Novel Approaches general panel discussion

We propose a hypothesis-generating observational study that explores the relationship between obsessive-compulsive (OC) personality traits and the severity of vertigo-related anxiety in patients with common peripheral vestibular disorders. Despite similar vestibular test results, some patients report disabling dizziness, while others cope more easily — suggesting that psychological traits may act as symptom amplifiers. This proposed study will include patients diagnosed with BPPV, vestibular neuritis, or Menière’s disease. Each participant will complete validated instruments including the Vertigo Handicap Inventory (VHI), the Generalized Anxiety Disorder-7 (GAD-7) scale, and the Obsessive-Compulsive Inventory-Revised (OCI-R). We will analyze the correlation between obsessive-compulsive traits and reported anxiety intensity, adjusting for diagnosis and vestibular dysfunction severity. We believe that identifying psychological vulnerability in vestibular patients can lead to earlier, individualized management strategies — including integration of cognitive-behavioral therapy in selected cases.

We will introduce the latest findings from clinical research on Meniere's disease and benign paroxysmal positional vertigo, as well as the latest findings from basic research on hair cells in the otolith organs

Meniere disease

Vertiginous symptoms in patients with Meniere's disease (MD) are weather-related. Endolymphatic hydrops (EH) have been thought to be the pathological basis of MD. Endolymphatic space (ELS) volume can be evaluated using three-dimensional analysis of 3-Tesla magnetic resonance imaging after intravenous injection of gadolinium enhancement. In patients with developed MD (average hearing levels in the affected ear of 40-70 dB), a significant negative correlation was found between atmospheric pressure change and vestibular ELS rate on the affected side. Negative atmospheric pressure changes may influence vestibular ELS volume in patients with moderate hearing impairment

Benign paroxysmal positional vertigo (BPPV)

Posterior canal-type benign paroxysmal positional vertigo (pc-BPPV) is diagnosed when positional torsional nystagmus is induced by the Dix-Hallpike test (DHT). When the DHT is repeated, positional nystagmus disappears. This phenomenon is known as BPPV fatigue. In cases where positional nystagmus cannot be induced by the DHT because of BPPV fatigue occurring just before a medical examination, or where positional nystagmus is not observed during the first DHT, we cannot make a diagnosis of pc-BPPV because the DHT can no longer induce the positional nystagmus typical of pc-BPPV. We have succeeded to develop a new maneuver to rapidly restore positional nystagmus in cases of BPPV fatigue, thereby facilitating accurate diagnosis

Modulation of the physiological function of hair cells in saccule

We investigate the influence of myosin regulatory light chain and myosin light chain kinase on the physiological function of inner ear hair cells. We confirmed the expression of NM2A/B and MYL9 on the apical surfaces of hair cells and of NM2A and MYL12A in hair bundles. We found that NM2 and MLCK inhibitors reduce the stiffness of hair bundles from the bullfrog's saccule. Moreover, MLCK inhibition inhibits the spontaneous oscillation of hair bundles and increases the resting open probability of transduction channels. In addition, MLCK inhibition elevates hearing thresholds in mice. We conclude that NM2 and the phosphorylation of RLC modulate the physiological function of hair cells and thereby help to set the normal operating conditions of hair bundles.