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Study Finds Motorist Disorientation Syndrome Is Not Only Caused by Vestibular Dysfunction

Journal of Vestibular Research article leads to greater insights into why some drivers get dizzy and disoriented behind the wheel

Amsterdam, the Netherlands – A large case series aimed at understanding the factors underlying Motorist Disorientation Syndrome (MDS) has found that patients experience severe, consistent symptoms comparable to vestibular migraine. Previously there has been speculation that underlying peripheral vestibular hypofunction, when the inner ear part of the balance system is not working properly, contributes to this presentation. However, vestibular deficits were not a consistent feature in the patients studied. The findings have been published in the Journal of Vestibular Research.

In recent years there has been increasing interest in the complex integration of input signals that control spatial orientation, retinal stability, and balance in response to a changing visual environment such as in a moving car. MDS is a term used to describe patients who primarily experience symptoms of dizziness and/or disorientation when driving a car. There is currently only a limited amount of evidence-based information available about this condition. 

Lead investigator Carolyn Ainsworth, MD, Neuro-otology, Department of ENT, Guy’s and St Thomas’ NHS Trust, explains, "Our research entailed looking at the presenting symptoms, characteristics and vestibular test results of a group of patients whose main complaint was of illusions of movement of self/vehicle when driving. We found consistencies in the presenting symptoms and a high symptom burden, however only 60% of patients had underlying vestibular test deficits. Although this does not exclude vestibular dysfunction, it does raise the possibility of other factors contributing to the development of this presentation.”

The study also found similarities to visually induced dizziness and persistent postural perceptual dizziness (PPPD), a functional neurological disorder. Other contributing factors could be anxiety and depression.

The symptoms of the 18 patients assessed were severe enough to cause 17 patients to change their driving habits. Six subjects stopped driving completely, while 11 stopped driving on roads that provoke MDS (open, featureless roads, going over the brow or descending hills, or going around corners). Only one patient continued to drive as usual. 

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Caption: Results from a study published in the Journal of Vestibular Research increase understanding of the underlying factors of Motorist Disorientation Syndrome. Credit: Public Domain Pictures via Pixabay

"Diagnostic criteria are very much needed to aid research into effective treatments for patients. This study provides data that can contribute to discussion about where MDS should be placed within the current framework for diagnosis of vestibular disorders. In turn, improved recognition and appropriate classification of this symptom complex will help clinicians recognize the specific features of the condition, inspiring further research into the role of potential factors such as visual dependency and facilitating further research into treatment," Dr. Ainsworth concludes. 

Read the summary of the article by Christine Strange here.

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NOTES FOR EDITORS
“Motorist disorientation syndrome: clinical features and vestibular findings,” by Carolyn Ainsworth, Rosalyn Davies, Ian Colvin, and Louisa Murdin (https://doi.org/10.3233/VES-220088), Journal of Vestibular Research, Volume 33, issue 5 (October 2023), published by IOS Press. 

The article is openly available at https://content.iospress.com/articles/journal-of-vestibular-research/ve….

Copies of this paper and additional information are also available to credentialed journalists upon request. Please contact Diana Murray, IOS Press, at +1 718-640-5678 or d.murray@iospress.com. Journalists who wish to interview the authors should contact Carolyn Ainsworth, MD, c/o ENT Secretaries, at +44 20 7188 7188, extension 82215, or carolyn.ainsworth@gstt.nhs.uk

ABOUT THE JOURNAL OF VESTIBULAR RESEARCH (JVR)
The Journal of Vestibular Research (JVR) is an international peer-reviewed journal that publishes experimental and observational studies, review papers, theoretical papers based on current knowledge of the vestibular system, and letters to the Editor. Topics include space and motion sickness, balance disorders, vestibular rehabilitation, the anatomy of vestibular, vestibulo-ocular, vestibulo-spinal, and vestibulo-autonomic pathways, and more. Led by Editor-in-Chief Joseph Furman, MD, PhD, of the University of Pittsburgh, PA, USA, JVR has been designated as the official journal of the Bárány Society, the world’s leading professional organization devoted to vestibular research and its translation into clinical practice. https://jvr-web.org

ABOUT IOS PRESS
IOS Press is an international scientific, technical, medical (STM) publishing house established in 1987 in Amsterdam. We produce around 90 journals and 70 books annually in a broad range of subject categories, primarily specializing in health and life sciences (including neurosciences, medical informatics, cancer research, and rehabilitation) and computer sciences (including artificial intelligence, data science, and semantic web). In addition, we offer specialized services that support scientific advancement. www.iospress.com