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Benign paroxysmal positional vertigo as a complication of 90-day head-down bed rest

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to report the occurrence of benign paroxysmal positional vertigo (BPPV) in a 90-day head-down bed rest experiment and evaluate the potential relationship between BPPV-related seizures and bone metabolic changes.

Methods and design

Five cases of lateral semicircular canal (LSC) BPPV were diagnosed during a 90-day head-down bed rest experiment. Five age-matched subjects who participated in this experiment and never felt dizziness or vertigo were assigned as controls. The differences between the BPPV and the controls in lumbar bone mineral density, 25-hydroxyvitamin D level, corrected serum calcium, potassium, sodium, phosphorus, iron, uric acid and N-terminal osteocalcin were analyzed to determine the cause of LSC-BPPV.

Results

BPPV occurred from Day 17 to Day 42 during head-down bed rest. The occurrences of BPPV were related to low 25-hydroxyvitamin D level (BPPV:20.70 ± 1.95 ng/L vs. control: 30.59 ± 2.75 ng/L at Day 30 during HDBR, p < 0.05). The relatively longer duration in the prone posture at 6° head down in this experiment may have a potential role in the involvement of the LSC. The maneuver used in the experiment effectively alleviated the acute symptoms of LSC-BPPV.

Conclusion

The cases of LSC-BPPV in the early period of 90-day of head-down bed rest were related to the low 25-hydroxyvitamin D level and the 6° head-down posture. These results suggest that the potential role of unloading-induced bone loss on BPPV-related seizures deserves attention in future studies of long-term bed rest.

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References

  1. Alessandrini M, Micarelli A, Pavone I, Viziano A, Micarelli D, Bruno E (2013) Persistent benign paroxysmal positional vertigo: our experience and proposal for an alternative treatment. Eur Arch Otorhinolaryngol 270:2769–2774

    Article  Google Scholar 

  2. Chen ZJ, Chang CH, Hu LY, Tu MS, Lu T, Chen PM, Shen CC (2016) Increased risk of benign paroxysmal positional vertigo in patients with anxiety disorders: a nationwide population-based retrospective cohort study. BMC Psychiatry 16:238. https://doi.org/10.1186/s12888-016-0950-2

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Lopez-Esca′ mez JA, Ga′ miz MJ, Finana MG, Perez AF, Canet IS (2002) Position in bed is associated with left or right location in benign paroxysmal positional vertigo of the posterior semicircular canal. Am J Otolaryngol 23:263–266

    Article  Google Scholar 

  4. He LL, Li XY, Hou MM, Li XQ (2019) Association between bone mineral density and benign paroxysmal positional vertigo: a meta-analysis. Eur Arch Otorhinolaryngol 276:1561–1571

    Article  Google Scholar 

  5. Yang B, Lu Y, Xing D, Zhong W, Tang Q, Liu J, Yang X (2020) Association between serum vitamin D levels and benign positional vertigo: a systematic review and meta-analysis of observational studies. Eur Arch Otorhinolaryngol 277:169–177

    Article  Google Scholar 

  6. Ziavra NV, Bronstein AM (2004) Is uric acid implicated in benign paroxysmal positional vertigo? J Neurol 251:115

    Article  Google Scholar 

  7. Hargens AR, Vico L (2016) Long-duration bed rest as an analog to microgravity. J Appl Physiol 120:891–903

    Article  Google Scholar 

  8. Polensek SH, Tusa RJ, Sterk CE (2009) The challenges of managing vestibular disorders: a qualitative study of clinicians’ experiences associated with low referral rates for vestibular rehabilitation. Int J Clin Pract 63(11):1604–1612

    Article  CAS  Google Scholar 

  9. Manzoni GC, Torelli P (2005) Epidemiology of typical and atypical craniofacial neuralgias. Neurol Sci 26:S65–S67

    Article  Google Scholar 

  10. Callbucci F, Gognetti F, Bollini C, Cuscini A, Michelucci R, Tassinari CA (1986) Intracranial microvascular decompression for “cryptogenic” hemifacial spasm, trigeminal and glossopharyngeal neuralgia, paroxysmal vertigo and tinnitus: I. surgical technique and results. ltal J Neurol Sci 7:359–366

    Article  Google Scholar 

  11. Gyo K (1988) Benign paroxysmal positional vertigo as a complication of postoperative bed rest. Larygnoscope 88:332–333

