DizzinessNCT06893029
Dizziness Due to Visual Stimuli in Patients With Concussion and Other Causes of Dizziness: Examination of Balance Behaviour
A study testing Postural Response upon physical optokinetic stimulation and Postural Response upon virtual optokinetic stimulation in people with Dizziness and Concussion (Diagnosis), run by Dominik Straumann at 2 sites in Switzerland.
Trial summary
This research project aims to measure how balance is affected by special visual stimulation. Dizziness caused by complex moving visual patterns, known as optokinetic stimulation, is usually called visually induced dizziness (VID). Read more about this study
- Who is it for?
- Ages 18 to 60 yearsHealthy volunteers can take part
- Conditions the study is for
- Dizziness, Concussion (Diagnosis), Traumatic Brain Injury
- What is being tested?
- Postural Response upon physical optokinetic stimulation and Postural Response upon virtual optokinetic stimulation
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 240 participants
- Where
- 2 sitesSwitzerland
- Study dates
- 14 May 2025to 31 Oct 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Age between 18 and 60 years
- Binocular vision
- Recent concussion/mTBI within 4 weeks to 18 months post-injury for concussed patients
- Diagnosis related to dizziness or VID within 4 weeks to 18 months for non-concussed dizzy patients (including vestibular migraine)
- Signed ICF for included participants or signed general consent for retrospectively included patients if an ICF cannot be obtained.
Who cannot join
- BMI greater than 30
- Acute vestibular syndrome lasting at least 24 hours
- Severe non-correctable visual impairment
- Balance issues not dizziness-related, including:
- Neurological conditions (e.g., migraine)
- Orthopaedic conditions (e.g., lower extremity injury)
Show all 14Show fewer
- Infectious diseases
- Other medical contexts
- Dizziness attributed to prescribed drugs, substance abuse, or mental disorders
- Cognitive impairments compromising task comprehension
- Preceding history of traumatic brain injury in the last 12 months
- History of severe traumatic brain injury with persisting impairments
- Other potentially confounding problems (e.g., psychiatric disease)
- Frequent episodes of rotatory vertigo
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Samuel Meyer, MSc contact
Switzerland2 sites, 2 recruiting
- Recruiting
BrainCare Medical Group
Zurich, Canton of Zurich, 8002
Nina Feddermann, Dr. med., +41 44 500 41 50, nina.feddermann@braincare.swiss
+41 44 500 41 50, info@braincare.swiss
- Recruiting
University Hospital Zurich, Department of Neurology
Zurich, Canton of Zurich, 8006
Dominik Straumann, Prof. Dr. med., +41 44 255 55 64, Dominik.Straumann@usz.ch
Samuel Meyer, MSc, +41 43 253 73 17, Samuel.Meyer@usz.ch
About this study
Official title: Visually Induced Dizziness in Concussed and Non-Concussed Dizzy Patients: Identifying the Pathophysiology of Postural Control Upon Optokinetic Stimuli
This research project aims to measure how balance is affected by special visual stimulation. Dizziness caused by complex moving visual patterns, known as optokinetic stimulation, is usually called visually induced dizziness (VID).
The study includes patients with persistent symptoms after a concussion and those with non-traumatic dizziness. Healthy participants serve as a control group for the comparison of balance and symptom responses.
Read more
The optokinetic stimulation is done using either a physical rotating disk or a virtual reality (VR) headset. The visual effects are created by bright moving dots. During the stimulation, these patterns move in a specific manner and directions while the subject's balance is recorded. Symptoms such as dizziness, headache, and nausea are also documented.
The goal of this project is to improve objective diagnosis of VID. By comparing patients and healthy subjects, the study aim to assess the severity of the disorder. It is also assumed that using different visual stimuli during the balance assessment will offer more sensitive and accurate results.
In the long term, this innovative assessment method shall support clinicians to establish the diagnosis of VID, and improve the treatment and management of patients with VID.
Read the detailed description
Sport-related concussion (SRC) refers to traumatic head injuries caused by direct biomechanical forces to the head, neck or body during physical activity. Due to very heterogeneous clinical patterns in concussed patients including multiple clinical profiles and subtypes, standardised diagnosis for SRC is still in scope of research. Thus, diagnostic procedures are currently based on clinical examination and subjective complaints using questionnaires, while objective assessments supporting a diagnosis for concussed patients are lacking. Only some functional limitations are recorded via objective methods, but no quantification and no diagnosis are possible.
