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The purpose of investigation is to assess the levels of metabolic factors (hydroxyvitamin D, homocysteine) between patients with vestibular dysfunction of peripheral origin (BPPV) and central origin (vestibular migraine). Also we will analyse another factors (such as anxiety and depression) and optimize therapeuthical approach accordingly with the data.
Dizziness causes up to 2 to 15% of primary neurological complaints. In some patients who have undergone acute vertigo, postural instability, persistent postural perceptual vertigo (PPPV) develops, while in other similar cases occurs full recovery. So, it is necessary to search for neurophysiological, metabolic and psychophysiological factors and associated premorbid conditions that affect the outcome of neurovestibular compensation.
The case-control study will include 2 groups of patients suffering from vertigo of central and peripherial etiology. First group is recruited with patients were diagnosed with peripherial vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), Meniere disease, vestibular neuritis. The proposal number of subjects in the first group is about forty. The second group will consist of forty patients with central vestibular disfunction: vestibular migraine, central positional vertigo etc. The inclusion of patient with persistent postural perceptual dizziness is discussed. Patients will be tested for hydroxyvitamin D and homocysteine in serum using an enzyme-linked immunosorbent assay (ELISA). The perception of the severity of disability was assessed using the Dizziness scale Handicap Inventory (DHI). All patients will undergo psychological test, including tas-26 scale, Beck's Depression Inventory, Spielberg-Hanin'sscale. Statistical analysis was carried out with the Statistical Analysis System (SAS) package. The relationships will be assessed using the chi squared test and logistic regression. The level of significance is set at p < 0.05. The methods for small samples (Mann-Whitney U ) will be used. It is presumed that differences in vitamin D levels beetween two groups will be considerable.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients with peripherial vestibular disorder | Forty patients with BPPV, vestibular neuritis or another peripherial vestibular disorder |
| |
| patients with central vestibular disorder | Forty patients vestibular disorder of central origin |
| |
| healthy controls | twenty healthy control without balance problems |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| diagnostic blood test | Diagnostic Test | vitamin D deficiency/insufficiency reveal, hyperhomocysteinaemia reveal |
|
| Measure | Description | Time Frame |
|---|---|---|
| vitamin D deficiency/insufficiency reveal | enzyme-linked immunosorbent assay (ELISA). | Through 1-6 months of diagnosis established. |
| hyperhomocysteinaemia reveal | enzyme-linked immunosorbent assay (ELISA). | Through 1-6 months of diagnosis established. |
| Measure | Description | Time Frame |
|---|---|---|
| correlation between metabolic and neuropsychological disorders | neuropsychological test, including tas-26 scale, Beck's Depression Inventory, Spielberg-Hanin'scale. | through study completion, an average of 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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patients from clinic with damage of peripheral and central origin
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ludmila Antonenko, professor | Contact | 89265774431 | luda6917@yandex.ru | |
| Anna Bedenko, PhD student | Contact | 89164989851 | mailanna91@yandex.ru |
| Name | Affiliation | Role |
|---|---|---|
| Anna Bedenko, PhD student | I.M. Sechenov First Moscow State Medical University (Sechenov University) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinic of Neurology and Neurosurgery of I.M. Sechenov First Moscow State Medical University (Sechenov University) | Recruiting | Moscow | Russia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Bedenko A.S., Antonenko L.М., Barinov A.N. Metabolic disorders in the pathogenesis of various causes of dizziness and instability // Annals of the Russian academy of medical sciences. - 2020. - Vol. 75. - N. 6. - P. 605-608. doi: 10.15690/vramn1244 | ||
| Background | Bedenko A.S. Vertigo in neurological practice: rare causes and difficult decisions. Medical alphabet. 2019;2(19):34-36. (In Russ.) https://doi.org/10.33667/2078-5631-2019-2-19(394)-34-36 | ||
| Background | Bedenko A.S. Metabolic factors in pathogenesis of migraine and unsteadiness. Medical alphabet. 2020;(33):18-20. (In Russ.) https://doi.org/10.33667/2078-5631-2020-33-18-20 | ||
| Result | Bedenko A.S. Vertigo caused by vestibular migraine: current problems of pathogenesis, diagnostics and therapy. Epilepsy and paroxysmal conditions. 2020;12(3):177-181. (In Russ.)https://doi.org/10.17749/2077-8333/epi.par.con.2020.032 |
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I give my consent to provide actual study protocol. However, It is impossible to provide stastistical documents and primary patient's documentation (It is forbidden by Local Ethic Committee of Sechenov University)
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| ID | Term |
|---|---|
| D065635 | Benign Paroxysmal Positional Vertigo |
| D020338 | Vestibular Neuronitis |
| D008575 | Meniere Disease |
| D014808 | Vitamin D Deficiency |
| D020138 | Hyperhomocysteinemia |
| ID | Term |
|---|---|
| D014717 | Vertigo |
| D015837 | Vestibular Diseases |
| D007759 | Labyrinth Diseases |
| D004427 | Ear Diseases |
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| neuropsychological test | Diagnostic Test | neuropsychological test, including tas-26 scale, Beck's Depression Inventory, Spielberg-Hanin'scale. |
|
| D010038 |
| Otorhinolaryngologic Diseases |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000160 | Vestibulocochlear Nerve Diseases |
| D012181 | Retrocochlear Diseases |
| D003389 | Cranial Nerve Diseases |
| D018159 | Endolymphatic Hydrops |
| D001361 | Avitaminosis |
| D003677 | Deficiency Diseases |
| D044342 | Malnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D000592 | Amino Acid Metabolism, Inborn Errors |
| D008661 | Metabolism, Inborn Errors |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008286 | Malabsorption Syndromes |
| D008659 | Metabolic Diseases |
| D014804 | Vitamin B Deficiency |