Incremental Vestibulo-ocular Reflex Adaptation as a Novel Treatment for Dizziness in People With Multiple Sclerosis

Inclusion criteria

• Neurologist-confirmed diagnosis of primary progressive or relapsing and remitting MS per The 2017 Revision of the McDonald Criteria and the Magnetic Resonance Imaging in MS, or a healthy volunteer without a diagnosis of multiple sclerosis or any related neurological conditions
• Fluent in speaking and understanding English
• Subjects with multiple sclerosis have self-reported vestibular symptoms of dizziness, imbalance, and/or a history of at least two falls in the prior 12 months

Exclusion criteria

• Clinically isolated syndrome or radiologically isolated syndrome.
• Worsening MS symptoms during the prior 60 days
• Immunotherapy change in the prior 60 days
• Self-reported cognitive impairment that limits independence with basic and instrumental activities of daily living
• Systolic blood pressure \> 180 mmHg and/or diastolic blood pressure \> 90 mmHg at rest
• Static visual acuity with correction of worse than 1.0 logMAR
• Manifest ocular misalignment ≥ 5 diopters (e.g., tropia, lazy eye, strabismus}
• Convergence insufficiency
• Intra-nuclear ophthalmoplegia
• Vestibular Migraine
• Major orthopedic conditions that limit cervical spine range of motion or that alter walking
• Self-reported current or potential for pregnancy during enrollment
• Ongoing participation in vestibular rehabilitation for dizziness