DIZZYNET—a European network initiative for vertigo and balance research: visions and aims

Journal of Neurology, Apr 2016

Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo often receive either inappropriate or inadequate treatment. The most important reasons for this deplorable situation are insufficient interdisciplinary cooperation, nonexistent standards in diagnostics and therapy, the relatively rare translations of basic science findings to clinical applications, and the scarcity of prospective controlled multicenter clinical trials. To overcome these problems, the German Center for Vertigo and Balance Disorders (DSGZ) started an initiative to establish a European Network for Vertigo and Balance Research called DIZZYNET. The central aim is to create a platform for collaboration and exchange among scientists, physicians, technicians, and physiotherapists in the fields of basic and translational research, clinical management, clinical trials, rehabilitation, and epidemiology. The network will also promote public awareness and help establish educational standards in the field. The DIZZYNET has the following objectives as regards structure and content: to focus on multidisciplinary translational research in vertigo and balance disorders, to develop interdisciplinary longitudinal and transversal networks for patient care by standardizing and personalizing the management of patients, to increase methodological competence by implementing common standards of practice and quality management, to internationalize the infrastructure for prospective multicenter clinical trials, to increase recruitment capacity for clinical trials, to create a common data base for patients with vertigo and balance disorders, to offer and promote attractive educational and career paths in a network of cooperating institutions. In the long term, the DIZZYNET should serve as an internationally visible network for interdisciplinary and multiprofessional research on vertigo and balance disorders. It ideally should equally attract the afflicted patients and those managing their disorders. DIZZYNET will not compete with the traditional national or international societies active in the field, but will function as an additional structure that addresses some of the above problems.

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DIZZYNET—a European network initiative for vertigo and balance research: visions and aims

J Neurol DIZZYNET-a European network initiative for vertigo and balance research: visions and aims Andreas Zwergal 0 1 2 3 4 5 Thomas Brandt 0 1 2 3 4 5 Mans Magnusson 0 1 2 3 4 5 Christopher Kennard 0 1 2 3 4 5 0 German Center for Vertigo and Balance Disorders, DSGZ, University of Munich , Munich , Germany 1 Department of Neurology, University of Munich , Munich , Germany 2 & Andreas Zwergal 3 Nuffield Department of Clinical Neurosciences, University of Oxford , Oxford , UK 4 Department of Otorhinolaryngology, Clinical Sciences, Lund University and Ska ̊ne University Hospital , Lund , Sweden 5 Clinical Neurosciences, University of Munich , Munich , Germany Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo often receive either inappropriate or inadequate treatment. The most important reasons for this deplorable situation are insufficient interdisciplinary cooperation, nonexistent standards in diagnostics and therapy, the relatively rare translations of basic science findings to clinical applications, and the scarcity of prospective controlled multicenter clinical trials. To overcome these problems, the German Center for Vertigo and Balance Disorders (DSGZ) started an initiative to establish a European Network for Vertigo and Balance Research called DIZZYNET. The central aim is to create a platform for collaboration and exchange among scientists, physicians, technicians, and physiotherapists in the fields of basic and translational research, clinical management, clinical trials, rehabilitation, and epidemiology. The network will also promote public awareness and help establish educational standards European Dizzynet; Balance disorders; Vestibular - This manuscript is part of a supplement sponsored by the German Federal Ministry of Education and Research within the funding initiative for integrated research and treatment centers. in the field. The DIZZYNET has the following objectives as regards structure and content: • • to focus on multidisciplinary translational research in vertigo and balance disorders, to develop interdisciplinary longitudinal and transversal networks for patient care by standardizing and personalizing the management of patients, to increase methodological competence by implementing common standards of practice and quality management, to internationalize the infrastructure for prospective multicenter clinical trials, to increase recruitment capacity for clinical trials, to create a common data base for patients with vertigo and balance disorders, to offer and promote attractive educational and career paths in a network of cooperating institutions. In the long term, the DIZZYNET should serve as an internationally visible network for interdisciplinary and multiprofessional research on vertigo and balance disorders. It ideally should equally attract the afflicted patients and those managing their disorders. DIZZYNET will not compete with the traditional national or international societies active in the field, but will function as an additional structure that addresses some of the above problems. Introduction Vertigo Dizziness Over the last decades the field of vertigo and balance research has undergone fundamental changes. Its methodological armamentarium has rapidly developed and nowadays includes genetic, biochemical, imaging techniques as well as neurophysiology, mathematical modeling and robotics. Novel diagnostic tests have been introduced to clinical practice such as the video head-impulse test, the subjective visual vertical, vestibular-evoked potentials, and automated analyses of posture and gait. New pharmacological agents have been developed to treat vestibular, ocular motor and cerebellar disorders. Prospective clinical trials have become increasingly important to prove the efficacy and benefit of these agents. Quality of life and functioning aspects have been recognized as an essential part of the management of patients with vestibular disorders. The concept of higher vestibular functions has set new foci for the impact of the vestibular system on cognition, spatial orientation and memory, navigation and hemispheric lateralization. These developments have brought new challenges. For example, the increasing demand for transfer of basic knowledge to patients has led to more studies being planned but their number greatly exceeds the current recruitment capacities of single institutions. In contrast to other medical research fields (cardiology, oncology, immunology, vascular neurology), the field of vertigo and balance has an almost nonexistent culture of prospective multicenter studies. This state of affairs can be seen in the striking rarity of such studies. It is also difficult to expand patient recruitment so as to satisfy a multicenter network because the technical equipment and study expertise for high-quality data collection are only available at a few centers. This situation is further complicated by diff (...truncated)


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Andreas Zwergal, Thomas Brandt, Mans Magnusson, Christopher Kennard. DIZZYNET—a European network initiative for vertigo and balance research: visions and aims, Journal of Neurology, 2016, pp. 2-9, Volume 263, Issue 1, DOI: 10.1007/s00415-015-7912-3