Common questionnaires to assess VID in concussed patients and for vestibular disorders are the visual vertigo analogue scale (VVAS), and the situational vertigo questionnaire (SVQ), though there exist more. The dizziness handicap inventory (DHI) is used to classify the general aspect of dizziness. Other methods to support VID diagnosis have been developed including subjective visual vertical assessment or balance screenings with optokinetic stimulation. Such objective findings are essential for a reliable diagnosis supporting subjective complaints. However, determined parameters and observed pathologies vary among studies and thus, a classification via objective assessments in VID patients is still in scope of research. Nevertheless, symptom assessment is still considered as one of the best and reliable method to support diagnosis and success in treatment.
Outcomes of previously discussed and used questionnaires to assess VID rely on patients' compliance. Subjective evaluations on dizziness are challenging for patients and may therefore diverge from objective measurements. In addition, questionnaires do not explicitly distinguish between vertigo and dizziness. Moreover, self-reported symptoms showed moderate correlation to objective findings. This highlights the importance of realising objective methods such as balance assessments.
Some objective assessments to identify VID, and to discriminate among patient groups and healthy subjects have been introduced. But most of the studies investigating VID examined a broad variety of vestibular disorders, rarely including concussion.
Concerning balance assessment combined with optokinetic stimulation, several studies found significant differences among control groups and patients with vestibular disorders and dizziness, but findings varied across calculated parameters. Overall, mean deviations on sway path tended to be more predictive than lean sway, and significant effects are supposed to be in stimulated planes. Additionally for path length, there exists two quotients representing the balance response ratio between eyes open and eyes closed (Romberg quotient), and the ratio between eyes open and optokinetic stimulation (optokinetic quotient), which both showed significant effects comparing healthy subjects and visual vertigo patients. However, parameters evaluated from velocity were often in favour compared to path length. Furthermore, prolonged exposure to optokinetic stimulation triggered symptoms in patients with visual vestibular mismatch but not in control subjects, supporting the hypotheses of symptom exacerbation by visual motion. Regarding defined triggers for VID, one could assume that triggers are based on an individual level and therefore include various visual motion conditions such as complex, large-field or moving elements in order to conflict one's sensory integration. Given those multidimensional conditions for an assessment, the use of VR environments for this project benefits a broad and flexible range in VID assessment. Regarding the mentioned studies, one could assume that balance evaluation on multiple optokinetic stimuli and comparison to reference values based on healthy subjects has the potential to increase the sensitivity of the balance screening for VID subjects, and in particular concussed patients.
This project aims to generate greater reliability using a more differentiated balance assessment with optokinetic stimulation. Findings are assumed to help identifying potential VID on a more individual basis and support accurate classification.
- Being tested
- Postural Response upon physical optokinetic stimulation, Postural Response upon virtual optokinetic stimulation
- Keywords
- Visually induced dizziness
- Medical subject headings
- Dizziness, Brain Concussion, Disease, Brain Injuries, Traumatic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Postural Response upon physical optokinetic stimulationDiagnostic test
The physical optokinetic stimulation consists of rotating stimulation in either direction using a physical disc (de Vestel, et al., 2022; Guerraz et al., 2001; van Ombergen et al., 2016). The assessment is conducted in complete dark, unless the fluorescent dots (approx. 11% covered of the disc area.). The disc has a diameter of 1 m. Stimulation time per trial will be 30 s.
