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BCM - Baylor College of Medicine

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Center for Balance Disorders

Clinical Research

The Center for Balance Disorders conducts clinical research in order to study and evaluate the function of the vestibular system. Some of our grants have been funded by:

  • The Clayton Foundation for Research
  • National Institutes of Health National Institute on Deafness and Other Communication Disorders and National Eye Institute
  • National Aeronautics and Space Administration
  • National Space Biomedical Research Institute
  • The American Occupational Therapy Foundation

Treatments for Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo is the most common vestibular disorder. Patients with this problem complain of vertigo elicited by various head rotations. It can be disorienting, somewhat disabling, and can interfere with sleep and driving skills. Studies have been performed at the Center for Balance Disorders to consider the effectiveness of various treatments and the influence of symptoms such as rhinosinusitis.

Cohen HS, Sangi-Haghpeykar H. Nystagmus parameters and subtypes of benign paroxysmal positional vertigo. Acta Otolaryngol. 2010 Sep;130(9):1019-23.

Cohen HS, Sangi-Haghpeykar H. Canalith repositioning variations for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2010 Sep;143(3):405-12.

Cohen HS, Stewart MG, Brissett AE, Olson KL, Takashima M, Sangi-Haghpeykar H. Frequency of sinus disease in normal subjects and patients with benign paroxysmal positional vertigo. ORL J Otorhinolaryngol Relat Spec. 2010;72(1):63-7.

Lawson J, Bamiou DE, Cohen HS, Newton J. Positional vertigo in a Falls Service. Age Ageing. 2008 Sep;37(5):585-9.

Cohen HS, Murphy EK. An augmented liberatory maneuver for benign paroxysmal positional vertigo for patients who are difficult to move. Otolaryngol Head Neck Surg. 2007 Feb;136(2):309-10.

Cohen HS, Kimball KT. Response characteristics of nystagmus elicited by the Dix-Hallpike maneuver in canalithiasis and cupulolithiasis subtypes of benign paroxysmal positional vertigo. Abstracts of the Association for Research in Otolaryngology Midwinter Meeting, 2005.

Cohen HS, Kimball KT. Effectiveness of treatments for benign paroxysmal positional vertigo of the posterior canal. Otol Neurotol. 2005 Sep;26(5):1034-40.

Cohen HS, Kimball KT. Treatment variations on the Epley maneuver for benign paroxysmal positional vertigo. Am J Otolaryngol. 2004 Jan-Feb;25(1):33-7.

Cohen HS. Side-lying as an alternative to the Dix-Hallpike test of the posterior canal. Otol Neurotol. 2004 Mar;25(2):130-4.

Cohen HS, Kimball KT, Stewart MG. Benign paroxysmal positional vertigo and comorbid conditions. ORL J Otorhinolaryngol Relat Spec. 2004;66(1):11-5.

Cohen HS, Jerabek J. Efficacy of treatments for posterior canal benign paroxysmal positional vertigo. Laryngoscope. 1999 Apr;109(4):584-90.

Management of Adaptation to Altered Sensorimotor States

Research at the Center for Balance Disorders involves collaborative studies with NASA (NSBRI) to improve balance adaptation times of astronauts in space and upon returning to earth.

Mulavara AP, Feiveson AH, Fiedler J, Cohen H, Peters BT, Miller C, Brady R, Bloomberg JJ. Locomotor function after long-duration space flight: effects and motor learning during recovery. Exp Brain Res. 2010 May;202(3):649-59.

Roller CA, Cohen HS, Bloomberg JJ, Mulavara AP. Improvement of obstacle avoidance on a compliant surface during transfer to a novel visual task after variable practice under unusual visual conditions. Percept Mot Skills. 2009 Feb;108(1):173-80.

Mulavara AP, Cohen HS, Bloomberg JJ. Critical features of training that facilitate adaptive generalization of over ground locomotion. Gait Posture. 2009 Feb;29(2):242-8.

Buccello-Stout RR, Bloomberg JJ, Cohen HS, Whorton EB, Weaver GD, Cromwell RL. Effects of sensorimotor adaptation training on functional mobility in older adults. J Gerontol B Psychol Sci Soc Sci. 2008 Sep;63(5):P295-300.

Cohen HS, Bloomberg JJ. Modified dynamic visual acuity tests after acoustic neuroma resection. Acta Otolaryngol. 2007 Aug;127(8):825-8.

Moore ST, MacDougall HG, Peters BT, Bloomberg JJ, Curthoys IS, Cohen HS. Modeling locomotor dysfunction following spaceflight with Galvanic vestibular stimulation. Exp Brain Res. 2006 Oct;174(4):647-59.

Gottshall KR, Hoffer ME, Cohen HS, Moore RJ. Active head movements facilitate compensation for effects of prism displacement on dynamic gait. J Vestib Res. 2006;16(1-2):29-33.

Cohen HS, Bloomberg JJ, Mulavara AP. Obstacle avoidance in novel visual environments improved by variable practice training. Percept Mot Skills. 2005 Dec;101(3):853-61.

Cohen HS. Update on the status of rehabilitative countermeasures to ameliorate the effects of long-duration exposure to microgravity on vestibular and sensorimotor function. J Vestib Res. 2003;13(4-6):405-9.

Cohen HS, Bloomberg JJ, Mulavara A, Roller CA. Variable practice to facilitate motor learning for countermeasures. Abstracts: 6th 338 NASA Symposium on The Role of the Vestibular Organs in the Exploration of Space, Portland, Oregon. J Vestib Res. 2002;11(3-5):405-9:337-8.

