Neuro-otology

The Neuro-otology Unit investigates the neuroscience and clinical disorders of balance.  Although “otology” means “ear science”, and indeed inner ear (or vestibular) disorders are a common source of balance problems in patients, the work of the unit is not confined to the vestibular system.  We also explore the role played by other inputs in balance control and its disorders, such as the visual and proprioceptive systems, as well as the fascinating central integration process taking place in the brain.  We use a large variety of research procedures, including neuro-physiology, movement science, imaging and psychophysical techniques, and run specialised clinics for patients with dizziness, eye movement and balance problems.

Current research interests involve the effects of small vessel brain disease (Professor Adolfo Bronstein), traumatic brain injury (Dr Barry Seemungal) and inter-hemipsheric competition (Dr Qadeer Arshad) on spatial orientation and balance.  We put considerable effort in trying to understand the basic mechanisms of balance and spatial orientation, both in health and disease, so that new rehabilitation and treatment procedures can be developed.


Image credit: Figure by Barry Seemungal and adapted from Kaski et al. Temporoparietal encoding of space and time during vestibular-guided orientation. Brain (2016) 139 (2): 392-403. Published by Oxford University Press on behalf of The Guarantors of Brain.

Research

Research themes

  • Cortical control of balance and spatial orientation 
  • Visual input, balance and "visual vertigo" 
  • Motion sickness
  • Small vessel disease and dizziness in the elderly 
  • Head injury and dizziness 
  • Rehabilitation of balance disorders

