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Prevention of recurrent benign paroxysmal positional vertigo with vitamin D supplementation: a meta-analysis

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Abstract

Research Background

Vitamin D insufficiency/deficiency is known to be related to occurrences and recurrences of benign paroxysmal positional vertigo (BPPV). However, the efficacy of vitamin D supplementation in reducing recurrences of BPPV remains to be established. We performed a meta-analysis to determine the therapeutic effects of vitamin D supplementation, with or without calcium, for preventing recurrences of BPPV.

Methods

We searched the PubMed, the Embase, the Web of Science and the reference lists of the articles. We included randomized or non-randomized trials that determined the efficacy of supplementing vitamin D or related compounds, alone or with calcium, in comparison to placebo or no intervention in preventing recurrences of BPPV. The primary outcome was the number of patients with BPPV recurrences. Data were collected and pooled using a weighted relative risk (RR) with corresponding 95% CIs, where possible, by adopting the fixed-effect or random-effect model according to the heterogeneity among the studies. The between-study heterogeneity was tested using the χ2 test and the I2 statistic, and funnel plots were used to evaluate any publication bias.

Results

We included five trials (four non-randomized trials and one randomized controlled trial) with a total of 1250 participants. The analyses showed a significant preventive effect on the recurrences of BPPV (RR = 0.37; 95% CI = 0.18–0.76; p = 0.007 with the random-effects model) with supplementation of vitamin D. Although a considerable heterogeneity was detected among the studies, the sensitivity analyses showed the reliability and stability of our results.

Conclusions

Vitamin D supplementation provides a benefit for secondary prevention of BPPV. Supplementation of vitamin D should be considered in patients with frequent attacks of BPPV, especially when serum vitamin D is subnormal.

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Fig. 1
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Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Funding

This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (no. NRF-2016R1D1A1B04935568).

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Authors and Affiliations

  1. Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea

    Seong-Hae Jeong

  2. Department of Neurology, Korea University Medical Center, Seoul, Republic of Korea

    Sun-Uk Lee

  3. Department of Neurology, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Seoul, 463-707, Korea

    Ji-Soo Kim

  4. Dizziness Center, Seoul National University Bundang Hospital, Seongnam, Korea

    Ji-Soo Kim

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  1. Seong-Hae Jeong
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  2. Sun-Uk Lee
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Contributions

SHJ acquired and analyzed the data, and drafted the manuscript. SUL acquired and analyzed the data, and revised the manuscript. JSK conceptualized and supervised the study, and revised the manuscript.

Corresponding author

Correspondence to Ji-Soo Kim.

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Jeong, SH., Lee, SU. & Kim, JS. Prevention of recurrent benign paroxysmal positional vertigo with vitamin D supplementation: a meta-analysis. J Neurol 269, 619–626 (2022). https://doi.org/10.1007/s00415-020-09952-8

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