Rehabilitation Paradigms for Chronic Vertigo

The effectiveness of structured exercise was studied to see if vertigo decreased, postural control improved, and essential life tasks could be performed more independently.

Cohen HS, Bloomberg JJ. Modified dynamic visual acuity tests after acoustic neuroma resection. Acta Otolaryngol. 2007 Aug;127(8):825-8.

Cohen HS, Murphy EK. An augmented liberatory maneuver for benign paroxysmal positional vertigo for patients who are difficult to move. Otolaryngol Head Neck Surg. 2007 Feb;136(2):309-10.

Cohen HS. Disability and rehabilitation in the dizzy patient. Curr Opin Neurol. 2006 Feb;19(1):49-54.

Cohen HS. (2005) Disability in vestibular disorders. In: Herdman, SJ (Ed.). Vestibular Rehabilitation, 3rd edition. Philadelphia: Davis.

Cohen HS, Kimball KT. Decreased ataxia and improved balance after vestibular rehabilitation. Otolaryngol Head Neck Surg. 2004 Apr;130(4):418-25.

Cohen HS, Kimball KT. Changes in a repetitive head movement task after vestibular rehabilitation. Clin Rehabil. 2004 Mar;18(2):125-31.

Cohen HS. (2004) Vestibular rehabilitation and stroke. In Gillen G and Burkhardt A (Eds.). Stroke Rehabilitation: A Function-Based Approach. 2nd edition, pp. 164-71. St. Louis: Mosby.

Cohen HS, Kimball KT. Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngol Head Neck Surg. 2003 Jan;128(1):60-70.

Cohen HS, Wells J, Kimball KT, Owsley C. Driving disability and dizziness. J Safety Res. 2003;34(4):361-9.

Cohen HS, Kimball KT. Improvements in path integration after vestibular rehabilitation. J Vestib Res. 2002;12(1):47-51.

Cohen HS. Specialized knowledge and skills in adult vestibular rehabilitation for occupational therapy practice. Am J Occup Ther. 2001 Nov-Dec;55(6):661-5.

Cohen HS. Vestibular disorders and impaired path integration along a linear trajectory. J Vestib Res. 2000;10(1):7-15.

Cohen HS, Kimball KT. Development of the vestibular disorders activities of daily living scale. Arch Otolaryngol Head Neck Surg. 2000 Jul;126(7):881-7.

Cohen HS, Kimball KT, Adams AS. Application of the vestibular disorders activities of daily living scale. Laryngoscope. 2000 Jul;110(7):1204-9.

Cohen HS, Gavia JA. A task for assessing vertigo elicited by repetitive head movements. Am J Occup Ther. 1998 Sep;52(8):644-9.

Cohen H, Kane-Wineland M, Miller LV, Hatfield CL. Occupation and visual/vestibular interaction in vestibular rehabilitation. Otolaryngol Head Neck Surg. 1995 Apr;112(4):526-32.

Cohen H. Defining disablement in otolaryngology. Ear Nose Throat J. 1995 Apr;74(4):233-7.

Vestibular Evoked Myogenic Potentials

Bithermal caloric tests and rotary chair (RC) testing assess lateral semicircular canal function, and are the most commonly used vestibular function tests, but these tests do not give a complete picture, as they generally evaluate superior vestibular nerve function. Vestibular evoked myogenic potentials (VEMP) measure saccule/inferior vestibular nerve function and may be particularly important for generation of postural responses and vertical vestibulo-ocular reflex generated during head motion.

Isaacson B, Murphy E, Cohen H. Does the method of sternocleidomastoid muscle activation affect the vestibular evoked myogenic potential response? J Vestib Res. 2006;16(4-5):187-91.

Epidemiologic Testing for Vestibular and Balance Disorders

Cohen HS, Kimball KT. Usefulness of some current balance tests for identifying individuals with disequilibrium due to vestibular impairments. J Vestib Res. 2008;18(5-6):295-303.

Other Clinical Research

Cohen HS, Sangi-Haghpeykar H. Walking speed and vestibular disorders in a path integration task. Gait Posture. 2011 Feb;33(2):211-3.

Roberts JC, Cohen HS, Sangi-Haghpeykar H. Vestibular disorders and dual task performance: impairment when walking a straight path. J Vestib Res. 2011;21(3):167-74.

Cohen HS, Gottshall KR, Graziano M, Malmstrom EM, Sharpe MH. International survey of vestibular rehabilitation therapists by the Barany Society Ad Hoc Committee on Vestibular Rehabilitation Therapy. J Vestib Res. 2009;19(1-2):15-20.

Murphy EK. Modifications in infrared intraoperative neuromonitoring camera and supports. Am J Electroneurodiagnostic Technol. 2008 Sep;48(3):209-11.

Murphy EK. Use of an infrared camera to improve the outcome of facial nerve monitoring. Am J Electroneurodiagnostic Technol. 2008 Mar;48(1):38-47.

Moore ST, MacDougall HG, Gracies JM, Cohen HS, Ondo WG. Long-term monitoring of gait in Parkinson's disease. Gait Posture. 2007 Jul;26(2):200-7.

Ondo WG, Almaguer M, Cohen H. Computerized posturography balance assessment of patients with bilateral ventralis intermedius nuclei deep brain stimulation. Mov Disord. 2006 Dec;21(12):2243-7.