{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:21:49Z","timestamp":1792790509857,"version":"4.5.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold>Balance training with vibrotactile neurofeedback (VNF) can improve balance and subjective impairment in age-related vertigo and dizziness.<jats:italic>Ginkgo biloba<\/jats:italic>dry extract EGb 761 has been shown to improve subjective impairment in chronic vertigo and the efficacy of conventional balance training. The combination was expected to work synergistically in this difficult-to-treat population.<\/jats:p><jats:p><jats:bold>Objectives:<\/jats:bold>To demonstrate the efficacy of VNF added to EGb 761 for age-related vertigo and dizziness.<\/jats:p><jats:p><jats:bold>Design:<\/jats:bold>Multicenter, prospective, controlled, randomized, single-blind, two-arm trial (German Clinical Trials Register<jats:ext-link>https:\/\/www.drks.de<\/jats:ext-link>No. DRKS00007633).<\/jats:p><jats:p><jats:bold>Setting:<\/jats:bold>Specialist offices and tertiary care outpatient department.<\/jats:p><jats:p><jats:bold>Participants:<\/jats:bold>One hundred and twenty subjects aged 60+ years with chronic dizziness for over 3 months, a Dizziness Handicap Inventory (DHI) Sum Score &amp;gt;25 and fall risk in balance-related situations as measured by the geriatric Standard Balance Deficit Test Composite Score (gSBDT-CS)&amp;gt;40. Patients with other distinct vestibular pathology (e.g., Meni\u00e9re's disease, stroke, BPPV) were excluded.<\/jats:p><jats:p><jats:bold>Intervention:<\/jats:bold>EGb 761 (80 mg twice daily for 12 weeks) plus 10 days of individually adapted balance training with VNF, randomized 1:1 to sensitive (active) or non-sensitive (sham) neurofeedback.<\/jats:p><jats:p><jats:bold>Measurements:<\/jats:bold>The change in gSBDT-CS after 6 weeks (primary), other gSBDT outcomes, DHI, cognition, hearing, and safety.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold>One hundred nine of 120 enrolled subjects received both treatments at least once. Over 12 weeks, the gSBDT-CS improved by 6.7 (active) vs. 4.5 (sham). There was a difference in favor of the active treatment of \u22122.4 (95% CI \u22125.4; 0.6) after 6 weeks. Under active treatment, more pronounced effects occurred in all secondary analyses and in nearly all secondary endpoints. The DHI sum score decreased from 44.1 to 31.1 in the total sample with a treatment group difference after 6 weeks of \u22123.1, 95% CI (\u22127.1; 0.9). No safety issues were reported.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold>Over 12 weeks, the combination of balance training with VNF and<jats:italic>Ginkgo biloba<\/jats:italic>dry extract EGb 761 reached a clinically relevant improvement of age-related vertigo and dizziness with a good pharmacological safety profile.<\/jats:p>","DOI":"10.3389\/fneur.2021.691917","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T18:39:48Z","timestamp":1638383988000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Balance Training With Vibrotactile Neurofeedback and Ginkgo Biloba Extract in Age-Related Vertigo"],"prefix":"10.3389","volume":"12","author":[{"given":"Lars","family":"Decker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Basta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Burkart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3233\/VES-2009-0343","article-title":"Classification of vestibular symptoms: towards an international classification of vestibular disorders 2009","volume":"19","author":"Bisdorff","year":"2009","journal-title":"J Vest Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3238\/arztebl.2016.0058b","article-title":"Degenerative changes of the vestibular receptors as underlying mechanism","volume":"113","author":"Ernst","year":"2016","journal-title":"Dtsch Arztebl Int."},{"key":"B3","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1097\/NPT.0000000000000120","article-title":"Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline","volume":"40","author":"Hall","year":"2016","journal-title":"J Neurol Phys Ther."},{"key":"B4","doi-asserted-by":"publisher","first-page":"276","DOI":"10.12688\/f1000research.14089.1","article-title":"The effectiveness of exercise-based vestibular rehabilitation in adult patients with chronic dizziness: a systematic review","volume":"7","author":"Kundakci","year":"2018","journal-title":"F1000 Res."},{"key":"B5","article-title":"Berlin: Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. 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