Wider research activities

Ménière's & Vestibular UK also works with other organisation to prioritise and further research into vestibular conditions.

British Society of Neuro-Otology 2025

Priority Setting Partnership

British Society of Neuro-Otology 2025

BSNO aims to provide a forum for informal discussion and the opportunity to present research in related topics of neuro-otology, balance disorders and vestibular science. Meetings attract all those engaged in clinical or scientific research in neuro-otology including, but not limited to, audiological physicians; ENT surgeons; neurologists; physicists and psychologists.

Ménière’s & Vestibular UK are pleased to work with the British Society of Neuro-Otology (BSNO), providing admin support for their biennial event. 

The 2025 event was a landmark international conference, welcoming over 200 delegates from 20 countries, dedicated to the pioneering work of Professor Adolfo Bronstein in the field of neuro-otology.

Professionals from all stages of their careers are encouraged to attend. On the last day, awards are given for the best poster and best oral presentation at the conference. This year, the judges chose to split the two awards, so there were joint winners in each category. A summary of the winning presentations are provided here. Well done to all involved, including Yuxiao Li, PhD Student, Imperial College London (UK) who received a special mention for ‘Best Young Presenter’

Best Free Paper - Poster Presentation (joint-winners)

Developing a New Acute Vestibular Outcome Measure

Luke Wilkinson, Physiotherapist, Imperial College University (UK)

People who experience dizziness while in hospital often describe how distressing and disorientating these symptoms can be. Vestibular (balance) problems are common after illness or injury, yet in acute hospital settings there is currently no questionnaire designed specifically to capture how these symptoms affect patients whilst they are admitted to hospital.

This project arose from concerns raised by both patients and clinicians that many existing dizziness questionnaires are not suitable for use in hospital. Most were developed for community or outpatient settings and include questions about activities such as shopping, driving, or social participation, which are not relevant to people who are acutely unwell, bed-bound, or recovering from serious injury. As a result, these questionnaires can feel confusing, burdensome, or meaningless at a time when patients are at their most vulnerable.

The aim of this study was to begin developing a new acute vestibular questionnaire that reflects what actually matters to patients in hospital. The project is ongoing and is currently focused on identifying themes, refining questions, ensuring they are clear, relevant and acceptable, and testing whether the questionnaire can be used reliably in busy acute care settings. Further work will explore how best to apply the questionnaire in hospital care to meet the needs of dizzy patients.

This work was partly supported by Ménière’s & Vestibular UK, whose funding contributed to the research assistant role on the project. Their support helped ensure that patient experience was central to the research from the outset.

Functional Gains of Balance and Postural Control in Parkinson’s Disease using Exergaming

Ha-Jun Yoon, Research Associate, University of Leicester (UK)

Falls are a major concern for people with Parkinson's Disease (PD) because of impaired balance. While traditional exercise and brainwave training (neurofeedback) can help, we explored combining them for a more effective solution. We investigated a 12-week intervention combining Virtual Reality (VR) Exergaming with real-time EEG Neurofeedback. This approach aims to train PD patients to suppress alpha brain oscillations, which are linked to poorer balance. 42 people with PD were randomized to either a real Neurofeedback group or a SHAM control group (exergame alone). The intervention group showed significant improvements in balance and postural control, which were not seen in the sham group. The neurofeedback successfully normalised sensory integration, allowing patients to use vestibular and proprioceptive information more efficiently. The intervention induced a significant shift to a more active, dynamic reactive balance strategy, which is a more robust strategy for fall prevention. Combining exergaming with real-time neurofeedback offers a significant advantage to critical balance systems over exergaming alone, providing an engaging and accessible intervention to enhance postural stability and potentially reduce falls in the PD population.

Best Free Paper - Oral Presentation (joint-winners)

Effects of attentional engagement on vestibular perception and processing

Malhar Mukne, Medical Student, Imperial College London (UK)

Many situations in daily life require our brains to detect and respond to very weak sensory signals. For example, we can recognise a quiet voice in the distance calling our name, or sense subtle pressure changes under our feet that help us keep our balance. When these signals are very faint, psychological factors like attention and expectation can strongly influence how we perceive and experience them. In certain chronic dizziness disorders, such as Persistent Postural-Perceptual Dizziness (PPPD), people often feel as if they are swaying around and very unstable, despite standing still (and having good scores on clinical measures of balance). One possible explanation of this is that the brain has become overly sensitive to attending and detecting small swaying movements that would otherwise not reach conscious awareness, which individuals then experience as “dizziness”.

To investigate this idea, we recorded the brain activity from 23 healthy participants whilst they experienced very slow (i.e. barely perceivable) movements in a rotating chair. This was done in complete darkness with white noise playing, so they could not use any vision or sound to identify the direction they were moving in. In some trials, they were asked to pay close attention to the chair’s movement and rotations (and report its direction after each trial), whilst in others they were told to let their mind wander and think about anything they wished.

When paying conscious attention to the chair’s rotations, participants were more aware of each individual rotation and also perceived these rotations as being stronger/more intense (even though the speed of movement was exactly the same). This shows that attention can influence how we perceive self-motion. These perceptual results were mirrored in the brain activity data: we saw much stronger brain responses when paying conscious attention (with very little brain response otherwise). So, what do these results mean? They reveal that paying close attention to very slow self-motion can make your brain process these movements more, leading to them feeling more intense. This may help explain why many people with chronic dizziness report that their symptoms improve during situations that take their mind away from their balance (and why clinical interventions using distraction tasks can often be helpful). We have also collected data on standing balance and vestibular-evoked eye movements to understand these attention-based mechanisms further and hopefully better inform clinical practice.

Physical Activity and Fear Avoidance Over Time in Patients with Acute/Subacute versus Chronic Unilateral Vestibulopathy (UVP).

Lien Van Laer PT, PhD, Faculty of Medicine and Health Sciences /MOVANT, University of Antwerp (Belgium)

On 14 November 2025, I had the opportunity to present the results of a multicenter study conducted by Apeldoorn’s Dizziness Center (the Netherlands), Leiden University (the Netherlands), and the University of Antwerp (Belgium), titled Physical Activity and Fear Avoidance Over Time in Patients with Acute/Subacute versus Chronic Unilateral Vestibulopathy (UVP). This prospective cohort study investigated how physical activity and fear-avoidance beliefs change over time in adults with acute/subacute versus chronic UVP, using accelerometry and the Vestibular Activities Avoidance Instrument. Patients underwent two assessments: the first at baseline and the second 2–3 months later.

Results showed that individuals with acute/subacute UVP exhibited a significant increase in physical activity from baseline to follow-up (+198 min/week), whereas those with chronic UVP showed no meaningful change. Physical activity levels were further influenced by baseline fear-avoidance beliefs and by etiology, with lower activity observed in individuals reporting high fear-avoidance and in those with medically induced UVPs (e.g., following vestibular schwannoma resection) compared to idiopathic etiologies such as vestibular neuritis. The relationship between physical activity and fear-avoidance beliefs was assessed at both time points, with the strongest association found in the acute/subacute group at baseline. Overall, the findings highlight the connection between fear-avoidance beliefs and physical activity, particularly early after onset, and underscore the importance of assessing these psychological factors to guide individualized management strategies. The results of this study were published here. I would like to thank all co-authors, and especially first author Hanna Koppelaar-van Eijsden, for her outstanding work on this study.