nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2026-1-91-98nnp-2782Research ArticleREVIEWSОБЗОРЫThe contribution of vestibular dysfunction to the development of imbalance in type 2 diabetes mellitus and diabetic polyneuropathyВклад вестибулярной дисфункции в развитие неустойчивости при сахарном диабете 2-го типа и диабетической полиневропатииhttps://orcid.org/0000-0001-9414-1936АзимоваА. А.AzimovaA. A.

Амина Арметовна Азимова

кафедра неврологии с курсом рефлексологии и мануальной терапии

125993; ул. Баррикадная, 2/1, стр. 1; Москва

Amina Armetovna Azimova

Department of Neurology with a course of reflexology and manual therapy

125993; 2/1, Barrikadnaya St., Build. 1; Moscow

amina.azimova97@mail.ruhttps://orcid.org/0000-0002-0193-2243ЗамерградМ. В.ZamergradM. V.

кафедра неврологии с курсом рефлексологии и мануальной терапии; ОСП «Российский геронтологический научно-клинический центр»

129226; ул. 1-я Леонова, 16; 109240; ул. Яузская, 11/6; Москва

Department of Neurology with a course of reflexology and manual therapy; Russian Clinical and Research Center of Gerontology

129226; 16, 1st Leonova St.; 109240; 11/6, Yauzskaya St.; Moscow

https://orcid.org/0000-0002-0940-3469ДоскинаЕ. В.DoskinaE. V.

кафедра эндокринологии

125993; ул. Баррикадная, 2/1, стр. 1; Москва

Department of Endocrinology

125993; 2/1, Barrikadnaya St., Build. 1; Moscow

https://orcid.org/0009-0006-5858-8902СапинаА. И.SapinaA. I.

109240; ул. Яузская, 11/6; Москва

109240; 11/6, Yauzskaya St.; Moscow

КучероваА. В.KucherovaA. V.

109240; ул. Яузская, 11/6; Москва

109240; 11/6, Yauzskaya St.; Moscow

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ГБУЗ «Городская клиническая больница им. И.В. Давыдовского ДЗМ»РоссияRussian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University; I.V. Davydovsky City Clinical Hospital, Moscow Healthcare DepartmentRussian FederationГБУЗ «Городская клиническая больница им. И.В. Давыдовского ДЗМ»РоссияI.V. Davydovsky City Clinical Hospital, Moscow Healthcare DepartmentRussian Federation2026220220261819198Copyright © Azimova A.A., Zamergrad M.V., Doskina E.V., Sapina A.I., Kucherova A.V., 20262026Азимова А.А., Замерград М.В., Доскина Е.В., Сапина А.И., Кучерова А.В.Azimova A.A., Zamergrad M.V., Doskina E.V., Sapina A.I., Kucherova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2782

   Body balance is maintained thanks to the coordinated work of the proprioceptive, visual and vestibular systems. Diabetes mellitus affects each of these systems, leading to the development of postural instability and an increased risk of falls in this group of patients. The high incidence of diabetic peripheral neuropathy and retinopathy has prompted detailed study of these conditions. It has been established that these conditions, leading to reduced visual acuity, sensory deficits and sensory ataxia, impair stability and increase the frequency of falls. At the same time, there is evidence of the potentially damaging effect of diabetes mellitus on the vestibular system with the development of subclinical vestibulopathy. Since the vestibular system plays an essential role in maintaining balance, timely detection of relevant disorders can be of considerable value in developing measures to prevent falls in this group of patients. Meanwhile, the prevalence and precise mechanisms of damage to the vestibular system in diabetes remain unclear, and the results of studies conducted in this area are characterised by high methodological and statistical heterogeneity, which makes it difficult to draw a single conclusion.

