Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/132587
Title: Using Pupillometry to Evaluate Balance in Patients Implanted with a Cochleo-Vestibular Implant
Authors: Tang, Joyce
Ramos De Miguel, Ángel 
Falcón González, Juan Carlos
Borkoski Barreiro,Silvia 
Rodríguez Montesdeoca, Isaura
Ramos Macías, Ángel Manuel 
UNESCO Clasification: 321305 Cirugía de garganta, nariz y oídos
Keywords: Older-Adults
Falls
Cochleo-Vestibular Implant
Pupillometry
Balance, et al
Issue Date: 2024
Journal: Journal of Clinical Medicine 
Abstract: Maintaining balance comes naturally to healthy people. In subjects with vestibulopathy, even when compensated, and especially if it is bilateral, maintaining balance requires cognitive effort. Pupillometry is an established method of quantifying cognitive effort. Background/Objectives: We hypothesized that pupillometry would be able to capture the increased effort required to maintain posture in subjects with bilateral vestibulopathy in increasingly difficult conditions. Additionally, we hypothesized that the cognitive workload during balance tasks, indexed by pupil size, would decrease with the activation of the BionicVEST cochleo-vestibular implants. Methods: Subjects with a cochleo-vestibular implant as of March 2023 were recruited, excluding those with ophthalmological issues that precluded pupillometry. Pupillometry was performed using a validated modified videonystagmography system. Computed dynamic posturography and a Modified Clinical Test of Sensory Integration on Balance were performed while the pupil was recorded. Tests were first performed after 24 h of deactivating the vestibular component of the implant. Thereafter, it was reactivated, and after 1 h of rest, the tests were repeated. The pupil recording was processed using custom software and the mean relative pupil diameter (MRPD) was calculated. Results: There was an average of 10.7% to 24.2% reduction in MRPD when the vestibular implant was active, with a greater effect seen in tasks of moderate difficulty, and lesser effect when the task was easy or of great difficulty. Conclusions: Despite technical challenges, pupillometry appears to be a promising method of quantifying the cognitive effort required for maintaining posture in subjects with bilateral vestibulopathy before and after vestibular implantation.
URI: http://hdl.handle.net/10553/132587
ISSN: 2077-0383
DOI: 10.3390/jcm13133797
Source: Journal Of Clinical Medicine, [ISSN 2077-0383], v. 13 (13), (Julio 2024)
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