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Biomedical subjects

R Johansson

Publications and source records attributed to R Johansson.

At least 91 records · Page 5Linked to original sources

Postural control and vestibulospinal function in patients selected for cochlear implantation.

Postural control, vestibular and eye motor function were evaluated in seven postlingually deaf patients before cochlear implantation and were compared with 21 control subjects. Vibration to the calf muscles or galvanic electrical stimulation of the vestibular nerves, perturbed stance and body sway velocity, statistical variance of antero-posterior body sway and identification of characteristic parameters of postural dynamics were all evaluated. Vibration-induced body sway was increased among the patients compared with the normal subjects and there were differences in characteristic parameters of postural dynamics, indicating decreased postural control. Galvanic stimulation induced a body sway not significantly different from the control group suggesting that the patients selected for cochlear implantation, and with an otherwise reduced postural control, are sensitive to electrical stimulation of the vestibular nerve. Thus, postlingually deaf subjects who perceive a sensation of sound at electrical promontorial stimulation also respond with increased body sway to electrical stimulation aimed at the vestibular nerves. This finding may contribute an additional hypothesis to the causes of dizziness among cochlear implant patients, complementary to the that of wrongly placed electrodes and peroperative vestibular lesions.

Adult↗

Acoustic cues and postural control.

The effect of auditory input on postural control was evaluated in separate experiments performed in three groups of healthy volunteers. Auditory input took the form either of feedback signals generated by a force platform in response to the subject's postural control movements, or of field orientation (frame of reference) input provided by repeated clicks emitted by loudspeakers in a normally reverberative environment. The effect of these acoustic cues was measured in terms of body sway recorded on a force platform during stance perturbations induced by vibratory stimuli applied to the calf muscles either at low (120mW) or high (850 mW) intensity, the subject standing with eyes closed or open, as instructed. In the presence of feedback auditory input, body sway in response to low intensity vibratory stimulation was significantly reduced, but not that in response to high intensity stimulation. This may be due to the fact that the head and body movements induced by high intensity vibratory stimulation are so rapid and powerful that they override the information available or to the subject using other strategies for postural control in which auditory feedback, at least in the form used here, does not contribute useful information. The availability of field orientation input did not reduce body sway in response to vibratory stimulation at low intensity. This was probably due to the cognitive lag which precluded use being made of the input before the fast proprioceptive responses to vibratory stimulation had already occurred.

Acoustic Stimulation↗

Short vestibulo-ocular reflex time-constant in complete unilateral vestibular lesions.

The time-constant of the vestibulo-ocular reflex (VORtc) in response to short accelerations was studied in 18 patients with complete unilateral vestibular lesions: 12 patients with incomplete lesions and 9 healthy controls. The marked group differences in VORtc, which was short in patients with complete lesions and long (i.e., > or = 10 s) in the controls and some patients with incomplete lesions, suggests the finding of a long VORtc in a patient with a unilateral vestibular lesion to indicate the presence of an incomplete lesion. Moreover, one analytic method (where the initial phase of decay is weighted) showed the VORtc to be longer following stimulation toward the healthy ear than following stimulation toward the lesioned ear, whereas other analytic methods showed no direction asymmetry in VORtc.

Adult↗

Vestibular disturbance at frequencies above 1 Hz affects human postural control.

