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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery

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Otorinolaringologia 2005 September;55(3):147-53

language: Italian

Adaptation in vestibolopathies

Guidetti G.

Servizio di Audio-Vestibologia e Rieducazione Vestibolare Azienda Unità Sanitaria Locale di Modena, Modena


The equilibrium system can be modified by alterations of periferical inputs, or CNS activities, or motor outputs. Organism adaptation to new conditions requires some central mechanisms including: a change of value imputable to esteroceptive and proprioceptive information (recalibration), establishment of new reply program models (a new behavioural strategy), storage of new sensorial experience and emotional related one (memorization and psychologic adaptation). Mechanisms of functional adaptation are similar to sensitive-motor learning ones with involvement of procedural memory. Therefore they must be preserved through active processes and they can be very different in subjects. Despite a big plasticity of the equilibrium system, adaptation to a vestibolopathy is never complete. Some disfunctions remain and represent a sort of “vestibular scar” that can be supported by adequate techniques. The involvement limbic circuits, for example, causes a change of topokinetic memory in orientation and affectivity functions. Many factors can interfere with adaptation processes: lesion stability, CNS diseases, psychic condition, age, way of life, drugs, motor system condition, compensator and intercorrent system diseases. In the therapeutical field it’s necessary to consider all these factors using nootropic drugs, like piracetam, to accelerate adaptation physiological mechanisms to vestibular lesion thanks to their capability to improve neuronal plasticity and cognitive processes.

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