patients, who perceive dizziness as a subjective chief complaint of a concomitant cognitive impairment. This study aimed to establish risk prediction models for cognitive impairment in chronic dizzy patients based on data sources routinely collected in a dizziness center.

Methods: One hundred patients (age: 74.

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Low-intensity noisy galvanic vestibular stimulation (nGVS) can improve static and dynamic postural deficits in patients with bilateral vestibular loss (BVL). In this study, we aimed to explore the neurophysiological and neuroanatomical substrates underlying nGVS treatment effects in a rat model of BVL. Regional brain activation patterns and behavioral responses to a repeated 30 min nGVS treatment in comparison to sham stimulation were investigated by serial whole-brain F-FDG-PET measurements and quantitative locomotor assessments before and at nine consecutive time points up to 60 days after the chemical bilateral labyrinthectomy (BL).

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Background: Previous studies indicate that imbalance in patients with bilateral vestibulopathy (BVP) may be reduced by treatment with low-intensity noisy galvanic vestibular stimulation (nGVS).

Objective: To elucidate the potential mechanisms underlying this therapeutic effect. In particular, we determined whether nGVS-induced balance improvements in patients are compatible with stochastic resonance (SR)-a mechanism by which weak noise stimulation can paradoxically enhance sensory signal processing.

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Article Synopsis
  • Betahistine is often used for vestibular disorders, but its oral form may not be effective due to first-pass metabolism, prompting a study on alternative administration routes and doses for better outcomes.
  • Sixty rats underwent unilateral labyrinthectomy and were treated with different forms of betahistine, tested for behavioral recovery and changes in brain activity over 30 days.
  • Results showed that certain treatments, particularly high-dose intravenous and subcutaneous betahistine, significantly improved movement and postural control compared to sham treatment, indicating that application route and concurrent medication impact effectiveness.
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Objective: We aimed to relate clinical measures of disability in chronic cerebellar degeneration to structural whole-brain changes using voxel-based and surface-based morphometry (vbm and sbm). We were particularly interested in remote effects of cerebellar degeneration in the cerebral cortex.

Methods: We recruited 30 patients with cerebellar degeneration of different aetiologies (downbeat nystagmus syndrome, DBN n = 14, spinocerebellar ataxia, SCA n = 9, sporadic adult late-onset ataxia, SAOA n = 7).

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Background: Vestibular rehabilitation therapy (VRT) is effective for most patients with dizziness and imbalance. Home exercise programs are widely used. It is unknown, however, how specific the instructions for exercises have to be.

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Quantitative assessment of motor function is increasingly applied in fall risk stratification, diagnosis, and disease monitoring of neuro-geriatric disorders of balance and gait. Its broad application, however, demands for low-cost and easy to use solutions that facilitate high-quality assessment outside laboratory settings. In this study, we validated in 30 healthy adults (12 female, age: 32.

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Introduction: Orthoses are designed to achieve immobilization or off-loading of certain regions of the foot. Yet, their off-loading capacity for the specific regions has not yet been studied. Therefore, the aim of this study was to analyze the plantar pressure distribution of five commonly applied orthoses for foot and ankle in a healthy population.

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Background: Patients with bilateral vestibulopathy (BVP) suffer from impaired vestibular motion perception that is linked to deficits in spatial memory and navigation.

Objective: To examine the potential therapeutic effect of imperceptible noisy galvanic vestibular stimulation (nGVS) on impaired vestibular perceptual performance in BVP.

Methods: In 11 patients with BVP (mean age: 54.

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The aim of the study was to distinguish the hypokinetic gait disorder in idiopathic normal pressure hydrocephalus (NPH) patients from the gait decline in the elderly population by quantifying pathological gait parameter thresholds utilizing a multiple condition gait assessment. 55 NPH patients and 55 age-matched healthy subjects underwent a standardized gait assessment with eight gait conditions. Spatiotemporal gait parameters were assessed through a pressure-sensitive carpet.

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Background: Quantitative gait assessment is increasingly applied in fall risk stratification, diagnosis, and disease monitoring of neuro-geriatric gait disorders. Its broad application, however, demands for low-cost and mobile solutions that facilitate high-quality assessment outside laboratory settings. The aim of this study was to present and evaluate the concurrent validity of a mobile and low-cost gait assessment tool (mVEGAS) that combines body-fixed inertial sensors and a smartphone-based video capture for spatiotemporal identification of gait sequences.

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Background: Postural instability is a major disabling factor in patients with advanced Parkinson's disease (PD) and often resistant to treatment. Previous studies indicated that imbalance in PD may be reduced by low-intensity noisy galvanic vestibular stimulation (nGVS).

Objective: To investigate the potential mode of action of this therapeutic effect.

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Article Synopsis
  • Downbeat nystagmus (DBN) is a type of acquired eye movement disorder linked to issues in the vestibulo-cerebellar system, causing vision problems and balance difficulties.
  • The intensity of DBN can vary based on factors like gaze direction and position, and walking has been observed to reduce postural symptoms associated with the condition.
  • A study found that while standing, patients with DBN had central ocular-motor deficits, but during walking, their gaze stabilization improved and the frequency of nystagmus significantly decreased, indicating locomotion may help to reduce the severity of eye movement disruptions in DBN.
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Objective: To study the behavioral relevance of postural and ocular-motor deficits on daily activity and risk of falling in patients with bilateral vestibular hypofunction (BVH).

Methods: Thirty patients with BVH and 30 age- and gender-matched healthy controls participated in a continuous 2-week assessment of daily activities and mobility using a body-worn inertial sensor and a 6-month prospective fall risk assessment. At inclusion, patients and controls further underwent a multi-modal clinical, score- and instrument-based assessment of general health and balance status.

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