Effects of Combined Vestibular Rehabilitation and 25-Hydroxyvitamin D Supplementation on Vestibular Function in Patients with Vestibular Neuritis: A Randomized Controlled Trial

Abstract

Background and Aim:  Inflammatory processes play a key role in vestibular neuritis (VN) pathogenesis, and recent research has associated vitamin D deficiency with various conditions, including reduced serum 25-hydroxyvitamin D (25(OH) D) concentrations in individuals with acute VN. Given its notable immunomodulatory and anti-inflammatory actions, vitamin D may serve as an adjunct to enhance Vestibular Rehabilitation Therapy (VRT) outcomes. The present study examined the impact of combining 25(OH)D supplementation with VRT on vestibular function among patients with VN.

Methods: In this randomized controlled trial, 41 patients with VN were allocated into two groups. The VRT group (n=20) received individualized vestibular rehabilitation for 30 minutes, three times daily for 12 weeks. The VRT+VitD group (n=21) received the same VRT protocol plus a weekly oral dose of 50,000 IU of 25(OH)D for 12 weeks. Outcomes were assessed pre- and post-intervention using the Dizziness Handicap Inventory (DHI), Vertigo Symptom Scale-short form, and affected canal Vestibulo-Ocular Reflex (VOR) gains with video head impulse test, within- and between-groups.

Results: Both groups improved significantly across all measurements. The VRT+VitD group showed a normal serum level of vitamin D post-intervention (39.36±3.06; p<0.001) and greater improvements in subjective symptom reduction (DHI; p=0.023; partial η²=0.126), and VOR gains (p<0.001 with partial η²=0.459, 0.576, and 0.197 for lateral, anterior, and posterior canals, respectively) compared to the VRT group.

Conclusion: Correcting vitamin D deficiency supports and potentially enhances the effects of vestibular rehabilitation in patients with vestibular neuritis, although these outcomes should be interpreted with caution due to the study’s limitations.