The “broken escalator” phenomenon: Vestibular dizziness interferes with locomotor adaptation

Patel, M., Roberts, E., Arshad, Q., Bunday, K., Golding, J., Kaski, D. and Bronstein, A.M. 2020. The “broken escalator” phenomenon: Vestibular dizziness interferes with locomotor adaptation. Journal of Vestibular Research. 30 (2), pp. 81-94. https://doi.org/10.3233/ves-200693

TitleThe “broken escalator” phenomenon: Vestibular dizziness interferes with locomotor adaptation
TypeJournal article
AuthorsPatel, M., Roberts, E., Arshad, Q., Bunday, K., Golding, J., Kaski, D. and Bronstein, A.M.
Abstract

BACKGROUND: 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.

KeywordsVestibular system; Vertigo; Dizziness; Motor control; Meniere’s disease; vestibular neuritis; locomotor adaptation.
JournalJournal of Vestibular Research
Journal citation30 (2), pp. 81-94
ISSN0957-4271
Year2020
PublisherIOS Press
Accepted author manuscript
File Access Level
Open (open metadata and files)
Digital Object Identifier (DOI)https://doi.org/10.3233/ves-200693
Web address (URL)https://doi.org/10.3233/VES-200693
Publication dates
Published18 May 2020

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