   Поддержание равновесия тела обеспечивается благодаря скоординированной работе проприоцептивной, зрительной и вестибулярной систем. Сахарный диабет оказывает влияние на каждую из указанных систем, приводя к развитию постуральной неустойчивости и повышению риска падений в данной группе пациентов. Высокая частота диабетической периферической невропатии и ретинопатии способствовала их детальному изучению. Установлено, что эти состояния, приводя к снижению остроты зрения, сенсорному дефициту и сенситивной атаксии, ухудшают устойчивость и повышают частоту падений. В то же время имеются данные, свидетельствующие о потенциальном повреждающем действии сахарного диабета на вестибулярный аппарат с развитием субклинической вестибулопатии. Так как вестибулярная система играет существенную роль в поддержании равновесия, своевременное выявление соответствующих нарушений может представлять значительную ценность для разработки мер по профилактике падений в данной группе пациентов. Между тем распространенность и точные механизмы повреждения вестибулярного аппарата при диабете еще не выяснены, а результаты проведенных исследований в данной области отличаются высокой методологической и статистической гетерогенностью, что затрудняет формирование единого вывода.

сахарный диабетдиабетическая полиневропатиявестибулярная системавестибулярная дисфункциянеустойчивостьпадениянейровестибулярное исследованиевестибулярная реабилитацияdiabetes mellitusdiabetic polyneuropathyvestibular systemvestibular dysfunctioninstabilityfallsneurovestibular examinationvestibular rehabilitationИсследование не имело спонсорской поддержкиThe investigation has not been sponsoredReferencesHewston P, Deshpande N. Fear of falling and balance confidence in older adults with type 2 diabetes mellitus : a scoping review. Canadian J Diabetes. 2018;42:664-70. doi: 10.1016/j.jcjd.2018.02.009Hewston P, Deshpande N. Fear of falling and balance confidence in older adults with type 2 diabetes mellitus : a scoping review. Canadian J Diabetes. 2018;42:664-70. doi: 10.1016/j.jcjd.2018.02.009Napoli N, Chandran M, Pierroz DD, et al; IOF Bone and Diabetes Working Group. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2017;13:208-19. doi: 10.1038/nrendo.2016.153Napoli N, Chandran M, Pierroz DD, et al; IOF Bone and Diabetes Working Group. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2017;13:208-19. doi: 10.1038/nrendo.2016.153Dyck PJ, Kratz KM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology. 1993;43(4):817-24.Dyck PJ, Kratz KM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology. 1993;43(4):817-24.Alissa N, Shipper AG, Zilliox L, et al. A systematic review of the effect of physical rehabilitation on balance in people with diabetic peripheral neuropathy who are at risk of falling. Clin Interv Aging. 2024;19:1325-39. doi: 10.2147/CIA.S459492Alissa N, Shipper AG, Zilliox L, et al. A systematic review of the effect of physical rehabilitation on balance in people with diabetic peripheral neuropathy who are at risk of falling. Clin Interv Aging. 2024;19:1325-39. doi: 10.2147/CIA.S459492Infante M, Leoni M, Caprio M, Fabbri A. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. World J Diabetes. 2021 Jul 15;12(7):916-31. doi: 10.4239/wjd.v12.i7.916Infante M, Leoni M, Caprio M, Fabbri A. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. World J Diabetes. 2021 Jul 15;12(7):916-31. doi: 10.4239/wjd.v12.i7.916Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician. 2017;96:384-9.Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician. 