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The Science of Vertigo
David S. Zee, M.D.
Professor, Departments of Neurology, Ophthalmology, Otolaryngology,

Dr. David ZeeIn general our research focuses on the ubiquitous and vexing problems experienced by patients who have dizziness and vertigo.  We combine investigations in normal subjects and patients as we attempt to ferret out key principals for better diagnosis and treatments. Last year we published a landmark paper with an Italian colleague describing and explaining an amazing phenomenon. EVERBODY who lies in a strong MRI machine gets a nystagmus (involuntary jerking of the eyes) and some dizziness from activation of the inner ear labyrinth.  We discovered the physical mechanism (Lorenz forces or static hydrodynamic forces) and are now testing how to use this new way to test labyrinthine function by examining effects in normal subjects and in patients, as well as consider the potential to use magnetic fields as a potential rehabilitation tool.

More recently we have also used another technique based on magnetic fields called transcranial magnetic stimulation (TMS) which is a noninvasive way to stimulate a tiny part of the brain through the intact skull and temporarily inhibit its function. We have attacked the problem of the disturbed, disabling and distressing perceptions about whether they are upright or tilted which patients with inner ear labyrinthine and more central brain disorders can have and the consequent imbalance they experience. TMS allows us to stimulate a focal part of the brain, transiently inhibit its function and see how this influences higher-level integration of sensations that normally allow us to create a stable perception of the world. We measure the influence of these mini transient interruptions on one’s ability to decide what is upright by having the subject report on how upright a line looks. Our results so far indicate that a very small area of the brain is crucial for this and in particular this area functions most when we are faced with conflicting information about where we are (for example if our head it titled but our body is not). We call this making the correct coordinate transformations to achieve the necessary coherence amongst information from our eyes, our neck muscles and joints and our inner ears. We hope to develop this technique as a diagnostic test for patients with complicated perceptual problems and to give clues as to how we might rehabilitate them (for example with Tai Chi or Qi Gong exersises).

Dr. Zee began his scientific career at The Johns Hopkins University in 1965 as a medical student. His special interests are in eye movements, cerebellar function and motor learning, and vestibular disorders. His research combines studies in experimental models of disease, and in human patients and normal subjects, all aimed at understanding brain function and neurological disease. He has been Professor of Neurology, Ophthalmology, Otolaryngology and Neuroscience at Johns Hopkins since 1985. In 1994 he received the Ottorino Rossi prize from the University of Pavia in Italy and the Hallpike-Nylen Medal of the Barany Society in Uppsala, Sweden. He gave the inaugural Swithin Meadows Lecture at the National Hospital in London in 1995, the inaugural Houston Merritt Lecture of the American Academy of Neurology in 2003, the inaugural Alfred Kestenbaum Lecture in Wurzburg, Germany in 2005 and he was the inaugural Visiting Neurology Educator at the Mayo Clinic in Minnesota in 1980. He won the Johns Hopkins Professor’s clinical teaching award in 2002. He was the annual “Visiting Brain Scholar” in England in 2006. This year he gave the Lord Adrian lecture in Cambridge, England and the Michael Sanders Lecture at the Royal Society in London and was the Irwin Levy visiting Professor at Washington University, St. Louis. He is the coauthor of the textbook, The Neurology of Eye Movements with Dr. R. John Leigh, now in its fourth edition. He has had continuous NIH funding for his research since 1975. Learn more about Dr. Zee

Additional Information:

Read "Researchers Pinpoint the Cause of MRI Vertigo" - Johns Hopkins Press Release

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