Research summary

Our laboratory has been investigating clinical and molecular vestibular researches on vascular vertigo, genetic neuro-otological and neuro-ophthalmological (NONO) disorders, and vestibular rehabilitation. Despite the developments in imaging technology over the decades, a significant proportion of acute strokes may escape detection on imaging especially during the acute phase or when the lesions are small. Even though several diagnostic algorithms have been advanced for acute vascular vertigo, we await more comprehensive and sophisticated ones that can be applied to transient vestibular symptoms due to vascular compromise. Recently, we identified informative perfusion imaging in the evaluation of vascular vertigo, and characteristics and diagnostic criteria of cardiogenic vertigo. Genetic studies continue to shed light on the genetic background of NONO disorders. Novel genes affecting brain development and otolith biogenesis have been associated with various NONO disorders. We demonstrated the genetic heterogeneity of Korean episodic ataxia (EA) using whole-exome sequencing, and identified rare variants of putative candidate genes in some of MD patients using targeted gene sequencing using next generation sequencing (NGS) panel composed of 45 MD-associated genes. We also identified five FRMD7 mutations in 35% of infantile nystagmus syndrome cohort, expanding its mutational spectrum. Vestibular rehabilitation is an exercise-based program that has been in existence for over 70 years. A growing body of evidence supports the use of vestibular rehabilitation in patients with vestibular disorders, and evolving research has led to more efficacious interventions. We are developing new vestibular rehabilitation programs using virtual reality in various vestibular disorders, and trying to investigate the efficacy of new repositioning maneuvers in intractable benign paroxysmal positional vertigo (BPPV).

Selected publications

1. Kim HA, Ahn J, Park HS, Lee SM, Choi SY, Oh EH, Choi JH, Kim JS, Choi KD. Cardiogenic vertigo: characteristics and proposed diagnostic criteria. J Neurol. 2020 Oct 6.

2. Short-Term Central Adaptation in Benign Paroxysmal Positional Vertigo. Choi SY, Lee MJ, Oh EH, Choi JH, Choi KD. Front Neurol. 2020 Apr 21;11:260.

3. Effect of the Epley Maneuver and Brandt-Daroff Exercise on Benign Paroxysmal Positional Vertigo Involving the Posterior Semicircular Canal Cupulolithiasis: A Randomized Clinical Trial. Choi SY, Cho JW, Choi JH, Oh EH, Choi KD. Front Neurol. 2020 Dec 3;11:603541.

4. Choi KD, Choi SY, Choi JH, Kim SH, Lee SH, Jeong SH, Kim HJ, Choi JY, Kim JS. Characteristics of single ocular motor nerve palsy associated with anti-GQ1b antibody. J Neurol. 2019 Feb;266(2):476-479.

5. Choi JH, Oh EH, Park MG, Baik SK, Cho HJ, Choi SY, Lee TH, Kim JS, Choi KD. Early MRI-negative posterior circulation stroke presenting as acute dizziness. J Neurol. 2018 Dec;265(12):2993-3000.

6. Choi KD, Kim JS. Vascular vertigo: updates. J Neurol. 2018 Sep 5.

7. Choi SY, Jang JY, Oh EH, Choi JH, Park JY, Lee SH, Choi KD. Persistent geotropic positional nystagmus in unilateral cerebellar lesions. Neurology. 2018 Sep 11;91(11):1053-1057.

8. Choi JH, Jung JH, Oh EH, Shin JH, Kim HS, Seo JH, Choi SY, Kim MJ, Choi HY, Lee C, Choi KD. Genotype and Phenotype Spectrum of FRMD7-Associated Infantile Nystagmus Syndrome. Invest Ophthalmol Vis Sci. 2018 Jun 1;59(7):3181-3188.

9. Choi KD, Kim JS, Kim HJ, Jung I, Jeong SH, Lee SH, Kim DU, Kim SH, Choi SY, Shin JH, Kim DS, Park KP, Kim HS, Choi JH. Genetic Variants Associated with Episodic Ataxia in Korea. Sci Rep. 2017;7(1):13855.

10. Choi JH, Park MG, Choi SY, Park KP, Baik SK, Kim JS, Choi KD. Acute Transient Vestibular Syndrome: Prevalence of Stroke and Efficacy of Bedside Evaluation. Stroke. 2017;48(3):556-562.

11. Choi KD, Choi SY, Choi JH, Kim SH, Lee SH, Jeong SH, Kim HJ, Choi JY, Kim JS.Characteristics of single ocular motor nerve palsy associated with anti-GQ1b antibody. J Neurol. 2019 Feb;266(2):476-479.

12. Choi KD, Jen JC, Choi SY, Shin JH, Kim HS, Kim HJ, Kim JS, Choi JH. Late-onset episodic ataxia associated with SLC1A3 mutation. J Hum Genet. 2017 Mar;62(3):443-446.