Improvement of vertigo symptoms after 2 months of Vertigoheel treatment: a case series in patients with bilateral vestibulopathy and functional dizziness

BackgroundDizziness is a common leading symptom in bilateral vestibulopathy (BVP) and functional dizziness (FD), with significant negative effects on functional ability and quality of life. Vertigoheel is a widely used non-prescription drug for the treatment of vertigo. In order to generate systematic data for Vertigoheel in BVP and FD, we conducted a non-interventional study assessing vertigo symptoms.MethodsThis study was conducted as an open-label, prospective, monocentric, non-interventional case series (ClinicalTrials.gov identifier NCT05897853). Patients with BVP and FD received Vertigoheel according to market approval for an observational period of 2 months. Change from baseline after 2 months was assessed for the following endpoints: Dizziness Handicap Inventory (DHI) as the primary endpoint, quality of life (QoL) by EQ-5D-5L, and body sway by static posturography. Patients with FD were additionally assessed for depression and anxiety by PHQ-9 and GAD-7 questionnaires. Patients with BVP were assessed for vestibular function by video head impulse testing and caloric testing. Adverse events and other safety-related observations were evaluated.ResultsOf 41 patients with FD and 13 with BVP, two with FD and none with BVP dropped out before the follow-up visit. Both patient groups showed significantly improved disability caused by dizziness after 2 months: In BVP, the DHI decreased on average by 13.2 points from 45.4 to 32.2 (p < 0.001). In FD, the DHI decreased on average by 12.0 points from 46.5 to 34.5 (p < 0.001). In patients with FD, significant improvements were also observed for the secondary endpoints QoL, anxiety, and depression. No significant change was observed for posturography readouts. In patients with BVP, there were no statistically significant improvements for the secondary endpoints QoL, posturography, or vestibular function within the observation period. The study found no evidence of a safety risk.ConclusionThe study provides evidence for Vertigoheel’s clinical safety and limited evidence – because of the non-interventional design – for its effectiveness in BVP and FD that are considered disease entities with high medical need for new treatment options. The results may serve as the basis for randomized placebo-controlled trials

Glacial lake drainage in Patagonia (13-8 kyr) and response of the adjacent Pacific Ocean

Large freshwater lakes formed in North America and Europe during deglaciation following the Last Glacial Maximum. Rapid drainage of these lakes into the Oceans resulted in abrupt perturbations in climate, including the Younger Dryas and 8.2 kyr cooling events. In the mid-latitudes of the Southern Hemisphere major glacial lakes also formed and drained during deglaciation but little is known about the magnitude, organization and timing of these drainage events and their effect on regional climate. We use 16 new single-grain optically stimulated luminescence (OSL) dates to define three stages of rapid glacial lake drainage in the Lago General Carrera/Lago Buenos Aires and Lago Cohrane/Pueyrredón basins of Patagonia and provide the first assessment of the effects of lake drainage on the Pacific Ocean. Lake drainage occurred between 13 and 8 kyr ago and was initially gradual eastward into the Atlantic, then subsequently reorganized westward into the Pacific as new drainage routes opened up during Patagonian Ice Sheet deglaciation. Coupled ocean-atmosphere model experiments using HadCM3 with an imposed freshwater surface “hosing” to simulate glacial lake drainage suggest that a negative salinity anomaly was advected south around Cape Horn, resulting in brief but significant impacts on coastal ocean vertical mixing and regional climate

Comparison of Pharmacological Modulation of APP Metabolism in Primary Chicken Telencephalic Neurons and in a Human Neuroglioma Cell Line

Sequential cleavage of amyloid precursor protein (APP) by β- and γ-secretases and the formation of Aβ peptides are pivotal for Alzheimer's disease. Therefore, a large number of drugs has been developed targeting APP metabolism. However, many pharmacological compounds have been identified in vitro in immortalized APP overexpressing cell lines rather than in primary neurons. Here, we compared the effect of already characterized secretase inhibitors and modulators on Aβ formation in primary chicken telencephalic neurons and in a human neuroglioma cell line (H4) ectopically expressing human APP with the Swedish double mutation. Primary chicken neurons replicated the effects of a β-secretase inhibitor (β-secretase inhibitor IV), two γ-secretase inhibitors (DAPM, DAPT), two non-steroidal-anti-inflammatory drugs (sulindac sulfide, CW), and of the calpain inhibitor calpeptin. With the exception of the two γ-secretase inhibitors, all tested compounds were more efficacious in primary chicken telencephalic neurons than in the immortalized H4 cell line. Moreover, H4 cells failed to reproduce the effect of calpeptin. Hence, primary chicken telencephalic neurons represent a suitable cell culture model for testing drugs interfering with APP processing and are overall more sensitive to pharmacological interference than immortalized H4 cells ectopically expressing mutant human APP

