Symptom reduction in mal de débarquement syndrome with attenuation of the velocity storage contribution in the central vestibular pathways.
Jun Maruta, Catherine Cho, Theodore Raphan and 1 others
PMID 38486679WHAT IT FOUND
Both programmes reduced symptoms in many people with mal de débarquement at first, but readaptation relapsed more often.
The visual-vestibular conflict programme helped fewer initially yet appeared more durable over months.
Key findings
01In the velocity storage attenuation group, 10 of 23 reported immediate reduction by more than half, a 43% success rate described as above chance.
02In the VOR readaptation group, 16 of 20 reported immediate reduction by more than half, but only five of these 16 maintained that benefit through six months.
03In the attenuation group, none of the 10 with initial success rebounded to pre-treatment level at two weeks, despite all being exposed to prolonged passive motion on travel home.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study analysed 43 participants, and two Group 2 subjects dropped out by failing to participate in follow-up, so it is small and may not represent broader practice. Both groups received active treatment, so the study did not test either regimen against no treatment, and the authors could not completely rule out placebo effects. The primary symptom outcome was a single self-rated 0 to 10 scale intended to compare changes within a person, not to compare severity between people. Eye movement data were missing for several participants because of claustrophobia or equipment malfunction, and velocity storage was tested only during laboratory visits, so retention of physiological changes is unknown. The attenuation protocol required up to five days in a specialized laboratory, and some participants could not tolerate the intended speed or brightness. The two groups were not balanced on one pre-treatment eye movement measure, g1, although the authors focused on within-group changes.
Declared interests
The study was supported by NIH NIDCD grants R21DC018390 and R01DC019928.
The easy way to misread this
Do not conclude that the attenuation programme is an established treatment for mal de débarquement. It was a small exploratory study, both groups received active treatment, so the study did not test either regimen against no treatment, and the authors could not completely rule out placebo effects.