Mount Sinai Human Balance Laboratory

Publications related to our treatments

What is MdDS?


MdDS Treatment:

  1. Dai M, Cohen B, Smouha E, Cho C Readaptation of the Vestibulo-Ocular Reflex Relieves the Mal De Debarquement Syndrome. Frontiers in Neurolog;5:124. doi: 10.3389/fneur.2014.00124. eCollection 2014. This is the original study that describes the method of treatment we use. To download:
  2. Dai M, Cohen B, Cho C, Shin S, Yakushin SB Treatment of the Mal De Debarquement Syndrome: A 1-Year Follow-up. Frontiers in Neurolog;05 May 2017 | eCollection 2017. This is the original study on 141 patients. To download:
  3. Dai M. Mount Sinai School of Medicine, VOR Readaptation
  4. Dai M, Yakushin SB, Cho C, Smouha E, and Cohen B. Treatment of the Mal de Debarquement Syndrome in 160 cases. XXIX Bárány Society Meeting, Korea, Seoul, June 5-8, 2016.   This is one of our recent abstracts about  MdDS treatment, which was presented at the Bárány Society Meeting.                                                                                                    

    The Mal de Debarquement Syndrome (MdDS) is a feeling of constant swaying, rocking and/or bobbing that generally follows a passive motion such as after travel on the sea (the Classic form). It can also occur spontaneously (the Aberrant or Spontaneous form).  The associated symptoms include gate ataxia, head pressure, cognitive dysfunction (brain fog), blurred vision, agoraphobia, insomnia, depression and exhaustion. MdDS is likely elicited by maladaptation of Velocity Storage in the Vestibulo-Ocular Reflex (VOR). In 2014, we published the results of treatment of MdDS in 24 patients produced by visual-vestibular re-adaptation of the VOR. There was a high rate of success (70%) after one-year follow up. Here, we report an additional 160 cases treated from Oct 2014 to Oct 2015. Patients: 133 females, 27 males, 130 with Classic MdDS, 30 with Aberrant MdDS. Ages 47±13, 18-82. Duration: 36±48 months (1 mon – 27 yrs). Physical Measures: Fukuda, internal rocking, static posturography, spontaneous nystagmus. The average rocking frequency was ~0.2Hz (1 cycle per 5sec). Primary Protocol: Rolling the head at the frequency of rocking while viewing a vertical axis full-field optokinetic (OKN) stimulus at speeds of 2°/s – 15°/s. Additional Protocols: 1. Horizontal or vertical OKN without head motion. 2. Horizontal OKN and head up/down motion. Sessions: 0.5–5 minutes, 3-10 times per day for 4-5 days. Outcome Measures: Subjective rating of global improvement on a 10-pt scale and static posturography. Specific symptoms such as bobbing, trampoline walking, head pressure, brain fog and vision, etc were specifically reported. Clinical Significance: Defined as a 50% reduction from subjective rating reported on the last day of intervention. Results: The rate of success for all patients was 75% (scores: 6.3±1.9 before, and 2.6±2.1 after). For Classic cases it was 81% and for Aberrant cases 43%. For duration >= 3 years, the rate was 66% (N=54) and for < 3 years, 79% (N = 106). Two patients with a history of more than 20 years had a significant improvement (60% & 69%). Thus, the results are similar to those in our 2014 study. The patients to be treated earlier appeared to have better outcomes compared with patients who had delayed treatments but in the latter group, there was significant benefit. Further results will be reported when the long term follow-up and postural analyses are completed.

  5. New Treatment Successful for Rare and Disabling Movement Disorder, the Mal de Debarquement Syndrome (MdDS). NEW YORK, August 7, 2014 /Press Release
  6. Cohen B, Yakushin SB, Cho C Hypothesis: The Vestibular and Cerebellar Basis of the Mal de Debarquement Syndrome. Frontiers in Neurology; 2018 Feb 5;9:28. doi: 10.3389/fneur.2018.00028. eCollection 2018: http://

Papers about our MdDS treatment written by the others:

  1. Worst Nightmare: Feeling Motion Sick Years After a Trip — It Happened to These People.
  2. New treatment successful for rare, disabling movement disorder, the Mal de Debarquement Syndrome (MdDS)
  3. Eliza Strickland, What to Do When Your Brain Insists You’re Always on a Boat
  4. Mucci V, Perkisas T, Jillings SD, Van Rompaey V, Van Ombergen A, Fransen E, Vereeck L, Wuyts FL, Van de Heyning PH, Browne CJ. , Sham-Controlled Study of Optokinetic Stimuli as Treatment for Mal de Debarquement Syndrome. Front Neurol. 2018 Oct 25;9:887
  5. Shankar Kikkeri N, Siddiqui JH., Mal de Debarquement Syndrome: A Case Report. Cureus. 2018 Sep 7;10(9): e3270. doi: 10.7759/cureus.3270.

Useful links:

Our Laboratory (Contact information is out of date)

MdDS Foundation


Motion Sickness Treatment:

  1. Dai M, Raphan T, Cohen B. Prolonged reduction of motion sickness sensitivity by visual-vestibular interaction. Exp Brain Res. 2011 May;210(3-4):503-13. doi: 10.1007/s00221-011-2548-8. Epub 2011 Feb 2.