DrBarry Seemungal, PhD FRCP

RESEARCH FOCUS

TRAUMATIC BRAIN INJURY (TBI)

TBI is a major cause of persistent dizziness, imbalance and falls. A central theme of my work is that post-traumatic vestibular disability is often multifactorial (combined peripheral and central mechanisms) and may be missed when vestibular perception is attenuated despite intact reflex function — a phenomenon we have termed vestibular agnosia.

Key programme themes:

• Brain mechanisms of imbalance in TBI
• Vestibular agnosia and perceptual–reflex dissociation
• Longitudinal predictors of balance recovery
• Treatable vestibular disorders in TBI (e.g. BPPV)
• Scalable diagnostics and biomarker development
• Neuromodulation approaches for vestibular dysfunction

Selected TBI publications:

• Calzolari E et al.; Seemungal BM. Vestibular agnosia in traumatic brain injury and its link to imbalance. Brain. 2021.
• Hadi Z et al.; Seemungal BM. Balance recovery and its link to vestibular agnosia in traumatic brain injury. J Neurol. 2025.
• Marcus HJ et al. Vestibular dysfunction in acute traumatic brain injury. J Neurol. 2019.
• Smith RM et al.; Seemungal BM. Management of BPPV in acute TBI: feasibility RCT. Pilot Feasibility Stud. 2020.
• Rust HM et al.; Seemungal BM. Force dependency of BPPV in acute TBI. JNNP. 2022.
• Hadi Z et al.; Seemungal BM. Brain mechanisms explaining postural imbalance in TBI. Brain Connect. 2024.

COMPLEMENTARY PROGRAMMES:

1 - PARKINSON’S DISEASE (Moulton Charity)

We also investigate balance and falls in Parkinson’s disease, providing a complementary model of network-level postural instability and neuromodulation-based intervention. This strengthens the translational and mechanistic framework underpinning our TBI programme.

2 - VESTA Vertigo Screening and Treatment App (Imperial Charity Innovation Award)

We are developing a patient-facing vestibular screening tool and app to enable treatment of common vestibular disorders in the community. We plan to develop an NHS-ready diagnostic and treatrment app. Additionally, the app will enhance our ability to monitor patients' at home for research studies.

3 - Vestibular space physiology

We use non-invasive deep brain stimulation approaches for modulating spatial orientation and motion sickness, both critical for human space exploration.

CURRENT TEAM MEMBERS

• Ms Kate Lewis — PhD Candidate; MRC Doctoral Fellow; Senior Vestibular Therapist
  Vestibular–autonomic overlap in acute traumatic brain injury.

• Mr Zaeem Hadi — PhD Candidate / Postgraduate Research Assistant
  Neuroimaging and electrophysiological biomarkers of vestibular agnosia in TBI.

• Mr Nathan Kiatwongwanich — PhD Candidate (Thai Government Scholar)
  Temporal interference deep brain stimulation for vestibular dysfunction in TBI.

• Dr Rebecca Smith — Post-doctoral Vestibular Therapist; NIHR & Imperial BRC funded
  Treatment of benign paroxysmal positional vertigo (BPPV), a common and treatable inner-ear disorder affecting ~70% of TBI patients with dizziness.