The Development of Vestibular-Perceptual Adaptation Paradigms for Treating Persistent Vertigo & Perceived Disequilibrium

眩晕/平衡失调是患有外周前庭疾病或 脑震荡后，尤其是恢复期较长的个体。脑震荡和前庭疾病 导致眩晕/不平衡、眼球运动异常、自我运动知觉改变和不平衡。 前庭知觉退化最近被认为与平衡问题有关。尽管现有的治疗方法 重新训练平衡和反射性眼球运动，对自我运动知觉在其中所起的作用知之甚少 从持续的眩晕/失衡中恢复过来，或者如何有效地重新训练这些异常的感知。 这一职业发展奖将确立埃里克·安森博士作为临床科学家的地位，拥有人类方面的专业知识。 前庭研究包括从生理学到知觉的基础科学和翻译科学 加强对患有慢性眩晕/眩晕的患者的护理和生活质量。这款K23将确保 安森博士在3个主要领域发展了专业知识：1)高级脑震荡管理培训；2) 认知和情绪对SMP的影响；3)统计学方法、知觉心理物理学和 前庭-眼反射(VOR)适应。安森博士组建了一个由多学科专家组成的团队 脑震荡治疗(杰弗里·巴扎里安，医学博士，公共卫生硕士)，认知和情绪对平衡的影响(Mark 卡彭特，博士；杰弗里·斯塔布，医学博士)，前庭适应(迈克尔·舒伯特，PT，博士)和知觉 心理物理学(本杰明·克兰，医学博士；马克·卡彭特，博士；杰里米·贾米森，博士) 实现他的目标。 安森博士将进行一系列研究来回答这些重要问题。他将调查是否 症状相似的不同疾病状态(脑震荡和前庭疾病)会导致自我意识的差异 运动知觉(目标1)。他将确定前庭反射和前庭自主知觉 独立适应(目标2)。他将利用与平衡相关的高海拔焦虑来研究 情绪调节、身体摆动和自我运动感知(目标3)。这项研究计划利用了独特的 罗切斯特大学现有的资源，包括CTSI和Anson博士实验室的设备， 克兰、巴扎里安和杰米森。卡彭特博士的研究实验室提供了访问独特资源的途径 探索与平衡相关的焦虑作为压力源，以及增强自我运动知觉的训练方法。Dr。 Staab的诊所和研究实验室提供了认知行为疗法培训的独特资源 以及有导致持续性眩晕的行为变量的患者。建议的培训和指导 研究符合NIDCD听力和平衡研究战略计划，具体地说 解决当前对健康和疾病中自我运动感知的理解。拟议的培训将 为未来的R01应用奠定基础，使用自我运动感知训练来增强电流 前庭康复，改善前庭疾病或脑震荡患者的生活质量。

Vertigo/disequilibrium is a frequent medical complaint for individuals with peripheral vestibular disorders or after concussion, especially individuals with lengthy recovery periods. Concussion and vestibular disease often result in vertigo/disequilibrium, abnormal eye movements, altered self-motion perception, and imbalance. Degraded vestibular perception has recently been linked to balance problems. Despite existing therapies to retrain balance and reflexive eye movements, little is known about the role that self-motion perception plays in the recovery from persistent vertigo/disequilibrium or how to effectively re-train these abnormal perceptions. This career development award will establish Dr. Eric Anson as a clinician scientist with expertise in human vestibular research including basic science ranging from physiology to perception and translational science to enhance the care and quality of life for individuals experiencing chronic dizziness/vertigo. This K23 will ensure Dr. Anson develops expertise in 3 primary domains: 1) Advanced concussion management training; 2) Influence of cognition and emotion on SmP; and 3) statistical methods, perceptual psychophysics, and vestibulo-ocular reflex (VOR) adaptation. Dr. Anson has assembled a multi-disciplinary team of experts in concussion management (Jeffery Bazarian, MD, MPH), cognitive and emotional impacts on balance (Mark Carpenter, PhD; Jeffery Staab, MD), vestibular adaptation (Michael Schubert, PT, PhD), and perceptual psychophysics (Benjamin Crane, MD, PhD; Mark Carpenter, PhD; Jeremy Jamieson, PhD) to facilitate achievement of his goals. Dr. Anson will conduct a series of studies to answer these important questions. He will investigate whether different disease states (concussion and vestibular disease) with similar symptoms lead to differences in self- motion perception (Aim 1). He will determine whether vestibular reflexes and vestibular self-motion perception adapt independently (Aim 2). He will use balance-related anxiety at high heights to investigate the link between emotional regulation, body sway, and self-motion perception (Aim 3). This research plan leverages unique existing resources at the University of Rochester including the CTSI and equipment in the labs of Drs. Anson, Crane, Bazarian, and Jamieson. Dr. Carpenter’s research lab provides access to unique resources for exploring balance-related anxiety as a stressor and training methods to enhance self-motion perception. Dr. Staab’s clinic and research lab provide access to unique resources for training in cognitive behavioral therapy and patients with behavioral variables that contribute to persistent vertigo. The proposed training and mentored research are consistent with the NIDCD strategic plan for research in hearing and balance, specifically addressing current understanding of self-motion perception in health and disease. The proposed training will be the foundation for future R01 applications using self-motion perceptual training to enhance current vestibular rehabilitation, improving quality of life for individuals with vestibular disease or concussion.