Postural Response upon virtual optokinetic stimulationDiagnostic test
The virtual optokinetic stimulation is implemented in virtual reality goggles (Meta Quest 3, Meta Platforms, Menlo Park, CA, USA) applying oscillating and rotating stimulation in frontal and vertical axis with coherent or incoherent stimuli. The assessment in the virtual environment will be as similar as possible compared the physical stimulation. Hence, the virtual environment simulation complete dark, unless the fluorescent dots (approx. 15% covered of the disc area.). In addition to the rotating condition, the virtual dots are able to oscillate on the horizontal or vertical axis to create a more sensitive evaluation method than the physical one (Laurens et al., 2011). Stimulation time per trial will be 30 s.
| Study group | Role | What they receive |
|---|---|---|
| Healthy Subjects (Physical / Virtual) | Active comparator | Cross-over design for healthy subjects, physical optokinetic stimulation in advance to virtual optokinetic stimulation. Receives: Diagnostic Test: Postural Response upon physical optokinetic stimulation; Diagnostic Test: Postural Response upon virtual optokinetic stimulation |
| Healthy Subjects (Virtual / Physical) | Active comparator | Cross-over design for healthy subjects, virtual optokinetic stimulation in advance to physical optokinetic stimulation. Receives: Diagnostic Test: Postural Response upon physical optokinetic stimulation; Diagnostic Test: Postural Response upon virtual optokinetic stimulation |
| Patients (Physical) | Experimental | These patients are only examined with the physical stimulation to avoid excessive symptom burden. Receives: Diagnostic Test: Postural Response upon physical optokinetic stimulation |
| Patients (Virtual) | Experimental | These patients are only examined with the virtual stimulation to avoid excessive symptom burden. Receives: Diagnostic Test: Postural Response upon virtual optokinetic stimulation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Sensitivity of Postural Response to Optokinetic Stimulation
To identify visually induced dizziness through the balance assessment, cutoff values based on calculated balance parameters will be evaluated to differentiate balance responses between concussed patients, non-concussed dizzy patients, and healthy controls. The reference will be the VID assessment performed during the clinical examination.
Measurement Tool:
- 6D sensor system (accelerometer and gyroscope) placed on the lower back and head.
- acceleration in m/s^2
- gyroscope in deg/s)
Unit of Measure: Calculations on the balance responses from each measuring site and sensor type (accelerometer, gyroscope) include temporal and spectral parameters such as:
- 95% area of motion (m^2/s^4, deg^2/s^2)
- RMS, SD, Mean (m/s^2, deg/s)
- Power Spectral Density (PSD) between 0.1-2 Hz ((m^2/s^4)/Hz, (deg^2 /s^2)/Hz)
- Power Spectral Density (PSD) at stimulation frequency of 1/3 Hz((m^2/s^4)/Hz, (deg^2 /s^2)/Hz)
Comparison:
- Balance parameters among the investigated groups
Measured: Time Point 1: During the first intervention, measurement on a single day. Time Point 2: 15 minutes after the first intervention, measurement on a single day
Secondary outcomes (2)
Identification of Different Postural Characteristics Response to Optokinetic Stimulation
It is hypothesized that patients with different diagnoses will exhibit distinct postural response patterns, which can be quantified and categorised. Based on the diagnosis, specific characteristics from the determined parameters shall be analysed.
Measurement Tool:
- 6D sensor system (accelerometer and gyroscope) placed on the lower back and head.
- acceleration in m/s^2
- gyroscope in deg/s)
Unit of Measure: Calculations on the balance responses from each measuring site and sensor type (accelerometer, gyroscope) include temporal and spectral parameters such as:
- 95% area of motion (m^2/s^4, deg^2/s^2)
- RMS, SD, Mean (m/s^2, deg/s)
- Power Spectral Density (PSD) between 0.1-2 Hz ((m^2/s^4)/Hz, (deg^2 /s^2)/Hz)
- Power Spectral Density (PSD) at stimulation frequency of 1/3 Hz((m^2/s^4)/Hz, (deg^2 /s^2)/Hz)
Comparison:
- Differences and rates of change in determined parameters are clustered across these groups
Measured: Time Point 1: During the first intervention, measurement on a single day. Time Point 2: 15 minutes after the first intervention, measurement on a single day
Severity of Visually Induced Dizziness
The balance assessment outcome shall be used to categorise the severity of visually induced dizziness based on calculated balance parameters.
Measurement Tool:
- 6D sensor system (accelerometer and gyroscope) placed on the lower back and head.
