As the issue of diagnosing central causes of vertigo and dizziness has become “primetime”, with new diagnostic algorithms such as Hints and Hints plus, and new technologies such as quantitative remote VOG, it seems time to evaluate these “game-changers” with objective and rigorous research. What does and does not change outcomes? We need to test the old and to develop new diagnostic algorithms for vestibular diagnosis. Technology, including devices and software analysis packages, and training of technicians in proper use and physicians in proper interpretation of vestibular function tests, need to be vetted and their drawbacks acknowledged and improved upon.
Treating vertigo and dizziness, and especially those from central causes, remains empirical and anecdotal, with a lack of controlled trials. New technologies, such as transcranial magnetic stimulation, and virtual reality have potential, but are still largely experimental and unproven. Similar considerations apply to medications and programs of physical therapy. What really works? Genetics and epigenetics, and individualized precision medicine have made great progress, yet have been barely applied to the disabled vestibular patient. Pharmacological approaches based on contemporary ion channel and synaptic physiology, have yet to realize their great potential to make treatment more rationale.
Finally, not to be forgotten are the advances in understanding of the perceptual and cognitive accompaniments, including the psychiatric morbidities, that are related to vestibular disorders. What we previously identified as a relatively small area of the brain called vestibular cortex has enlarged, especially due to new functional imaging techniques, to encompass almost the entire cerebral hemispheres. How can this expanded concept of cognitive and perceptual circuits related to vestibular function be applied to the clinic?
Many questions remain unanswered about causes and treatment of central dizziness and vertigo, but many new technologies and conceptual approaches are waiting to be applied to vestibular disorders. They require imaginative and rigorous quantitative research.
Thus, topic editors will welcome any types of manuscripts - research article, brief research article, review, and mini-review - about, but not limited to the following themes:
• Newly defined central vertigo and ocular motor syndromes
• Cognitive and perceptual aspects of central vestibular disorders
• Genetics of central vertigo and dizziness
• Pharmacophysiology of central vertigo and dizziness
• Mechanisms of central ocular motor abnormalities
• Imaging and early diagnosis of vascular insufficiency and stroke in the acutely dizzy patients
• Role of machine learning and artificial intelligence in the diagnosis of central causes of vertigo and dizziness
• Management of central vertigo and ocular motor dysfunction
• Emerging treatments for central vertigo and abnormal ocular motility
As the issue of diagnosing central causes of vertigo and dizziness has become “primetime”, with new diagnostic algorithms such as Hints and Hints plus, and new technologies such as quantitative remote VOG, it seems time to evaluate these “game-changers” with objective and rigorous research. What does and does not change outcomes? We need to test the old and to develop new diagnostic algorithms for vestibular diagnosis. Technology, including devices and software analysis packages, and training of technicians in proper use and physicians in proper interpretation of vestibular function tests, need to be vetted and their drawbacks acknowledged and improved upon.
Treating vertigo and dizziness, and especially those from central causes, remains empirical and anecdotal, with a lack of controlled trials. New technologies, such as transcranial magnetic stimulation, and virtual reality have potential, but are still largely experimental and unproven. Similar considerations apply to medications and programs of physical therapy. What really works? Genetics and epigenetics, and individualized precision medicine have made great progress, yet have been barely applied to the disabled vestibular patient. Pharmacological approaches based on contemporary ion channel and synaptic physiology, have yet to realize their great potential to make treatment more rationale.
Finally, not to be forgotten are the advances in understanding of the perceptual and cognitive accompaniments, including the psychiatric morbidities, that are related to vestibular disorders. What we previously identified as a relatively small area of the brain called vestibular cortex has enlarged, especially due to new functional imaging techniques, to encompass almost the entire cerebral hemispheres. How can this expanded concept of cognitive and perceptual circuits related to vestibular function be applied to the clinic?
Many questions remain unanswered about causes and treatment of central dizziness and vertigo, but many new technologies and conceptual approaches are waiting to be applied to vestibular disorders. They require imaginative and rigorous quantitative research.
Thus, topic editors will welcome any types of manuscripts - research article, brief research article, review, and mini-review - about, but not limited to the following themes:
• Newly defined central vertigo and ocular motor syndromes
• Cognitive and perceptual aspects of central vestibular disorders
• Genetics of central vertigo and dizziness
• Pharmacophysiology of central vertigo and dizziness
• Mechanisms of central ocular motor abnormalities
• Imaging and early diagnosis of vascular insufficiency and stroke in the acutely dizzy patients
• Role of machine learning and artificial intelligence in the diagnosis of central causes of vertigo and dizziness
• Management of central vertigo and ocular motor dysfunction
• Emerging treatments for central vertigo and abnormal ocular motility