title: Resting in darkness improves downbeat nystagmus: evidence from an observational study.
abstract: Resting in an upright position during daytime decreases downbeat nystagmus (DBN). When measured in brightness only, that is, without intermitting exposure to darkness, it does not make a significant difference whether patients have previously rested in brightness or in darkness. In real-world scenarios, people are often exposed to brightness and darkness intermittently. The aim of this study was to analyze whether resting in brightness or resting in darkness was associated with a lower post-resting DBN after intermitting exposures to brightness and darkness. Eight patients were recorded with three-dimensional video-oculography in brightness and darkness conditions, each following two 2-h resting intervals under either brightness or darkness resting conditions. The dependent variable was DBN intensity, measured in mean slow phase velocity. A repeated measures ANOVA with the factors measurement condition (brightness vs. darkness), resting condition (brightness vs. darkness), and time (after first vs. second resting interval) showed a significant effect for the factor resting condition, where previous resting in darkness was associated with a significantly lower DBN relative to previous resting in brightness (P < 0.01). The clinical relevance is to advise patients with DBN to rest in darkness.
authors.affiliation: Division of Internal Medicine, Basel University Hospital, Basel, Switzerland.
authors.forename: Rainer
authors.initials: R
authors.lastname: Spiegel
authors.affiliation: Department of Neurology, Essen University Hospital, Essen, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Claassen
authors.affiliation: Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Teufel
authors.affiliation: Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany.
authors.forename: Stanislav
authors.initials: S
authors.lastname: Bardins
authors.affiliation: Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany.|Institute of Medical Technology, Brandenburg University of Technology, Cottbus-Senftenberg, Senftenberg, Germany.
authors.forename: Erich
authors.initials: E
authors.lastname: Schneider
authors.affiliation: Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Lehrer Rettinger
authors.affiliation: Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Jahn
authors.affiliation: Serviço de Neurologia, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil.
authors.forename: Fábio Anciães
authors.initials: FA
authors.lastname: da Silva
authors.affiliation: Ear, Nose and Throat Department of the 3rd Medical Faculty, Charles University, Prague, Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Hahn
authors.affiliation: Department of Medicine, Giessen University Hospital, Giessen, Germany.
authors.forename: Parvis
authors.initials: P
authors.lastname: Farahmand
authors.affiliation: Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Brandt
authors.affiliation: Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Strupp
authors.affiliation: Department of Neurology, Bern University Hospital, Bern, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Kalla
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003624:Darkness; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000473:pathology* / Q000503:physiopathology; D012146:Rest
keywords: downbeat nystagmus; oscillopsia; resting; symptom relief; video-oculographic measurement (VOG)