Dizziness Due to Visual Stimuli in Patients With Concussion and Other Causes of Dizziness: Examination of Balance Behaviour
Visually Induced Dizziness in Concussed and Non-Concussed Dizzy Patients: Identifying the Pathophysiology of Postural Control Upon Optokinetic Stimuli
Dominik Straumann
240 participants
May 14, 2025
INTERVENTIONAL
Conditions
Summary
This research project aims to measure how balance is affected by special visual stimulation. Dizziness caused by complex moving visual patterns, known as optokinetic stimulation, is usually called visually induced dizziness (VID). The study includes patients with persistent symptoms after a concussion and those with non-traumatic dizziness. Healthy participants serve as a control group for the comparison of balance and symptom responses. The optokinetic stimulation is done using either a physical rotating disk or a virtual reality (VR) headset. The visual effects are created by bright moving dots. During the stimulation, these patterns move in a specific manner and directions while the subject's balance is recorded. Symptoms such as dizziness, headache, and nausea are also documented. The goal of this project is to improve objective diagnosis of VID. By comparing patients and healthy subjects, the study aim to assess the severity of the disorder. It is also assumed that using different visual stimuli during the balance assessment will offer more sensitive and accurate results. In the long term, this innovative assessment method shall support clinicians to establish the diagnosis of VID, and improve the treatment and management of patients with VID.
Eligibility
Inclusion Criteria5
- Age between 18 and 60 years
- Binocular vision
- Recent concussion/mTBI within 4 weeks to 18 months post-injury for concussed patients
- Diagnosis related to dizziness or VID within 4 weeks to 18 months for non-concussed dizzy patients (including vestibular migraine)
- Signed ICF for included participants or signed general consent for retrospectively included patients if an ICF cannot be obtained.
Exclusion Criteria14
- BMI greater than 30
- Acute vestibular syndrome lasting at least 24 hours
- Severe non-correctable visual impairment
- Balance issues not dizziness-related, including:
- Neurological conditions (e.g., migraine)
- Orthopaedic conditions (e.g., lower extremity injury)
- Infectious diseases
- Other medical contexts
- Dizziness attributed to prescribed drugs, substance abuse, or mental disorders
- Cognitive impairments compromising task comprehension
- Preceding history of traumatic brain injury in the last 12 months
- History of severe traumatic brain injury with persisting impairments
- Other potentially confounding problems (e.g., psychiatric disease)
- Frequent episodes of rotatory vertigo
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Interventions
The physical optokinetic stimulation consists of rotating stimulation in either direction using a physical disc (de Vestel, et al., 2022; Guerraz et al., 2001; van Ombergen et al., 2016). The assessment is conducted in complete dark, unless the fluorescent dots (approx. 11% covered of the disc area.). The disc has a diameter of 1 m. Stimulation time per trial will be 30 s.
The virtual optokinetic stimulation is implemented in virtual reality goggles (Meta Quest 3, Meta Platforms, Menlo Park, CA, USA) applying oscillating and rotating stimulation in frontal and vertical axis with coherent or incoherent stimuli. The assessment in the virtual environment will be as similar as possible compared the physical stimulation. Hence, the virtual environment simulation complete dark, unless the fluorescent dots (approx. 15% covered of the disc area.). In addition to the rotating condition, the virtual dots are able to oscillate on the horizontal or vertical axis to create a more sensitive evaluation method than the physical one (Laurens et al., 2011). Stimulation time per trial will be 30 s.
Locations(2)
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NCT06893029