Talk:Vestibulocerebellar syndrome

There is a group of 3 of us who will be working on this page and continuing to edit it in pieces over the next week and will have it edited and more complete by Friday March 25th. It may not look complete until then as we are working on it in stages. Randiew390 (talk) 20:57, 6 April 2011 (UTC)

Cool. If you could use advice on anything, please leave a message here on the talk page. Note by the way that new material should go at the bottom of the talk page, and you can sign messages by typing ~~~~ at the end. Looie496 (talk) 17:54, 19 March 2011 (UTC)

Let me add that you might find our cerebellum article useful as a starting point. You shouldn't use it as a reference, because Wikipedia articles shouldn't reference other Wikipedia articles, but it may help to give you an intuitive grasp about what is going on in this condition. Looie496 (talk) 18:03, 19 March 2011 (UTC)

primary vs secondary articles

several of the references appear to be primary research articles instead of the preferred secondary references.NeuroJoe (talk) 02:47, 23 March 2011 (UTC)

I suspect that's fine for now. If/when this aims for GA or FA status then it'll have to use secondary sources. Basket of Puppies 03:21, 23 March 2011 (UTC)

They are better than nothing; but still stressing the importance of searching and reading secondary sources would be a good idea for all students.--Garrondo (talk) 07:54, 23 March 2011 (UTC)

Yes, I agree with you both. Some of the topics the students are working on this semester are relatively rare and there are few or no good review sources of information, so in those cases they've been told that primary sources are ok. NeuroJoe (talk) 19:06, 23 March 2011 (UTC)

Fast comment on format of citations

As a minor comment: inline citations in wikipedia go after and not before the full stop of the sentence, there is no space between the full stop and the ref, and after the ref goes a space before the next sentence. A correct example would be "Hello world, I feel great today. Today is sunny.". Would be great if students in this article corrected these mistakes. I'll make further comments as I have time. Bests.--Garrondo (talk) 10:00, 23 March 2011 (UTC)

References

General Comments

from AlexGoldy

So a lot of the material you have composed is really great. You give a pretty comprehensive overview of vestibulocerebellar syndrome, thereby making it easy to determine the origins and causes of the disease, as well as the possible treatments for it. There are a few areas, though that I think could be improved. First (and this is probably the easiest), I would recommend just going through the article and checking for grammar and spelling errors. I know that right off the bat I saw misspelling of the word "heel" and a run-on sentence. Besides this, though, I noticed that there were a fair number of repetitive sentences. You mention early on that somebody would have difficulty buttoning their shirt (and one other example), but then later, you say that a person afflicted with this would begin to have difficulty doing every day tasks. This seems a bit redundant, so I think that you could get rid of that sentence. There were several other instances where this occurred. Also, there was one instance where it seemed like there was a contradiction. You state that there is research being done on a certain locus with respect to the syndrome, but then later on say that there has been no locus found that directly causes the disease. I was just a little bit confused on that issue. It would also be interesting to learn more about the current research being done on this syndrome, as it seems to be pretty unique (this can be connected to the genetics of the disease). Finally, in terms of Wikipedia citing etc., I don't think you need to hyperlink a word to another Wikipedia article each time that word appears. Just once should be fine. Also, I would say you could use a parenthetical citation each time you repeat using a source. So, in summary, check for errors, look for repetition (and maybe even make the language a bit simpler), check that one contradiction, and check your citing. Other than that, it looks pretty good! AlexGoldy (talk) 03:32, 6 April 2011 (UTC)