- acceleration in m/s^2
- gyroscope in deg/s)
Unit of Measure: Calculations on the balance responses from each measuring site and sensor type (accelerometer, gyroscope) include temporal and spectral parameters such as:
- 95% area of motion (m^2/s^4, deg^2/s^2)
- RMS, SD, Mean (m/s^2, deg/s)
- Power Spectral Density (PSD) between 0.1-2 Hz ((m^2/s^4)/Hz, (deg^2 /s^2)/Hz)
- Power Spectral Density (PSD) at stimulation frequency of 1/3 Hz((m^2/s^4)/Hz, (deg^2 /s^2)/Hz)
Comparison:
- Balance parameters will be classified into clusters, such as normal, borderline, and abnormal balance behaviour.
Measured: Time Point 1: During the first intervention, measurement on a single day. Time Point 2: 15 minutes after the first intervention, measurement on a single day
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Mar 2025
- Study start14 May 2025
- Primary completion1 Apr 2027 (estimated)
- Study completion31 Oct 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for DizzinessStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Crossover
- Model description
- The project is organised in 4 arms, as healthy subjects and patients will be examined. Optokinetic stimulation will be applied to eighter by a physical disc or a head mounted device using virtual application. Healthy subjects will conduct a physical and a virtual balance assessment with visual stimulation, in a cross-over design. Patients will only conduct one type of balance assessment, physical or virtual, to prevent symptom exacerbation. This limitation for dizzy patients is based on the experience of leading clinicians from the vertigo center and on former research projects in the field of VID (de Vestel, et al., 2022; Guerraz et al., 2001; van Ombergen et al., 2016).
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 240 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Dominik Straumann
- Sponsor type
- University, hospital or other
- Collaborators
- University Hospital, Zürich, BrainCare Medical Group
- Responsible party
- Sponsor-investigator, Dominik Straumann, University of Zurich
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06893029
- Sponsor's protocol ID
- 2024-00956
- Status last verified
- Sep 2025
- First submitted
- 6 Mar 2025
- Last updated
- 19 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Data from the CRF, raw values from the balance measurements, and calculated balance parameter will be shared IPD: * Diagnosis related to VID: * Group assignment * Informed Consent * Anthropometric data (weight, height) * Age * Questionnaire's data: DHI, VVAS, SVQ, SSQ * Symptom burden during balance assessment * Completion of assessment * Balance raw data * Calculated balance parameters
Publications
Laurens J, Awai L, Bockisch CJ, Hegemann S, van Hedel HJ, Dietz V, Straumann D. Visual contribution to postural stability: Interaction between target fixation or tracking and static or dynamic large-field stimulus. Gait Posture. 2010 Jan;31(1):37-41. doi: 10.1016/j.gaitpost.2009.08.241. Epub 2009 Sep 22.
PubMed 19775892Agarwal K, Bronstein AM, Faldon ME, Mandala M, Murray K, Silove Y. Visual dependence and BPPV. J Neurol. 2012 Jun;259(6):1117-24. doi: 10.1007/s00415-011-6311-7. Epub 2011 Nov 24.
PubMed 22113702Fife TD, Giza C. Posttraumatic vertigo and dizziness. Semin Neurol. 2013 Jul;33(3):238-43. doi: 10.1055/s-0033-1354599. Epub 2013 Sep 21.
PubMed 24057827Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015 Aug;33(3):541-50, vii. doi: 10.1016/j.ncl.2015.04.010.
PubMed 26231270Kontos AP, Sufrinko A, Sandel N, Emami K, Collins MW. Sport-related Concussion Clinical Profiles: Clinical Characteristics, Targeted Treatments, and Preliminary Evidence. Curr Sports Med Rep. 2019 Mar;18(3):82-92. doi: 10.1249/JSR.0000000000000573.
PubMed 30855306Van Ombergen A, Lubeck AJ, Van Rompaey V, Maes LK, Stins JF, Van de Heyning PH, Wuyts FL, Bos JE. The Effect of Optokinetic Stimulation on Perceptual and Postural Symptoms in Visual Vestibular Mismatch Patients. PLoS One. 2016 Apr 29;11(4):e0154528. doi: 10.1371/journal.pone.0154528. eCollection 2016.
PubMed 27128970Pavlou M, Davies RA, Bronstein AM. The assessment of increased sensitivity to visual stimuli in patients with chronic dizziness. J Vestib Res. 2006;16(4-5):223-31.
