Reduction in Posterior Semicircular Canal Gain by Age in Video Head Impulse Testing. Observational Study

Jiménez, Gloria Guerra; Pérez-Fernández, Nicolas

doi:10.1016/j.otoeng.2014.10.011

Cited by 10 publications

(6 citation statements)

References 24 publications

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“…The present study also explains the existence of refixation saccades in 100% of the individuals with motion sickness compared to that of their counterparts. The presence of refixation saccades is in agreement with various studies reported earlier with vestibular-related pathologies (MacDougall et al, 2009;Macdougall et al, 2013;Jiménez and Fernández, 2016;Redondo-Martínez et al, 2016). Refixation saccades occur when the variation is present between the stimulated sides of the coplanar canals and that of the nonstimulated side, therefore making the VOR generate compensatory eye movement to maintain gaze stability even during head rotation (Bronstein and Gresty, 1991).…”

Section: Discussionsupporting

confidence: 90%

Higher Asymmetry Ratio and Refixation Saccades in Individuals with Motion Sickness

2018

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Section: Discussionsupporting

confidence: 90%

Higher Asymmetry Ratio and Refixation Saccades in Individuals with Motion Sickness

2018

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“…Conversely, no substantial difference in terms of time needed to recover or convert into typical BPPV could be found among different subgroups, prevailing a time-period greater than a week across all different BPPV forms ( Figure 1E). Preliminary correlation analysis between patient's age and VOR-gain values for each SC (both pre-and post-treatment) in subjects with defined affected SC (n. 53) was performed prior to investigating VOR-gain behavior among different subgroups, to ensure lack of consistent age-related bias involving canal activity (50). Only a negative correlation between patients' age and presenting VOR-gains for the other vertical SC ipsilaterally to the affected canal (rho = −0.279, p = 0.043) and for the contralateral SC other than the canal coupled with the affected SC (rho = −0.302, p = 0.028) was found (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

Feasibility of Using the Video-Head Impulse Test to Detect the Involved Canal in Benign Paroxysmal Positional Vertigo Presenting With Positional Downbeat Nystagmus

et al. 2020

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Positional downbeat nystagmus (pDBN) represents a relatively frequent finding. Its possible peripheral origin has been widely ascertained. Nevertheless, distinguishing features of peripheral positional nystagmus, including latency, paroxysm and torsional components, may be missing, resulting in challenging differential diagnosis with central pDBN. Moreover, in case of benign paroxysmal positional vertigo (BPPV), detection of the affected canal may be challenging as involvement of the non-ampullary arm of posterior semicircular canal (PSC) results in the same oculomotor responses generated by contralateral anterior canal (ASC)-canalolithiasis. Recent acquisitions suggest that patients with persistent pDBN due to vertical canal-BPPV may exhibit impaired vestibulo-ocular reflex (VOR) for the involved canal on video-head impulse test (vHIT). Since canal hypofunction normalizes following proper canalith repositioning procedures (CRP), an incomplete canalith jam acting as a "low-pass filter" for the affected ampullary receptor has been hypothesized. This study aims to determine the sensitivity of vHIT in detecting canal involvement in patients presenting with pDBN due to vertical canal-BPPV. We retrospectively reviewed the clinical records of 59 consecutive subjects presenting with peripheral pDBN. All patients were tested with video-Frenzel examination and vHIT at presentation and after resolution of symptoms or transformation in typical BPPV-variant. BPPV involving non-ampullary tract of PSC was diagnosed in 78%, ASC-BPPV in 11.9% whereas in 6 cases the involved canal remained unidentified. Presenting VOR-gain values for the affected canal were greatly impaired in cases with persistent pDBN compared to subjects with paroxysmal/transitory nystagmus (p < 0.001). Each patient received CRP for BPPV involving the hypoactive canal or, in case of normal VOR-gain, the assumed affected canal. Each subject exhibiting VOR-gain reduction for the involved Castellucci et al. vHIT in Positional Downbeat Nystagmus canal developed normalization of vHIT data after proper repositioning (p < 0.001), proving a close relationship with otoliths altering high-frequency cupular responses. According to our results, overall vHIT sensitivity in detecting the affected SC was 72.9%, increasing up to 88.6% when considering only cases with persistent pDBN where an incomplete canal plug is more likely to occur. vHIT should be routinely used in patients with pDBN as it may enable to localize otoconia within the labyrinth, providing further insights to the pathophysiology of peripheral pDBN.

