著者

國弘 幸伸

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.63, no.6, pp.533-548, 2004 (Released:2009-06-05)

参考文献数

87

被引用文献数

13 6

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The subjective visual vertical (SVV) signifies the visually determined gravitational vertical. The measurement of SVV is clinically used as a method to assess the degree of dysfunction in the otolith, primary vestibular nerves, and central graviceptive pathways.Perception of vertical, however, does not depend solely on the function of those pathways, but is affected by various factors such as visual information, head position relative to gravity, and linear acceleration forces acting on the gravity vector. In addition, it undergoes a kind of 'vestibular compensation', that is, the tilt of SVV decreases within days to weeks even if the function of the organ responsible for the tilt does not restore function. In examining the patient with vertigo or dysequilibrium, the physician must be well acquainted with those factors affecting SVV and its natural course.This article also referred to the difference between SVV tilts and room tilt illusions. The former are usually stable and chronic signs and manifest as a continuum of angle of tilt up to abut 300. In contrast, the latter occur paroxysmally or transiently in 90° steps.In clinical practice, the measurement of SVV is not so commonly carried out as compared to the recordings of nystagmus. It is expected, however, that SVV be more widely taken into account in clinical practice because the tilt of SVV and the occurrence of nystagmus do not share the same anatomical structures, thus SVV can provide a greater understanding of the patient's complaints and underlying pathologies.

著者

室伏 利久

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.77, no.6, pp.525-531, 2018-12-31 (Released:2019-02-01)

参考文献数

21

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The history of clinical studies on vestibular migraine (migraine associated vertigo) was reviewed. Archeological studies suggested that headache itself had already existed in the Neolithic era, because bony defects in the skull which could have arisen from trepanation had been found in the remains of this era. Medical observations on migraine were made by Hippocrates of Kos, and Aretaeus of Kappadocia described migraine-associated vertigo in the 2nd century A.D. Studies on migraine and migraine-associated vertigo (vestibular migraine) began in the modern era. As hypotheses on the pathophysiology of migraine, three theories have been proposed, including the vascular theory, the neural theory, and the trigemino-vascular theory. As important articles concerning the clinical studies, three papers were published. The first was published by Bickerstaff. He reported cases of basilar-type migraine, in which vertigo occurs as an aura of migrainous headache. The second was published by Kayan and Hood. In this paper, the authors described various characteristics of vestibular migraine, which are still valid. The third was published by Neuhauser et al., in which the authors proposed diagnostic criteria for vestibular migraine, which serve as the basis for the current official diagnostic criteria. Finally, the author remarked that clarification of the pathophysiology of vestibular migraine and association with Meniere's disease are the most important issues that need to be resolved.

著者

五島 史行

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.75, no.4, pp.228-233, 2016-08-31 (Released:2016-10-01)

参考文献数

13

被引用文献数

2

---

Headaches are a similar physical complaint to dizziness that is a functional disorder and it is difficult to ascertain any physical abnormality in such subjects. In addition, both of the symptoms may be caused by a possible fatal illness. Headaches are quite common in healthy subjects and it is a common comorbid disorder with dizziness. We found out that 163 (40%) of 403 patients with intractable dizziness complained of some type of headache. So far the relationship between headache and dizziness has not been intensively investigated. One reason for this is that the physicians who are specialized in vestibular disorders usually focus on the dizzy symptom and do not have much interest in the comorbid headache in the same patient. Recently the relationship between migraine and dizziness has attracted more interest than before and the diagnostic criteria of vestibular migraine have been proposed by the ICHD (International Classification of Headache Disorders). It is important to have basic knowledge concerning headaches to understand the vestibular migraine. Migraine and tension type headaches are important primarily headache disorders. It is well known that the patients with migraine are at a higher risk of having dizziness as a complaint. When we treat the dizzy patients with headache, it is important to identify the type of the comorbid headache. The prophylactic treatment is more important than the acute treatment. The point is to promote the life style change and pharmacotherapy. The first line of medical treatment is a Ca blocker, such as lomerizine hydrochloride, followed by valproic acid, and amitriptyline. Collaboration with headache specialists is also an important strategy.

