Prognosis after acute unilateral vestibulopathy: Usefulness of the suppression head impulse paradigm (SHIMP)

2021 ◽  
pp. 1-10
Author(s):  
Augusto Pietro Casani ◽  
Rachele Canelli ◽  
Francesco Lazzerini ◽  
Elena Navari
Keyword(s):  
Cross Sectional Study ◽  
Head Impulse Test ◽  
Cross Sectional ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Group 2 ◽  
Unilateral Vestibulopathy ◽  
Vestibular Damage ◽  
Acute Unilateral Vestibulopathy

OBJECTIVES: This cross-sectional study aims to describe the features of the suppression head impulse paradigm (SHIMP) in acute unilateral vestibulopathy (AUV) and to define its role in predicting the recovery of patients. METHODS: Thirty patients diagnosed with AUV were retrospectively analyzed. The dizziness handicap inventory score and video head impulse test parameters performed 4–8 weeks from the AUV onset constituted the main outcome measures. Patients with a worse recovery (Group 1) and patients who recovered spontaneously (Group 2) were compared. RESULTS: The SHIMP vestibulo-ocular reflex (VOR) gain was statistically significantly lower than the conventional head impulse paradigm (HIMP) VOR gain (P <  0.001). The SHIMP VOR gain was negatively correlated with the DHI (P <  0.001) and was positively correlated with the HIMP VOR gain (P <  0.001) and the SHIMP overt saccades (%) (P <  0.001). Patients with a worse recovery exhibited the following: higher DHI (P <  0.001), lower SHIMP and HIMP VOR gain (P <  0.001 and P = 0.007, respectively), and lower SHIMP and greater HIMP overt saccade prevalence values (P = 0.007 and P = 0.032, respectively). CONCLUSIONS: The SHIMP and HIMP help in improving our approach to AUV. SHIMP appears to better identify the extent of the vestibular damage in patient suffering from AUV than HIMP and could provide interesting information about the course of the disease. Particularly, the analysis of SHIMP VOR gain and overt saccade prevalence would provide useful information about the recovery of patients.

scholarly journals Vestibulo-Ocular Reflex Function in Adolescents With Sport-Related Concussion: Preliminary Results

2019 ◽  
Vol 11 (6) ◽  
pp. 479-485 ◽  
Author(s):  
Abdulaziz A. Alkathiry ◽  
Anthony P. Kontos ◽  
Joseph M. Furman ◽  
Susan L. Whitney ◽  
Eric R. Anson ◽  
...  
Keyword(s):  
Vestibular System ◽  
Rank Order ◽  
Head Impulse Test ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Horizontal Semicircular Canal ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Impulse Function ◽  
Vestibulo Ocular Reflex

Background: Oculomotor impairments, dizziness, and imbalance are common after sports-related concussion (SRC) in adolescents and suggest a relationship between SRC and vestibular system dysfunction. However, it is not clear whether the source of these problems is attributable to the peripheral or central vestibular system. Hypothesis: The video Head Impulse Test (vHIT), which assesses peripheral vestibular function, will show differences in gain between adolescents with and without SRC. Furthermore, there will be an association between vHIT and clinical balance and vestibular/oculomotor testing. Study Design: Cross-sectional study. Level of Evidence: Level 2. Methods: Twenty-five symptomatic adolescents aged between 12 and 19 years with a recent (within 10 days) SRC and 22 healthy controls aged 13 to 20 years were assessed using the vHIT, Balance Error Scoring System (BESS), and Vestibular Ocular Motor Screening (VOMS) tools. The vestibulo-ocular reflex (VOR) gain was calculated independently for right and left head impulses. Independent-samples t tests or Mann-Whitney U tests for nonnormal distributions were used to compare concussed patients and controls on the measures. Spearman rank-order correlations were used to assess the association of vHIT with BESS and VOMS. Results: VOR gain in all adolescents with SRC was greater than 0.8, which is considered within normal limits. VOR gain and BESS scores were not significantly different between groups. Adolescents with SRC had significantly worse VOMS item scores than adolescents without SRC ( P < 0.001). There were no significant correlations among vHIT gain and VOMS or BESS. Conclusion: There was no evidence for dysfunction in the peripheral horizontal semicircular canal function at high rotation speeds (ie, vHIT) after SRC, and vHIT was unrelated to balance and vestibular/oculomotor symptoms and dysfunction. However, adolescents with SRC scored worse on vestibular and oculomotor testing than those without SRC. Vestibular dysfunction and symptoms after SRC may be centrally derived. Clinical Relevance: We do not recommend the assessment of head impulse function in adolescents with SRC unless more definitive signs of peripheral vestibular injury are present. We recommend using the VOMS to assess symptoms of suspected SRC injury in adolescents.

