The Balance and Falls Center at UCSF is interested in trying to research practical questions about dizziness in vertigo. We are also especially focused on vestibular migraine, as it is the most common form of dizziness that we see. We are interested in:

  • How prevalent are dizziness and vertigo?
  • What is the best way to evaluate patients with dizziness and vertigo?
  • What are the best treatment options for different types of dizziness and vertigo?
  • We are also interested in patient attitudes, neurocognitive effects, and predictors of treatment success

There are several current studies that are currently enrolling:

Current Studies

A Pilot Trial of Galcanezumab for Vestibular Migraine

Vestibular migraine is a distinct subtype of migraine that causes episodic vertigo/dizziness. To date, there have been no randomized clinical trials comparing a drug to placebo for treating vestibular migraine. We’re looking for adults 18-75 years old who are diagnosed with definite or probable vestibular migraine per Bárány Society criteria to examine the effectiveness of a new FDA-approved calcitonin gene-related peptide (CGRP) antagonist drug called galcanezumab (Emgality). Please refer to the attached pamphlet to see if you may be eligible to participate in this study.

Characterization of Resting-State and Functional Connectivity Changes in Vestibular Migraine

In this study, which is being conducted in partnership with Emory University, participants with vestibular migraine will undergo a functional Magnetic Resonance Imaging scan (fMRI).  The fMRI will study brain anatomy during rest, and also changes in brain activity during short video clips that can induce vertigo.  Results will be compared to brain scans of normal subjects, and also those with migraine headaches, who don't have vertigo.  We hope to better understand brain areas and neural networks that are involved in generating vestibular symptoms in those with vestibular migraine.  

Virtual Reality Based Vestibular Rehabilitation

The main treatment for many vestibular disorders in physical therapy.  However, some patients with vestibular problems, like vestibular hypofunction, still don't feel completely back to normal after physical therapy.  In partnership with physical therapists at UCSF, we are conducting a study to understand if vestibular physical therapy within the virtual environment can help those with vestibular disorders.  In virtual reality, the environment can be carefully controlled, which has advantages to traditional therapy, allowing for difficulty escalation as the subject improves performance.  However, there are also challenges, as some patients with vestibular conditions cannot tolerate the virtual environment.  We hope to better understand whether or not virtual reality is helpful, and if so, in which conditions do we see the most benefit.  

Predictors of Vestibular Treatment Success

In this larger study, we are recruiting subjects with different vestibular disorders in a prospective database that will be able to track the effectiveness of different treatment options, and whether or not certain factors can help predict treatment success.

VM-PATHI: Vestibular Migraine Patient Assessment Tool and Handicap Inventory

For patients with a confirmed diagnosis with Vestibular Migraine, this survey is a validated measure of disease related suffering. Scores are possible between 0 to 100; with 0 indicating no disease related suffering, and 100 indicating the highest possible disease related suffering. The score appears at the bottom of the form, and is updated in real-time. This tool is not intended for diagnosis; but instead to help guide research into vestibular migraine. If you believe you are suffering from Vestibular Migraine; please contact your local qualified medical professional.  

Development of VM-PATHI was generously supported by Hearing Research Inc.

Click here to take the survey

Click here for the Pubmed reference for the manuscript that provides additional information on the development and validation of VM-PATHI

Past studies:

Understanding the Dizziness Handicap Inventory (DHI): A Cross Sectional Analysis of Symptom Factors That Contribute to DHI Variance. Formeister EJ, Krauter R, Kirk L, Zhu TR, Rizk HG, Sharon JD. Otol Neurotol. 2020 Jan;41(1):86-93. doi: 10.1097/MAO.0000000000002438. PMID: 31644479

In this study, we looked at the Dizziness Handicap Inventory, a widely used patient reported measure of dizziness, to find out what contributes to worse dizziness related symptoms. We found that scores were higher when anxiety and depression were present, and also if the dizziness had more triggers, more descriptors, and occurred more frequently.

The Interrelations Between Different Causes of Dizziness: A Conceptual Framework for Understanding Vestibular Disorders. Zhu RT, Van Rompaey V, Ward BK, Van de Berg R, Van de Heyning P, Sharon JD. Ann Otol Rhinol Laryngol. 2019 Sep;128(9):869-878. doi: 10.1177/0003489419845014. Epub 2019 Apr 25. Review. PMID: 31018648

In this study, we synthesized available data to present a conceptual framework for understanding different causes of dizziness and their interrelationships.

The Epidemiology of Vestibular Migraine: A Population-based Survey Study. Formeister EJ, Rizk HG, Kohn MA, Sharon JD. Otol Neurotol. 2018 Sep;39(8):1037-1044. doi: 10.1097/MAO.0000000000001900. PMID: 30020261

In this study, using a large database (NHIS), we calculated that vestibular migraine affects 2.7% of adults in the United States.