Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo

Background: Balance training with vibrotactile neurofeedback (VNF) can improve balance and subjective impairment in age-related vertigo and dizziness. Ginkgo biloba dry extract EGb 761 has been shown to improve subjective impairment in chronic vertigo and the efficacy of conventional balance trainin...

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Autores principales:	Lars Decker, Dietmar Basta, Martin Burkart, Arne Ernst
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	presbyvestibulopathy balance training vibrotactile neurofeedback Ginkgo biloba balance deficit Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3aa159a1064a4947b918205c518f2820
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spelling	oai:doaj.org-article:3aa159a1064a4947b918205c518f28202021-12-01T18:39:33ZBalance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo1664-229510.3389/fneur.2021.691917https://doaj.org/article/3aa159a1064a4947b918205c518f28202021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.691917/fullhttps://doaj.org/toc/1664-2295Background: Balance training with vibrotactile neurofeedback (VNF) can improve balance and subjective impairment in age-related vertigo and dizziness. Ginkgo biloba dry extract EGb 761 has been shown to improve subjective impairment in chronic vertigo and the efficacy of conventional balance training. The combination was expected to work synergistically in this difficult-to-treat population.Objectives: To demonstrate the efficacy of VNF added to EGb 761 for age-related vertigo and dizziness.Design: Multicenter, prospective, controlled, randomized, single-blind, two-arm trial (German Clinical Trials Register https://www.drks.de No. DRKS00007633).Setting: Specialist offices and tertiary care outpatient department.Participants: One hundred and twenty subjects aged 60+ years with chronic dizziness for over 3 months, a Dizziness Handicap Inventory (DHI) Sum Score >25 and fall risk in balance-related situations as measured by the geriatric Standard Balance Deficit Test Composite Score (gSBDT-CS)>40. Patients with other distinct vestibular pathology (e.g., Meniére's disease, stroke, BPPV) were excluded.Intervention: EGb 761 (80 mg twice daily for 12 weeks) plus 10 days of individually adapted balance training with VNF, randomized 1:1 to sensitive (active) or non-sensitive (sham) neurofeedback.Measurements: The change in gSBDT-CS after 6 weeks (primary), other gSBDT outcomes, DHI, cognition, hearing, and safety.Results: One hundred nine of 120 enrolled subjects received both treatments at least once. Over 12 weeks, the gSBDT-CS improved by 6.7 (active) vs. 4.5 (sham). There was a difference in favor of the active treatment of −2.4 (95% CI −5.4; 0.6) after 6 weeks. Under active treatment, more pronounced effects occurred in all secondary analyses and in nearly all secondary endpoints. The DHI sum score decreased from 44.1 to 31.1 in the total sample with a treatment group difference after 6 weeks of −3.1, 95% CI (−7.1; 0.9). No safety issues were reported.Conclusion: Over 12 weeks, the combination of balance training with VNF and Ginkgo biloba dry extract EGb 761 reached a clinically relevant improvement of age-related vertigo and dizziness with a good pharmacological safety profile.Lars DeckerDietmar BastaMartin BurkartArne ErnstFrontiers Media S.A.articlepresbyvestibulopathybalance trainingvibrotactile neurofeedbackGinkgo bilobabalance deficitNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	presbyvestibulopathy balance training vibrotactile neurofeedback Ginkgo biloba balance deficit Neurology. Diseases of the nervous system RC346-429
spellingShingle	presbyvestibulopathy balance training vibrotactile neurofeedback Ginkgo biloba balance deficit Neurology. Diseases of the nervous system RC346-429 Lars Decker Dietmar Basta Martin Burkart Arne Ernst Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo
description	Background: Balance training with vibrotactile neurofeedback (VNF) can improve balance and subjective impairment in age-related vertigo and dizziness. Ginkgo biloba dry extract EGb 761 has been shown to improve subjective impairment in chronic vertigo and the efficacy of conventional balance training. The combination was expected to work synergistically in this difficult-to-treat population.Objectives: To demonstrate the efficacy of VNF added to EGb 761 for age-related vertigo and dizziness.Design: Multicenter, prospective, controlled, randomized, single-blind, two-arm trial (German Clinical Trials Register https://www.drks.de No. DRKS00007633).Setting: Specialist offices and tertiary care outpatient department.Participants: One hundred and twenty subjects aged 60+ years with chronic dizziness for over 3 months, a Dizziness Handicap Inventory (DHI) Sum Score >25 and fall risk in balance-related situations as measured by the geriatric Standard Balance Deficit Test Composite Score (gSBDT-CS)>40. Patients with other distinct vestibular pathology (e.g., Meniére's disease, stroke, BPPV) were excluded.Intervention: EGb 761 (80 mg twice daily for 12 weeks) plus 10 days of individually adapted balance training with VNF, randomized 1:1 to sensitive (active) or non-sensitive (sham) neurofeedback.Measurements: The change in gSBDT-CS after 6 weeks (primary), other gSBDT outcomes, DHI, cognition, hearing, and safety.Results: One hundred nine of 120 enrolled subjects received both treatments at least once. Over 12 weeks, the gSBDT-CS improved by 6.7 (active) vs. 4.5 (sham). There was a difference in favor of the active treatment of −2.4 (95% CI −5.4; 0.6) after 6 weeks. Under active treatment, more pronounced effects occurred in all secondary analyses and in nearly all secondary endpoints. The DHI sum score decreased from 44.1 to 31.1 in the total sample with a treatment group difference after 6 weeks of −3.1, 95% CI (−7.1; 0.9). No safety issues were reported.Conclusion: Over 12 weeks, the combination of balance training with VNF and Ginkgo biloba dry extract EGb 761 reached a clinically relevant improvement of age-related vertigo and dizziness with a good pharmacological safety profile.
format	article
author	Lars Decker Dietmar Basta Martin Burkart Arne Ernst
author_facet	Lars Decker Dietmar Basta Martin Burkart Arne Ernst
author_sort	Lars Decker
title	Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo
title_short	Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo
title_full	Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo
title_fullStr	Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo
title_full_unstemmed	Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo
title_sort	balance training with vibrotactile neurofeedback and ginkgo biloba extract in age-related vertigo
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/3aa159a1064a4947b918205c518f2820
work_keys_str_mv	AT larsdecker balancetrainingwithvibrotactileneurofeedbackandginkgobilobaextractinagerelatedvertigo AT dietmarbasta balancetrainingwithvibrotactileneurofeedbackandginkgobilobaextractinagerelatedvertigo AT martinburkart balancetrainingwithvibrotactileneurofeedbackandginkgobilobaextractinagerelatedvertigo AT arneernst balancetrainingwithvibrotactileneurofeedbackandginkgobilobaextractinagerelatedvertigo
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Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo

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