2017;96:384-9.Bell DS. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy. South Med J. 2010;103:265-7. doi: 10.1097/SMJ.0b013e3181ce0e4dBell DS. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy. South Med J. 2010;103:265-7. doi: 10.1097/SMJ.0b013e3181ce0e4dYau JWY, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35:556-64. doi: 10.2337/dc11-1909Yau JWY, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35:556-64. doi: 10.2337/dc11-1909Ouyang S, Zhang X, Li H, et al. Cataract, glaucoma, and diabetic retinopathy are independent risk factors affecting falls in the older adult with eye diseases. Geriatr Nurs. 2023 Sep-Oct;53:170-4. doi: 10.1016/j.gerinurse.2023.07.001Ouyang S, Zhang X, Li H, et al. Cataract, glaucoma, and diabetic retinopathy are independent risk factors affecting falls in the older adult with eye diseases. Geriatr Nurs. 2023 Sep-Oct;53:170-4. doi: 10.1016/j.gerinurse.2023.07.001Jorgensen IEH, Devantier L, Tankisi H, et al. The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy. Peer J. 2023 Nov 13;11:e16382. doi: 10.7717/peerj.16382Jorgensen IEH, Devantier L, Tankisi H, et al. The impact of vestibular dysfunction on falls and postural instability in individuals with type 2 diabetes with and without diabetic polyneuropathy. Peer J. 2023 Nov 13;11:e16382. doi: 10.7717/peerj.16382Zhang J, Ye L, Bai X, et al. Cervical and ocular vestibular evoked myogenic potentials in patients with Diabetic Peripheral Neuropathy. Diabetol Metab Syndr. 2023;15(1):100. doi: 10.1186/s13098-023-01068-zZhang J, Ye L, Bai X, et al. Cervical and ocular vestibular evoked myogenic potentials in patients with Diabetic Peripheral Neuropathy. Diabetol Metab Syndr. 2023;15(1):100. doi: 10.1186/s13098-023-01068-zKumar P, Singh NK, Raveendran RK, et al. The functioning of otolith organs in individuals with type-II diabetes mellitus. Hear Res. 2025 Aug 28;467:109412. doi: 10.1016/j.heares.2025.109412Kumar P, Singh NK, Raveendran RK, et al. The functioning of otolith organs in individuals with type-II diabetes mellitus. Hear Res. 2025 Aug 28;467:109412. doi: 10.1016/j.heares.2025.109412Konukseven O, Polat SB, Karahan S, et al. Electrophysiologic vestibular evaluation in type 2 diabetic and prediabetic patients: Air conduction ocular and cervical vestibular evoked myogenic potentials. Int J Audiol. 2015 Aug;54(8):536-43. doi: 10.3109/14992027.2014.971887Konukseven O, Polat SB, Karahan S, et al. Electrophysiologic vestibular evaluation in type 2 diabetic and prediabetic patients: Air conduction ocular and cervical vestibular evoked myogenic potentials. Int J Audiol. 2015 Aug;54(8):536-43. doi: 10.3109/14992027.2014.971887Gawron W, Pospiech L, Orendorz-Fraczkowska K, Noczynska A. Are there any disturbances in vestibular organ of children and young adults with Type I diabetes? Diabetologia. 2002 May;45(5):728-34. doi: 10.1007/s00125-002-0813-xGawron W, Pospiech L, Orendorz-Fraczkowska K, Noczynska A. Are there any disturbances in vestibular organ of children and young adults with Type I diabetes? Diabetologia. 2002 May;45(5):728-34. doi: 10.1007/s00125-002-0813-xAgrawal Y, Carey JP, Della Santina CC, et al. Diabetes, vestibular dysfunction, and falls: analyses from the National Health and Nutrition Examination Survey. Otol Neurotol. 2010 Dec;31(9):1445-50. doi: 10.1097/MAO.0b013e3181f2f035Agrawal Y, Carey JP, Della Santina CC, et al. Diabetes, vestibular dysfunction, and falls: analyses from the National Health and Nutrition Examination Survey. Otol Neurotol. 