Thanks for the feedback. I fixed the heel typo and scanned for any other obvious ones. We had some trouble because there is very little research to draw from since the disease is so rare. A few of our sources mentioned certain loci as potential sources of symptoms of the disease but none mentioned a single locus for the disease itself. We will talk about ways to reword or reorganize some of this information so that is more clear to understand and take a look at the sections that were repetitive. Thanks! MKMurphy (talk) 15:12, 6 April 2011 (UTC)

from Orourkcd

First of all, good work on the article! It seems like a challenging article to fully research because it has only been identified in three families. My first comment is about the heading organization. Some of the other wikipedia articles have had their history sections at the end and I think this provides a better flow of information. I know that wikimedicine has an article on organization, so you may want to check that to see if everything looks to be in a similar order. The symptoms section is very descriptive and provides excellent information. In the beginning of the causes section, you may want to consider rewriting the sentence beginning with "this could be..." because it seems a little informal and, if there is doubt that abnormalities in the flocculus are the cause then that should be stated outright. I like that you elaborated on the trials of medicine in the management ssystem rather than just stating that they had little success. Although this is just a stylistic comment, you may want to combine the prognosis and management sections as they seem to be talking about relatively similar material. Again, this is only an opinion but it does seem better if they were to be connected in a single paragraph (perhaps even starting out with the diagnosis portion). The research section is thorough given that there doesn't seem to be much current research going on. Orourkcd (talk) 04:28, 7 April 2011 (UTC)

Thanks for the input! The headings are reorganized so that causes and symptoms are first and history is toward the end and I agree that this seems like a better flow. In the causes section, the exact abnormalities in the flocculus are unknown so I reworded that part. Hopefully it is more clear more. Several other people commented about the organization about the management and prognosis sections. I agree that the information in both is somewhat limited and overlaps quite a bit. Since they are different topics I think it would be good to keep them as separate sections but we will either try and expand on the information we have or try to find some more research.MKMurphy (talk) 01:00, 22 April 2011 (UTC)

from Kamilaosypiuk

You guys have done a great job on this article so far. The explanations you provide are clear and concise, with language that is understandable for the average reader. The article is also well organized and covers each of the important aspects of the topic. Some sections of the article, such as those on causes and treatments, could be improved by expanding them further, though this may be difficult due to the evident lack of known information. Perhaps you could expand on the information that is known by giving a more detailed account of specific studies that have been conducted in search of the cause of the disease and the possible treatments. In addition, the article could be enhanced by the addition of images, such as ones that demonstrate the anatomical location of the vestibulocerebellum and flocculonodular lobe. Overall the article is well written and thoroughly researched. Nice work. Kamilaosypiuk (talk) 05:53, 7 April 2011 (UTC)

Thanks for the help. Other people also suggested the use of images. Hopefully the ones we've added are helpful. I agree that there seems to be a lot of room for more details and explanation of causes, treatments, and research. As I mentioned to a few other reviewers, for the most part we have included all of the information from the studies that exist for vestibulocerebellar syndrome. Since there are only three known families to have the disease there have been very few studies conducted so there aren't that many sources to draw from. We will definitely try to dig up some more research though.MKMurphy (talk) 01:39, 23 April 2011 (UTC)

from Crockeer

So far, your article looks great! Off the bat, the introduction describes what the disease is, its causes and background, and gives a basic overview of what will be further addressed in the article. In the history/origin section, (as well as symptoms and causes) there is a lot of complex medical terminology. Many of terms are thrown around without any definitions. This could make the article very difficult to read for someone not versed in biology, and is very hard to follow as clinking on links for every other word for definitions can get rather tedious. Describing some of the terms would make the article clearer and easier to follow, as well as add some bulk to the page. Otherwise the article is much more compact than it needs to be. You may want to consider expanding the symptoms, prognosis and management sections to add more detail and expound on the research you have already conducted.

There are several places were by simply further describing your information would make the article overall clearer and longer. For example, in the causes section, you discuss that vestibulocerebeller syndrome has clinical similarities to ataxia, however do not list what they are, or discuss the significance of the affected chromosomes (13q31-q33). Personally I loved the research section. It described the details of a particular experiment and the areas being focused on in current researcher. Research was also discussed regarding the disease’s initial discovery. Overall, it was a great article! You guys clearly are well versed on the disease and researched the topic in depth. It has a lot of crucial information and is very well written. (talk) (Crockeer (talk) 18:45, 7 April 2011 (UTC))