Table_1_Improvement of vertigo symptoms after 2 months of Vertigoheel treatment: a case series in patients with bilateral vestibulopathy and functional dizziness.DOCX

BackgroundDizziness is a common leading symptom in bilateral vestibulopathy (BVP) and functional dizziness (FD), with significant negative effects on functional ability and quality of life. Vertigoheel is a widely used non-prescription drug for the treatment of vertigo. In order to generate systematic data for Vertigoheel in BVP and FD, we conducted a non-interventional study assessing vertigo symptoms.MethodsThis study was conducted as an open-label, prospective, monocentric, non-interventional case series (ClinicalTrials.gov identifier NCT05897853). Patients with BVP and FD received Vertigoheel according to market approval for an observational period of 2 months. Change from baseline after 2 months was assessed for the following endpoints: Dizziness Handicap Inventory (DHI) as the primary endpoint, quality of life (QoL) by EQ-5D-5L, and body sway by static posturography. Patients with FD were additionally assessed for depression and anxiety by PHQ-9 and GAD-7 questionnaires. Patients with BVP were assessed for vestibular function by video head impulse testing and caloric testing. Adverse events and other safety-related observations were evaluated.ResultsOf 41 patients with FD and 13 with BVP, two with FD and none with BVP dropped out before the follow-up visit. Both patient groups showed significantly improved disability caused by dizziness after 2 months: In BVP, the DHI decreased on average by 13.2 points from 45.4 to 32.2 (p ConclusionThe study provides evidence for Vertigoheel’s clinical safety and limited evidence – because of the non-interventional design – for its effectiveness in BVP and FD that are considered disease entities with high medical need for new treatment options. The results may serve as the basis for randomized placebo-controlled trials.</p

Video abstract for the publication: Improvement of vertigo symptoms after 2 months of Vertigoheel treatment: a case series in patients with bilateral vestibulopathy and functional dizzines

This is a presentation from the lead author of this peer-reviewed original research article explaining a clinical study in English and German. This was a real-world study in two relevant vertigo conditions and and treatment effects of the natural multitarget medication Vertigoheel. The video represents the opinion of the presenter.</p

Morphodynamic limits to environmental signal propagation across landscapes and into strata

The sedimentary record contains unique information about landscape response to environmental forcing at timescales that far exceed landscape observations over human timescales. However, stochastic processes can overprint and shred evidence of environmental signals, such as sediment flux signals, and so inhibit their transfer to strata. Our community currently lacks a quantitative framework to differentiate between environmental signals and autogenic signals in field-scale analysis of strata. Here we develop a framework and workflow to estimate autogenic thresholds for ancient sediment routing systems. Crucially these thresholds can be approximated using measurements that are readily attainable from field systems, circumventing the low temporal resolution offered by strata. This work demonstrates how short-term system dynamics can be accessed from ancient sediment routing systems to place morphodynamic limits on environmental signal propagation across ancient landscapes and into strata

Glaciar León, Chilean Patagonia: late-Holocene chronology and geomorphology

Glaciar León is a temperate, grounded outlet of the eastern North Patagonian Icefield (NPI). It terminates at an active calving margin in Lago Leones, a 10 km long proglacial lake. We take a multidisciplinary approach to its description and use ASTER imagery and clast sedimentology to describe the geomorphology of the glacier and its associated moraines. We date periods of glacier retreat over the last 2500 years using a combination of lichenometric, dendrochronological, cosmogenic and optically stimulated luminescence techniques and show that the glacier receded from a large terminal moraine complex some 2500 years ago and underwent further significant recession from nineteenth-century moraine limits. The moraine dates indicate varying retreat rates, in conjunction with significant downwasting. The bathymetry of Lago Leones is characterized by distinct ridges interpreted as moraine ridges that dissect the lake into several basins, with water depths reaching 360 m. The fluctuations of Glaciar León appear to have been controlled by the interplay between climatic forcing and calving dynamics.</p