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“…Isolated bilateral posterior semicircular dysfunction on vHIT has been reported in elderly individuals with a complaint of dizziness. 19,20 The authors of these studies have attributed isolated bilateral posterior semicircular canal dysfunction to aging. Isolated posterior canal dysfunction has also been reported in other conditions such as idiopathic sudden sensorineural hearing loss, 21 posterior semicircular canal aplasia, 22 and labyrinthine ischemia in the common cochlear artery territory.…”

Section: Discussionmentioning

confidence: 99%

“…The present study included 42 young adults in the age range of 18 to 40 years as participants. Among them, 19 All the participants underwent pure-tone audiometry and immittance evaluation. All participants had "normal" hearing sensitivity and middle ear functioning.…”

Section: Participantsmentioning

confidence: 99%

Video Head Impulse Test in Persons with Blindness: Feasibility and Outcomes

2022

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Background To achieve balance, persons with blindness (PWB) use proprioceptive and vestibular cues rather than the visual system; however, PWB are equally susceptible to acquire vestibular disorders. Reliable assessments of the vestibular system in PWB are essential to determine the presence or absence of vestibular disorders. Purpose The saccular and the utricular functioning can be assessed using cervical vestibular-evoked myogenic potential and ocular vestibular-evoked myogenic potential, respectively. Evaluation of the functional integrity of the semicircular canals requires an assessment of the vestibular ocular reflex; however, this can be challenging in PWB. Video head impulse test (vHIT) assesses the vestibular ocular reflex (VOR) elicited against the natural high-frequency head movement in the planes of all six semicircular canals. This study aimed to explore the feasibility and outcomes of administering vHIT in PWB. Research Design Standard (static) groups comparison. Study Sample Nineteen young PWB and 23 age-matched adults with “normal” vision (control group) were included in the study. Data Collection and Analyses PWB underwent vHIT once, while the control group was tested in three conditions; condition 1 was used to simulate blindness for the control group, where vHIT was done in a pitch-dark room without prior instructions; condition 2 included vHIT testing in daylight, without a fixed visual target and any instructions; and condition 3 involved vHIT in daylight in the presence of a set visual target and with standard instructions to maintain visual focus on the visual target. Results The VOR gain was abnormal in the PWB group for all the canals. Among the PWB, the lateral canals (mean = 0.63) had the best VOR gain, followed by the anterior canals (mean = 0.53) and the posterior canals (mean = 0.31). In the control group, the VOR gain was significantly reduced in condition 1. There was no significant difference between the VOR gain in the PWB group and the control group in condition 1 for the lateral and the anterior canals. A higher proportion of participants in the PWB group had the presence of refixation saccades. Conclusion VOR is significantly reduced in PWB but not completely absent. There may be a need to develop normative data for blind individuals to decide whether or not a person with blindness has a vestibular dysfunction, specifically a VOR deficit.

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Reduction in Posterior Semicircular Canal Gain by Age in Video Head Impulse Testing. Observational Study

Cited by 10 publications

References 24 publications

Higher Asymmetry Ratio and Refixation Saccades in Individuals with Motion Sickness

Higher Asymmetry Ratio and Refixation Saccades in Individuals with Motion Sickness

Feasibility of Using the Video-Head Impulse Test to Detect the Involved Canal in Benign Paroxysmal Positional Vertigo Presenting With Positional Downbeat Nystagmus

Video Head Impulse Test in Persons with Blindness: Feasibility and Outcomes

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