Clinical interest of postural and vestibulo-ocular reflex changes induced by cervical muscles and skull vibration in compensated unilateral vestibular lesion patients.

Skull vibration induces nystagmus in unilateral vestibular lesion (UVL) patients. Vibration of skull, posterior cervical muscles or inferior limb muscles alters posture in recent UVL patients. This study aimed to investigate the postural effect of vibration in chronic compensated UVL patients. Vibration was applied successively to vertex, each mastoid, each side of posterior cervical muscles and of triceps surae in 12 UVL patients and 9 healthy subjects. Eye movements were recorded with videonystagmography. Postural control was evaluated in eyes open (EO) and eyes closed (EC) conditions. Sway area, sway path, anteroposterior and medio-lateral sways were recorded.A vibration induced nystagmus (VIN) beating toward the healthy side was obtained for each UVL patient during mastoid vibration. In EO, only sway path was higher in UVL group during vibration of mastoids and posterior cervical muscles.The EO postural impairments of UVL patients could be related to the eye movements or VIN, leading to visual perturbations, or to a proprioceptive error signal, providing an erroneous representation of head position. The vibration-induced sway was too small to be clinically useful. Vestibulo-ocular reflex observed with videonystagmography during mastoid vibration seems more relevant to reveal chronic UVL than vestibulo-spinal reflex observed with posturography.

Sensorimotor specificities in balance control of expert fencers and pistol shooters.

Motor skills during sport activity are influenced by practice-related constraints and leads to the development of appropriate postural sensorimotor strategies. Fencing is highly requiring visual monitoring and high-speed motor skills while retaining efficient balance control. Conversely, pistol shooting is a static activity requiring a high control of body sway. This study aimed to evaluate balance control and the related neurosensory organisation through reproducible postural tasks with and without sensory conflict. Twelve expert fencers, 10 expert shooters and 10 sedentary controls have performed a static posturographic test and a sensory organisation test (in 6 different sensory situations based upon sway-referenced vision and support surface, C1 to C6). Shooters yielded a better balance control during C1 (eyes open) and C2 (eyes closed) than fencers and controls. Fencers showed a better balance control in C5 (eyes closed with sway-referenced support surface) than shooters and controls. While this study confirms the beneficial effects of physical activities on balance control, a differential effect on balance characteristics due to the acquired specific motor skills was also noted. In addition to high proprioceptive sensitivity in sportsmen, dynamic constraints in fencing force fencers to permanently select the most relevant information to manage better sensory conflicting situations.

Effect of chronic and subchronic organic solvents exposure on balance control of workers in plant manufacturing adhesive materials.

High-level occupational exposure to volatile organic solvents may elicit neurotoxic effects, especially on central and peripheral structures involved in balance ability. Studies on balance control in relation with exposure levels close to the threshold limit values are scarce. This study aimed to assess the neurotoxic effects of chronic and subchronic exposure to organic solvents among workers in plant manufacturing adhesive materials. Balance control was evaluated in 18 subjects, mainly exposed to n-hexane and toluene, with current median exposure levels of 222 and 102 mg/m(3), respectively, and a median exposure duration of 21 years, and in 32 nonexposed controls, using posturography tests with and without sensory conflicting situations. Tests were undergone at the beginning of the work shift (chronic exposure) following a week end, and after 72 h (subchronic exposure). Balance control performance was lower in chronically exposed workers compared to controls, and got worse after subchronic exposure, particularly during situations, where vestibular information was important. Our study suggests that a low-level and prolonged exposure to volatile organic solvents, mainly n-hexane and toluene, in the workplace is associated with deleterious central effects involved in postural regulation. This neurotoxicity is characterized by difficulties to use the most relevant information to control balance, leading to altered management of sensory conflicting situations.

Impaired neuromotor functions in hospital laboratory workers exposed to low levels of organic solvents.

Solvents are ubiquitous in industrial societies in a wide range of processes, and long-term exposure to these organic compounds may impair neuromotor functions such as equilibrium function. However, there is limited knowledge of effects on posture and gaze control after organic solvent exposures below workplace threshold limit values. The aim of this study was to evaluate the consequences of low-level co-exposure to organic solvents on balance and gaze control in hospital laboratory workers. Twelve hospital laboratory female subjects mainly exposed to toluene and ethanol, with median exposure duration of 24 years, and 12 non-exposed female controls were submitted to posturography and oculomotricity testings including sensory organization and motor control tests and saccade and smooth pursuit tests. Although current measured exposure values to toluene and ethanol were much below workplace threshold limit values (current median exposure levels of 32.5 mg/cubic meter and 39.9 mg/cubic meter, respectively), exposed workers displayed a weaker balance and a less precise gaze control. They presented, on the one hand, a reduced ability to resolve sensorial conflict situations compared to controls, particularly when situations were managed by the vestibular information, and, on the other hand, longer saccadic reaction time. Organic solvents might have an impact on vestibular pathways involved in postural control and exert a depressant central pathway effect implicated in the management of oculomotor response. Evaluating balance control in sensory conflicting situations and saccadic reaction time is proposed as a way to reveal subclinical neurotoxicological effects due to low-level exposure to organic solvents.