PubMed 17538212Patricios JS, Schneider KJ, Dvorak J, Ahmed OH, Blauwet C, Cantu RC, Davis GA, Echemendia RJ, Makdissi M, McNamee M, Broglio S, Emery CA, Feddermann-Demont N, Fuller GW, Giza CC, Guskiewicz KM, Hainline B, Iverson GL, Kutcher JS, Leddy JJ, Maddocks D, Manley G, McCrea M, Purcell LK, Putukian M, Sato H, Tuominen MP, Turner M, Yeates KO, Herring SA, Meeuwisse W. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711. doi: 10.1136/bjsports-2023-106898.
PubMed 37316210Guerraz M, Yardley L, Bertholon P, Pollak L, Rudge P, Gresty MA, Bronstein AM. Visual vertigo: symptom assessment, spatial orientation and postural control. Brain. 2001 Aug;124(Pt 8):1646-56. doi: 10.1093/brain/124.8.1646.
PubMed 11459755De Vestel C, De Hertogh W, Van Rompaey V, Vereeck L. Comparison of Clinical Balance and Visual Dependence Tests in Patients With Chronic Dizziness With and Without Persistent Postural-Perceptual Dizziness: A Cross-Sectional Study. Front Neurol. 2022 May 24;13:880714. doi: 10.3389/fneur.2022.880714. eCollection 2022.
PubMed 35685740Dannenbaum E, Chilingaryan G, Fung J. Visual vertigo analogue scale: an assessment questionnaire for visual vertigo. J Vestib Res. 2011;21(3):153-9. doi: 10.3233/VES-2011-0412.
PubMed 21558640
Study at a glance
From the registry record, last updated by the sponsor on 19 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Visually Induced Dizziness in Concussed and Non-Concussed Dizzy Patients: Identifying the Pathophysiology of Postural Control Upon Optokinetic Stimuli
- ClinicalTrials.gov ID
- NCT06893029
- Acronym / sponsor ID
- 2024-00956
- Keywords
- Visually induced dizziness
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 240 participants (estimated)
- Lead sponsor
- Dominik StraumannUniversity, hospital or other
- Collaborators
- University Hospital, Zürich, BrainCare Medical Group
- Study start
- 14 May 2025 (actual)
- Primary completion
- 1 Apr 2027 (estimated)
- Study completion
- 31 Oct 2027 (estimated)
- First posted
- 25 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This research project aims to measure how balance is affected by special visual stimulation. Dizziness caused by complex moving visual patterns, known as optokinetic stimulation, is usually called visually induced dizziness (VID).
The study includes patients with persistent symptoms after a concussion and those with non-traumatic dizziness. Healthy participants serve as a control group for the comparison of balance and symptom responses.
The optokinetic stimulation is done using either a physical rotating disk or a virtual reality (VR) headset. The visual effects are created by bright moving dots. During the stimulation, these patterns move in a specific manner and directions while the subject's balance is recorded. Symptoms such as dizziness, headache, and nausea are also documented.
The goal of this project is to improve objective diagnosis of VID. By comparing patients and healthy subjects, the study aim to assess the severity of the disorder. It is also assumed that using different visual stimuli during the balance assessment will offer more sensitive and accurate results.
In the long term, this innovative assessment method shall support clinicians to establish the diagnosis of VID, and improve the treatment and management of patients with VID.
Detailed description
Sport-related concussion (SRC) refers to traumatic head injuries caused by direct biomechanical forces to the head, neck or body during physical activity. Due to very heterogeneous clinical patterns in concussed patients including multiple clinical profiles and subtypes, standardised diagnosis for SRC is still in scope of research. Thus, diagnostic procedures are currently based on clinical examination and subjective complaints using questionnaires, while objective assessments supporting a diagnosis for concussed patients are lacking. Only some functional limitations are recorded via objective methods, but no quantification and no diagnosis are possible.