Thanks for the feedback! Other people also mentioned that we used complex medical terminology that all readers may not understand. Hopefully our parenthetical explanations help to clarify those terms. We tried to look for more research and information to expand on the symptoms section, but unfortunately there is limited research on this syndrome. We also reworded the prognosis and management sections to make them more clear and distinct. You made a good point about not describing the clinical similarities to ataxia so we added that to make the section more clear. For the significance of the affected chromosomes, there was limited information on that topic because it is only thought to have something to do with ocular abnormalities. There is still no known locus that is the cause of this syndrome. Randiew390 (talk) 19:59, 27 April 2011 (UTC)Randiew390

from Migliozzi88

Great job so far guys. You have a well written article here on a relatively hard to research topic. My group was looking into this topic originally but couldn't find anything but primary source papers and only a few of those at that, so kudos to you. One of the difficulties I came across in reading your article was in using some of your links for reference, which in cases like nystagmus, esophoria, oscillopsia, and a few others, were mere stubs. I realize this is no fault of your own but only reinforces the fact that this topic, and those that relate to it, are relatively uncovered in the realm of wikipedia. I think this gives your article a lot of potential for future growth as these stubs become articles. Also, throughout the article Vestibulocerebellar syndrome is also referred to as a disease as well as a disorder. There are key differences between syndromes and disorders and I would avoid using both to describe Vestibulocerebellar syndrome if at all possible. Other than these minor details, great job so far. — Preceding unsigned comment added by Migliozzi88 (talk • contribs) 22:41, 7 April 2011 (UTC)

Thanks! I thought that was a good point about the wikilinks so I added some brief descriptions of symptoms to hopefully provide a more meaningful explanation. I also clarified the disease/disorder/syndrome use. I looked back on some of the literature to double check and Vestibulocerebellar syndrome is referred to as both a disorder and a syndrome but not as a disease. I changed all of our uses of disease but if you still find anything ambiguous let us know!MKMurphy (talk) 16:59, 22 April 2011 (UTC)

I am writing comments here as I read through the article, but hopefully you find some of them helpful. In the Intro, you could maybe add a few details on what exactly happens to the vestibulocerebellum and flocculonodular lobe. Are cells degenerated? This may be nitpicky, but the last sentence could be reworded to, "It has been found to be genetically distinct from other seemingly similar forms of neurological diseases such as episodic ataxia types 1 and 2, and due to its rarity, little is known about specific details of the pathology or long-term treatment options." For the Origin/History section, is there any more information about the families? I'm curious about how many people in the families are affected and maybe even the names of the families. In addition, I would consider moving this section further down in your article. I think the most important information, such as the Signs/Symptoms and the Causes, should go right after the intro. In the Symptoms section, could you find any information about how often these attacks occurred and how long they lasted? This information might also give the reader more insight into the effects of this disease. As I believe Erin mentioned above, some elaboration on the chromosomes would definitely be helpful. Overall, though, I thought you guys did a good job summarizing the disease with understandably few references available. As mentioned in other comments, some elaboration on certain disease mentions would definitely help, but you guys seem to be on the right track.

Chouda (talk) 01:07, 8 April 2011 (UTC)

Thanks for the feedback. Unfortunately most of the details you mentioned aren't explained in the sources we have. The research is very scarce and for the most part we have included as much detail as possible from what we have been able to find. Researchers know that something causes a failure in the normal function of the flocculonodular lobe but little else. They know that it is different from other disorders because they have probed for markers and these tests were negative but have not found any positive abnormalities indicating the actual pathology of vestibulocerebellar syndrome. We also tried to find detailed information of the affected families but that information is not available either. We tried not to get into too much useless detail (i.e. the exact directions and angles of abnormal eye movements) but several other people have similar comments about including more details about symptoms and causes so we will try and see if there is any other important information we may have missed.MKMurphy (talk) 16:59, 22 April 2011 (UTC)

