One of the nation’s leading researchers in vestibular disorders, Daniel Merfeld, PhD, has been awarded a four-year, $2 million grant from the U.S. Department of Defense (DOD) to test a screening tool for vestibular disorders.
Dr. Merfeld, who is professor and vice chair of research in The Ohio State University Wexner Medical Center Department of Otolaryngology – Head and Neck Surgery, will soon begin his study “Evaluating a Portable Virtual-Reality (VR) Balance Test as a Vestibular Assessment Screen.” He also serves as senior vestibular scientist at the Naval Medical Research Unit-Dayton.
He envisions medical personnel eventually using the screening tool in war zones for on-site evaluations of soldiers with balance dysfunction from blast injuries and other casualties. The simple balance screening might also help physicians determine fall risk and whether clinical vestibular diagnostic testing, including vestibular threshold testing, is warranted.
A Portable Screening Tool
“Our prototype is a head-mounted set of goggles with LED display developed by Charles River Analytics, who are partners in this effort,” Dr. Merfeld says. The person being screened will stand while wearing the goggles, creating a consistent, reproducible 3D VR scene.
He says the virtual scene is likely to be something uncluttered, like the wall of a room, with a table and a picture on the wall. The test will evaluate all of the contributors to balance: vision, motion and orientation of the head, and kinesthesia. Researchers will test an individual with eyes open and eyes closed, as well as while standing on foam or a firm surface. Then, researchers will manipulate the VR scene to help tease apart sensory contributions.
The research study will quantify the correlation between vestibular function and balance in 100 healthy civilians, 100 healthy military personnel and additional participants with mild traumatic brain injury. They will be divided across age groups from 18 to 80 years old.
Possibilities for Civilian Use
With the portability of the goggles, Dr. Merfeld sees potential for a number of applications in civilian life as well. “If this is successful, we could do screenings on bigger populations to help evaluate athletes with possible concussion symptoms on a sideline, to intervene for school children suffering hidden (i.e., unknown) vestibular or balance issues, or to reduce falls in nursing homes or hospitals.”
He points out that estimates of deaths each year due to falls from vestibular dysfunction range anywhere from 48,000 to 152,000. The upper range would make these vestibular-related injuries the third leading cause of death in the United States, following heart disease and cancer. Even at the lowest estimate of 48,000, it would be the 10th leading cause of death.
Dr. Merfeld continues, “We screen vision and hearing often, but we don’t do anything for vestibular function until someone complains of symptoms. This could be a screening test to help determine who should be tested by a vestibular specialist to help improve quality of life. It’s long been known that imbalance is highly correlated with age. We also could go to nursing homes with this screening to help determine which people are most likely to fall.”
He has secured National Institutes of Health funding for vestibular studies in the civilian sector that he believes will be complementary to this latest study with the DOD.
Dr. Merfeld is leading an effort to organize a National Vestibular Meeting to be held in Dayton, Ohio, in May 2019. For more information about the meeting, please visit go.osu.edu/VORmeeting.