Common questionnaires to assess VID in concussed patients and for vestibular disorders are the visual vertigo analogue scale (VVAS), and the situational vertigo questionnaire (SVQ), though there exist more. The dizziness handicap inventory (DHI) is used to classify the general aspect of dizziness. Other methods to support VID diagnosis have been developed including subjective visual vertical assessment or balance screenings with optokinetic stimulation. Such objective findings are essential for a reliable diagnosis supporting subjective complaints. However, determined parameters and observed pathologies vary among studies and thus, a classification via objective assessments in VID patients is still in scope of research. Nevertheless, symptom assessment is still considered as one of the best and reliable method to support diagnosis and success in treatment.
Outcomes of previously discussed and used questionnaires to assess VID rely on patients' compliance. Subjective evaluations on dizziness are challenging for patients and may therefore diverge from objective measurements. In addition, questionnaires do not explicitly distinguish between vertigo and dizziness. Moreover, self-reported symptoms showed moderate correlation to objective findings. This highlights the importance of realising objective methods such as balance assessments.
Some objective assessments to identify VID, and to discriminate among patient groups and healthy subjects have been introduced. But most of the studies investigating VID examined a broad variety of vestibular disorders, rarely including concussion.
Concerning balance assessment combined with optokinetic stimulation, several studies found significant differences among control groups and patients with vestibular disorders and dizziness, but findings varied across calculated parameters. Overall, mean deviations on sway path tended to be more predictive than lean sway, and significant effects are supposed to be in stimulated planes. Additionally for path length, there exists two quotients representing the balance response ratio between eyes open and eyes closed (Romberg quotient), and the ratio between eyes open and optokinetic stimulation (optokinetic quotient), which both showed significant effects comparing healthy subjects and visual vertigo patients. However, parameters evaluated from velocity were often in favour compared to path length. Furthermore, prolonged exposure to optokinetic stimulation triggered symptoms in patients with visual vestibular mismatch but not in control subjects, supporting the hypotheses of symptom exacerbation by visual motion. Regarding defined triggers for VID, one could assume that triggers are based on an individual level and therefore include various visual motion conditions such as complex, large-field or moving elements in order to conflict one's sensory integration. Given those multidimensional conditions for an assessment, the use of VR environments for this project benefits a broad and flexible range in VID assessment. Regarding the mentioned studies, one could assume that balance evaluation on multiple optokinetic stimuli and comparison to reference values based on healthy subjects has the potential to increase the sensitivity of the balance screening for VID subjects, and in particular concussed patients.
This project aims to generate greater reliability using a more differentiated balance assessment with optokinetic stimulation. Findings are assumed to help identifying potential VID on a more individual basis and support accurate classification.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (participant)
- Number of arms
- 4
- Model description
- The project is organised in 4 arms, as healthy subjects and patients will be examined. Optokinetic stimulation will be applied to eighter by a physical disc or a head mounted device using virtual application. Healthy subjects will conduct a physical and a virtual balance assessment with visual stimulation, in a cross-over design. Patients will only conduct one type of balance assessment, physical or virtual, to prevent symptom exacerbation. This limitation for dizzy patients is based on the experience of leading clinicians from the vertigo center and on former research projects in the field of VID (de Vestel, et al., 2022; Guerraz et al., 2001; van Ombergen et al., 2016).
| Arm | Type | Receives |
|---|---|---|
| Healthy Subjects (Physical / Virtual) | Active comparator | Diagnostic Test: Postural Response upon physical optokinetic stimulation, Diagnostic Test: Postural Response upon virtual optokinetic stimulationCross-over design for healthy subjects, physical optokinetic stimulation in advance to virtual optokinetic stimulation. |
| Healthy Subjects (Virtual / Physical) | Active comparator | Diagnostic Test: Postural Response upon physical optokinetic stimulation, Diagnostic Test: Postural Response upon virtual optokinetic stimulationCross-over design for healthy subjects, virtual optokinetic stimulation in advance to physical optokinetic stimulation. |
| Patients (Physical) | Experimental | Diagnostic Test: Postural Response upon physical optokinetic stimulationThese patients are only examined with the physical stimulation to avoid excessive symptom burden. |
| Patients (Virtual) | Experimental | Diagnostic Test: Postural Response upon virtual optokinetic stimulationThese patients are only examined with the virtual stimulation to avoid excessive symptom burden. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Age between 18 and 60 years
- Binocular vision
- Recent concussion/mTBI within 4 weeks to 18 months post-injury for concussed patients
- Diagnosis related to dizziness or VID within 4 weeks to 18 months for non-concussed dizzy patients (including vestibular migraine)
- Signed ICF for included participants or signed general consent for retrospectively included patients if an ICF cannot be obtained.