2010 Dec;31(9):1445-50. doi: 10.1097/MAO.0b013e3181f2f035Bermudez Rey MC, Clark TK, Merfeld DM. Balance Screening of Vestibular Function in Subjects Aged 4 Years and Older: A Living Laboratory Experience. Front Neurol. 2017;8:631. doi: 10.3389/fneur.2017.00631Bermudez Rey MC, Clark TK, Merfeld DM. Balance Screening of Vestibular Function in Subjects Aged 4 Years and Older: A Living Laboratory Experience. Front Neurol. 2017;8:631. doi: 10.3389/fneur.2017.00631Yang TH, Chen CH, Cheng YF, et al. Association of Peripheral Vestibular Disorder with Diabetes: A Population-Based Study. J Pers Med. 2024 Jul 19;14(7):768. doi: 10.3390/jpm14070768Yang TH, Chen CH, Cheng YF, et al. Association of Peripheral Vestibular Disorder with Diabetes: A Population-Based Study. J Pers Med. 2024 Jul 19;14(7):768. doi: 10.3390/jpm14070768McCrimmon RJ, Ryan CM, Frier BM. Diabetes and cognitive dysfunction. Lancet. 2012 Jun 16;379(9833):2291-9. doi: 10.1016/S0140-6736(12)60360-2McCrimmon RJ, Ryan CM, Frier BM. Diabetes and cognitive dysfunction. Lancet. 2012 Jun 16;379(9833):2291-9. doi: 10.1016/S0140-6736(12)60360-2Blevins BL, Vinters HV, Love S, et al. Brain arteriolosclerosis. Acta Neuropathol. 2021 Jan;141(1):1-24. doi: 10.1007/s00401-020-02235-6Blevins BL, Vinters HV, Love S, et al. Brain arteriolosclerosis. Acta Neuropathol. 2021 Jan;141(1):1-24. doi: 10.1007/s00401-020-02235-6Гусева АЛ, Пальчун ВТ. Хроническое головокружение: подходы к диагностике и лечению. Журнал неврологии и психиатрии им. С.С. Корсакова. 2020;120(12):131-7. doi: 10.17116/jnevro2020120121131Guseva AL, Pal’chun VT. Clinical diagnosis and treatment of chronic dizziness. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(12):131-7 (In Russ.). doi: 10.17116/jnevro2020120121131Myers SF, Ross MD, Jokelainen P, et al. Morphological evidence of vestibular pathology in long-term experimental diabetes mellitus. I. Microvascular changes. Acta Otolaryngol. 1985;100(5-6):351-64. doi: 10.3109/00016488509126559Myers SF, Ross MD, Jokelainen P, et al. Morphological evidence of vestibular pathology in long-term experimental diabetes mellitus. I. Microvascular changes. Acta Otolaryngol. 1985;100(5-6):351-64. doi: 10.3109/00016488509126559Myers SF, Ross MD. Morphological evidence of vestibular pathology in long-term experimental diabetes mellitus. II. Connective tissue and neuroepithelial pathology. Acta Otolaryngol. 1987;104(1-2):40-9. doi: 10.3109/00016488709109045Myers SF, Ross MD. Morphological evidence of vestibular pathology in long-term experimental diabetes mellitus. II. Connective tissue and neuroepithelial pathology. Acta Otolaryngol. 1987;104(1-2):40-9. doi: 10.3109/00016488709109045Myers SF. Myelin-sheath abnormalities in the vestibular nerves of chronically diabetic rats. Otolaryngol Head Neck Surg. 1998;119(5):432-8. doi: 10.1016/s0194-5998(98)70098-1Myers SF. Myelin-sheath abnormalities in the vestibular nerves of chronically diabetic rats. Otolaryngol Head Neck Surg. 1998;119(5):432-8. doi: 10.1016/s0194-5998(98)70098-1Myers SF, Tormey MC, Akl S. Morphometric analysis of horizontal canal nerves of chronically diabetic rats. Otolaryngol Head Neck Surg. 1999;120(2):174-9. doi: 10.1016/S0194-5998(99)70402-XMyers SF, Tormey MC, Akl S. Morphometric analysis of horizontal canal nerves of chronically diabetic rats. Otolaryngol Head Neck Surg. 1999;120(2):174-9. doi: 10.1016/S0194-5998(99)70402-XKocdor P, Kaya S, Erdil M, et al. Vascular and Neuroepithelial Histopathology of the Saccule in Humans With Diabetes Mellitus. Otol Neurotol. 