The goal of this clinical trial is to visualize the possible activation of vestibular centers in the brain using in patiens with unilateral vestibular damage, specifically in patients after vestibular schwannoma surgery. The main questions it aims to answer are: 1. Is there a difference in the proces sof activation of vestibular centers in patients with unilateral vestibular disorder and healthy subjects. 2. Are we able to effect this activation with our postoperative treatment? Researchers will compare the obtained results between patients with unilateral vestibular disorder and healthy controls. Participants will be asked to fill out the set of questionaires, to undergo clinical objective vestibular examnation and examination in magnetic resonance.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Vestibular schwannoma resection leads to partial or combined acute unilateral peripheral or combined vestibular lesion.The organism responds with the process of central vestibular compensation.
Department of Otorhinolaryngology and Head and Neck Surgery, 1st Medical Faculty Charles University and University Hospital Motol
Prague, Czechia
Identification of cortical vestibular center in acute unilateral vestibular lesion
Fuctional magnetic resonance (fMRI) could display certain areas of the brain and its pathways involved in the process of central compensation resulting from the acute unilateral vestibular lesion. We aim to compare pre- and post- operative fMRI results with the results of healthy controls to see whether there is a difference in activating vestibular centers and maintaining the equilibrium after the central compensation occurs. Different level of activation of vestibular cortical areas, resp. differences in activation in response to optokinetic stimulation will be measured in healthy controls and study group. Evaluation of functional brain MRI will be provided by expert neuroradiologist. Vestibular function will be assessed by objective vestibular tests (videonystagmography, video Head Impuls Test) and by subjective scales (questionnaires - The Penn Acoustic Neuroma Quality-of-Life scale, Dizziness Handicap Inventory - in both the higher score indicates higher handicap).
Time frame: baseline and one week
Change in cortical activation in response to acute onset of vestibular loss
Evaluation of differences between control and study group in functional brain MRI in response to wide field optokinetic stimulation. Differences in size and level of activation of vestibular cortical areas will be evaluated by expert neuroradiologist.
Time frame: baseline and one week
Possible influence of vestibular training in virtual reality environment on the rate of vestibular center activation
The cohort group, which undergoes vestibular rehabilitation in virtual reality environment, will be evaluated and compared to control and study group. Functional brain MRI in response to wide field optokinetic stimulation will be evaluated by expert neuroradiologist. The obtained data could serve as a basis for understanding the possibility of influencing the central compensation process and potentially, in the future, utilizing virtual reality as a tool for vestibular training.
Time frame: baseline and 3 months
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