Key exclusion criteria (14 listed)
- BMI greater than 30
- Acute vestibular syndrome lasting at least 24 hours
- Severe non-correctable visual impairment
- Balance issues not dizziness-related, including:
- Dizziness attributed to prescribed drugs, substance abuse, or mental disorders
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Postural Response upon physical optokinetic stimulationThe physical optokinetic stimulation consists of rotating stimulation in either direction using a physical disc (de Vestel, et al., 2022; Guerraz et al., 2001; van Ombergen et al., 2016). The assessment is conducted in complete dark, unless the fluorescent dots (approx. 11% covered of the disc area.). The disc has a diameter of 1 m. Stimulation time per trial will be 30 s. | Diagnostic test | Healthy Subjects (Physical / Virtual), Healthy Subjects (Virtual / Physical), Patients (Physical) |
| Postural Response upon virtual optokinetic stimulationThe virtual optokinetic stimulation is implemented in virtual reality goggles (Meta Quest 3, Meta Platforms, Menlo Park, CA, USA) applying oscillating and rotating stimulation in frontal and vertical axis with coherent or incoherent stimuli. The assessment in the virtual environment will be as similar as possible compared the physical stimulation. Hence, the virtual environment simulation complete dark, unless the fluorescent dots (approx. 15% covered of the disc area.). In addition to the rotating condition, the virtual dots are able to oscillate on the horizontal or vertical axis to create a more sensitive evaluation method than the physical one (Laurens et al., 2011). Stimulation time per trial will be 30 s. | Diagnostic test | Healthy Subjects (Physical / Virtual), Healthy Subjects (Virtual / Physical), Patients (Virtual) |
Primary outcome
Sensitivity of Postural Response to Optokinetic Stimulation
Time frame: Time Point 1: During the first intervention, measurement on a single day. Time Point 2: 15 minutes after the first intervention, measurement on a single day
To identify visually induced dizziness through the balance assessment, cutoff values based on calculated balance parameters will be evaluated to differentiate balance responses between concussed patients, non-concussed dizzy patients, and healthy controls. The reference will be the VID assessment performed during the clinical examination. Measurement Tool: * 6D sensor system (accelerometer and gyroscope) placed on the lower back and head. * acceleration in m/s^2 * gyroscope in deg/s) Unit of Measure: Calculations on the balance responses from each measuring site and sensor type (accelerometer, gyroscope) include temporal and spectral parameters such as: * 95% area of motion (m^2/s^4, deg^2/s^2) * RMS, SD, Mean (m/s^2, deg/s) * Power Spectral Density (PSD) between 0.1-2 Hz ((m^2/s^4)/Hz, (deg^2 /s^2)/Hz) * Power Spectral Density (PSD) at stimulation frequency of 1/3 Hz((m^2/s^4)/Hz, (deg^2 /s^2)/Hz) Comparison: * Balance parameters among the investigated groups
2 secondary outcomes
Identification of Different Postural Characteristics Response to Optokinetic Stimulation
Time frame: Time Point 1: During the first intervention, measurement on a single day. Time Point 2: 15 minutes after the first intervention, measurement on a single day
Severity of Visually Induced Dizziness
Time frame: Time Point 1: During the first intervention, measurement on a single day. Time Point 2: 15 minutes after the first intervention, measurement on a single day
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Sep 2025.
- Background: PubMed 19775892Laurens J, Awai L, Bockisch CJ, Hegemann S, van Hedel HJ, Dietz V, Straumann D. Visual contribution to postural stability: Interaction between target fixation or tracking and static or dynamic large-field stimulus. Gait Posture. 2010 Jan;31(1):37-41. doi: 10.1016/j.gaitpost.2009.08.241. Epub 2009 Sep 22.
- Background: PubMed 22113702Agarwal K, Bronstein AM, Faldon ME, Mandala M, Murray K, Silove Y. Visual dependence and BPPV. J Neurol. 2012 Jun;259(6):1117-24. doi: 10.1007/s00415-011-6311-7. Epub 2011 Nov 24.