2016 Jun;37(5):553-7. doi: 10.1097/MAO.0000000000001018Kocdor P, Kaya S, Erdil M, et al. Vascular and Neuroepithelial Histopathology of the Saccule in Humans With Diabetes Mellitus. Otol Neurotol. 2016 Jun;37(5):553-7. doi: 10.1097/MAO.0000000000001018Ferber-Viart C, Dubreuil C, Duclaux R. Vestibular evoked myogenic potentials in humans : a review. Acta Otolaryngol. 1999;119(1):6-15. doi: 10.1080/00016489950181864Ferber-Viart C, Dubreuil C, Duclaux R. Vestibular evoked myogenic potentials in humans : a review. Acta Otolaryngol. 1999;119(1):6-15. doi: 10.1080/00016489950181864Вавилова АА. О некоторых ярких страницах в истории вестибулологии ХХ века (исторический обзор, дискуссионные вопросы). Часть IV. Нистагм и история его изучения. От визуальной оценки до электро- и видеонистагмографии. Российская оториноларингология. 2023;22(6):102-13. doi: 10.18692/1810-4800-2023-6-102-113Vavilova AA. On some bright pages in history of vestibulology of 20<sup>th</sup> century (historical review, controversial issues) Part IV. Nystagmus and history of its study. From visual assessment to electro- and videonystagmography. Russian Otorhinolaryngology. 2023;22(6):102-13. (In Russ.). doi: 10.18692/1810-4800-2023-6-102-113MacDougall HG, Weber KP, McGarvie LA, et al. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology. 2009;73:1134-41. doi: 10.1212/WNL.0b013e3181bacf85MacDougall HG, Weber KP, McGarvie LA, et al. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology. 2009;73:1134-41. doi: 10.1212/WNL.0b013e3181bacf85DiLiberto FE, Kamath HER, Olson ML, et al. When, where, and why should we look for vestibular dysfunction in people with diabetes mellitus? Front Rehabil Sci. 2024 Jan 11;4:1306010. doi: 10.3389/fresc.2023.1306010DiLiberto FE, Kamath HER, Olson ML, et al. When, where, and why should we look for vestibular dysfunction in people with diabetes mellitus? Front Rehabil Sci. 2024 Jan 11;4:1306010. doi: 10.3389/fresc.2023.1306010Gioacchini FM, Albera R, Re M, et al. Hyperglycemia and diabetes mellitus are related to vestibular organs dysfunction: truth or suggestion? A literature review. Acta Diabetol. 2018 Dec;55(12):1201-7. doi: 10.1007/s00592-018-1183-2Gioacchini FM, Albera R, Re M, et al. Hyperglycemia and diabetes mellitus are related to vestibular organs dysfunction: truth or suggestion? A literature review. Acta Diabetol. 2018 Dec;55(12):1201-7. doi: 10.1007/s00592-018-1183-2Nourizadeh N, Jahani M, Jafarzadeh S. Auditory and Vestibular Assessment of Patients with Type Two Diabetes Mellitus: A Case-Control Study. Iran J Otorhinolaryngol. 2021 Sep;33(118):263-9. doi: 10.22038/ijorl.2021.55334.2899Nourizadeh N, Jahani M, Jafarzadeh S. Auditory and Vestibular Assessment of Patients with Type Two Diabetes Mellitus: A Case-Control Study. Iran J Otorhinolaryngol. 2021 Sep;33(118):263-9. doi: 10.22038/ijorl.2021.55334.2899Mahalingasivam AA, Jespersen AK, Ejskjaer N, et al. The co-existence of peripheral and vestibular neuropathy in diabetes: a cross-sectional study. Eur Arch Otorhinolaryngol. 2024 Feb;281(2):663-72. doi: 10.1007/s00405-023-08130-6Mahalingasivam AA, Jespersen AK, Ejskjaer N, et al. The co-existence of peripheral and vestibular neuropathy in diabetes: a cross-sectional study. Eur Arch Otorhinolaryngol. 