Research Papers: Gerotarget (Focus on Aging):

The potential role of epigenetic modulations in BPPV maneuver exercises

Kun-Ling Tsai _, Chia-To Wang, Chia-Hua Kuo, Yuan-Yang Cheng, Hsin-I Ma, Ching-Hsia Hung, Yi-Ju Tsai and Chung-Lan Kao

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Oncotarget. 2016; 7:35522-35534. https://doi.org/10.18632/oncotarget.9446

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Kun-Ling Tsai1, Chia-To Wang2,3, Chia-Hua Kuo4, Yuan-Yang Cheng3,5,7, Hsin-I Ma6, Ching-Hsia Hung1, Yi-Ju Tsai1 and Chung-Lan Kao2,7

1 Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

2 Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan

3 Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

4 Department of Sports Sciences, University of Taipei, Taipei, Taiwan

5 Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan

6 Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

7 Department of Physical Medicine and Rehabilitation, School of Medicine National Yang-Ming University, Taipei, Taiwan

Correspondence to:

Chung-Lan Kao, email:

Keywords: benign paroxysmal positional vertigo, microRNA, Sirtuin 1, maneuver exercises, Gerotarget

Received: March 04, 2016 Accepted: May 10, 2016 Published: May 18, 2016


Benign paroxysmal positional vertigo (BPPV) is one of the most common complaints encountered in clinics and is strongly correlated with advanced age or, possibly, degeneration. Redistribution exercises are the most effective approaches to treat BPPV, and canalith repositioning procedure (CRP) cure most BPPV cases. However, the mechanisms through which the treatment modulates systemic molecules in BPPV patients remain largely unknown. In this study, we report that the miR-34a and Sirtuin 1 (SIRT1) genes correlated with the treatment effects of CRP in BPPV subjects. We found that miR-34a expression was largely inhibited and SIRT1 expression was significantly reversed after BPPV maneuver treatment. We also confirmed that the PPAR-γ, PGC-1 and FoxO gene expressions were decreased immediately after canalith repositioning procedure (CRP) for BPPV, and were largely increased after a complete cure of BPPV. Moreover, we observed that after a complete recovery of BPPV, the ROS concentrations, pro-inflammatory cytokine concentrations and p53 expression levels were attenuated. We conclude that BPPV treatment might involve some epigenetic regulations through the mediation of miR-34a, SIRT1 functions and repression of redox status.

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