The Clinical Trial Protocol: MRI Performance and Risk Factors of Bilateral Vestibular Hypofunction: A Multi-center Cross-sectional Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Dizziness Handicap Inventory
研究概览
简要总结
Bilateral vestibular hypofunction (BVH) is a chronic disorder in which the balance organs or vestibular pathways on both sides do not work normally. People with BVH may experience unsteadiness, blurred or unstable vision during head movement, difficulty walking, and an increased risk of falls. At present, there are limited targeted medical treatments, and the reasons why symptoms are severe in some patients but mild in others are not fully understood.
This prospective, multicenter, cross-sectional study will investigate the relationships among vestibular function, brain structure and function, blood biomarkers, patient-reported symptoms, and disease severity in people with BVH. The study will enroll approximately 120 participants from five medical centers in China, including about 80 patients with BVH and 40 age-matched healthy controls.
Participants will undergo vestibular function tests, including videonystagmography, caloric testing, sinusoidal harmonic acceleration testing, video head impulse testing, vestibular evoked myogenic potentials, and sensory organization testing. Brain imaging will include resting-state functional magnetic resonance imaging, diffusion tensor imaging, and diffusion kurtosis imaging. Participants will also complete questionnaires related to dizziness, anxiety and depression, daily activities, and symptom severity, and blood samples will be collected for biochemical and inflammatory marker testing.
The main hypothesis is that BVH severity is associated with measurable changes in vestibular function, brain functional connectivity and microstructure, inflammatory or metabolic biomarkers, and patient-reported quality of life. By combining clinical testing, neuroimaging, laboratory measures, and symptom scales, this study aims to improve understanding of the mechanisms of BVH and to support future development of more individualized diagnostic and rehabilitation strategies.
详细描述
This is a prospective, multicenter, cross-sectional observational study designed to investigate the clinical, vestibular, neuroimaging, biochemical, and patient-reported characteristics associated with bilateral vestibular hypofunction (BVH). The study will recruit patients with BVH and age-matched healthy controls from five medical centers in China. The planned total sample size is approximately 120 participants, including about 80 patients with BVH and 40 healthy controls.
The main objective of the study is to clarify the relationships among vestibular function, brain structure and function, biochemical variables, patient-reported symptoms, quality of life, and the severity of BVH. The study will also examine patterns of brain activity, functional connectivity, and diffusion-related microstructural changes using resting-state functional magnetic resonance imaging (rs-fMRI), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI). By integrating these assessments, the study aims to identify clinical and biological factors that may be associated with disease severity and functional impairment in BVH.
After providing written informed consent, eligible participants will undergo collection of demographic and clinical information, including age, sex, education, blood pressure, height, weight, and medical history. Participants will then complete a series of vestibular function assessments, neuroimaging examinations, clinical symptom scales, and laboratory tests. The study is observational and cross-sectional; no investigational drug, device, surgical procedure, or therapeutic intervention will be assigned as part of the study.
Vestibular function will be assessed using several complementary tests. Videonystagmography will be used to record and evaluate eye movements, including spontaneous nystagmus, gaze, saccade, and smooth pursuit eye movements. Caloric testing will be used to evaluate bilateral vestibular responsiveness and symmetry. Sinusoidal harmonic acceleration testing will assess vestibulo-ocular reflex performance during rotational stimulation. Video head impulse testing will assess dynamic semicircular canal function. Vestibular evoked myogenic potentials will be used to evaluate otolith-related vestibular function, and sensory organization testing will assess balance control under different sensory conditions.
Neuroimaging will include anatomical magnetic resonance imaging, resting-state functional magnetic resonance imaging, diffusion tensor imaging, and diffusion kurtosis imaging. During magnetic resonance imaging, participants will be instructed to remain still, relax, breathe steadily, keep their eyes closed while remaining awake, and avoid intentional cognitive tasks. Anatomical imaging will be used to screen for intracranial structural abnormalities. Resting-state functional magnetic resonance imaging will be used to examine spontaneous brain activity and functional connectivity. Diffusion tensor imaging and diffusion kurtosis imaging will be used to assess white matter integrity and microstructural tissue features.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 16 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Sex unrestricted, age over 16 years old.
- •Patients meeting the diagnostic criteria for bilateral vestibulopathy (BVP) and presbyvestibulopathy (PVP)
- •Participants or their legal representatives, who comprehensively understand the research purpose, demonstrate sufficient compliance with the study protocol, have the ability to communicate and cooperate, and have signed the informed consent form.
排除标准
- •Administration of medications potentially affecting cerebral function, including psychotropic drugs (antidepressants, anxiolytics) or prolonged anti-vertigo medication usage.
- •Presence of severe cardiovascular or systemic medical conditions, organ dysfunction, or significant mobility impairments.
- •Significant local or systemic diseases, or psychiatric disorders causing cognitive impairment, specifically schizophrenia, major depressive disorder, or generalized anxiety disorder.
- •Pregnant or lactating women.
- •Participation in alternative pharmaceutical or medical device clinical trials within the preceding 3-month period.
- •Clinically significant head movement restrictions.
- •Subjects assessed by investigators as unsuitable for study participation.
- •Individuals with contraindications for MRI, including cardiac pacemakers, implanted electronic devices, claustrophobia, metallic implants incompatible with magnetic resonance imaging and medications potentially compromising MRI scan safety.
结局指标
主要结局
Dizziness Handicap Inventory
时间窗: Within 1 month after enrollment
The Dizziness Handicap Inventory is a 25-item questionnaire used to assess perceived vestibular disability. Each item is scored using three response categories of 0, 2, or 4, with a total score ranging from 0 to 100; higher scores indicate greater dizziness-related handicap. Severity is categorized as mild 0-30, moderate 30-60, and severe 61-100.
次要结局
- Vestibular Disorders Activities of Daily Living Scale(Within 1 month after enrollment)
- Hospital Anxiety and Depression Scale(Within 1 month after enrollment)
- Visual Analog Scale(Within 1 month after enrollment)
- Video Head Impulse Test(Within 1 month after enrollment)
研究者
YUCHEN JIN
Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Shanghai 6th People's Hospital