Slower MRI Machine Entry for Vertigo

Recruiting in Palo Alto (17 mi)

Overseen by Bryan Ward, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Johns Hopkins University

Disqualifiers: Pacemaker, Metal implants, Pregnancy, others

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

Vertigo, dizziness, and imbalance are commonly reported by patients and technologists when near high-field strength magnets (\>4 Tesla, T) used for magnetic resonance imaging (MRI) (1-5) Prior research from the investigators has established that the mechanism is likely a Lorentz force occurring in the inner ear, as a result of interactions with normal electrical currents in the inner ear and the strong static magnetic field of the MRI machine. The investigators have recently developed preliminary data to suggest that slower rates of entry into the magnetic field can greatly attenuate the sensations of vertigo. The explanation for this is that the rates of vestibular adaptation exceed that of the stimulus, allowed a reduction or elimination of the symptoms of vertigo. The aim of this study is to recruit individuals who are already getting an MRI scan as part of other research studies to randomize the rate of entry into and exit from the static magnetic field (i.e., before and after imaging is performed). The usual rate of entry is 20 seconds. This will be increased to one, two or three minutes. The investigators will record subjective sensations of dizziness and vertigo associated with the entry into the MRI.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications, so it's unclear. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Slower MRI Machine Entry for Vertigo?

The research highlights the importance of MRI in diagnosing vertigo-related conditions, suggesting that a slower entry into the MRI machine might help reduce anxiety and discomfort, potentially improving the accuracy of the imaging results for patients with vertigo. ^{1 2 3 4 5}

How does the treatment 'Slower MRI Machine Entry for Vertigo' differ from other treatments for vertigo?

This treatment is unique because it focuses on the method of entering the MRI machine more slowly, which may help reduce vertigo symptoms during the scan. Unlike other treatments that might involve medication or physical therapy, this approach modifies the MRI procedure itself to potentially alleviate discomfort. ^{1 2 3 6 7}

Eligibility Criteria

This trial is for people who are scheduled to have an MRI scan at a high-strength magnet (7 Tesla). They must not have pacemakers, defibrillators, metal implants, cochlear implants, or ferromagnetic clips in the brain. Pregnant individuals and those with severe claustrophobia or any contraindications from the standard MRI questionnaire cannot participate.

Inclusion Criteria

You are not scheduled to have an MRI scan using a 7 Tesla MRI machine.

Exclusion Criteria

You have a pacemaker, defibrillator wires, metal implants, cochlear implants, or certain metal clips in your brain.

Pregnancy

If you are afraid of small or enclosed spaces, you may not be able to complete the test.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo MRI scans with varying rates of entry and exit into the magnetic field to assess vertigo symptoms

Up to 6 minutes per session

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Rate of Entry (Behavioral Intervention)

Trial Overview The study tests if entering the strong magnetic field of an MRI machine more slowly can reduce vertigo and dizziness. Normally patients enter in 20 seconds; this will be extended to one, two, or three minutes. Participants' feelings of dizziness will be recorded as they go into and come out of the MRI.

Participant Groups

Group I: 3-minute entry Experimental Treatment 1 Intervention

The participant will undergo an MRI scan using a slower rate of entry than that specified by the manufacturer. This rate of entry is three minutes (180 seconds).

Group II: 2-minute entry Experimental Treatment 1 Intervention

The participant will undergo an MRI scan using a slower rate of entry than that specified by the manufacturer. This rate of entry is two minutes (120 seconds).

Group III: 1-minute entry Experimental Treatment 1 Intervention

The participant will undergo an MRI scan using a slower rate of entry than that specified by the manufacturer. This rate of entry is one minute (60 seconds).

Group IV: Standard Duration Active Control 1 Intervention

The participant will undergo an MRI scan using the manufacturer's rate of entry into and exit from the MRI machine. This rate of entry and exit is 20 seconds.

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

Johns Hopkins University School of Medicine Baltimore, MD

Who Is Running the Clinical Trial?

Johns Hopkins University Lead Sponsor

National Institute on Deafness and Other Communication Disorders (NIDCD) Collaborator

References

1. United States pubmed.ncbi.nlm.nih.gov

Vertigo-related cerebral blood flow changes on magnetic resonance imaging. [2014] A prospective study using magnetic resonance imaging on a consecutive cohort of patients with cervical vertigo.

