# Sensory integration of auditory and visual cues in diverse contexts given age, vestibular hypofunction and hearing loss

> **NIH NIH R21** · NEW YORK UNIVERSITY · 2020 · $158,180

## Abstract

ABSTRACT
 More than 1/3 of adults in the United States seek medical attention for vestibular disorders and hearing
loss; disorders that can triple one’s fall risk and have a profound effect on one’s participation in activities of daily
living. Hearing loss has been shown to reduce balance performance and could be one modifiable risk factor for
falls. Patients with vestibular hypofunction tend to avoid busy, hectic, visually complex, and loud environments
because these environments provoke dizziness and imbalance. While the visual impact on balance is well
known, less is known about the importance of sounds for balance. In search for a possible mechanism to explain
a relationship between what we hear and balance control, some studies suggested that sounds may serve as
an auditory anchor, providing spatial cues for balance, similar to vision. However, the majority of these studies
tested healthy adults’ response to sounds with blocked visuals. It is also possible that a relationship between
hearing loss and balance problems is navigated via an undetected vestibular deficit. By understanding the role
of auditory input in balance control, we can be better equipped to help this large portion of the population who
seek medical attention for vestibular disorders and hearing loss. Therefore, there is a critical need for a
systematic investigation of balance performance in response to simultaneous visual and auditory perturbations,
similar to real-life situations.
 To answer this need, our team used recent advances in virtual reality technology and developed a Head
Mounted Display (HMD) protocol of immersive environments, combining specific manipulations of visuals and
sounds, including generated sounds (i.e., white noise) and real-world recorded sounds (e.g., a train approaching
a station). This research will answer the following questions: (1) Are sounds used for balance and if yes, via what
mechanism? (2) Do individuals with single-sided hearing loss have a balance problem even without any
vestibular issues? (3) Are those with vestibular loss destabilized by sounds? To address these questions, the
following specific aims will be investigated in individuals with unilateral peripheral vestibular hypofunction
(n=45), individuals with single-sided deafness (n=45), and age-matched controls (n=45): Aim 1: Establish the
role of generated and natural sounds in postural control in different visual environments; Aim 2: Determine the
extent to which a static white noise can improve balance within a dynamic visual environment. We expect to
clarify the role of sounds in the control of balance. This contribution will be significant because the mechanism
underlying possible link between hearing loss and falls needs to be better understood. Our work will inform the
development of improved balance assessments, specifically whether balance tests need to include postural
responses to sounds. Hearing status may need to be considered as a potential indicator of increased f...

## Key facts

- **NIH application ID:** 10046458
- **Project number:** 1R21DC018101-01A1
- **Recipient organization:** NEW YORK UNIVERSITY
- **Principal Investigator:** Anat Vilnai Lubetzky
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $158,180
- **Award type:** 1
- **Project period:** 2020-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10046458

## Citation

> US National Institutes of Health, RePORTER application 10046458, Sensory integration of auditory and visual cues in diverse contexts given age, vestibular hypofunction and hearing loss (1R21DC018101-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10046458. Licensed CC0.

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