Readaptation Treatment of Mal de Debarquement Syndrome With a Virtual Reality App: A Pilot Study.
Identifieur interne : 000016 ( Main/Corpus ); précédent : 000015; suivant : 000017Readaptation Treatment of Mal de Debarquement Syndrome With a Virtual Reality App: A Pilot Study.
Auteurs : Sergei B. Yakushin ; Reilly Zink ; Brian C. Clark ; Chang LiuSource :
- Frontiers in neurology [ 1664-2295 ] ; 2020.
Abstract
Mal de Debarquement syndrome (MdDS) is composed of constant phantom sensations of motion, which are frequently accompanied by increased sensitivity to light, inability to walk on a patterned floor, the sensation of ear fullness, head pressure, anxiety, and depression. This disabling condition generally occurs in premenopausal women within 2 days after prolonged passive motion (e.g., travel on a cruise ship, plane, or in a car). It has been previously hypothesized that MdDS is the result of maladaptive changes in the polysynaptic vestibulo-ocular reflex (VOR) pathway called velocity storage. Past research indicates that full-field optokinetic stimulation is an optimal way to activate velocity storage. Unfortunately, such devices are typically bulky and not commonly available. We questioned whether virtual reality (VR) goggles with a restricted visual field could effectively simulate a laboratory environment for MdDS treatment. A stripes program for optokinetic stimulation was implemented using Google Daydream Viewer. Five female patients (42 ± 10 years; range 26-50), whose average MdDS symptom duration was 2 months, participated in this study. Four patients had symptoms triggered by prolonged passive motion, and in one, symptoms spontaneously occurred. Symptom severity was self-scored by patients on a scale of 0-10, where 0 is no symptoms at all and 10 is the strongest symptoms that the patient could imagine. Static posturography was obtained to determine objective changes in body motion. The treatment was considered effective if the patient's subjective score improved by at least 50%. All five patients reported immediate improvement. On 2-month follow-ups, symptoms returned only in one patient. These data provide proof of concept for the limited-visual-field goggles potentially having clinical utility as a substitute for full-field optokinetic stimulation in treating patients with MdDS in clinics or via telemedicine.
DOI: 10.3389/fneur.2020.00814
PubMed: 33013617
PubMed Central: PMC7461907
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Readaptation Treatment of Mal de Debarquement Syndrome With a Virtual Reality App: A Pilot Study.</title><author><name sortKey="Yakushin, Sergei B" sort="Yakushin, Sergei B" uniqKey="Yakushin S" first="Sergei B" last="Yakushin">Sergei B. Yakushin</name><affiliation><nlm:affiliation>Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Zink, Reilly" sort="Zink, Reilly" uniqKey="Zink R" first="Reilly" last="Zink">Reilly Zink</name><affiliation><nlm:affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Electrical Engineering and Computer Science, Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Clark, Brian C" sort="Clark, Brian C" uniqKey="Clark B" first="Brian C" last="Clark">Brian C. Clark</name><affiliation><nlm:affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Biomedical Sciences, Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Chang" sort="Liu, Chang" uniqKey="Liu C" first="Chang" last="Liu">Chang Liu</name><affiliation><nlm:affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Electrical Engineering and Computer Science, Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33013617</idno><idno type="pmid">33013617</idno><idno type="doi">10.3389/fneur.2020.00814</idno><idno type="pmc">PMC7461907</idno><idno type="wicri:Area/Main/Corpus">000016</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000016</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Readaptation Treatment of Mal de Debarquement Syndrome With a Virtual Reality App: A Pilot Study.</title><author><name sortKey="Yakushin, Sergei B" sort="Yakushin, Sergei B" uniqKey="Yakushin S" first="Sergei B" last="Yakushin">Sergei B. Yakushin</name><affiliation><nlm:affiliation>Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Zink, Reilly" sort="Zink, Reilly" uniqKey="Zink R" first="Reilly" last="Zink">Reilly Zink</name><affiliation><nlm:affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Electrical Engineering and Computer Science, Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Clark, Brian C" sort="Clark, Brian C" uniqKey="Clark B" first="Brian C" last="Clark">Brian C. Clark</name><affiliation><nlm:affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Biomedical Sciences, Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Chang" sort="Liu, Chang" uniqKey="Liu C" first="Chang" last="Liu">Chang Liu</name><affiliation><nlm:affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Electrical Engineering and Computer Science, Ohio University, Athens, OH, United States.