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. 2023 Aug 1;149(8):670-680.
doi: 10.1001/jamaoto.2023.1275.

Association of Bilateral Vestibulopathy With and Without Hearing Loss With Cognitive-Motor Interference

Maya Danneels  1 , Ruth Van Hecke  1 , Laura Leyssens  1 , Raymond van de Berg  2   3 , Ingeborg Dhooge  1   4 , Dirk Cambier  1 , Vincent Van Rompaey  5   6 , Leen Maes  1   4
Affiliations

Association of Bilateral Vestibulopathy With and Without Hearing Loss With Cognitive-Motor Interference

Maya Danneels et al. JAMA Otolaryngol Head Neck Surg. .

Abstract

Importance: The past years, evidence suggested that the primary symptoms traditionally associated with bilateral vestibulopathy (BV) do not represent the full picture of this patient population. Recent literature also demonstrated cognitive impairment. However, although multitasking and dual-tasking are widely present in everyday activities, most of these studies assessed cognitive function only in single-task conditions.

Objective: To uncover the association of BV with and without hearing loss with cognitive and motor performance and cognitive-motor interference.

Design, setting, and participants: This prospective case-control study assessed persons with an isolated BV and persons with BV and a concomitant hearing loss compared with a healthy control group. Data were analyzed in December 2022. The study was conducted at Ghent University (Ghent, Belgium). Data collection took place between March 26, 2021, and November 29, 2022.

Main outcomes and measures: All participants completed the 2BALANCE dual-task protocol, comprising a static and a dynamic motor task that was combined with 5 visual cognitive tasks. These cognitive tasks assessed mental rotation, visuospatial memory, working memory, response inhibition (executive function), and processing speed. All cognitive tasks were performed in a single-task condition (while seated) and in a dual-task condition (combined with a static and a dynamic motor task). The static task comprised balancing on a force platform with foam pad, and the dynamic task comprised walking at a self-selected speed on the GAITRite Walkway. Both motor tasks were performed in the single-task and dual-task condition.

Results: Nineteen persons with BV and hearing loss (mean [SD] age, 56.70 [10.12] years; 10 women [52.6%]), 22 persons with an isolated BV (mean [SD] age, 53.66 [13.35] years; 7 women [31.8%]), and 28 healthy control participants were included (mean [SD] age, 53.73 [12.77] years; 12 women [42.9%]). Both patient groups had mental rotation and working memory impairment in a single-task condition and slower processing speed when walking (ie, during the dynamic dual-task condition). Additionally, the patient group with hearing loss had impaired visuospatial memory and executive function deficits in single-task and dual-task conditions, while this could only be elicited when performing a motor task in persons with isolated BV (ie, when dual-tasking).

Conclusion and relevance: The findings of this case-control study suggest an association between vestibular function and cognitive and motor performance, even greater in persons with a concomitant hearing loss than in persons with an isolated BV.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Danneels reported grants from Fonds Wetenschappelijk Onderzoek (FWO) during the conduct of the study. Dr Van Hecke reported grants from FWO during the conduct of the study. Dr Van de Berg reported grants from Medel outside the submitted work. Dr Van Rompaey reported grants from FWO during the conduct of the study and grants from Cochlear and Medel outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Measurements of Participant Cognitive Data
These data are presented for the single-task (ST), static dual-task (SDT), and dynamic dual-task (DDT) conditions. The error bars signify the 95% CIs of the estimated marginal means. BV indicates bilateral vestibulopathy; HC, healthy control; HL, hearing loss; NH, normal hearing.
Figure 2.
Figure 2.. Measurements of Participants’ Performance of Static Motor and Dynamic Motor Tasks
These data are presented for the single-task (ST), mental rotation task (MR), Corsi block (CB), coding task, visual Stroop task (vSTR), and the visual backward digit recall test (vBDRT). The error bars signify the 95% CIs of the estimated marginal means. BV indicates bilateral vestibulopathy; HC, healthy control; HL, hearing loss; NH, normal hearing.
See this image and copyright information in PMC

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