Mucci Viviana, Perkisas Tyché, Jillings Steven Douglas, Van Rompaey Vincent, Van Ombergen Angelique, Fransen Erik, Vereeck Luc, Wuyts Floris L, Van de Heyning Paul H, Browne Cherylea J
Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.
Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Front Neurol. 2018 Oct 25;9:887. doi: 10.3389/fneur.2018.00887. eCollection 2018.
Mal de Debarquement Syndrome (MdDS) is a condition characterized by a perception of self-motion in the absence of a stimulus, with two onset types: Motion-Triggered and Spontaneous. Currently, the pathophysiology is unknown and consequently, the therapeutic options are limited. One proposed treatment protocol, developed by Dai and colleagues is based on optokinetic stimulation, which aims to re-adapt the vestibular ocular reflex. This study aimed to reproduce the treatment protocol developed by Dai and colleagues and to assess if a placebo effect is present in the treatment protocol and lastly, aimed to further investigate the treatment on MdDS patient outcomes. Twenty-five MdDS patients (13 Motion-Triggered and 12 Spontaneous) were exposed to 5 consecutive days of optokinetic treatment (consisting of exposure to optokinetic stimuli with head movements). Eleven of these 25 patients were also exposed to 2 days of a sham treatment prior to the OKN treatment. Posturography measurements and reported symptoms [e.g., using the visual analog scale (VAS)] of patients were assessed throughout the treatment. Posturography data of the patients was compared with the data of 20 healthy controls. No placebo effect was recorded with any changes in postural data and VAS scale. After the optokinetic treatment, a significant improvement in postural control was observed in 48% of patients, of whom 70% were of the Motion-Triggered subtype (-values: Area under the Curve-Anterior Posterior < 0.001; Area under the Curve-Medio Lateral < 0.001, Confidence Ellipse Area (CEA) < 0.001, Velocity < 0.001). The protocol was effective in approximately half of the MdDS patients that took part in the study, with no placebo effect recorded. The Motion-Triggered group responded better to treatment than the Spontaneous group. In addition to this, this study indicates that the greatest postural changes occur within the first 3 days of treatment, suggesting that a shorter protocol is possible. Overall, these findings support what was previously observed in Dai's studies, that optokinetic stimulation can reduce and ease self-motion perception in those with MdDS. Thus, validating the reproducibility of this protocol, suggesting that a consistent and uncomplicated implementation across treatment centers is possible.
下船综合征（MdDS）是一种在没有刺激的情况下出现自我运动感知的病症，有两种发病类型：运动触发型和自发型。目前，其病理生理学尚不清楚，因此治疗选择有限。戴及其同事制定的一种建议治疗方案基于视动刺激，旨在重新调整前庭眼反射。本研究旨在重现戴及其同事制定的治疗方案，评估该治疗方案中是否存在安慰剂效应，最后进一步研究该治疗对MdDS患者预后的影响。25名MdDS患者（13名运动触发型和12名自发型）连续5天接受视动治疗（包括头部运动时接受视动刺激）。这25名患者中有11名在视动治疗前还接受了2天的假治疗。在整个治疗过程中评估患者的姿势描记测量结果和报告的症状[例如，使用视觉模拟量表（VAS）]。将患者的姿势描记数据与20名健康对照者的数据进行比较。姿势数据和VAS量表的任何变化均未记录到安慰剂效应。视动治疗后，48%的患者姿势控制有显著改善，其中70%为运动触发型亚型（-值：前后曲线下面积<0.001；中外侧曲线下面积<0.001，置信椭圆面积（CEA）<0.001，速度<0.001）。该方案对参与研究的大约一半MdDS患者有效，未记录到安慰剂效应。运动触发型组对治疗的反应比自发型组更好。除此之外，本研究表明最大的姿势变化发生在治疗的前3天内，这表明可能采用更短的治疗方案。总体而言，这些发现支持了戴的研究中先前观察到的结果，即视动刺激可以减少和缓解MdDS患者的自我运动感知。因此，验证了该方案的可重复性，表明在各治疗中心进行一致且简单的实施是可行的。
