VOR Precision Training for Vestibular Disorders

Age: Any Age
Sex: Any
Trial Phase: Academic
Sponsor: Massachusetts Eye and Ear Infirmary
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how noise affects balance and movement in individuals with vestibular disorders and examines whether the brain can improve balance signals through VOR precision training, a specialized therapy. It targets those with peripheral vestibular damage, such as from vestibular schwannoma (a type of tumor affecting balance nerves), and tests them before and after surgery. Healthy individuals with no history of balance or ear problems participate as a comparison group. Suitable candidates include patients with specific vestibular damage, like vestibular schwannoma, or individuals without any prior inner ear or neurological issues. As an unphased trial, this study provides a unique opportunity to contribute to foundational research that may lead to new therapies for vestibular disorders.

Will I have to stop taking my current medications?

If you are taking vestibular suppressant medications like benzodiazepines, antihistamines, or anticholinergics, you will need to stop taking them to participate in this trial.

What prior data suggests that VOR precision training is safe for vestibular disorders?

Research has shown that VOR precision training, which aids balance and eye movements, is generally well-tolerated. Some studies suggest that after five weeks of similar training, participants experience improved balance and eye control without major side effects. Other findings indicate that VOR precision improves with training over time, and this improvement is expected to be safe.

As this trial is in an early stage, it primarily examines how well the brain can adapt to enhance balance and eye coordination. While detailed safety data is still limited, early-stage trials typically continue to gather this information. Overall, initial research suggests the training is likely safe, but discussing the most current details with the trial team is advisable.12345

Why are researchers excited about this trial?

Researchers are excited about VOR precision training for vestibular disorders because it offers a new way to improve balance and dizziness issues by focusing on precision eye movement exercises. Unlike traditional treatments that might rely on medication or physical therapy to broadly address symptoms, this method specifically targets the vestibulo-ocular reflex (VOR), which is crucial for maintaining stable vision during head movements. By training the VOR directly, this approach has the potential to offer more targeted and effective symptom relief, particularly for patients with specific types of vestibular damage.

What evidence suggests that VOR precision training is effective for vestibular disorders?

Research has shown that VOR precision training can improve balance and eye movement in people with inner ear disorders. In this trial, participants with peripheral vestibular dysfunction, including those with vestibular schwannoma, will undergo VOR precision training. One study found that balance problems in patients with vestibular schwannoma (a type of ear tumor) are linked to the effectiveness of their VOR (Vestibulo-Ocular Reflex). This reflex helps maintain steady vision during head movements. Early results suggest that training enhances VOR precision, potentially leading to better balance and reduced dizziness. This improvement is expected to be noticeable compared to their abilities before training.23678

Are You a Good Fit for This Trial?

This trial is for people with certain inner ear conditions like Vestibular Schwannoma, requiring surgery, or healthy individuals with normal vestibular function and hearing. Participants should not have other ear or neurological diseases (except migraines) and must not be taking medication that affects the vestibular system.

Inclusion Criteria

For healthy participants: normal results in a standard test for balance and dizziness.
You need to have a hearing test done for each ear if you have a vestibular schwannoma.
I have undergone tests to check my balance before surgery for a brain tumor.
See 6 more

Exclusion Criteria

I have a brain tumor affecting my hearing but no other ear or neurological conditions.
I have no history of ear or brain diseases.
I am not taking any medication for dizziness.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-operative Assessment

Assessment of vestibular precision in patients with vestibular schwannoma before surgery

Varies
1 visit (in-person)

Sub-acute Post-operative Assessment

Assessment of vestibular precision 6 weeks after vestibular nerve surgery

6 weeks
1 visit (in-person)

Chronic Post-operative Assessment

Assessment of vestibular precision 6 months after vestibular nerve surgery

6 months
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • VOR precision training
Trial Overview The study focuses on 'VOR precision training' to understand how noise impacts the balance system in both healthy subjects and those with vestibular damage. It aims to see if patients can learn to better recognize signals amidst this noise, potentially improving balance.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Peripheral Vestibular DysfunctionExperimental Treatment1 Intervention
Group II: Normal ControlsExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Massachusetts Eye and Ear Infirmary

Lead Sponsor

Trials
115
Recruited
15,000+

Published Research Related to This Trial

The incremental VOR adaptation (IVA) training method significantly improved the vestibulo-ocular reflex (VOR) gain in a 51-year-old male with bilateral vestibular hypofunction, showing improvements of 179% to 600% over 645 days of use.
In addition to enhancing VOR gain, the IVA method also led to improvements in standing posture and gait, indicating its potential effectiveness in rehabilitating individuals with severe vestibular issues.
VOR adaptation training and retention in a patient with profound bilateral vestibular hypofunction.Gimmon, Y., Migliaccio, AA., Kim, KJ., et al.[2020]
Vestibular rehabilitation therapy (VRT) is an effective exercise-based treatment that helps improve balance, reduce vertigo, and enhance daily activities for individuals with vestibular disorders, regardless of age or the cause of their symptoms.
Key exercises in VRT focus on head-eye movements and balance tasks, and even short, frequent sessions can significantly aid in vestibular recovery by promoting adaptation and substitution mechanisms.
Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises.Han, BI., Song, HS., Kim, JS.[2022]
Vestibular rehabilitation is an effective exercise-based program that has been shown to improve various symptoms related to vestibular disorders, including imbalance, dizziness, and anxiety, through a process called central compensation.
Recent advancements in techniques such as balance training, gaze stability training, and the use of virtual reality have enhanced the efficacy of vestibular rehabilitation, making it beneficial even for patients with chronic vestibular disorders.
Advances in Vestibular Rehabilitation.Sulway, S., Whitney, SL.[2019]

Citations

VOR Precision Training for Vestibular DisordersThis trial measures how accurately people can balance and move their eyes in response to motion, focusing on both healthy individuals and those with balance ...
Imbalance and dizziness caused by unilateral vestibular ...In this study, we show that the balance and perceptual dysfunction experienced by patients with VS scales with VOR metrics that capture information about the ...
Vestibular Precision: Physiology & PathophysiologyWe predict that VOR precision will gradually improve during training and that after training VOR precision will be better than the pre-training data. The ...
Imbalance and dizziness caused by unilateral vestibular ...In this study, we show that the balance and perceptual dysfunction experienced by patients with VS scales with VOR metrics that capture information about the ...
Changes in patient-perceived balance and vestibular ...Hearing outcomes are well-documented for patients with vestibular schwannoma (VS) treated with Gamma Knife stereotactic radiosurgery (GK-SRS).
Improvement After Vestibular Rehabilitation Not Explained by ...Our results suggest that 5 weeks of vestibular rehabilitation using gaze and gait stability exercises improves both subjective and behavioral performance
Effect of vestibular loss on head-on-trunk stability in ...Quantitative assessment of the vestibulo-ocular reflex (VOR) revealed a reduction in VOR gain for individuals with vestibular schwannoma ...
Vestibular Precision: Physiology and PathophysiologyAs secondary outcome measures, we will determine if training one behavior generalizes to the non-trained behavior and if patient's symptoms are affected by ...
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