著者

鈴木 直人

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.56, no.5, pp.430-435, 1997 (Released:2009-06-05)

参考文献数

12

被引用文献数

2 2

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The visual system is considered to make a limited contribution to the maintenance of the upright posture, but is available for elaboration of postural stability, that is, for minimizing body oscillations while standing. These experiments investigated the roles of the visual framework in maintaining an upright posture. Body oscillations were measured as the deviation of the center of gravity using a gravicorder. The results were as follows. Both the area and the total length of the trace of body sway increased with the distance between the body and the wall. The standing posture also became unstable as an upper part of the wall inclined in the direction of the subject. Women were more affected than men under both conditions. These results indicate that the visual framework perceived peripherally plays an important role in postural stability while standing upright.

著者

安田 知久 相馬 啓子 國弘 幸伸 安田 宏一

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.78, no.1, pp.39-42, 2019-02-28 (Released:2019-04-01)

参考文献数

11

被引用文献数

1

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Ten healthy volunteers were spun passively on a revolving chair (0.5 Hz left-winded 7 rotation), asked to stand up immediately thereafter and take 30 steps with their eyes closed. The observations revealed that subjects having an anteverted posture turned to the right, whereas those with a retroverted posture turned to the left. To ascertain the reason for this directional switch, volunteers carried a 10-kg weight on their front or back while keeping their axis vertical. The front-weighted subjects turned to the right like the subjects with the anteverted posture, while the back-weighted subjects turned to the left like those with the retroverted posture. The results indicated that shifting of the center of gravity, and not the posture, was the reason for the difference. When the subjects kept their arms up forward horizontally and the legs high up as in Fukuda's stepping test, they turned to the right, because their horizontal arms and highly up legs set the weight forward. The neutral pose, with the arms hanging down along the side of the body and stepping low, was scarcely associated with any turning.

著者

北原 糺

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.66, no.2, pp.41-51, 2007 (Released:2008-10-10)

参考文献数

26

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PCR stands for polymerase chain reaction. It was invented to amplify specific regions of a DNA strand in tissues, resulting in the tremendous development in biochemical and molecular biological fields. Nowadays, the PCR method is also quite available in inner ear researches as modified versions, because it needs just small amounts of samples in inner ear tissues. The modified versions are as follows: reverse transcription (RT)-PCR, real-time quantitative PCR, in situ PCR, DNA subtraction, DNA microarray, single nucleotide polymorphism (SNP) analysis for using mRNA and reporter gene assay, gel mobility assay for using genomic DNA. Here in this paper, we would like to introduce the PCR method from original to modified in our inner ear biological field.

著者

代田 文彦

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.36, no.1, pp.159-162, 1977 (Released:2009-09-16)

著者

大木 紫

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.56, no.4, pp.321-331, 1997 (Released:2009-06-05)

参考文献数

50

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This article reviews the nucleus prepositus hypoglossi (NPH) which has been proved to contribute to generation of horizontal eye movements. In general, the NPH receives inputs from oculomotor related nuclei (e.g. the bilateral NPH, the medial vestibular nucleus and ipsilateral burst neuron areas), and projects directly to the bilateral NPH, the vestibular nuclei, the ocular motor nuclei and vestibulo-cerebellar structures. According to these different neural connections, the NPH has been divided into subdivi-sions. Several types of neural activities relating to eye movements are observed in NPH neurons, most of which are increased during ipsiversive horizontal eye movements. The majority of the neurons encode both eye velocity and position signals (burst-tonic neurons). Some of the neurons project to the abducens nucleus. In addition, a class of NPH cells show a burst of activity during a variety of rapid eye movements in cats (burster-driving neurons). These neurons receive disynaptic vestibular input contralaterally and project to burst neuron areas. There are also NPH cells encoding both eye- and head-velocity signals in monkeys (eye-head-velocity neurons). Lesions of the NPH impair gaze holding, implying that the NPH functions as, at least a part of, the neural integrator. However, saccade feedback and putative smooth-pursuit integrators are not influenced after a partial lesion in the NPH. The results suggest that distinct classes of cells spread over the NPH. In summary, the NPH is involved in several aspects of horizontal eye movements and may also function as a part of the neural integrator.

