Clinical Efficacy and Metabolomics Modifications Induced by Polyphenol Compound Supplementation in the Treatment of Residual Dizziness Following Repositioning Maneuvers in Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV) represents the most frequent cause of peripheral vertigo. In most cases it is successfully treated by canalith repositioning procedure (CRP), but it is often followed by a continuous lightheadedness in absence of vertigo or nystagmus (residual dizziness, RD). Our aim is to describe the clinical effectiveness and the urine metabolomics profile treating these patients by a polyphenol compound supplementation. We enrolled 30 patients reporting RD after BPPV successfully treated using CRP. A supplementation with a Polyphenol compound was administered for 60 days, and patients were evaluated after 30 and 60 days of treatment by a self-administered questionnaires (Visual Analog Scales for Dizziness and Nausea, Dizziness Handicap Inventory, DHI) and by urine metabolomics analysis performed by 1H-NMR spectroscopy and multivariate followed by univariate analysis. Most patients reported an excellent or good efficacy of RD with a significant decrease for VAS and DHI values. The metabolomics analysis identified six significant metabolites related to the treatment: 1-methylnicotinamide, anserine, Hippurate, lysine, methyl succinate, and urea indicating an inflammatory activities and antioxidant properties of the polyphenol compound. These preliminary data suggest that supplementation with a polyphenol compound cold induces some metabolic changes that can help recover RD. However, the future steps will require confirmation with a more significant cohort of patients and an extension of the metabolomic evaluation to other problems concerning the different clinical aspects of BPPV, such as the high relapse found in a high percentage of patients.