The effect of primary vestibular disturbance on postural control was investigated in 11 normal subjects exposed to perturbation by bi-polar binaural galvanic stimulation of the vestibular nerve. The stimulus consisted of 30 s of sinusoidal galvanic stimulation at a frequencies of 0.2, 0.3, 0.5, 1.0, 1.5, 2.0, 3.0 and 4.0 Hz, with a current of +/- 1 mA, the subject standing with open or closed eyes, the response evoked being recorded with a force platform. As compared with resting values, i.e. no stimuli, variance of lateral body sway was significantly greater at all frequencies tested in the closed eyes condition and at frequencies of 0.2, 0.5, 1.0, 3.0 and 4.0 Hz in the open eyes condition; using a high pass filter with a cut-off frequency of 0.1 Hz, variance of lateral body sway was significantly greater at frequencies 0.2, 0.3, 0.5, 1.0 and 2.0 Hz in the closed eyes condition and at frequencies 0.5 and 2.0 Hz in the open eyes condition. These findings suggest that in the lateral plane vestibular input affects and probably contributes to human postural control over a wider frequency range than suggested by findings in previous studies. The trends in sagittal body sway were similar. Moreover, the visual contribution appears to enable the subject to suppress vestibular input causing lateral body sway only in the lower frequency range (here at 0.2 and 0.3 Hz), but with regard to the concomitant sagittal body sway at a much wider range of frequencies (here at all frequencies tested except 1.5 Hz).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Discrimination between patients with acoustic neuroma and with peripheral vestibular lesion by human posture dynamics.

A group of normal subjects (n = 17) was compared with two groups of patients, either with vestibular neuritis (n = 18) or with acoustic neuroma (n = 35) by means of posturography when stance was perturbed with vibrators attached to the calf muscles. Dynamic control of human posture was quantified by means of system identification, and the characteristic parameters of swiftness, stiffness, and damping of a transfer function from vibration to force platform response were used for further comparison. Fisher linear discriminant analysis was used to distinguish sets of parameters characteristic of each disease. Hence it was possible to distinguish the vestibular neuritis group both from the normal group (p < 0.01), and from the patients with acoustic neuroma (p < 0.001). The normal group was characterized by a different postural performance, with higher swiftness and stability parameters (stiffness, damping) than those of the patient groups. These findings indicate that there are differences in the dynamic control of posture between the two patient categories, which may require the development of differentiated rehabilitation programs.

Adult↗

Dynamic properties of feed back control of human posture in subjects with vestibular neuritis.

Postural control was studied in 22 subjects with vestibular neruitis within 14 days after the onset of symptoms. Dynamic feed back control of posture were evaluated by analyzing the postural responses to vibration toward calf muscles applied according to a PRBS schedule. Properties of the dynamic control was normalized as swiftness, stiffness and damping of the responses. There was no prominent group differences between the 22 subjects with vestibular neuritis and 17 normal subjects. However, when studying the change in parameters evoked by presence or absence of visual information it was found that the abundant changes of control parameters, especially in stiffness, met in normal subjects had declined in subjects with vestibular neuritis. The present finding suggests that although subjects after an acute vestibular lesion may achieve a sufficient postural control by utilizing information from other somatosensory receptors, this is concomitant with changes of the feed back control.

Adult↗

Postural control reduced by subanesthetic nitrous oxide narcosis.

The effects of subanesthetic (21%) nitrous oxide (N2O) narcosis on postural control, as measured by posturography were studied in 12 subjects. Vibration induced body sway, with open and closed eyes, and body sway induced by a visual stimulus were evaluated. Adaptation was measured as the quotient of body sway variance between the second and first halves of each trial. Change in postural strategy was evaluated as change in the variance of shear forces relative to change in body sway. Subjective evaluation of narcosis was recorded. Body sway variance increased significantly during exposure to N2O, and equally for all body sway inducing stimuli. With the eyes open, adaptation to vibratory perturbation was significantly reduced by N2O. Postural strategy was unaffected by N2O, but differed significantly between stimuli, with relatively less involvement of shear forces during vibratory perturbation in the eyes open condition than during the other body sway inducing stimuli. Subjective evaluation of narcosis correlated with body sway variance during the visual stimulus. The present findings indicate that subanesthetic N2O narcosis reduces postural control. Adaptation to a balance disturbing stimulus, with undisturbed vision, is decreased by N2O. Visual clues are shown to be crucial to the postural strategy adopted to maintain balance. The effects of N2O are assumed to be due to impairment of sensorimotor integration in the CNS.

Adaptation, Physiological↗

Evaluation of some nonrecursive digital filters for signals of auditory evoked responses.

