protocolSection identificationModule nctId: NCT06370897, orgStudyIdInfo id: 337421, briefTitle: Prediction & Mechanisms of Recovery Following IEDS, statusModule overallStatus: NOT_YET_RECRUITING, startDateStruct date: 2024-04, primaryCompletionDateStruct date: 2028-04, completionDateStruct date: 2028-09, studyFirstPostDateStruct date: 2024-04-17, lastUpdatePostDateStruct date: 2024-04-17, sponsorCollaboratorsModule leadSponsor name: University of Plymouth, class: OTHER, descriptionModule briefSummary: Inner Ear Decompression sickness (IEDS) accounts for 20% of all types of decompression sickness (the bends) in divers. The condition commonly affects the peripheral vestibular system (inner ear). IEDS results in acute symptoms of dizzyness (vertigo) and imbalance. Even with the recommended treatment of hyperbaric oxygen therapy some people do not recovery fully. However, even in the presence of a permanent vestibular deficit many people can show a behavioural recovery where symptoms improve over time. Recovery can be aided by vestibular rehabilitation (VR) which is now routine for acute IEDS but was not provided before 2021, and is not widespread across the UK (United Kingdom) or world, meaning people may have a suboptimal recovery.This project will investigate if and how people recover after an acute episode of IEDS and whether people who had IEDS in the past show changes in the central (brain) processing of vestibular function and in symptoms of dizziness, balance and posture.This project has two main parts. Part one is a prospective observational study where people with an acute onset of IEDS are serially monitored while they are receiving hyperbaric treatment and VR over 10-14 days. Part two is a retrospective observational study where who have had IEDS in the past 15 years are re-assessed in a one-off session. The tests in both parts involve clinical tests and specialist eye movement recordings that assess vestibular function. We will also determine the site of any vestibular pathology by using selective stimulation of the vestibular end organ or nerve and assess whether there are any changes in how the structure and function of central vestibular pathways in the brain. In people with chronic IEDS with vestibular symptoms we will offer participants a course of VR over 12 weeks and assess whether this is associated with any improvement in symptoms., conditionsModule conditions: Decompression Sickness, designModule studyType: OBSERVATIONAL, designInfo observationalModel: COHORT, timePerspective: OTHER, enrollmentInfo count: 41, type: ESTIMATED, armsInterventionsModule, outcomesModule primaryOutcomes measure: Side of peripheral vestibular damage: Prospective cohort, primaryOutcomes measure: Site of peripheral vestibular damage: Prospective cohort, primaryOutcomes measure: Extent of peripheral vestibular damage: Prospective cohort, primaryOutcomes measure: Side of peripheral vestibular damage: Retrospective cohort, primaryOutcomes measure: Site of peripheral vestibular damage:Retrospective cohort, primaryOutcomes measure: Extent of peripheral vestibular damage:Retrospective cohort, secondaryOutcomes measure: VOR gain v HIT: Prospective Study, secondaryOutcomes measure: VOR gain: Prospective Study, secondaryOutcomes measure: VOR Time constant:Prospective Study, secondaryOutcomes measure: Patient reported outcome measure: Prospective Study, secondaryOutcomes measure: Clinical measure of walking: Prospective Study, secondaryOutcomes measure: Clinical measure of balance: Prospective Study, secondaryOutcomes measure: Posturography: Prospective Study, secondaryOutcomes measure: Perception of verticality: Prospective Study, secondaryOutcomes measure: Functional MRI response to an optokinetic stimulus: Prospective Study, secondaryOutcomes measure: Vestibular Evoked myogenic Potentials latency: Prospective Study, secondaryOutcomes measure: Vestibular Evoked myogenic Potentials amplitude: Prospective Study, secondaryOutcomes measure: VOR gain: Retrospective Study, secondaryOutcomes measure: VOR Time constant: Retrospective Study, secondaryOutcomes measure: Patient reported outcome measure: Retrospective Study, secondaryOutcomes measure: Clinical measure of walking: Retrospective Study, secondaryOutcomes measure: Clinical measure of balance: Retrospective Study, secondaryOutcomes measure: Posturography: Retrospective Study, secondaryOutcomes measure: Perception of verticality: Retrospective Study, secondaryOutcomes measure: Functional MRI response to an optokinetic stimulus: Retrospective Study, secondaryOutcomes measure: Vestibular Evoked myogenic Potentials latency: Retrospective Study, secondaryOutcomes measure: Vestibular Evoked myogenic Potentials amplitude: Retrorospective Study, eligibilityModule sex: ALL, minimumAge: 18 Years, maximumAge: 85 Years, stdAges: ADULT, stdAges: OLDER_ADULT, hasResults: False