2. Italy pubmed.ncbi.nlm.nih.gov

Neuroradiological features of vertigo. [2016] The diagnostic pathway in a patient with vertigo starts with the accurate evaluation of medical history followed by a general physical and neurological examination. This step can often lead to the identification of the correct cause of the disease or, at least, to a distinction between peripheral and central vertigo. Neuroradiological investigations have to be considered as elective diagnostic procedures and include: computed tomography (CT), magnetic resonance (MR), MR angiography (MRA), angiography. For the diagnosis of peripheral vertigo, benign paroxysmal positional vertigo, labyrinthitis, Meniere disease, perilymphatic fistula, local trauma, toxic labyrinthitis, acute otitis media and chronic middle ear effusion,the role of imaging techniques is controversial. CT and MR are performed to rule out other pathologies and to confirm the diagnosis. Increased resolution and application of special MR sequences enhancing the intralabyrinthine fluids have enabled more detailed analysis of labyrinthine structures and pathology. Both T2 and T1 contrast sequences are necessary. A high resolution CT study is required when otitis media is suspected and in the follow-up of post-traumatic vertigo. The causes of central vertigo are numerous and include: vertebro-basilar circulation vascular events, multiple sclerosis (MS), migraine-associated vertigo, cerebellar and brainstem tumors, CNS infections. Among them cerebrovascular ischemia and multiple sclerosis are the most frequent. In these situations imaging studies become mandatory. CT can diagnose most cerebellar hemorrhages and some cerebellar and brainstem acute ischemia, enhanced MR has proved to be the most sensitive tool to detect posterior fossa lesion. Diffusion-weighted MR can reveal acute ischemic changes before routine MR. There has been evidence that MR angiography, providing angiogram-like images of the intracranial vessels may sometimes avoid invasive angiography. MRA resolution is not as good as traditional angiography and may also be compromised by movements and other artifacts. Selective angiography of the posterior circulation is often indicated for therapeutic decisions.

3. Norway pubmed.ncbi.nlm.nih.gov

Magnetic resonance examination of the inner ear and cerebellopontine angle in patients with vertigo and/or abnormal findings at vestibular testing. [2019] The inner ears of 167 patients with vertigo and/or abnormal findings at vestibular testing were studied using magnetic resonance (MR). Pathology potentially explaining vertigo was found in 54 patients, and was detected in the posterior fossa (28%), the internal auditory canal (28%) and the membranous labyrinth (44%). The overall percentage of pathology and the percentage of pathology found in the membranous labyrinth was high and was probably influenced by the referral pattern in our hospital where high resolution MR of the inner ear (three dimensional Fourier transformation-constructive interference in steady state sequence; 3DFT-CISS sequence) is available. Unenhanced, and especially gadolinium (Gd)-enhanced T1-weighted spin-echo images, are needed to detect most of the pathology inside the internal auditory canal, and some of the lesions inside the membranous labyrinth. 3DFT-CISS images are the only images that can show fibrous obliteration of the intralabyrinthine fluid spaces, and are therefore necessary to recognise most of the intralabyrinthine pathology. Finally, T2-weighted spin-echo images are best suited to demonstrate cerebellar or brain stem infarction. An additional MR-angiography sequence (three dimensional Fourier transformation-fast imaging with steady precession; 3DFT-FISP) is used when vascular compression of the cochleovestibular nerve is suspected. MR is the method of choice to look for pathology in patients with vertigo, and allows detection of pathology that remains invisible with other imaging techniques. However, well adapted sequences are needed to detect these lesions.

4. United States pubmed.ncbi.nlm.nih.gov

The costs and utility of imaging in evaluating dizzy patients in the emergency room. [2018] To determine the usefulness and the costs of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of patients with dizziness in the emergency department (ED).

5. Italy pubmed.ncbi.nlm.nih.gov

[Changes in the blood-labyrinth barrier. Assessments by magnetic resonance]. [2015] Recent progress in magnetic resonance imaging (MRI), with contrast-enhanced and steady-state sequences, allows fine depiction of labyrinth abnormalities related to neoplastic, inflammatory, ischemic, degenerative or traumatic disorders. We examined 488 patients with sensorineural hearing loss, vertigo or dizziness, but normal CT findings, to evaluate MR capabilities in showing labyrinth conditions.

6. United States pubmed.ncbi.nlm.nih.gov

MRI Artifacts and Cochlear Implant Positioning at 3 T In Vivo. [2022] To evaluate the assessment of the internal auditory canal and the labyrinth in relation to different CI magnet positions and MRI sequences at 3 T.

7. Japan pubmed.ncbi.nlm.nih.gov

Measurement of cerebral blood flow with two-dimensional cine phase-contrast mR imaging: evaluation of normal subjects and patients with vertigo. [2004] The purpose of this study was to determine whether or not the vertebral flow of patients with vertigo and normal brain magnetic resonance (MR) images was decreased in comparison with normal controls.