Vestibular Balance Disorders (cont.)
What research is being done for balance disorders?
BPPV is the most common balance disorder. Because the source of the
problem—displaced otoconia—is located deep within the ear, doctors have had
to rely mainly on observation and a medical history to make a diagnosis.
Researchers supported by the National Institute on Deafness and Other
Communication Disorders (NIDCD) now have created a head-mounted apparatus
that uses 3-D animation to map the location of otoconia in the inner ear.
The apparatus is built around a pair of infrared video goggles that gather
data from eye and head movements and then sends it to a computer program for
mapping. A second computer program uses the data to develop a step-by-step
guide for repositioning maneuvers to dislodge the otoconia from the
semicircular canals. If shown to be effective in clinical trials, the
apparatus and its software programs will help doctors more accurately
diagnose BPPV and guide repositioning maneuvers to ensure the best possible
treatment.
Other NIDCD-supported scientists are looking at the molecular mechanisms
that regulate the development of the inner ear. One research team has
identified a gene that encodes a protein that helps in the formation of the
semicircular canals and their related sensory tissue. Another team has
identified a family of genes, called the otopetrins, which help form
otoconia in mice. Findings from the mouse study could help researchers
determine if otoconia destroyed by aging, medications, infections, or trauma
can someday be regenerated in humans with balance problems.
NIDCD-supported scientists also are experimenting with several types of
vestibular prostheses, or replacement parts, in balance-impaired animals.
Researchers hope these devices will one day be used to compensate for
vestibular system loss in people.
One prosthesis uses a head-mounted motion sensor to mimic the ear and
brain's natural signaling system. The sensor measures the head's rotation
and sends the information to a microprocessor. The microprocessor then
converts the signals into electrical impulses and sends them to an electrode
implanted in the ear. The electrode stimulates the vestibular nerve,
creating a signal that helps the brain move the eyes to compensate for the
head's rotation.
A second prosthesis is designed to simulate the movement of fluid within
the semicircular canal. In a normal ear, fluid changes help the brain
understand the movement and position of the head. The device combines
microcontroller circuitry with a tiny mechanical device that increases
normal fluid movement to provide a stronger vestibular signal to the brain.
Researchers also are studying the effectiveness of different types of
rehabilitative exercises as a treatment option for balance disorders. In one
NIDCD-funded study, researchers have used virtual reality technology to
simulate the aisles of a grocery store. Using a real cart attached to a
custom-built treadmill in front of a projection screen, patients “walk” down
aisles, scanning virtual store shelves for items on their list. Researchers
are testing whether practicing in the virtual store will lessen episodes of
dizziness in the real world, especially in visually complex environments.
SOURCE: National Institute on Deafness and Other Communication Disorders. Balance Disorders.
Last Editorial Review: 9/23/2011
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