The power of balance

Scientists have just cured a really common disorder – but you’ve probably never heard of it.

In fact, your doctor has probably never heard of it. 

It is hard to convey the immense relief this gives patients after suffering for decades.

This is the first effective treatment for Mal de Debarquement Syndrome (MdDS), a condition where people continue to feel off-balance long after a boat, plane or lengthy car journey. It’s caused by a problem with the body’s vestibular system — crucial for our balance and orientation, and the subject of an article collection called Vestibular Contributions to Health and Disease.

Selected as a 2018 Spotlight finalist, the Research Topic is a towering success. With another promising cure already in clinical trials, and powerful new diagnostic techniques, the volume has already received more than 80 citations, 67,000 article views and 8,700 article downloads. The MdDS cure has also been celebrated in The Washington Post

Professor Bernard Cohen explains why he and fellow clinician-scientists Dr Richard Lewis and Dr Jose Antonio Lopez-Escamez launched this Research Topic, some of its outcomes, and how winning the 2018 Frontiers Spotlight Award would help sufferers of balance disorders worldwide.

Why was this Research Topic created? 

Millions of people each year seek medical attention for dizziness, vertigo and fainting. These, and other symptoms, come from disorders with the vestibular system — a sensory organ in the inner ear. In ageing Western populations, the burden is growing — but according to Cohen, most physicians have very limited ability to diagnose and treat these common disorders.

“Our patients come with thousands of dollars of expensive MRIs, hearing tests, balance tests and physiotherapy treatments that are to no avail.” 

Cohen has been a pioneer in the field for more than 50 years, but views recent developments as particularly important to the field and to patients. 

“Exciting research developments over the last 15 years substantially improve our knowledge of the basic mechanisms that underlie vestibular function and disease. Many of these findings, however, have not yet been widely disseminated. This Research Topic aims to make them clear and accessible to all — and thereby improve understanding and treatment of vestibular disorders.” 

What type of research is included?   

Vestibular Contributions to Health and Disease brings together diverse observations and experimental findings from sufferer to cell that underpin the latest understanding of the vestibular system.

Several articles explore the neural anatomy and circuitry of the vestibular system, and its complex interconnection with automatic functions like control of heart rate and blood pressure — central to understanding motion sickness.

Some try to crack the code of the bony, thimble-sized vestibular sensory organ in the inner ear — and how this could be affected by MRI scans.

Others deal with the effects of age on balance, which gets progressively worse from age 10 to 70.

But most exciting of all, the research delivers new methods for the diagnosis and treatment of vestibular disorders.

What are some outcomes of the Research Topic?

Cohen is rightly proud of the authors’ additions to the physician’s toolkit.

“These are fundamental advances in our clinical capabilities and need to be widely recognized.”

“For instance, Michael Halmagyi and colleagues provided a new technique which makes it possible to separate vestibular lesions from central nervous system strokes at the bedside. That’s power!”

But prominent among these is his own contribution — the first-ever effective treatment for Mal de Debarquement Syndrome.

“Our treatment showed a 75% improvement in 121 patients initially, falling to about 50% after one year. We have now treated more than 400 MdDS patients, and the treatment success rate is the same.”

This may be just a first glimpse of the Research Topic’s potential, with a clinical trial now underway to test another of its prospective new treatments — the first for vasovagal syncope, or unexplained, intermittent fainting.

Vitally, the Research Topic has also succeeded in disseminating these new tools and understanding to a huge audience of scientists, physicians and even patients.

“We continue to have people calling almost daily who have seen our work published by Frontiers and cannot find adequate medical care elsewhere.”

Why should this Research Topic win the 2018 Spotlight Award?

Cohen is emphatic about the winning potential of the Research Topic — with a prize of US $100,000 to fund a conference on vestibular disorders.

“I believe that this conference, if held, will have an important effect on the health and welfare of people around the world.

“It would provide a powerful impetus to engage more scientists and physicians into this field and promote our understanding of vestibular, cerebellar and autonomic disorders.”

And there is already no shortage of new content.

“A hypothesis paper by the editors of this volume suggested many experiments to further study MdDS. It would be fantastic to present the results of these and other companion papers at the conference.”

About the Frontiers Spotlight Award

The annual Frontiers Spotlight Award supports emerging and important fields of research published as a Research Topic in Frontiers journals. The winning team of Topic Editors receives US$100,000 to organize an international scientific conference on the theme of their successful Research Topic. Learn more about the Award

About Frontiers Research Topics

Research Topics are peer-reviewed article collections published around specialized themes. They bring together leading researchers from different institutions, locations and fields of interest, who collaborate and contribute articles.

Published on Frontiers’ award-winning platform, Research Topics are fully open and accessible, and become highly visible collections of work, enhancing both the readership and citations of articles. Learn more about Research Topics

How to enter

Every Research Topic that closes within the award period and is completed with at least 10 articles, will be considered for the Spotlight Award. Shape your field and have the chance to organize your own conference — suggest your Research Topic today!

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Research Topic Editors

Bernard Cohen     Icahn School of Medicine at Mount Sinai, USA

Bernard Cohen
Icahn School of Medicine at Mount Sinai, USA

Richard Lewis     Harvard University, USA

Richard Lewis
Harvard University, USA

Jose Antonio Lopez-Escamez     Junta de Andalucía de Genómica e Investigación Oncológica, Spain

Jose Antonio Lopez-Escamez
Junta de Andalucía de Genómica e Investigación Oncológica, Spain