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Frontiers in neurology</title><idno type="ISSN">1664-2295</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Mal de Debarquement syndrome (MdDS) is composed of constant phantom sensations of motion, which are frequently accompanied by increased sensitivity to light, inability to walk on a patterned floor, the sensation of ear fullness, head pressure, anxiety, and depression. This disabling condition generally occurs in premenopausal women within 2 days after prolonged passive motion (e.g., travel on a cruise ship, plane, or in a car). It has been previously hypothesized that MdDS is the result of maladaptive changes in the polysynaptic vestibulo-ocular reflex (VOR) pathway called velocity storage. Past research indicates that full-field optokinetic stimulation is an optimal way to activate velocity storage. Unfortunately, such devices are typically bulky and not commonly available. We questioned whether virtual reality (VR) goggles with a restricted visual field could effectively simulate a laboratory environment for MdDS treatment. A stripes program for optokinetic stimulation was implemented using Google Daydream Viewer. Five female patients (42 ± 10 years; range 26-50), whose average MdDS symptom duration was 2 months, participated in this study. Four patients had symptoms triggered by prolonged passive motion, and in one, symptoms spontaneously occurred. Symptom severity was self-scored by patients on a scale of 0-10, where 0 is no symptoms at all and 10 is the strongest symptoms that the patient could imagine. Static posturography was obtained to determine objective changes in body motion. The treatment was considered effective if the patient's subjective score improved by at least 50%. All five patients reported immediate improvement. On 2-month follow-ups, symptoms returned only in one patient. These data provide proof of concept for the limited-visual-field goggles potentially having clinical utility as a substitute for full-field optokinetic stimulation in treating patients with MdDS in clinics or via telemedicine.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33013617</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>16</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1664-2295</ISSN><JournalIssue CitedMedium="Print"><Volume>11</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Frontiers in neurology</Title><ISOAbbreviation>Front Neurol</ISOAbbreviation></Journal><ArticleTitle>Readaptation Treatment of Mal de Debarquement Syndrome With a Virtual Reality App: A Pilot Study.</ArticleTitle><Pagination><MedlinePgn>814</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fneur.2020.00814</ELocationID><Abstract><AbstractText>Mal de Debarquement syndrome (MdDS) is composed of constant phantom sensations of motion, which are frequently accompanied by increased sensitivity to light, inability to walk on a patterned floor, the sensation of ear fullness, head pressure, anxiety, and depression. This disabling condition generally occurs in premenopausal women within 2 days after prolonged passive motion (e.g., travel on a cruise ship, plane, or in a car). It has been previously hypothesized that MdDS is the result of maladaptive changes in the polysynaptic vestibulo-ocular reflex (VOR) pathway called velocity storage. Past research indicates that full-field optokinetic stimulation is an optimal way to activate velocity storage. Unfortunately, such devices are typically bulky and not commonly available. We questioned whether virtual reality (VR) goggles with a restricted visual field could effectively simulate a laboratory environment for MdDS treatment. A stripes program for optokinetic stimulation was implemented using Google Daydream Viewer. Five female patients (42 ± 10 years; range 26-50), whose average MdDS symptom duration was 2 months, participated in this study. Four patients had symptoms triggered by prolonged passive motion, and in one, symptoms spontaneously occurred. Symptom severity was self-scored by patients on a scale of 0-10, where 0 is no symptoms at all and 10 is the strongest symptoms that the patient could imagine. Static posturography was obtained to determine objective changes in body motion. The treatment was considered effective if the patient's subjective score improved by at least 50%. All five patients reported immediate improvement. On 2-month follow-ups, symptoms returned only in one patient. These data provide proof of concept for the limited-visual-field goggles potentially having clinical utility as a substitute for full-field optokinetic stimulation in treating patients with MdDS in clinics or via telemedicine.</AbstractText><CopyrightInformation>Copyright © 2020 Yakushin, Zink, Clark and Liu.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Yakushin</LastName><ForeName>Sergei B</ForeName><Initials>SB</Initials><AffiliationInfo><Affiliation>Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zink</LastName><ForeName>Reilly</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Electrical Engineering and Computer Science, Ohio University, Athens, OH, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clark</LastName><ForeName>Brian C</ForeName><Initials>BC</Initials><AffiliationInfo><Affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Biomedical Sciences, Ohio University, Athens, OH, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Chang</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Electrical Engineering and Computer Science, Ohio University, Athens, OH, United States.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R21 DC018390</GrantID><Acronym>DC</Acronym><Agency>NIDCD NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Front Neurol</MedlineTA><NlmUniqueID>101546899</NlmUniqueID><ISSNLinking>1664-2295</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Mal de Debarquement syndrome</Keyword><Keyword MajorTopicYN="N">bobbing</Keyword><Keyword MajorTopicYN="N">readaptation</Keyword><Keyword MajorTopicYN="N">rocking</Keyword><Keyword MajorTopicYN="N">swaying</Keyword><Keyword MajorTopicYN="N">velocity storage</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>22</Day></PubMedPubDate><PubMedPubDate 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