2024 Feb;281(2):663-72. doi: 10.1007/s00405-023-08130-6La Scaleia B, Siena A, D’Onofrio L, et al. Deterioration of Vestibular Motion Perception: A Risk Factor for Postural Instability and Falls in Elderly With Type 2 Diabetes. Diabetes Metab Res Rev. 2024 Oct;40(7):e3845. doi: 10.1002/dmrr.3845La Scaleia B, Siena A, D’Onofrio L, et al. Deterioration of Vestibular Motion Perception: A Risk Factor for Postural Instability and Falls in Elderly With Type 2 Diabetes. Diabetes Metab Res Rev. 2024 Oct;40(7):e3845. doi: 10.1002/dmrr.3845Merfeld DM, Park S, Gianna-Poulin C, et al. Vestibular perception and action employ qualitatively different mechanisms. I. Frequency response of VOR and perceptual responses during Translation and Tilt. J Neurophysiol. 2005 Jul;94(1):186-98. doi: 10.1152/jn.00904.2004Merfeld DM, Park S, Gianna-Poulin C, et al. Vestibular perception and action employ qualitatively different mechanisms. I. Frequency response of VOR and perceptual responses during Translation and Tilt. J Neurophysiol. 2005 Jul;94(1):186-98. doi: 10.1152/jn.00904.2004Wagner AR, Kobel MJ, Merfeld DM. Impacts of Rotation Axis and Frequency on Vestibular Perceptual Thresholds. Multisens Res. 2022 Jan 5;35(3):259-87. doi: 10.1163/22134808-bja10069Wagner AR, Kobel MJ, Merfeld DM. Impacts of Rotation Axis and Frequency on Vestibular Perceptual Thresholds. Multisens Res. 2022 Jan 5;35(3):259-87. doi: 10.1163/22134808-bja10069Jauregui-Renaud K, Aranda-Moreno C, Villasenor-Moreno JC, et al. Derealization symptoms according to the subjective visual vertical during unilateral centrifugation in patients with type 2 diabetes mellitus. J Vestib Res. 2019;29(2-3):111-20. doi: 10.3233/VES-190652Jauregui-Renaud K, Aranda-Moreno C, Villasenor-Moreno JC, et al. Derealization symptoms according to the subjective visual vertical during unilateral centrifugation in patients with type 2 diabetes mellitus. J Vestib Res. 2019;29(2-3):111-20. doi: 10.3233/VES-190652Moossavi A, Shaabani M, Nasli Esfahani E, et al. Subclinical vestibular dysfunction in type 1 diabetes mellitus. Hearing Balance Commun. 2021;19(2):86-95. doi: 10.1080/21695717.2020.1870823Moossavi A, Shaabani M, Nasli Esfahani E, et al. Subclinical vestibular dysfunction in type 1 diabetes mellitus. Hearing Balance Commun. 2021;19(2):86-95. doi: 10.1080/21695717.2020.1870823Jauregui-Renaud K, Aranda-Moreno C, Herrera-Rangel A. Utricular hypofunction in patients with type 2 diabetes mellitus. Acta Otorhinolaryngol Ital. 2017;37(5):430-5. doi: 10.14639/0392-100X-1243Jauregui-Renaud K, Aranda-Moreno C, Herrera-Rangel A. Utricular hypofunction in patients with type 2 diabetes mellitus. Acta Otorhinolaryngol Ital. 2017;37(5):430-5. doi: 10.14639/0392-100X-1243Palidis DJ, Wyder-Hodge PA, Fooken J, Spering M. Distinct Eye Movement Patterns Enhance Dynamic Visual Acuity. PLoS One. 2017;12:e0172061. doi: 10.1371/journal.pone.0172061Palidis DJ, Wyder-Hodge PA, Fooken J, Spering M. Distinct Eye Movement Patterns Enhance Dynamic Visual Acuity. PLoS One. 2017;12:e0172061. doi: 10.1371/journal.pone.0172061Ward BK, Wenzel A, Kalyani RR, et al. Characterization of Vestibulopathy in Individuals with Type 2 Diabetes Mellitus. Otolaryngol Head Neck Surg. 2015 Jul;153(1):112-8. doi: 10.1177/0194599815576717Ward BK, Wenzel A, Kalyani RR, et al. Characterization of Vestibulopathy in Individuals with Type 2 Diabetes Mellitus. Otolaryngol Head Neck Surg. 2015 Jul;153(1):112-8. doi: 10.1177/0194599815576717Gravesande J, Richardson J. Identifying non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus : a systematic review. Disabil Rehabil. 2017 Jul;39(15):1459-65. doi: 10.1080/09638288.2016.1199741Gravesande J, Richardson J. Identifying non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus : a systematic review. Disabil Rehabil. 