Bilateral vestibulopathy (BVP) is a debilitating condition characterized by persistent imbalance and a markedly increased risk of falls, resulting from bilateral loss of vestibular function. While vestibular rehabilitation remains the mainstay of treatment, its efficacy is often limited, and no pharmacological interventions with strong evidence have been established yet. Neurotrophic factors, particularly brain-derived neurotrophic factor (BDNF), are known to play a crucial role in the development, maintenance, and regeneration of vestibular hair cells and their afferent neurons. However, clinical application of BDNF is hindered by its large molecular size, poor permeability across the blood-labyrinth barrier, and the need for invasive inner ear delivery.
Makoto Kinoshita (Wed,) studied this question.