Recent publications


1. Patel M, Agarwal K, Arshad Q, Hariri M, Rea P, Seemungal BM, Golding JF, Harcourt JP, Bronstein AM et al., Intratympanic steroids vs. gentamicin in unilateral Ménière's disease: a randomised double-blind comparative effectiveness trial, Lancet, ISSN: 1474-547X
2. Yousif N, Fu RZ, Abou-El-Ela Bourquin B, Bhrugubanda V, Schultz SR, Seemungal BM. Dopamine Activation Preserves Visual Motion Perception Despite Noise Interference of Human V5/MT. J Neurosci. 2016 Sep 7;36(36):9303-12. doi: 10.1523/JNEUROSCI.4452-15.2016. PubMed PMID: 27605607; PubMed Central PMCID: PMC5013183.
3. Perceived state of self during motion can differentially modulate numerical magnitude allocation. Arshad Q, Nigmatullina Y, Roberts RE, Goga U, Pikovsky M, Khan S, Lobo R, Flury AS, Pettorossi VE, Cohen-Kadosh R, Malhotra PA, Bronstein AM. Eur J Neurosci. 2016 Sep;44(6):2369-74. doi: 10.1111/ejn.13335. Epub 2016 Aug 10.
4. Kaski D, Pradhan V, Bronstein AM. Clinical features of functional (psychogenic) eye movement disorders. J Neurol Neurosurg Psychiatry. 2016 Sep 28. pii: jnnp-2016-313608. doi: 10.1136/jnnp-2016-313608. [Epub ahead of print] PubMed PMID: 27683918.
5. Lateralisation of the Vestibular Cortex Is More Pronounced in Left-Handers.
Nigmatullina Y, Siddiqui S, Khan S, Sander K, Lobo R, Bronstein AM, Arshad Q.
Brain Stimul. 2016 Aug 3. pii: S1935-861X(16)30204-2. doi: 10.1016/j.brs.2016.08.001.
6. Seemungal BM. Screening for BPPV in falls: an easy but big clinical "win".
BMJ. 2016 Jun 1;353:i3004. doi: 10.1136/bmj.i3004. PubMed PMID: 27250837.
7. Braga RM, Fu RZ, Seemungal BM, Wise RJ, Leech R. Eye Movements during Auditory
Attention Predict Individual Differences in Dorsal Attention Network Activity.
Front Hum Neurosci. 2016 May 9;10:164. doi: 10.3389/fnhum.2016.00164. eCollection
2016. PubMed PMID: 27242465; PubMed Central PMCID: PMC4860869.
8. Bidirectional Modulation of Numerical Magnitude. Arshad Q, Nigmatullina Y, Nigmatullin R, Asavarut P, Goga U, Khan S, Sander K, Siddiqui S, Roberts RE, Cohen Kadosh R, Bronstein AM, Malhotra PA. Cereb Cortex. 2016 May;26(5):2311-24. doi: 10.1093/cercor/bhv344.
9. Yousif N, Bhatt H, Bain PG, Nandi D, Seemungal BM. The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception. Eur J Neurol. 2016 Mar;23(3):668-70. doi: 10.1111/ene.12947. Epub 2016 Jan 23. PubMed PMID: 26800658; PubMed Central PMCID: PMC4819708.
10. Kaski D, Quadir S, Nigmatullina Y, Malhotra PA, Bronstein AM, Seemungal BM. Temporoparietal encoding of space and time during vestibular-guided orientation. Brain. 2016 Feb;139(Pt 2):392-403. doi: 10.1093/brain/awv370. PubMed PMID: 26719385; PubMed Central PMCID: PMC4805090.
11. Patel M, Arshad Q, Roberts RE, Ahmad H, Bronstein AM. Chronic Symptoms After Vestibular Neuritis and the High-Velocity Vestibulo-Ocular Reflex. Otol Neurotol. 2016 Feb;37(2):179-84. doi: 10.1097/MAO.0000000000000949. PubMed PMID: 26719963; PubMed Central PMCID: PMC4712355.
12. Gardner MR, Stent C, Mohr C, Golding JF. Embodied perspective-taking indicated by selective disruption from aberrant self motion. Psychol Res. 2016 Feb 22. [Epub ahead of print] PubMed PMID: 26902293.
13. Golding JF, Gresty MA. Biodynamic Hypothesis for the Frequency Tuning of Motion Sickness. Aerosp Med Hum Perform. 2016 Jan;87(1):65-8. doi: 10.3357/AMHP.4295.2016. PubMed PMID: 26735236.
14. Golding JF. Motion sickness. Handb Clin Neurol. 2016;137:371-90. doi: 10.1016/B978-0-444-63437-5.00027-3. PubMed PMID: 27638085.
15. Kaski D, Bronstein AM, Edwards MJ, Stone J. Cranial functional (psychogenic) movement disorders. Lancet Neurol. 2015 Dec;14(12):1196-205. doi: 10.1016/S1474-4422(15)00226-4. Review. PubMed PMID: 26581970.
16. Li LM, Leech R, Scott G, Malhotra P, Seemungal B, Sharp DJ. The effect of oppositional parietal transcranial direct current stimulation on lateralized brain functions. Eur J Neurosci. 2015 Dec;42(11):2904-14. doi: 10.1111/ejn.13086. PubMed PMID: 26414683; PubMed Central PMCID: PMC4737321.
17. Seemungal BM. The Components of Vestibular Cognition - Motion Versus Spatial Perception. Multisens Res. 2015;28(5-6):507-24. Review. PubMed PMID: 26595954.
18. Ahmad H, Cerchiai N, Mancuso M, Casani AP, Bronstein AM. Are white matter
abnormalities associated with "unexplained dizziness"? J Neurol Sci. 2015 Nov
15;358(1-2):428-31. doi: 10.1016/j.jns.2015.09.006. Epub 2015 Sep 4. PubMed PMID:
26412160; PubMed Central PMCID: PMC4640145.
19. Arshad Q, Cerchiai N, Goga U, Nigmatullina Y, Roberts RE, Casani AP, Golding
JF, Gresty MA, Bronstein AM. Electrocortical therapy for motion sickness.
Neurology. 2015 Oct 6;85(14):1257-9. doi: 10.1212/WNL.0000000000001989. Epub 2015
Sep 4. PubMed PMID: 26341870; PubMed Central PMCID: PMC4607597.
20. Patel M, Roberts RE, Riyaz MU, Ahmed M, Buckwell D, Bunday K, Ahmad H, Kaski, Arshad Q, Bronstein AM. Locomotor adaptation is modulated by observing the actions of others. J Neurophysiol. 2015 Sep;114(3):1538-44. doi: 10.1152/jn.00446.2015. Epub 2015 Jul 8. PubMed PMID: 26156386; PubMed Central PMCID: PMC4561633.
21. Bronstein AM, Kaski D, Cutfield N, Buckwell D, Banga R, Ray J, Chavda S, Irving R. Head-Jolting Nystagmus: Occlusion of the Horizontal Semicircular Canal Induced by Vigorous Head Shaking. JAMA Otolaryngol Head Neck Surg. 2015 Aug;141(8):757-60. doi: 10.1001/jamaoto.2015.0711. PubMed PMID: 25996844.
22. Nigmatullina Y, Hellyer PJ, Nachev P, Sharp DJ, Seemungal BM. The neuroanatomical correlates of training-related perceptuo-reflex uncoupling in dancers. Cereb Cortex. 2015 Feb;25(2):554-62. doi: 10.1093/cercor/bht266. PubMed PMID: 24072889; PubMed Central PMCID: PMC4380084.

Job opportunities

The Neuro-otology Unit will soon be advertising two academic research posts:

  • a Clinical Research Fellow with interest and expertise in neurology, imaging and balance disorders
  • a Postdoctoral Research Associate with expertise in EEG/EMG signal processing, quantitative MRI processing or, ideally, both.

These two posts will be for a duration of 3 years to investigate the clinical, imaging and neuro-physiology of the dizziness and unsteadiness in patients with small-vessel white matter disease. Informal expressions of interest are welcome; please e-mail a.bronstein@imperial.ac.uk.

Personnel

Video - playlist widget

In a spin

The misery of motion sickness could be ended within five to ten years thanks to a new treatment being developed by scientists at Imperial.

In a spin

In a spin

Dr Qadeer Arshad explains a new treatment for motion sickness

The misery of motion sickness could be ended within five to ten years thanks to a new treatment being developed by scientists at Imperial.

Virtual reality for vertigo

Virtual reality for vertigo

Dr Ed Roberts discusses using virtual reality to treat vertigo

After certain ear conditions, some patients find supermarket aisles or busy transport hubs make them feel incredibly dizzy. Can virtual reality help retrain their brains?