Hi! This is a really interesting topic and seems like you guys have found a lot of sources for it. Not much else comes up when you enter this into a search engine. I think something that you need to work on throughout the paper is certain clarifications. Although you have links to other articles, they aren't very clear. I'm also curious as to what, specifically, is affected in the regions of the brain that cause this disease. You mention in the symptoms section that they experience "ataxic gait" and other things which don't seem related to eye movement. Are these symptoms due to the ataxic eye movements or is the disease in a more progressed state? I would consider rewording the first sentence under causes because if this is a genetic disease then they "acquire" it from their parents, not during the first few years of their life. If having these genes only increases your susceptibility to the disease then it would make sense, but if that is the case then you should clarify that. I'm also curious as to why amitriptyline hydrochloride would have even been considered for treatment in the first place because it's an antidepressant. And for formatting of the article, words to other articles should only be linked once (at the first mention of the word). Needs some clarification in places, but overall it's an interesting topic. Good luck! Dbaush (talk) 01:38, 8 April 2011 (UTC)

Thanks! Several other people mentioned clarifying terminology so hopefully the parenthetical explanations I added will help. As I mentioned to David, the research is pretty limited and it has not been determined exactly what is affected in the brain that causes the abnormalities. Ataxic gait does occur in a more progressed state and is usually experienced in conjunction with eye abnormalities and vertigo, nausea, etc. I reworded the symptoms section a bit to try to clarify. Also thanks for pointing out our use of "acquire." Although they don't know which gene is responsible researchers believe it is an inherited condition, not a matter of susceptibility. I also fixed the use of multiple wikilinks. The sources that we used did not mention the reasons for choosing the drugs they tested for treatment but that is something that we can try and look into to possible expand the content of the page.MKMurphy (talk) 16:59, 22 April 2011 (UTC)

Peer Review

Overall this is a fairly well written article, it seems like you really put a lot of work into this. In general this article is written in a way that presents the scientific information in a way that would be easily understood by wikipedia readers who do not have a strong science background. There are a few changes that you could make that would just clarify some ideas. In the origin/ history section you say when the syndrome was discovered and by "Farmer et al. and ... Vance et al" I know that you are talking about scientists who wrote a paper about this (or at least I assume) however that would not be clear to most people, so I might want to clarify this. Then it would be helpful to the reader if you expanded upon what a vestibulo-ocular reflex is, since most people would not understand this term. I don't really think that it is necessary to have the prognosis section when it appears as though the information covered falls under the management category, I would suggest just merging these ideas. Then there are several areas where you might want to link the article to other wikipedia pages to help the reader direct their own research of the syndrome. Always have a last look through what you wrote in the article because there you can always find a grammar/ spelling mistake that you didn't catch before.Lauren.ching (talk) 02:55, 8 April 2011 (UTC)

Thanks Lauren, we specified with more clarity in the origin /history section in regards to the discoverers. We also made sure to explain in parenthesis a brief definition of the common symptoms to make it easier to read. We need a prognosis section to describe the transformation of the syndrome as a patient ages. This syndrome has been shown to be progressive and different symptoms develop as you age with greater severity. We will continue to make sure our grammar/spelling is correct but highlighting these mistakes would make it easier for us too. Thanks again for your contribution! Bazoberr (talk) —Preceding undated comment added 04:35, 27 April 2011 (UTC).

I really like your article and think that you guys have done a very well done job. I just have a few comments to make about the management section. First off, I think it might be better to call it something along the lines of therapy. I would try to go into further detail as to how the trials were performed with the drugs. Which drugs were used and how were they performed. Is there any research going on to promote further other drugs as a possibility? You may also want to address what the dramamine and antihistamine drugs do. Overall it looks good. A way to make it better is to do more research - elaborate more! boothra (talk) —Preceding undated comment added 23:46, 8 April 2011 (UTC).

Thanks for the feedback! We mentioned before that these drugs target the symptoms, such as nausea and dizzines. I placed a hyperlink to the drug to reveal the mechanisms used to provide further clarity. As far as research directions, it is very difficult to propose a path when there is still so much to be learned about this syndrome. For the most part, the articles we read are more clinical studies regarding the rare syndrome. Drugs developed specifically for this syndrome do no exist. Bazoberr (talk) —Preceding undated comment added 04:25, 27 April 2011 (UTC).