2017 Jul;39(15):1459-65. doi: 10.1080/09638288.2016.1199741Park SH. Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging Clin Exp Res. 2018 Jan;30(1):1-16. doi: 10.1007/s40520-017-0749-0Park SH. Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging Clin Exp Res. 2018 Jan;30(1):1-16. doi: 10.1007/s40520-017-0749-0Hall CD, Herdman SJ, Whitney SL, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. J Neurol Phys Ther. 2022 Apr 1;46(2):118-77. doi: 10.1097/NPT.0000000000000382Hall CD, Herdman SJ, Whitney SL, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. J Neurol Phys Ther. 2022 Apr 1;46(2):118-77. doi: 10.1097/NPT.0000000000000382Sulway S, Whitney SL. Advances in Vestibular Rehabilitation. Adv Otorhinolaryngol. 2019;82:164-9. doi: 10.1159/000490285Sulway S, Whitney SL. Advances in Vestibular Rehabilitation. Adv Otorhinolaryngol. 2019;82:164-9. doi: 10.1159/000490285Boyer FC, Percebois-Macadre L, Regrain E, et al. Vestibular rehabilitation therapy. Neurophysiol Clin. 2008 Dec;38(6):479-87. doi: 10.1016/j.neucli.2008.09.011Boyer FC, Percebois-Macadre L, Regrain E, et al. Vestibular rehabilitation therapy. Neurophysiol Clin. 2008 Dec;38(6):479-87. doi: 10.1016/j.neucli.2008.09.011Иванова ГЕ, Кунельская НЛ, Парфенов ВА и др. Вестибулярная реабилитация в комплексной терапии вестибулярного головокружения (согласованное мнение экспертов). Неврология, нейропсихиатрия, психосоматика. 2024;16(1):114-21. doi: 10.14412/2074-2711-2024-1-114-121Ivanova GE, Kunelskaya NL, Parfenov VA, et al. Vestibular rehabilitation in complex therapy of vestibular vertigo (consensus of experts). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2024;16(1):114-21 (In Russ.). doi: 10.14412/2074-2711-2024-1-114-121Замерград МВ. Реабилитация при заболеваниях вестибулярной системы. Неврология, нейропсихиатрия, психосоматика. 2013;5(1):18-22. doi: 10.14412/2074-2711-2013-2392Zamergrad MV. Rehabilitation in vestibular system diseases. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2013;5(1):18-22 (In Russ.). doi: 10.14412/2074-2711-2013-2392Telian SA, Shepard NT, Smith-Wheelock M, Kemink JL. Habituation therapy for chronic vestibular dysfunction: preliminary results. Otolaryngol Head Neck Surg. 1990 Jul;103(1):89-95. doi: 10.1177/019459989010300113Telian SA, Shepard NT, Smith-Wheelock M, Kemink JL. Habituation therapy for chronic vestibular dysfunction: preliminary results. Otolaryngol Head Neck Surg. 1990 Jul;103(1):89-95. doi: 10.1177/019459989010300113Лиленко СВ, Янов ЮК, Лиленко АС. Тест сенсорной организации в оценке односторонней периферической вестибулярной дисфункции. Российская оториноларингология. 2014;(3):66-72. Доступно по ссылке: https://cyberleninka.ru/article/n/test-sensornoy-organizatsii-v-otsenke-odnostoronney-perifericheskoy-vestibulyarnoy-disfunktsii (дата обращения 02. 10. 2025).Lilenko SV, Yanov YuK, Lilenko AS. Sensory organisation test in assessment of unilateral peripheral vestibular dysfunction. Russian Otolaryngology. 2014;(3):66-72. Available at: https://cyberleninka.ru/article/n/test-sensornoy-organizatsii-v-otsenke-odnostoronney-perifericheskoy-vestibulyarnoy-disfunktsii (accessed 02. 10. 2025) (In Russ.).Han BI, Song HS, Kim JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol. 2011 Dec;7(4):184-96. doi: 10.3988/jcn.2011.7.4.184Han BI, Song HS, Kim JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol. 2011 Dec;7(4):184-96. doi: 10.3988/jcn.2011.7.4.184

The authors declare that there are no conflicts of interest present.