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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