著者

望月 文博 宮本 康裕 四戸 達也 笹野 恭之 荒井 光太郎 西本 寛志 稲垣 太朗 大原 章裕 鈴木 香 三上 公志 谷口 雄一郎 肥塚 泉

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.78, no.6, pp.595-601, 2019-12-31 (Released:2020-02-05)

参考文献数

16

被引用文献数

1

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Japan has become a super-aging society, and the number of elderly persons with dizziness is increasing. In addition, elderly persons with dizziness have a high risk of falling, and fractures caused by falls can decrease the life span. It is therefore necessary to take appropriate countermeasures. Treatments for dizziness are wide-ranging and include physical therapy, such as canalith repositioning, and pharmacotherapy. However, many patients do not improve even after these treatments. In this study, we compared the results of stabilometry examined before and after the use of a cane in 21 patients aged 65 years or older with a history of dizziness who visited our department (DHI score of 28 points or higher). The use of a cane improved the following measured parameters: total length of body sway, area of body sway, and unit area body sway length at the time of eye opening and closing. To prevent falling, somatic sense input and skeletal muscle input focused on the lower extremities are important. It is expected that these inputs decline in elderly persons, and based on the results of the current study, it is likely that the use of prosthetics, such as a cane, will play an important role in the future in supporting these subjects.

著者

加藤 保司 宮崎 眞佐男

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.69, no.2, pp.87-90, 2010 (Released:2010-06-01)

参考文献数

12

被引用文献数

1

---

Seventy-two patients with dizziness or vertigo having C4-7 cervical disk disease had their systolic blood pressure (BP) measured before and after the head-up test with tonometry. We demonstrated that significant depression of the systolic BP was seen in the patient group compared with the normal group during the head-up test. There were 11 patients in whom vertigo or dizziness was induced by each head-up test, and all of them showed a BP depression of 19 mmHg or more. However, 26 patients had a BP depression of only 9 mmHg or less, which was within normal limits, and none showed vertigo or dizziness. It was considered whether the main cause of vertigo or dizziness induced by the head-up test among the patients with cervical lesion was BP depression. The other causes of vertigo or dizziness among the patients who showed BP depression of 18 mmHg or less could possibly be blood flow insufficiency in the brain stem, acoustic nerve ischemia, Powers syndrome, carotid artery stenosis, platelet hyper-aggregation or psychosomatic factors.

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.76, no.5, pp.385-559, 2017-10-31 (Released:2018-01-01)

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抄録集

著者

中原 はるか 竹森 節子 鶴岡 尚志

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.57, no.4, pp.435-442, 1998 (Released:2009-10-13)

参考文献数

17

---

Spatial orientation is influenced by many factors such as vision, hearing, vestibular input, and so on. However, the details of when and which factor exert influence on this process remain mostly unknown. We investigated the influence of height on spatial orientation under various conditions.Body movement was recorded by stabilometry for 30 seconds under each of three visual conditions (eyes open without gaze fixation, eyes closed, and eyes open with gaze fixation) at 0 m, 1 m, 2 m, and 10 m22 cm high in 30 normal volunteers (14 males and 16 females) who had no history of vertigo or dizziness. Eight of subjects claimed to be acrophobic.The total length of the gravity center movements reflected the body sway best. The sway was minimal with eyes open and gaze fixated, and maximal with eyes closed. The sway increased at 10 m22 cm high, but was almost the same at 1 m and 2 m high. The acrophobic group was clearly worse than the non-acrophobic group at 10 m22 cm high. Their total shifting length increased because they became tense and shivered fractionally.Visual information which served as the base was useful for spatial orientation, and the mental factor of fear caused tension and the sway increased especially in the acrophobic group at 10 m22 cm high.

著者

土井 彰 田村 耕三 小桜 謙一 福井 直樹

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.65, no.6, pp.447-452, 2006 (Released:2009-06-05)

参考文献数

24

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A case of persistent primitive trigeminal artery with vertigo as the initial symptom is reported. The case was a 41-year-old female. Since 2002, the patient had repeated episodes of vertigo. In 2004, the patient experienced a loss of consciousness. No lesion causing dizziness was found by CT scan of the brain, MRI of the brain, ECG, brain wave examination, and a balance function test at the Department of Otolaryngology. Persistent primitive trigeminal artery and vertebrobasilar hypoplasia were suspected by MRA and the diagnosis was confirmed by angiography. It is advisable to consider MRA and angiography for vertigo or dizziness of unknown cause.

