Abstract Details

Title Repetitive Transcranial Magnetic Stimulation for Mal de Debarquement Syndrome

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P06 - (-)

Poster/Presentation
Number 011

Objective

Background BACKGROUND: Mal de debarquement syndrome (MdDS) is a chronic disorder of imbalance characterized by a feeling of rocking and swaying. The disorder starts after prolonged exposure to passive motion such as from a boat or plane. All medical treatment is palliative and symptoms that persist beyond six months show low likelihood of remission. New treatment options need to be explored.

Design/Methods DESIGN/METHODS: Ten subjects (8 women) with persistent MdDS lasting from 10 to 91 months were given one session each of four counterbalanced protocols: left 10Hz (high frequency), left 1Hz (low frequency), right 10Hz, and right 1Hz rTMS over the dorsolateral prefrontal cortex (DLPFC). The main outcome measure was the reduction of rocking sensation reported on a visual analogue scale.

Results RESULTS: 1) Right-handers improved most with 10Hz stimulation over the left DLPFC while left-handers improved most with 10Hz stimulation over the right DLPFC; 2) Low frequency DLPFC stimulation was associated with symptom worsening in some subjects; 3) Duration of symptoms was negatively correlated with treatment response; 4) rTMS was well-tolerated in MdDS subjects, showing similar rates of headache (10 of 40 sessions) as for other studies; 5) Fatigue occurred after six sessions usually with low frequency stimulation.

Conclusions CONCLUSIONS: rTMS was well-tolerated in subjects with MdDS with promising short-term symptom improvement. Future studies of rTMS in MdDS may consider sequential days of stimulation, longer post-rTMS observation periods, formal measurement of post-TMS fatigue, and randomization with a sham condition.

Authors/Disclosures
Yoon-Hee Cha, MD, FAAN (University of Minnesota) PRESENTER	The institution of Dr. Cha has received research support from Mal de Debarquement Balance Disorders Foundation. Dr. Cha has received research support from University of Minnesota. Dr. Cha has received research support from MNDrive.
	No disclosure on file
Robert W. Baloh, MD, FAAN	No disclosure on file
Salvatore DiMauro, MD (Columbia University Medical Center)	No disclosure on file
Salvatore DiMauro, MD (Columbia University Medical Center)	No disclosure on file
	No disclosure on file

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