Elucidating links between vestibular function, cognition, and sensorimotor behavior

每年，近25%-50%的老年人摔倒。然而，预防跌倒的努力并不是统一的 导致跌倒风险的有效因素还不完全清楚。前庭系统， 内耳的一部分，是跌倒风险的已知贡献者，最近的证据表明，认知 可能与前庭功能相互作用，影响跌倒。阿尔茨海默病(AD)患者跌倒 比认知健康的成年人和前庭功能障碍的人多2-3倍 认知上的变化。然而，这些关系还没有完全阐明。作为 前庭系统是多样的，识别哪些功能通路(即，反射性，知觉性， 视觉-前庭整合)与认知有关，不平衡对发育至关重要 有针对性的干预措施以减少跌倒。具体的目标是检查前庭的程度 功能与AD患者的感觉运动行为(平衡和跌倒)有关(目标1a) 前庭功能丧失成人的认知与感觉运动行为的关联程度 (目标1b)。还将对AD患者和前庭缺失患者进行明确的比较(AIM 1c)为了确定潜在的相似之处，并为正在进行的预防跌倒干预提供信息 这些患者群体。现有措施将与新的实验室技术相结合 为了直接为临床实践提供信息并阐明跌倒的基本机制 风险。K01获奖期将使PI能够在她现有的临床和研究基础上再接再厉 具备前庭科学方面的专业知识，并在以下领域提供有系统的培训：a)衰老，b) 认知和认知障碍，c)评估平衡和步态的先进技术， 以及d)测量眼球运动的先进技术。研究和培训经验 在此获奖期间，将帮助PI成为前庭的独立研究人员 生理学。拟议的工作将在俄亥俄州立大学的指导下进行 Dan Merfeld博士和Yuri Agrawal博士与来自 是各自领域的领军人物。拟议的培训活动和研究计划是一致的 与NIDCD的平衡研究战略计划，特别是解决当前 自我运动知觉在健康和疾病中的理解及其影响因素 在老年人中不平衡和下降。拟议的培训将成为未来R01的基础 使用高级前庭评估技术检查感觉变化的应用 与不同的病理和姿势控制的关系有关的功能。

Every year, nearly 25-50% of older adults fall. However, fall prevention efforts are not uniformly effective and factors contributing to fall risk are not completely understood. The vestibular system, part of the inner ear, is a known contributor to fall risk and recent evidence suggests that cognition may interact with vestibular function to influence falls. Patients with Alzheimer’s disease (AD) fall 2-3 times more than cognitively healthy adults and those with vestibular dysfunction exhibit changes in cognition. However, these relationships have not been fully elucidated. As the vestibular system is diverse, identifying which functional pathways (i.e., reflexive, perceptual, visual-vestibular integration) are related to both cognition and imbalance is vital for development of targeted interventions to reduce falls. The specific aims examine the extent to which vestibular function is associated with sensorimotor behaviors (balance and falls) in AD (Aim 1a) and the extent to which cognition is associated with sensorimotor behaviors in adults with vestibular loss (Aim 1b). Explicit comparisons between those with AD and vestibular loss will also be made (Aim 1c) in order to determine potential similarities and inform ongoing fall prevention interventions in these patient populations. Existing measures will be combined with novel laboratory techniques in order to directly inform clinical practice and elucidate fundamental mechanisms underlying fall risk. The K01 award period will enable the PI to build upon her existing clinical and research expertise in vestibular science and provide structured training in the following areas: a) aging, b) cognition and cognitive impairment, c) advanced techniques for assessment of balance and gait, and d) advanced techniques for measuring eye movements. Research and training experiences during this award period will help the PI become an independent researcher in vestibular physiology. The proposed work will take place at Ohio State University under the mentorship of Dr. Dan Merfeld and Dr. Yuri Agrawal in conjunction with subject area specific mentorship from leaders in their respective fields. The proposed training activities and research plan are consistent with the NIDCD’s strategic plan for research in balance, specifically addressing current understanding of self-motion perception in health and disease and factors contributing to imbalance and falls in older adults. The proposed training will be the foundation for future R01 applications using advanced vestibular assessment techniques to examine changes in sensory function related to diverse pathologies and relationships to postural control.