Viewing Target Distance Influences the Vestibulo-Ocular Reflex Gain when Assessed Using the Video Head Impulse Test

2018 ◽  
Vol 23 (5) ◽  
pp. 285-289 ◽  
Author(s):  
Patricia Castro ◽  
Sara Sena Esteves ◽  
Florencia Lerchundi ◽  
David Buckwell ◽  
Michael A. Gresty ◽  
...  
Keyword(s):  
Head Movements ◽  
Target Distance ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Gaze Stabilization ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Significant Difference ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Gaze stabilization during head movements is provided by the vestibulo-ocular reflex (VOR). Clinical assessment of this reflex is performed using the video Head Impulse Test (vHIT). To date, the influence of different fixation distances on VOR gain using the vHIT has not been explored. We assessed the effect of target proximity on the horizontal VOR using the vHIT. Firstly, we assessed the VOR gain in 18 healthy subjects with 5 viewing target distances (150, 40, 30, 20, and 10 cm). The gain increased significantly as the viewing target distance decreased. A second experiment on 10 subjects was performed in darkness whilst the subjects were imagining targets at different distances. There were significant inverse relationships between gain and distance for both the real and the imaginary targets. There was a statistically significant difference between light and dark gains for the 20- and 40-cm distances, but not for the 150-cm distance. Theoretical VOR gains for different target distances were calculated and compared with those found in light and darkness. The increase in gain observed for near targets was lower than predicted by geometrical calculations, implying a physiological ceiling effect on the VOR. The VOR gain in the dark, as assessed with the vHIT, demonstrates an enhancement associated with a reduced target distance.

Prevalence of Vestibular Dysfunction with Presbycusis among Elderly in Malaysia

2021 ◽  
Vol 15 (12) ◽  
pp. 3478-3480
Author(s):  
Mohammed Amin Onn ◽  
Khairi Md Daud ◽  
Rosdan Salim
Keyword(s):  
Pure Tone Audiometry ◽  
Cross Sectional Study ◽  
Vestibular Dysfunction ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Chi Square ◽  
Cross Sectional ◽  
Test Of Independence ◽  
Head Impulse ◽  
Chi Square Test

Objectives: This study aims to determine the prevalence of vestibular dysfunction in the Malaysian elderly and its association with presbycusis, age and other associated risk factors. Methods: A cross-sectional study was undertaken in a tertiary otorhinolaryngology department and the community. Adults aged 60 years and above who attended the ORL CLINIC with or without presbycusis were invited to participate. The main outcome measures, including the Malay Version Vertigo Symptoms Scale, pure tone audiometry and vestibular assessment, were obtained using a Video Head Impulse Test (VHIT). Results: The prevalence of vestibular dysfunction with presbycusis in the study population of 135 participants was 46.7 per cent (95 per cent confidence interval, 24.0 to 36.2 per cent). The median age was 68 years (range, 60–86 years). The A chi-square test of independence showed that there was significant association between Presbycusis and Tinnitus, X2 (1, N = 135) = 97.37, p < .001. A chi-square test of independence was performed to examine the relation between presbycusis and dizziness. The relation between these variables was significant, X2 (2, N = 135) = 28.42, p < .001. A chi-square test of independence showed that there was no significant association between presbycusis and VHIT, X2 (1, N = 135) = .01, p = .938. Conclusion: Vestibular dysfunction is independently associated with ageing and presbycusis. More research investigating the advantages of additional screening for vestibular dysfunction in older presbycusis patients is needed. Key words: Elderly; Presbycusis; Vestibular dysfunction; Video Head Impulse Test (VHIT)

scholarly journals Vestibulo-ocular reflex and the head impulse test

2012 ◽  
Vol 70 (12) ◽  
pp. 942-944 ◽  
Author(s):  
Eliana T. Maranhão ◽  
Péricles Maranhão-Filho
Keyword(s):  
Diagnostic Method ◽  
Vestibular Dysfunction ◽  
Head Impulse Test ◽  
Emergency Rooms ◽  
Brainstem Infarction ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Peripheral Vestibulopathy ◽  
Vestibulo Ocular Reflex

The authors highlights the importance of the vestibulo-ocular reflex examination through the head impulse test as a diagnostic method for vestibular dysfunction as well as, and primarily, a bedside semiotic resource capable of differentiating between acute peripheral vestibulopathy and a cerebellar or brainstem infarction in emergency rooms.