著者

山本 悦生 水上 千佳司 磯野 道夫 大村 正樹 広野 喜信

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.49, no.Suppl-6, pp.28-30, 1990 (Released:2009-06-05)

参考文献数

4

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The three-dimensional imaging used so far has processed digitalized information on the morphology of organs by the computer graphics technique. However, the conventional method has not been used clinically, because the processing of information has been inadequate.We observed the external aperture of the vestibular aqueduct in vivo using three-dimensional imaging by the surface reconstruction method. The width was measured in normal and diseased ears. Significant narrowing was observed in patients with Meniere's disease, while no difference in width was noted between normal subjects and those with chronic otitis media.This technique can be used to examine not only on the vestibular aqueduct but also other structures in the temporal bone. It should be useful in clarifying the pathophysiology of inner ear diseases and also in the surgical treatment.

著者

北原 糺

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.59, no.2, pp.103-111, 2000 (Released:2009-06-05)

参考文献数

49

被引用文献数

1

---

Vestibular compensation consists of the following stages: the inhibition of the contralesional medial vestibular nucleus (contra-MVe) activities at the acute stage after unilateral labyrinthectomy (UL) and the recovery and maintenance of the ipsilesional MVe (ipsi-MVe) spontaneous activities at the chronic stage after UL. In this paper, we reviewed molecular mechanisms of vestibular compensation in the central vestibular system by means of several morphological and pharmacological approaches in rats. Based on our examinations, we propose the following hypothesis. At the acute stage after UL, the activated neurons in the ipsi-MVe project their axons into the flocculus to inhibit the contra-MVe neurons via NMDA receptor, nitric oxide (NO), acetylcholine (Ach) and/or GABA-mediated signaling, resulting in the restoration of balance between intervestibular nuclear activities. At the chronic stage after UL, the flocculus depresses the inhibitory effects on the ipsi-MVe neurons via protein phosphatase 2A (PP2A) β, protein kinase C (PKC) and/or glutamate receptor (GluR) δ-2, to help the recovery and maintenance of the ipsi-MVe activities.

著者

五島 史行

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.64, no.4, pp.245-246, 2005 (Released:2009-06-05)

参考文献数

6

著者

重野 浩一郎

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.75, no.3, pp.115-122, 2016-06-30 (Released:2016-08-01)

参考文献数

20

被引用文献数

1

---

We investigated otolith function using the subjective visual vertical (SVV) in 54 patients with persistent geotropic positional nystagmus (Light cupula), 30 patients with persistent apogeotropic positional nystagmus (Heavy cupula) and 45 healthy subjects. To compare benign paroxysmal positional vertigo (BPPV), SVV was also measured in 56 patients with posterior canal canalolithiasis (PC) and 38 patients with lateral canal canalolithiasis (LC). Patients attended the clinic within 1 week after the onset of vertigo, and the SVVs were examined prior to treatment. The affected sides of Light cupula and Heavy cupula were estimated based on the neutral position at which the horizontal nystagmus direction was reversed. The average SVV toward the affected side showed significantly higher values, in this order: Light cupula>LC/PC>healthy subjects and Light cupula>Heavy cupula. Otolith dysfunction could be demonstrated on the affected side in Light cupula, whereas Heavy cupula exhibited a lesser degree of otolith dysfunction. The average SVV value toward the affected side of 0.9 is recommended as a cut-off value for Light cupula (sensitivity: 0.75, specificity: 0.86). The average SVV value>1.4 toward the affected side is also recommended as a cut-off for the detection of otolith dysfunction in Light cupula, PC and LC (specificity>0.93).

