Volume 1375, Issue 1 p. 66-73
Original Article

Resting in darkness improves downbeat nystagmus: evidence from an observational study

Rainer Spiegel

Corresponding Author

Rainer Spiegel

Division of Internal Medicine, Basel University Hospital, Basel, Switzerland

Address for correspondence: Rainer Spiegel, M.D., Ph.D., Division of Internal Medicine, University Hospital, Basel, Am Petersgraben 4, 4031 Basel, Switzerland. [email protected]Search for more papers by this author
Jens Claassen

Jens Claassen

Department of Neurology, Essen University Hospital, Essen, Germany

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Julian Teufel

Julian Teufel

Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany

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Stanislav Bardins

Stanislav Bardins

Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany

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Erich Schneider

Erich Schneider

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

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Nicole Lehrer (Rettinger)

Nicole Lehrer (Rettinger)

Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany

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Klaus Jahn

Klaus Jahn

Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany

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Fábio Anciães da Silva

Fábio Anciães da Silva

Serviço de Neurologia, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil

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Ales Hahn

Ales Hahn

Ear, Nose and Throat Department of the 3rd Medical Faculty, Charles University, Prague, Czech Republic

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Parvis Farahmand

Parvis Farahmand

Department of Medicine, Giessen University Hospital, Giessen, Germany

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Thomas Brandt

Thomas Brandt

Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany

The shared senior authors of this work.

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Michael Strupp

Michael Strupp

Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital, Munich, Germany

The shared senior authors of this work.

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Roger Kalla

Roger Kalla

Department of Neurology, Bern University Hospital, Bern, Switzerland

The shared senior authors of this work.

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First published: 22 July 2016
Citations: 4

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.