# Developing robust treatment options for Mal de Débarquement Syndrome

> **NIH NIH R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2022 · $527,187

## Abstract

ABSTRACT: Mal de Débarquement Syndrome (MdDS) is an under-recognized but nevertheless common
balance disorder, which in most cases occurs after exposure to prolonged passive motion. MdDS, a chronic
illness that can last for many years, is manifested by persistent false sensations of rocking/swaying or
gravitational pull. MdDS is debilitating as these symptoms and signs are typically accompanied by other
presumably secondary physical, cognitive, and affective problems. In addition to motion-triggered (MT) cases,
the same or indistinguishable symptoms can occur without a specific trigger, identified as spontaneous-onset
(SO) MdDS. Treatment options for MdDS are limited, and it was only recently that a breakthrough was made in
our clinical laboratory with physiological readaptation of the vestibulo-ocular reflex (VOR). The premise of this
treatment is that MdDS is caused by maladaptation of a functional component of the VOR called velocity storage,
which shapes spatial orientation and the perception of self-motion. The treatment has been administered by
maneuvering the head of the patient seated inside a cylindrical chamber during a full-field optokinetic stimulation
(OKS). Our current success rates immediately after treatment of MT and SO MdDS are 75% and 50%,
respectively. A follow-up study indicated that the success rates later fluctuate as well as that a significant number
of patients remain sensitive to bright lights, movements of visual objects, and transportation, pointing to the
treatment method's limitations. A primary hurdle is access to the treatment. Full-field OKS requires a specialized
set-up in a dedicated room, making the treatment possible only in several laboratories around the world. We
recently successfully pilot tested the efficacy of virtual reality (VR) goggles for MdDS treatment with the
readaptation approach. In this proposed project, VR goggles will be tested on a larger group of patients, and the
effects will be compared to those of full-field OKS. If proven to be effective, MdDS can be treated locally to
patients in many vestibular therapy offices, not only for initial treatment but also for remedial or follow-up
treatment when symptoms return. This proposal also addresses the weaknesses of the VOR readaptation
approach by testing complementary approaches. We hypothesize that reducing (habituating) the velocity storage
capacity decreases sensitivity to physical movement and improves MdDS symptoms as well as limits symptom
recurrence. We further hypothesize that desensitization to visual stimuli can reduce visually induced dizziness
frequently observed in patients with MdDS. We will verify whether these complementary treatments will provide
a better outcome compared to the readaptation treatment by itself. Lastly, we hypothesize that OKS without head
motion can reduce the false sensation of gravitational pull commonly reported by MdDS patients. Two hundred
MdDS patients will be recruited for the study. Patients will be tre...

## Key facts

- **NIH application ID:** 10531023
- **Project number:** 1R01DC019928-01A1
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** SERGEI YAKUSHIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $527,187
- **Award type:** 1
- **Project period:** 2022-08-05 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10531023

## Citation

> US National Institutes of Health, RePORTER application 10531023, Developing robust treatment options for Mal de Débarquement Syndrome (1R01DC019928-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10531023. Licensed CC0.

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