Mal de debarquement syndrome: new insights

Area of Science:

• Neuroscience
• Neurotology
• Brain Imaging

Background:

• Mal de Debarquement Syndrome (MdDS) is a debilitating neurotological disorder with significant morbidity and limited treatment options.
• Recent research shows growing interest in understanding MdDS's biological underpinnings and developing effective therapies.

Purpose of the Study:

• To investigate the neurobiological basis of Mal de Debarquement Syndrome (MdDS).
• To explore potential therapeutic targets for MdDS by examining brain network dynamics.

Main Methods:

• Functional neuroimaging (e.g., PET scans) to assess brain glucose metabolism in MdDS patients.
• Analysis of brain network coherence in relation to treatment response.

Main Results:

• Increased glucose metabolism observed in the left entorhinal cortex (EC) and amygdala in persistent MdDS.
• Decreased metabolism noted in prefrontal and temporal cortical regions.
• Repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex reduced MdDS symptoms, correlating with decreased parietal-occipital network coherence.

Conclusions:

• A novel theory proposes MdDS results from brain network entrainment due to oscillatory motion exposure, with impaired desynchronization.
• The entorhinal cortex and limbic system appear critical in MdDS pathophysiology.
• Future treatments may focus on desynchronizing these affected brain networks.