Metabolic Disorders and Vertigo

Study Overview
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Brief Summary
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The purpose of investigation is to assess the levels of metabolic factors (hydroxyvitamin D, homocysteine) between patients with vestibular dysfunction of peripheral origin (BPPV) and central origin (vestibular migraine). Also we will analyse another factors (such as anxiety and depression) and optimize therapeuthical approach accordingly with the data.

Detailed Description
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Dizziness causes up to 2 to 15% of primary neurological complaints. In some patients who have undergone acute vertigo, postural instability, persistent postural perceptual vertigo (PPPV) develops, while in other similar cases occurs full recovery. So, it is necessary to search for neurophysiological, metabolic and psychophysiological factors and associated premorbid conditions that affect the outcome of neurovestibular compensation. The case-control study will include 2 groups of patients suffering from vertigo of central and peripherial etiology. First group is recruited with patients were diagnosed with peripherial vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), Meniere disease, vestibular neuritis. The proposal number of subjects in the first group is about forty. The second group will consist of forty patients with central vestibular disfunction: vestibular migraine, central positional vertigo etc. The inclusion of patient with persistent postural perceptual dizziness is discussed. Patients will be tested for hydroxyvitamin D and homocysteine in serum using an enzyme-linked immunosorbent assay (ELISA). The perception of the severity of disability was assessed using the Dizziness scale Handicap Inventory (DHI). All patients will undergo psychological test, including tas-26 scale, Beck's Depression Inventory, Spielberg-Hanin'sscale. Statistical analysis was carried out with the Statistical Analysis System (SAS) package. The relationships will be assessed using the chi squared test and logistic regression. The level of significance is set at p < 0.05. The methods for small samples (Mann-Whitney U ) will be used. It is presumed that differences in vitamin D levels beetween two groups will be considerable.

Official Title
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Metabolic Disorders and Their Correction in Vertigo and Unsteadiness

Conditions
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Vestibular Neuritis, Meniere Disease, Benign Paroxysmal Positional Vertigo (BPPV), Vestibular Migraine, Central Positional Vertigo

Intervention / Treatment
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* Diagnostic Test: diagnostic blood test
* Diagnostic Test: neuropsychological test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Written informed consent of participation in the study; Age:over 18 years old complaints of dizziness and insteadiness Exclusion Criteria: Severe cognitive impairment (dementia) Severe depression Syncopal paroxysms Epileptic seizures Orthostatic hypotension Severe arrhythmia, unstable angina pectoris, acute myocardial infarction Pregnancy 8. Alcoholism, substance abuse and drug addiction Organic liver and kidney diseases with the development of functional disorders. Anemia (hemoglobin <10.5 g / dl for women and <11.5 g / dl for men) Active oncological process Demyelinating and neurodegenerative diseases.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients with peripherial vestibular disorder<br>Forty patients with BPPV, vestibular neuritis or another peripherial vestibular disorder | Diagnostic Test: diagnostic blood test<br>* vitamin D deficiency/insufficiency reveal, hyperhomocysteinaemia reveal<br>Diagnostic Test: neuropsychological test<br>* neuropsychological test, including tas-26 scale, Beck's Depression Inventory, Spielberg-Hanin'scale.<br>|
| patients with central vestibular disorder<br>Forty patients vestibular disorder of central origin | Diagnostic Test: diagnostic blood test<br>* vitamin D deficiency/insufficiency reveal, hyperhomocysteinaemia reveal<br>Diagnostic Test: neuropsychological test<br>* neuropsychological test, including tas-26 scale, Beck's Depression Inventory, Spielberg-Hanin'scale.<br>|
| healthy controls<br>twenty healthy control without balance problems | Diagnostic Test: diagnostic blood test<br>* vitamin D deficiency/insufficiency reveal, hyperhomocysteinaemia reveal<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vitamin D deficiency/insufficiency reveal | enzyme-linked immunosorbent assay (ELISA). | Through 1-6 months of diagnosis established. | 
| hyperhomocysteinaemia reveal | enzyme-linked immunosorbent assay (ELISA). | Through 1-6 months of diagnosis established. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| correlation between metabolic and neuropsychological disorders | neuropsychological test, including tas-26 scale, Beck's Depression Inventory, Spielberg-Hanin'scale. | through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Benign paroxysmal positional vertigo (BPPV), vestibular neuritis, vestibular migraine, central positional vertigo, Meniere disease, persistent postural-perceptual dizziness (PPPD), vitamin D deficiency, hyperhomocysteinaemia