著者

宇野 敦彦 中川 あや 堀井 新 武田 憲昭 久保 武

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.65, no.4, pp.213-222, 2006 (Released:2009-06-05)

参考文献数

52

被引用文献数

2

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Motion sickness is induced by unusual patterns of spatial information input, but not by a simple strong acceleration. Thus, in the process of the development of motion sickness, the disturbance of spatial orientation is noticed somewhere in the brain, leading to the expression of autonomic signs and symptoms. What part of the brain plays this key role?Peripheral vestibular input has repeatedly been proven to be necessary for motion sickness, even for visually-evoked motion sickness. The vestibular nucleus in the brain stem where spatial information including visual and somatosensory as well as vestibular inputs converge, is the primary candidate for this key structure. In the higher brain, the limbic system, particularly the amygdala, is another candidate. In our rat animal model, bilateral amygdala lesions significantly suppressed motion sickness signs, whereas hippocampus lesions did not. Using cFos protein expression as a marker for neuronal activation, we also showed that the central nucleus of the amygdala was activated by vestibular information during the hypergravity stimulation that induced motion sickness in rats.Involvement of the amygdala may explain some characteristic features of motion sickness, such as its diversity of signs ranging from sympathetic to parasympathetic, and its conditioned occurrence where by some susceptible persons become sick even in motionless vehicles.

著者

許斐 氏元 鈴木 衞 小川 恭生 大塚 康司 萩原 晃 稲垣 太郎 井谷 茂人 斉藤 雄

出版者

一般社団法人 日本めまい平衡医学会

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.73, no.6, pp.502-511, 2014-12-31 (Released:2015-02-01)

参考文献数

25

被引用文献数

1 14

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This study was performed to determine the frequency and degree of sleep disturbance in patients with dizziness using the Pittsburgh Sleep Quality Index, Japanese Version (PSQI-J), and investigate the relationship between dizziness and sleep disturbance. Fifty-two patients (20 male, 32 female) with a chief complaint of dizziness visited the dizziness clinic of the Department of Otolaryngology, Tokyo Medical University, for 3 months in 2013. The patients' age (average ± standard deviation) was 54.4±17.0 years (range, 10-88 years). The average PSQI global score was 7.6±4.2 points, which exceeds the 5.5-point cut-off for insomnia. In total, 67.3% of patients scored >6 points, and 35.8% scored >9 points, indicating definite sleep disturbance. With respect to the demography of disease groups, patients with Meniere's disease scored an average of 7.9 points, those with autonomic imbalance scored 8.8 points, and those with psychogenic dizziness scored 9.7 points; all of these diseases were associated with high PSQI scores. Patients with benign paroxysmal positional vertigo and patients with no abnormal findings showed relatively low scores (6.7 and 5.3 points, respectively). Patients with suspected sleep apnea syndrome, restless leg syndrome, and parasomnias tended to show high scores (>10 points). A high rate and high grade of sleep disturbance were confirmed in patients with dizziness, indicating that sleep quality affects several types of dizziness and vertigo. Understanding sleep disorders is helpful for the diagnosis and treatment of dizziness and provides a new perspective on the etiology of dizziness.

著者

松木 則夫 田中 大祐

出版者

Japan Society for Equilibrium Research

雑誌

Equilibrium Research (ISSN:03855716)

巻号頁・発行日

vol.60, no.1, pp.3-6, 2001 (Released:2009-06-05)

参考文献数

10

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Suncus murinus belongs to insectivora and has been developed as a laboratory animal in Japan. It is relatively small in size (male: 50-70g, female: 30-50g), and there are no problems in the handling, housing and breeding of the animal. We have found that administration of emetogenic drugs, X-ray irradiation and oscillation easily causes emesis in this animal. Since simple reciprocal shaking (frequency: 1 Hz, amplitude: 4cm) is enough to induce vomiting within as short as 2 min, Suncus murinus is currently the most sensitive animal to motion sickness. Information conserning the purchase and special animal chow is available at the Central Institute for Experimental Animals.Our knowledge of emesis and motion sickness is still very poor. The presence of a "vomiting center" and a "CTZ: chemoreceptor trigger zone" were proposed about a half century ago but substantiating evidence is still lacking. Antiemetic dugs have been developed to reduce the number of vomiting episodes; however, in terms of quality of life, complete blockade of nausea rather than vomiting is desirable. We believe that Suncus murinus will be a useful experimental animal for research on emesis and the development of new antiemetic drugs.