- Background: PubMed 24057827Fife TD, Giza C. Posttraumatic vertigo and dizziness. Semin Neurol. 2013 Jul;33(3):238-43. doi: 10.1055/s-0033-1354599. Epub 2013 Sep 21.
- Background: PubMed 26231270Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015 Aug;33(3):541-50, vii. doi: 10.1016/j.ncl.2015.04.010.
- Background: PubMed 30855306Kontos AP, Sufrinko A, Sandel N, Emami K, Collins MW. Sport-related Concussion Clinical Profiles: Clinical Characteristics, Targeted Treatments, and Preliminary Evidence. Curr Sports Med Rep. 2019 Mar;18(3):82-92. doi: 10.1249/JSR.0000000000000573.
- Background: PubMed 27128970Van Ombergen A, Lubeck AJ, Van Rompaey V, Maes LK, Stins JF, Van de Heyning PH, Wuyts FL, Bos JE. The Effect of Optokinetic Stimulation on Perceptual and Postural Symptoms in Visual Vestibular Mismatch Patients. PLoS One. 2016 Apr 29;11(4):e0154528. doi: 10.1371/journal.pone.0154528. eCollection 2016.
- Background: PubMed 17538212Pavlou M, Davies RA, Bronstein AM. The assessment of increased sensitivity to visual stimuli in patients with chronic dizziness. J Vestib Res. 2006;16(4-5):223-31.
- Background: PubMed 37316210Patricios JS, Schneider KJ, Dvorak J, Ahmed OH, Blauwet C, Cantu RC, Davis GA, Echemendia RJ, Makdissi M, McNamee M, Broglio S, Emery CA, Feddermann-Demont N, Fuller GW, Giza CC, Guskiewicz KM, Hainline B, Iverson GL, Kutcher JS, Leddy JJ, Maddocks D, Manley G, McCrea M, Purcell LK, Putukian M, Sato H, Tuominen MP, Turner M, Yeates KO, Herring SA, Meeuwisse W. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711. doi: 10.1136/bjsports-2023-106898.
- Background: PubMed 11459755Guerraz M, Yardley L, Bertholon P, Pollak L, Rudge P, Gresty MA, Bronstein AM. Visual vertigo: symptom assessment, spatial orientation and postural control. Brain. 2001 Aug;124(Pt 8):1646-56. doi: 10.1093/brain/124.8.1646.
- Background: PubMed 35685740De Vestel C, De Hertogh W, Van Rompaey V, Vereeck L. Comparison of Clinical Balance and Visual Dependence Tests in Patients With Chronic Dizziness With and Without Persistent Postural-Perceptual Dizziness: A Cross-Sectional Study. Front Neurol. 2022 May 24;13:880714. doi: 10.3389/fneur.2022.880714. eCollection 2022.
- Background: PubMed 21558640Dannenbaum E, Chilingaryan G, Fung J. Visual vertigo analogue scale: an assessment questionnaire for visual vertigo. J Vestib Res. 2011;21(3):153-9. doi: 10.3233/VES-2011-0412.
- Individual participant dataSharing planned: Yes. Data from the CRF, raw values from the balance measurements, and calculated balance parameter will be shared IPD: * Diagnosis related to VID: * Group assignment * Informed Consent * Anthropometric data (weight, height) * Age * Questionnaire's data: DHI, VVAS, SVQ, SSQ * Symptom burden during balance assessment * Completion of assessment * Balance raw data * Calculated balance parameters
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Samuel Meyer, MSc contact
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Postural Response upon physical optokinetic stimulation and Postural Response upon virtual optokinetic stimulation in people with Dizziness and Concussion (Diagnosis), run by Dominik Straumann at 2 sites in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 19 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Dominik Straumann, Prof. Dr. med. (+41 44 255 55 64, Dominik.Straumann@uzh.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Sensitivity of Postural Response to Optokinetic Stimulation (time frame: Time Point 1: During the first intervention, measurement on a single day. Time Point 2: 15 minutes after the first intervention, measurement on a single day). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06893029, which also lists 11 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Sep 2025.