Vestibulo-ocular reflex assessed with Video Head Impulse Test in children with Vestibular Migraine: Our experience

2020 ◽  
Vol 137 ◽  
pp. 110161
Author(s):  
Rosana Rodríguez-Villalba ◽  
Miguel Caballero-Borrego ◽  
Vanessa Villarraga ◽  
Victoria Rivero de Jesús ◽  
Maria Antonia Claveria ◽  
...  
Keyword(s):  
Vestibular Migraine ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex

scholarly journals Vestibulo-ocular reflex gain and compensatory saccades in three semicircular canals by video head impulse test

2019 ◽  
Author(s):  
Homa Zarrinkoob ◽  
Hadi Behzad ◽  
Seyed Mehdi Tabatabaee
Keyword(s):  
High Velocity ◽  
Semicircular Canals ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Low Velocity ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain ◽  
The Right

Background and Aim: One of the tools for ass­essing the vestibulo-ocular reflex (VOR) is using video head impulse test (vHIT). In this test by placing the head at different angles and shaking the head, three semicircular canals of the vestibular system in each ear can be exami­ned separately. The purpose of this study was to investigate the relationship between the low and high velocities of the vHIT test with VOR and its compensatory saccades. Methods: The vHIT test was performed by an examiner in 49 normal individuals aged 23–39 at low and high velocities. All participants had normal hearing, visual, and vestibular systems. Results: Mean gains in the horizontal, anterior and posterior semicircular canals in the right ear respectively were 0.92, 1 and 0.90 and in the left ear 0.93, 0.99 and 0.95 for low velocity and 0.78, 0.92 and 0.79 in the right ear and 0.80, 0.85 and 0.86 in the left ear for high velocity. Also, the number of compensatory saccade at high velocity was higher than those at the low velocity and the latency of compensatory sacc­ade was lower at the higher velocity. Conclusion: In the vHIT test, VOR gain decreases at high velocity that is statistically significant. Also, compensatory saccades are more likely to occur at high velocity with sma­ller delay. Therefore, high-velocity vHIT test is not recommended for the purpose of examining the VOR gain and compensatory saccade.

scholarly journals The Effect of Different Head Movement Paradigms on Vestibulo-Ocular Reflex Gain and Saccadic Eye Responses in the Suppression Head Impulse Test in Healthy Adult Volunteers

2021 ◽  
Vol 12 ◽  
Author(s):  
Dmitrii Starkov ◽  
Bernd Vermorken ◽  
T. S. Van Dooren ◽  
Lisa Van Stiphout ◽  
Miranda Janssen ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Healthy Adult ◽  
Head Movements ◽  
Head Impulse Test ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain ◽  
Head Impulses ◽  
Adult Volunteers

Objective: This study aimed to identify differences in vestibulo-ocular reflex gain (VOR gain) and saccadic response in the suppression head impulse paradigm (SHIMP) between predictable and less predictable head movements, in a group of healthy subjects. It was hypothesized that higher prediction could lead to a lower VOR gain, a shorter saccadic latency, and higher grouping of saccades.Methods: Sixty-two healthy subjects were tested using the video head impulse test and SHIMPs in four conditions: active and passive head movements for both inward and outward directions. VOR gain, latency of the first saccade, and the level of saccade grouping (PR-score) were compared among conditions. Inward and active head movements were considered to be more predictable than outward and passive head movements.Results: After validation, results of 57 tested subjects were analyzed. Mean VOR gain was significantly lower for inward passive compared with outward passive head impulses (p &lt; 0.001), and it was higher for active compared with passive head impulses (both inward and outward) (p ≤ 0.024). Mean latency of the first saccade was significantly shorter for inward active compared with inward passive (p ≤ 0.001) and for inward passive compared with outward passive head impulses (p = 0.012). Mean PR-score was only significantly higher in active outward than in active inward head impulses (p = 0.004).Conclusion: For SHIMP, a higher predictability in head movements lowered gain only in passive impulses and shortened latencies of compensatory saccades overall. For active impulses, gain calculation was affected by short-latency compensatory saccades, hindering reliable comparison with gains of passive impulses. Predictability did not substantially influence grouping of compensatory saccades.

Clinical Prevalence of Enhanced Vestibulo-Ocular Reflex Responses on Video Head Impulse Test

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Aitor Vargas-Alvarez ◽  
Elisabeth Ninchritz-Becerra ◽  
Miren Goiburu ◽  
Frank Betances ◽  
Jorge Rey-Martinez ◽  
...  
Keyword(s):  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Reflex Responses ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex
Sign in / Sign up

Export Citation Format

Share Document