    Google Scholar 

  12. Pavy-Le Traon A, Heer M, Narici MV, Rittweger J, Vernikos J (2007) From space to Earth: advances in human physiology from 20 years of bed rest studies (1986–2006). Eur J Appl Physiol 101:143–194

    Article  CAS  Google Scholar 

  13. Gleason AT, Kesser BW (2019) Dizziness and vertigo across the lifespan. Elsevier B.V, St. Louis

    Google Scholar 

  14. Kahraman SS, Ozcan O, Arli C, Ustun I, Erduran R, Akoglu, and Gokce C (2016) Calcium homeostasis during attack and remission in patients with idiopathic benign paroxysmal positional vertigo. Otol Neurotol 37:1388–1392

    Article  Google Scholar 

  15. Byun H, Chung JH, Lee SH, Park CW, Kim EM, Kim I (2019) Increased risk of benign paroxysmal positional vertigo in osteoporosis: a nationwide population-based cohort study. Sci Rep 9:3469

    Article  CAS  Google Scholar 

  16. Talaat BS, Abuhadied G (2014) Talaat AS and Abdelaal MSS (2014) Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol. https://doi.org/10.1007/s00405-014-3175-3

    Article  PubMed  Google Scholar 

  17. Algarni MA, Mirza AA, Althobaiti AA, Alnemari HH, Bakhsh LS (2019) Association of benign paroxysmal positional vertigo with vitamin D deficiency: a systematic review and meta-analysis. Eur Arch Oto-Rhino-Laryngol. https://doi.org/10.1007/s00405-018-5146-6

    Article  Google Scholar 

  18. Coenegrachts L, Stockmans I, Segers I, Bouillon R, Carmeliet G (2007) The effect of microgravity on 1,25-dihydroxyvitamin D3 signalling in Osteoblasts. Bremen Microgravity Sci Technol XIX-5/6:154–158

  19. Arnaud SB, Sherrard DJ, Maloney N, Whalen RT, Fung P (1992) Effects of 1-week head-down tilt bed rest on bone formation and the calcium endocrine system. Aerosp Med Hum Perform 63(1):14–20

    CAS  Google Scholar 

  20. Smith SM, Davis-street JE, Fesperman JV, Calkins D, Bawa M, Macias BR, Meyer RS, Hargens AR (2003) Evaluation of treadmill exercise in a lower body negative pressure chamber as a countermeasure for weightlessness-induced bone loss: a bed rest study with identical twins. J Bone Miner Res 18:2223–2230

    Article  Google Scholar 

  21. Zerowekh JE, Ruml LA, Gottschalk F, Pak CYC (1998) The effects of twelve weeks of bed rest on bone histology, biochemical markers of bone turnover, and calcium homeostasis in eleven normal subjects. J Bone Miner Res 13(10):1594–1601

    Article  Google Scholar 

  22. LeBlanc A, Schneider V, Spector E, Evans H, Rowe R, Lane H, Demers L, Lipton A (1995) Calcium absorption, endogenous excretion, and endocrine changes during and after long-term bed rest. Bone 16(4 Suppl):301S–304S

    Article  CAS  Google Scholar 

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Acknowledgements

This work was fully funded by China Manned Space Advanced Research Project (HY-5) and Key Project of State Key laboratory of Space Medicine Fundamentals and Application (SYFD180011801). We thank the American Journal Experts for editing our manuscript.

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Authors and Affiliations

  1. The State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26 Beiqing Road, Haidian District, Beijing, 100094, People’s Republic of China

    Linjie Wang, Junlian Liu, Quanchun Fan, Zhili Li, Zhongquan Dai, Lina Qu & Yinghui Li

  2. Shenzhen Institute of Green Interplanetary Space Technology, Shenzhen, 518000, People’s Republic of China

    Zhiqi Fan

  3. The Vertigo Clinic, Air Force General Hospital, Beijing, 100142, People’s Republic of China

    Xianrong Xu

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  1. Linjie Wang
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  2. Junlian Liu
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  3. Quanchun Fan
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  6. Zhili Li
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  9. Yinghui Li
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Correspondence to Linjie Wang.

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Wang, L., Liu, J., Fan, Q. et al. Benign paroxysmal positional vertigo as a complication of 90-day head-down bed rest. Eur Arch Otorhinolaryngol 278, 683–688 (2021). https://doi.org/10.1007/s00405-020-06124-2

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  • DOI: https://doi.org/10.1007/s00405-020-06124-2

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