Intra- and Interexaminer Variability of Two Separate Video Head Impulse Test Systems Assessing All Six Semicircular Canals

Abrahamsen, Emil Riis; Christensen, Ann-Eva; Hougaard, Dan Dupont

doi:10.1097/mao.0000000000001665

Cited by 30 publications

(30 citation statements)

References 21 publications

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“…Similarly, VOR gain improvements with HME (80% in patient 1 and 20% in patient 2) seem meaningful. They exceed minimal detectable change (MDC) suggested by studies in healthy subjects with MDC values ranging from 11% [repeatability coefficient of 0.1 and average VOR gain of 0.94, ( 18 )] to 14% [95% limits of agreement of 0.14 and average VOR gain of 1.06, ( 19 )].…”

Section: Discussionmentioning

confidence: 64%

Head-Movement-Emphasized Rehabilitation in Bilateral Vestibulopathy

et al. 2018

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Objective: Although there is evidence that vestibular rehabilitation is useful for treating chronic bilateral vestibular hypofunction (BVH), the mechanisms for improvement, and the reasons why only some patients improve are still unclear. Clinical rehabilitation results and evidence fromeye-head control in vestibular deficiency suggest that headmovement is a crucial element of vestibular rehabilitation. In this study, we assess the effects of a specifically designed head-movement-based rehabilitation program on dynamic vision, and explore underlying mechanisms.Methods: Two adult patients (patients 1 and 2) with chronic BVH underwent two 4-week interventions: (1) head-movement-emphasized rehabilitation (HME) with exercises based on active head movements, and (2) eye-movement-only rehabilitation (EMO), a control intervention with sham exercises without head movement. In a double-blind crossover design, the patients were randomized to first undergo EMO (patient 1) and–after a 4-week washout–HME, and vice-versa (patient 2). Before each intervention and after a 4-week follow-up patients’ dynamic vision, vestibulo-ocular reflex (VOR) gain, as well as re-fixation saccade behavior during passive headmotion were assessed with the head impulse testing device–functional test (HITD-FT).Results: HME, not EMO, markedly improved perception with dynamic vision during passive head motion (HITD-FT score) increasing from 0 to 60% (patient 1) and 75% (patient 2). There was a combination of enhanced VOR, as well as improved saccadic compensation.Conclusion: Head movement seems to be an important element of rehabilitation for BVH. It improves dynamic vision with a combined VOR and compensatory saccade enhancement.

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Section: Discussionmentioning

confidence: 64%

Head-Movement-Emphasized Rehabilitation in Bilateral Vestibulopathy

et al. 2018

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“…It is recommended to use precise and uniform criteria defining pathological saccades. Until a consensus is reached on this matter, application of the four standard criteria, defined in a recent study 14 , is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…Definition of clinical skills, previous experience, and specific requirements/qualifications need to be clearly defined for both clinical use and research purposes before optimal use of the vHIT test is possible. A recent study indicated that some level of prior experience is beneficial when performing the vHIT; therefore, it is recommended that future examiners undergo systematic training before performing vHIT in a clinical setting 14 . The vHIT test is not just a "plug and play" test; however, if performed correctly, it offers excellent objective diagnostics of vestibular system functioning.…”

Section: Discussionmentioning

confidence: 99%

“…This method, which provides near total removal of the rotational part of the eye movements during testing, is used when performing vertical SCC testing with the vHIT system B. Illustrations and a more detailed description of these two vHIT test methods are provided in the results section. A recent study included both of the abovementioned vHIT systems 14 . Because these vHIT systems use separate test methods for vertical SCC testing, both the 2D and 3D vHIT test methods were used in the evaluation of vestibular function.…”

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confidence: 99%

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Testing of all Six Semicircular Canals with Video Head Impulse Test Systems

Hougaard

Abrahamsen

2019

JoVE

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Throughout the last decade, there has been a rapid development of existing test procedures and methods evaluating the human vestibular system. In 2009 and 2013, commercially available video Head Impulse Testing (vHIT) has enabled clinicians to examine the function of all three paired semicircular canals within the vestibular system. The vHIT test has revolutionized vestibular testing and, at many clinics and hospitals around the world, this test is now considered the most important initial test of vertiginous patients. There are several manufacturers of vHIT systems around the world. A test protocol for two of the most widespread vHIT systems, EyeSeeCam and ICS Impulse, will be presented. Included in this protocol is a description of the two different test methods termed 2D vHIT testing and 3D vHIT testing. The vHIT system includes a lightweight goggle with accompanying software. The test is fast (5-10 min) and can be done with minimal discomfort to the person being examined. However, there are many steps of the test, and each of these steps may alter the final test results, if the individual steps of the test are not performed correctly. It is therefore of paramount importance that the examiner is familiar with the potential noise and/or artifact triggers. Systematic training of future examiners before performing vHIT in a clinical setting and compliance with this protocol may minimize these challenges of the test. The vHIT test is not just a "plug and play" test. However, if carried out correctly, this test offers excellent objective assessment of the function of the high frequency domain of the vestibular system. It has a very high positive predictive value and offers a specificity very close to one hundred percent.

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“…Interestingly, a study testing 2 separate vHIT systems revealed some level of interexaminer variability between 2 examiners when using the EyeSeeCam system for examination [13]. The authors therefore conclude that some level of experience is beneficial when performing the vHIT examination with this vHIT system.…”

Section: Resultsmentioning

confidence: 92%

Normative Vestibular-Ocular Reflex Gain Values for the Vertical Semicircular Canals

2020

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Objectives: To determine normative vestibular-ocular-reflex (VOR) gain values for the vertical semicircular canals (SCCs) within a Danish cohort of healthy adults. Normative data regarding the vertical SCCs are sparse. Assessing the function of all 6 SCCs is important, as some vestibular diseases may selectively affect specific SCCs. Methods: A prospective cross-sectional study of 60 subjects aged 18-65 years with no previous vestibular disorders. All subjects underwent complete examination of all 6 SCCs with EyeSeeCam video head impulse test (vHIT) system. Results: Mean VOR gain values of the right anterior and left posterior canal were 1.46 and 1.43 respectively. For the left anterior and right posterior canals, mean VOR gain values were 0.96 and 0.97 respectively. Conclusions: Our results suggest that mean VOR gain is close to 1.4 in the right anterior and left posterior plane and close to one for the left anterior and right posterior plane when testing the vertical SCCs in healthy adults with the EyeSeeCam vHIT system.

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Intra- and Interexaminer Variability of Two Separate Video Head Impulse Test Systems Assessing All Six Semicircular Canals

Abstract: Horizontal SCC testing: both v-HIT systems displayed good intra- and interexaminer variability. Vertical SCC testing: System B displayed good intra- and interexaminer variability whereas the opposite was true with system A.

Cited by 30 publications

References 21 publications

Head-Movement-Emphasized Rehabilitation in Bilateral Vestibulopathy

Head-Movement-Emphasized Rehabilitation in Bilateral Vestibulopathy

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems

Normative Vestibular-Ocular Reflex Gain Values for the Vertical Semicircular Canals

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