I like how the overall of each category is well-explained. If I may dig into each subcategory, first, the introduction could be a bit more concise and brief while you could include briefly about prognosis so that you are going over all of the categories that are to be discussed below. Also, it could be better if you put the last sentence from the history section into somewhere else, such as in the beginning of the second paragraph since you mention the difficulty of classification there already – just my thought. And if possible, since you already indicate primary and secondary criteria of the syndrome, you could restate them in the symptoms section? Also relocating the sentence about abnormal eye movements being one of the earliest indicators to the beginning of the paragraph in the symptoms section may organize the section better. If you could improve the management section, you could perhaps explain how, for example, lying down helps alleviate the attacks, or how drugs help. Overall, I spotted some grammatical errors and a careful editing should help your article improve. Debraborah (talk) 02:15, 8 April 2011 (UTC)

Thanks for feedback. We added some information about the prognosis in the introduction. However, we talked about trying to make the introduction more concise and thought that all of the information was relevant to giving a good overview. If there's a specific sentence or piece of information that you think is unnecessary though please let us know. We also though the last sentence in the history section was important because in addition to the other information mentioned in the paragraph, clinical similarities to those diseases make vestibulocerebellar sydrome even more difficult to classify. We did elaborate on that sentence more to try and connect these ideas a little better. We didn't mention the primary and secondary criteria in the symptoms section because they were specific to classification of vestibulocerebellar syndrome in that one study by Vance et al., they were not used for classification in other cases. We reworded some parts of the first paragraph in the symptoms section so that hopefully that abnormal eye movement sentence doesn't seem so out of place. As we mentioned in a couple other response, our research did not discuss the mechanisms in which the drugs are helpful, most likely because the mechanisms of the disorder itself are unknown. We have elaborated a little bit on how lying down helps but this isn't very explicitly addressed in the research either.MKMurphy (talk) 19:48, 27 April 2011 (UTC)

You guys did a great job on your research, if I could add a minor point, it would be to include an image of the vestibulocerebellum. Also, in the ‘Causes’ section you mention that the disorder is linked to a single genetic locus, which is on chromosome 13q31-q33, but you go onto say in ‘Research Directions’ that there has been no locus determined to cause the disorder. I think that it is an important section, and that maybe including additional information on current research would be helpful, and would make up for the lack of information available on treatment. I understand that you mean that chromosome 13 hasn’t been linked to previous known cerebellar ataxias, but it may be confusing to some other readers. An additional note: I had trouble finding secondary sources for my own topic, but the BC nursing school as well as the O’neill library interloan seems like a good place to start.(Luhizi (talk) 15:48, 8 April 2011 (UTC))

Thanks! We added a couple images that will hopefully put some of the anatomical information into context. I also reworded some parts of the causes section that deal with chromosome 13q31-q33 to try and make the whole article consistent. What we intended to convey was that this study found that chromosome 13q31-q33 was involved in some of the eye movement pathways that are affected by vestibulocerebellar syndrome. However, a locus for the disorder as a whole has not been found. Please let us know if any part of this still seems confusing.MKMurphy (talk) 02:33, 23 April 2011 (UTC)

Like the above reviews, I found the newly edited article to be informative and straightforward. Given the limited research on the topic, you guys were still able to create a complete article that provides readers with a well-rounded description of the disease. However, also like my fellow critics, I did stumble on one or two things I thought you might be able to improve upon. Within the second paragraph of the “Symptoms” topic, you say, “Once the attack ends, oscillopsia faded and the intensity of nystagmus decreased.” It seems as those you might want to keep the tenses consistent and keep the entire sentence in the past tense or in the present tense. Furthermore, I thought it might be useful to add some links to related topics at the bottom of the page – maybe a link over to episodic ataxia types 1 and 2. Along with adding some related topics you might also want to consider adding some external links. I think it would be interesting to have an external link to some research regarding the extremely rare cases of occur in Vestibulocerebellar syndrome North Carolina or perhaps even a link to the current research into the disease’s origin. Once again though, overall the article is off to a great start--Patrickmcgillen (talk) 04:56, 11 April 2011 (UTC)

