NIDCD supports research on balance and the vestibular system. Balance disorders affect a large proportion of the population, particularly the elderly. The vestibular system, with its receptor organs located in the inner ear, plays an important role in the maintenance of one's orientation in space, the control of balance while the body is immobile and in motion, and visual fixation of objects during head movement. Vestibular disorders can therefore yield symptoms of imbalance, vertigo (the illusion of motion), disorientation, instability, falling and visual blurring (particularly during motion). Deficits in vestibular function result from diverse disease processes, including infection, trauma, toxicity, impaired blood supply, autoimmune disease, impaired metabolic function and tumors.
In addition to its role in the stabilization of gaze and balance, recent findings from NIDCD-supported studies suggest that the vestibular system plays an important role in regulating blood pressure. The information emerging from these studies holds potential clinical relevance for the understanding and management of orthostatic hypotension (lowered blood pressure related to a change in body posture).
The linear acceleration detectors of the vestibular system, the otolithic organs, detect the forces produced by head tilt and by linear (forward-to-aft, side-to-side) head movements. How the vestibular apparatus and the nervous system resolve gravitational from linear accelerations in order to accurately perceive motion and control balance is currently under active study by NIDCD-supported investigators.
Investigations supported by the NIDCD are characterizing the genes essential to normal development and function in the vestibular system. The genetic bases of several inherited cerebellar syndromes of imbalance and incoordination are currently being investigated.
The institute supports research to develop and refine tests of balance and vestibular function. Computer-controlled systems measuring eye movement and body postural responses activated by stimulating specific parts of the vestibular sense organ and nerve have been developed and validated for clinical use. Also, tests of functional disability and physical rehabilitative strategies currently being applied in clinical and research settings will have important implications for refining the rehabilitation of patients with balance and vestibular disorders.
Recently, a prototype vestibular neural prosthesis has been developed by a team of NIDCD-funded investigators. Early-stage studies with this device demonstrates that the function of the inner ear balance system can be partially restored through electrostimulation of the vestibular nerve. Research is progressing in earnest to refine the vestibular prosthesis and to determine its viability for application to vestibular-deficient humans.
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