Unexplained Dizziness in the Elderly: The Role of Small Vessel Disease

  • Research type

    Research Study

  • Full title

    Unexplained Dizziness in the Elderly: The Role of Small Vessel Disease.

  • IRAS ID

    210182

  • Contact name

    A M Bronstein

  • Contact email

    a.bronstein@imperial.ac.uk

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    3 years, 0 months, 0 days

  • Research summary

    Dizziness is very common in the elderly and a major cause of reduced quality of life and increased falls in this population. It is difficult to treat, symptoms are often prolonged and result in multiple specialist consultations and the subsequent healthcare costs that this entails. Despite extensive investigations, the cause of dizziness remains unexplained in 30-50% of elderly patients.
    We propose to investigate the cause of unexplained dizziness in the elderly. This will lead to speedier diagnosis and aid the development of future treatments, benefitting both patients themselves and saving considerable healthcare resources. Cerebral small vessel disease (SVD) is the most common brain disorder. It is diagnosed by changes seen on brain imaging as a result of damage to the small vessels of the brain. It becomes more common with advancing age. We hypothesise that cerebral SVD, as seen on brain Magnetic Resonance Imaging (MRI), is a major cause of unexplained dizziness in the elderly. We aim to identify the mechanisms behind dizziness in SVD.
    The study will utilise imaging, physiological and psychometric testing and dizziness questionnaires all carried out a Charing Cross Hospital. We will test an elderly healthy volunteer group and compare results to a cohort of elderly patients with unexplained dizziness. We will use MRI to identify how the site and severity of SVD is correlated to the patient's dizziness symptoms and also how they correlate with laboratory tests of balance and stability. We will record electrical brain and muscle activity using Electroencephalogram (EEG) and Electromyography (EMG) to understand the neurophysiological basis of dizziness in patients with SVD. We will investigate the relationship between dizziness symptoms, EEG and changes in blood pressure when patients with SVD stand up. We will investigate whether dizziness might be one of the earliest features of SVD.

  • REC name

    North East - York Research Ethics Committee

  • REC reference

    17/NE/0133

  • Date of REC Opinion

    4 May 2017

  • REC opinion

    Further Information Favourable Opinion