"Diagnosis and treatment of Mal de Debarquement syndrome"
CATHERINE CHO, MD
Clinical Associate Professor of Neurology and Otolaryngology
NYU Grossman School of Medicine
Dr. Catherine Cho is an Associate Professor in the Departments of Neurology and Otolaryngology at the NYU Grossman School of Medicine, where she is the Division Director of Neurotology in the Neurology Department. She has been a member of the Barany Society since 2008 and is a member of the Mal de Debarquement Syndrome (MdDS) Subcommittee of the Classification Committee of the Barany Society.
Dr. Cho’s academic career began as a fellow in Movement Disorders at the Icahn School of Medicine at Mount Sinai studying gait abnormalities in Parkinson’s disease under the mentorship of the late Bernard Cohen, MD and Ted Raphan, PhD. As faculty there, her clinical interest broadened to include vestibular disorders, and her research interest shifted to the treatment of MdDS as developed by the late Mingjia Dai, PhD, who also acted as her mentor. After moving to NYU in 2015 to develop a clinical vestibular program, she continued to collaborate with Dr. Dai, Dr. Cohen, and Sergei Yakushin, PhD on the treatment of MdDS and motion sickness using optokinetic stimuli to modulate the velocity storage mechanism.
Based on monkey experiments conducted by Dr. Dai (2009), it was observed that after alternating head roll with rotating in the yaw plane, the velocity storage mechanism maladapted causing a prolonged vertical nystagmus in response to head roll after the roll while rotating stimulus was removed. This was thought to be due to the cross-coupling of the pitch orientation eigenvector that had been shifted in roll. He observed the same perversion of nystagmus in response to roll in some MdDS patients and developed an experimental intervention to try to counter the maladapted pitch orientation. Although, the nystagmus was not a consistent finding in humans, there was a more consistent response to the VOR readaptation protocol, supportive of the involvement of the velocity storage integrator in modulating the pitch orientation vector (2014). Using the optokinetic stimulus in readapting the velocity storage mechanism has also been demonstrated in Dr. Dai’s motion sickness trials.
Dr. Cho is collaborating with Dr. Yakushin to continue Dr. Dai’s and Dr. Cohen’s work to further our understanding of the neural mechanisms in motion sickness and MdDS, focusing on the interaction between the velocity storage mechanism and pitch orientation. An immediate goal is to better standardize the treatment protocol to address the various symptoms encountered in MdDS (pulling, bobbing, rocking, swaying, visual vertigo, and motion sickness) and to discover applications in other central vestibular disorders.