Assoc Prof Americo Migliaccio


Associate Professor, NeuRA Conjoint Assoc Prof, Graduate School of Biomedical Engineering, UNSW
Adjunct Assoc Prof, School of Medicine, Johns Hopkins University, USA

+612 9399 1030

Assoc Prof Americo Migliaccio heads a research group that investigates the neural mechanisms underlying the vestibulo-ocular reflex (VOR). He is particularly focused on determining the neural mechanisms important for recovery after partial injury of the vestibular organ/s. He is also developing a new rehabilitation technique and device to modify VOR function.

Projects Assoc Prof Americo Migliaccio is currently involved with


A new mouse model that determines the effects of a unilateral vestibular prosthesis on vestibular pl

Much like a cochlear implant restores auditory function, a vestibular prosthesis restores balance function. It is not clear whether the limited results from vestibular prostheses is due the device not stimulating one component (the otoliths) of the vestibular system essential for self-repair.


A new mouse model that determines the effects of a unilateral vestibular prosthesis on vestibular plasticity.

The effect of enhanced vestibular efferent transmission on plasticity of the mammalian vestibulo-ocu

We have identified a nerve-pathway crucial for balance adjustment and self-repair. We will test a mouse type that has this pathway genetically made more sensitive to determine whether stimulation of this pathway is a viable approach to improving recovery after balance loss in humans.


The effect of enhanced vestibular efferent transmission on plasticity of the mammalian vestibulo-ocular reflex (VOR)

Treating dizziness in older people

Despite effective treatments being available, up to 40% of older people with reported dizziness remain undiagnosed and untreated. A multidisciplinary assessment battery, with new validated assessments of vestibular impairments is required for diagnosing and treating older people with dizziness. This project will therefore aim to conduct a randomised-control trial of a multifaceted dizziness intervention based on a multidisciplinary assessment, and develop a multiple profile assessment of dizziness for use in Specialist Clinics.


Treating dizziness in older people

Development of a take-home rehabilitation device that improves vision and balance in patients with i

This project will develop a rehabilitation device based on a training technique we invented, which has been shown to significantly normalise the vestibulo-ocular reflex (VOR) response in patients with vestibular organ lesions.


Development of a take-home rehabilitation device that improves vision and balance in patients with injury to the balance organs


ASSOC PROF MICHAEL SCHUBERT Honorary Senior Research Fellow

ASSOC PROF PHILLIP CREMER Honorary Senior Research Fellow

ASSOC PROF ALAN BRICHTA Honorary Senior Research Fellow

DR REBECCA LIM Honorary Research Fellow

Chris Todd

CHRISTOPHER TODD Research Assistant

WILLIAM FIGTREE Research Assistant

Tanvir Ahmed



David Grenet



Pilot study of a new rehabilitation tool: improved unilateral short-term adaptation of the human angular vestibulo-ocular reflex.

Migliaccio AA, Schubert MC

A visual stimulus driving the VOR gain to unity toward the nonadapting side aids unilateral adaptation more so than no visual stimulus.

The mammalian efferent vestibular system plays a crucial role in the high-frequency response and short-term adaptation of the vestibuloocular reflex.

Hübner PP, Khan SI, Migliaccio AA

Although anatomically well described, the functional role of the mammalian efferent vestibular system (EVS) remains unclear. Unlike in fish and reptiles, the mammalian EVS does not seem to play a role in modulation of primary afferent activity in anticipation of active head movements. However, it could play a role in modulating long-term mechanisms requiring plasticity such as vestibular adaptation. We measured the efficacy of vestibuloocular reflex (VOR) adaptation in α9-knockout mice. These mice carry a missense mutation of the gene encoding the α9 nicotinic acetylcholine receptor (nAChR) subunit. The α9 nAChR subunit is expressed in the vestibular and auditory periphery, and its loss of function could compromise peripheral input from the predominantly cholinergic EVS. We measured the VOR gain (eye velocity/head velocity) in 26 α9-knockout mice and 27 cba129 control mice. Mice were randomly assigned to one of three groups: gain-increase adaptation (1.5×), gain-decrease adaptation (0.5×), or no adaptation (baseline, 1×). After adaptation training (horizontal rotations at 0.5 Hz with peak velocity 20°/s), we measured the sinusoidal (0.2-10 Hz, 20-100°/s) and transient (1,500-6,000°/s(2)) VOR in complete darkness. α9-Knockout mice had significantly lower baseline gains compared with control mice. This difference increased with stimulus frequency (∼ 5% <1 Hz to ∼ 25% >1 Hz). Moreover, vestibular adaptation (difference in VOR gain of gain-increase and gain-decrease adaptation groups as % of gain increase) was significantly reduced in α9-knockout mice (17%) compared with control mice (53%), a reduction of ∼ 70%. Our results show that the loss of α9 nAChRs moderately affects the VOR but severely affects VOR adaptation, suggesting that the EVS plays a crucial role in vestibular plasticity.

Isolated Vestibular Suppression Impairment With Vestibular Migraine: A Phenotypic CANVAS Variant.

Migliaccio AA, Watson SR

We propose that impaired VORS and VM are because of similar, but distinct, consequences of selective partial cerebellar dysfunction. The patient's VORS data are consistent with a CANVAS neuropathological study showing selective degeneration of the dorsal vermis of the cerebellum, a region thought to be important for VORS. Taken together our findings suggest the patient is a CANVAS variant. We hypothesise VORS impairment is part of CANVAS, but not revealed because of vestibular loss.

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