Auditory brain stem evoked responses are routinely used in audiology and otoneurology. Because recordings include more or less noise, the signals of evoked responses need digital filtering to suppress the noise. Nonrecursive digital filters are often the best since they can be organized to have no phase shift, which is essential in order not to distort sensitive parameters, as latency, in evoked responses. We have studied effects of some nonrecursive digital filters on the latency parameters of evoked responses. It turned out that digital filtering can have considerable influence on latencies, and thus the choice of appropriate filters is crucial.

Evaluation Studies as Topic↗

Studies on the individual and combined diuretic effects of four Vietnamese traditional herbal remedies (Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus).

Herbal remedies are widely used in Vietnam alongside modern drugs. We assessed the diuretic effect of four traditional Vietnamese herbal remedies from Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus, all claimed to produce an increase of diuresis. No influence was recorded for the 12- and 24-h urine output or on the sodium excretion for any of the drugs when tested under standardized conditions in a placebo controlled double-blind crossover model. The present study indicates the need for critical review of the present recommendations regarding therapy with plant materials in countries relying on empiric traditions.

Adult↗

Optimal coordination and control of posture and locomotion.

This paper presents a theoretical model of stability and coordination of posture and locomotion, together with algorithms for continuous-time quadratic optimization of motion control. Explicit solutions to the Hamilton-Jacobi equation for optimal control of rigid-body motion are obtained by solving an algebraic matrix equation. The stability is investigated with Lyapunov function theory, and it is shown that global asymptotic stability holds. It is also shown how optimal control and adaptive control may act in concert in the case of unknown or uncertain system parameters. The solution describes motion strategies of minimum effort and variance. The proposed optimal control is formulated to be suitable as a posture and stance model for experimental validation and verification. The combination of adaptive and optimal control makes this algorithm a candidate for coordination and control of functional neuromuscular stimulation as well as of prostheses.

Algorithms↗

Delayed onset of ototoxic effects of gentamicin in patients with Meniére's disease.

In treatment of Meniére's disease, installations of gentamicin are continued until there are signs of disturbance of vestibular or cochlear function. However, since it has been demonstrated that gentamicin is eliminated slowly from the inner ear, a continuing ototoxic effect may be suspected. The present study aimed to investigate the delay of onset of symptoms of ototoxic effects. Five patients with Meniére's disease and disabling vertigo were treated with intratympanic installation of gentamicin. The patients received two installations at two consecutive days, after which the treatment was abated, although no patient showed any symptoms of affection of the vestibular or cochlear end organs. All patients, however, developed vertigo and nystagmus beating toward the not treated ear within 3 to 5 days after the last installation. At 3 months and 1 year later, the treated ear showed no reaction on bithermal caloric stimulation and all patients had a complete relief of attacks of vertigo but hearing levels were about the same compared to before treatment. The present findings demonstrate a delayed onset of ototoxic effects and it is suggested that gentamicin treatment should not be carried on until symptoms develop. Furthermore, extremely low dose treatment may produce loss of vestibular function with the desired relief of vertigo and with less hazards of affecting the hearing level.

Adult↗

Effects of restrained cervical mobility on voluntary eye movements and postural control.

The effects of restrained cervical mobility on pursuit eye movements (PEMS), voluntary saccades and postural control, as measured by posturography, were studied in 11 healthy subjects whose cervical spine movement had been restrained for 5 days by means of a rigid neck-collar. At day 5 mean peak velocity of voluntary saccades at amplitudes of 40 degrees and 60 degrees was significantly reduced, as was mean peak gain of PEMs at a stimulus velocity of 50 degrees/s; the variance of body position in vibration-induced body sway was significantly increased, but there was no difference in variance of galvanically-induced body sway or in velocity of vibration-induced body sway. The results suggest that restriction of cervical movements per se affects voluntary eye movements, a conclusion also consistent with findings in patients with tension headache. Restriction of cervical movement only marginally affects postural control.

Adult↗