Thanks for the feedback! I read through the article again and fixed that spot and a few others with changing tense. I also added a few more internal links (although there aren't specific articles for episodic ataxia 1 and 2). I also agree that external links would be helpful. However, there aren't any websites that I have been able to find that pertain to our topic. When we were beginning our research we put in quite a bit of effort to find out more information on the NC families but nothing turned up. There are certainly many areas where this article could use more in depth information though so we'll keep looking.MKMurphy (talk) 02:33, 23 April 2011 (UTC)

Non-peer review

The article contains a lot of useful information but it is missing some important things:

• Most straightforwardly, it could really use a picture. You ought to be able to extract a picture from the cerebellum article to show the location of the flocculonodular lobe. Other pictures may be available on Wikimedia Commons, for example they have a complete set of Gray's Anatomy drawings, and there might be a good one among them.

• The article needs some background concerning the vestibular system. Here is the basic story: The vestibular system implements the sense of balance -- it uses sensors in the inner ear to detect changes in posture, and generates motor commands to compensate for them. The motor commands arise from a set of brainstem structures called the vestibular nuclei. One of the most important parts of the system is the so-called vestibulo-ocular reflex, which responds to changes in head direction by causing the eyes to counterrotate, so that they continue to point in the same direction. The cerebellum contains a small region specially dedicated to the vestibular system. The general function of the cerebellum is to fine-tune motor commands. It does this for the vestibular system by calibrating the commands it generates so that the postural adjustments are in the right direction and neither too large nor too small. When the vestibular part of the cerebellum is damaged, postural adjustements become erratic.

• It would be nice to say more about the mechanism of chemically-induced vestibulocerebellar syndrome, if information is available.

That's a start. Looie496 (talk) 17:01, 11 April 2011 (UTC)

Thanks! I added a couple pictures from Wikimedia Commons. I wasn't able to find a very good picture of the vestibulocerebellum as a whole but we can look into finding one from a public domain source. That's a great suggestion about adding information on the function of the vestibular system. One of the most common critiques from our peers was the lack of information on the causes and symptoms of vestibulocerebellar syndrome. It seems that adding this background information might help by giving readers a context. Would you recommend inserting this addition in the causes section or should we create an entirely new section? As I mentioned in some of the above responses, we have included almost all of the information that we have found on the disorder. Several of our sources are primary research that were more clinically focused and did not closely examine the chemical or molecular level of vestibulocerebellar syndrome. I do agree that more information is necessary so we will continue trying to find information to add.MKMurphy (talk) 02:45, 23 April 2011 (UTC)

I guess it seems reasonable to me to put the info into the causes section. Looie496 (talk) 04:34, 23 April 2011 (UTC)

I added the info on the vestibulocerebellum according to information I gathered from our text book. Please let us know if you think we need any additional information or if any corrections are necessary.MKMurphy (talk) 00:54, 29 April 2011 (UTC)

End of Boston College BI481 Project

Hi guys, nice job with the article. A few notes:

• From the intro: "Vestibulocerebellar syndrome, also known as vestibulocerebellar ataxia, is a progressive neurological disorder that causes a category of medical problems". What do you mean by a category? Do you have a specific one in mind? Say so if you do.
• The intro is too heavy on symptoms, particularly since you discuss symptoms in the next section.
• The first part of the Management section where you're discussing postural changes and closing the eyes to alleviate symptoms of the disorder should probably be referenced. The references that come later don't seem to specifically relate to what you're discussing in those first few sentences.

NeuroJoe (talk) 01:59, 8 May 2011 (UTC)

Thanks, Dr. Burdo! "Category" wasn't the right word to use in that sentence so I changed it to "variety." I also took out some of the eye abnormality symptoms in the introduction and left only nystagmus, which seemed to be the primary eye-related symptom based on the research, and two other more prevalent symptoms. The first few sentences in the management section seem like they are unrelated to the title of the article cited (reference #2) but I just looked back at that source and that is where we got the information. In the first few paragraphs of the article the authors discuss the general experiences of patients including symptoms, attack triggers, and alleviation mechanisms. Hope that's sufficient! MKMurphy (talk) 03:35, 10 May 2011 (UTC)