Association Between Saccule and Semicircular Canal Impairments and Cognitive Performance Among Vestibular Patients.
Kevin Pineault, Deryck Pearson, Eric Wei and 3 others
PMID 31567562WHAT IT FOUND
Patients with bilateral vestibular organ impairment made significantly more errors on a visual memory test than those with normal function.
They also performed worse on a cognitive sequencing task than age-matched controls. This links severe inner ear damage to specific cognitive deficits.
Key findings
01Patients with bilaterally absent saccule function made significantly more errors on the Benton Visual Retention Test compared to those with normal function.
02Patients with bilateral semicircular canal impairment also made significantly more errors on the Benton Visual Retention Test.
03Vestibular patients had significantly poorer performance on the Trail-Making Test Part B compared to matched controls, with each standard deviation increase in completion time associated with higher odds of vestibular impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study design is cross-sectional, so it cannot prove that vestibular impairment causes cognitive decline; it only shows an association. A significant number of patients (13 of 54) did not complete all vestibular tests, reducing the sample size for those analyses. Only 38 of the 54 patients could be matched to controls, further limiting the case-control analysis. The analysis of combined saccule and semicircular canal impairments was underpowered because only 11 patients had both. Controls were not tested with caloric irrigation, so some may have had undetected semicircular canal impairments. Cognitive testing occurred on the same day as vestibular testing, and although rest was provided, residual symptoms from the vestibular tests might have affected cognitive performance.
Declared interests
The authors declared no commercial or financial conflicts of interest. The study was supported by the National Institute on Aging and the Intramural Research Program of the NIA.
The easy way to misread this
Do not assume that unilateral vestibular impairment causes significant cognitive deficits. The study found no significant difference in cognitive performance for patients with unilateral issues compared to those with normal function, suggesting that the cognitive impact is specific to bilateral loss.