Utricular dysfunction in patients with orthostatic hypotension

Kim, Jae-Gyum; Lee, Jeong‐Heon; Lee, Sun-Uk; Choi, Jeong‐Yoon; Kim, Byung Jo; Kim, Ji-Soo

doi:10.1007/s10286-022-00890-1

Cited by 14 publications

(8 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies have described blood pressure fluctuations following acute vestibular deafferentation, specifically when otolith organs are involved [5], but research in specific patient populations has been limited. In the August issue of Clinical Autonomic Research, Kim and colleagues [10] describe the otolith reflex performance of a cohort of 155 patients presenting with orthostatic dizziness. They found abnormal otolith reflex responses in 43% of patients, with the majority demonstrating reduced or absent responses.…”

Section: Otolith Reflex Pathway Dysfunction In Orthostatic Intolerancementioning

confidence: 99%

“…Kim and colleagues [10] excluded patients with identified peripheral and central vestibular disorders, limiting the application of these findings to those without obvious Fig. 1 Vestibular-autonomic reflexes are involved in pathways associated with sympathetic and parasympathetic outflows [2,3].…”

Section: Prevalence Of Orthostatic Intolerance In Vestibular Pathologymentioning

confidence: 99%

“…Currently, clinical otolith reflex testing is available in most vestibular laboratories. These protocols utilize VEMPs, as described in Kim and colleagues' recent report [10]. VEMPs are electrophysiological measures used to describe the sacculo-collic reflex pathway (cervical VEMPs) or the utriculo-ocular reflex pathway (ocular VEMPs).…”

Section: Otolith Reflex Testingmentioning

confidence: 99%

“…The stimulus used to trigger the response is important, especially when evaluating an older population. Kim and colleagues [10] used an electric reflex hammer, providing more efficiently delivered translational accelerations than in commonly used protocols using air-conducted stimuli. In these commonly used protocols, we know that advancing age may impact results and some patients may not tolerate the required stimulus intensity.…”

Section: Challenges With Otolith Reflex Testingmentioning

confidence: 99%

See 3 more Smart Citations

The role of otolith reflexes in orthostatic intolerance

Bogle

2022

Clin Auton Res

View full text Add to dashboard Cite

Section: Otolith Reflex Pathway Dysfunction In Orthostatic Intolerancementioning

confidence: 99%

Section: Prevalence Of Orthostatic Intolerance In Vestibular Pathologymentioning

confidence: 99%

Section: Otolith Reflex Testingmentioning

confidence: 99%

Section: Challenges With Otolith Reflex Testingmentioning

confidence: 99%

See 2 more Smart Citations

The role of otolith reflexes in orthostatic intolerance

Bogle

2022

Clin Auton Res

View full text Add to dashboard Cite

“…Besides latencies, other standard parameters describing the oVEMP reflex pathway include amplitudes (in microvolts) and asymmetry ratio (AR; dimensionless) (3,14,15). These parameters and their alteration, alone or in conjunction with results from complementary methods such as cervical VEMP or video head impulse test, can help assess the function of the equilibrium system and diagnose various disorders of the vestibular organ and beyond (12,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

Measurement of Ocular Vestibular Evoked Myogenic Potentials: Nasion Reference Montage as an Alternative to the Clinical Standard Montage

Scherer,

Beule,

Lütkenhöner

et al. 2024

Otol Neurotol

View full text Add to dashboard Cite

Objective To compare two novel electrode montages for ocular, vestibular evoked myogenic potential using single-nasion reference electrodes with the clinical standard montage. Study Design Randomized crossover experiment. Setting Tertiary referral center. Participants Sixty healthy participants. Intervention Normal hearing and vestibular function were confirmed with an extensive test-battery. All ocular, vestibular evoked myogenic potential settings were measured with air-conducted tone bursts at 100-dB normal hearing level and a frequency of 500 Hz. Three electrode montages were measured in randomized order: the clinical standard montage (“S”), the nasion reference montage (“N”), and the nasion reference montage with a more lateral active electrode (“L”). Upgaze was standardized to 35 degrees. Main Outcome Measures Detection rate, latency of N1 and P1, peak-to-peak amplitude of N1 and P1, signal-to-noise ratio (SNR), asymmetry ratio (AR), concordance of expert assessment, and reliability. Results All electrode montages showed detection rates greater than 90%. Latencies for “L” were shorter than for “S” and “N.” Amplitudes and SNR for “S” and “N” were higher than for “L,” whereas the values for “S” and “N” did not differ significantly. For AR, no significant differences between the montages were assessed. Concordance of experts ranged from 78% for “L” and 89.8% for “N.” All montages provided excellent day-to-day reliability (intraclass correlation coefficient ≥0.9) for amplitudes and SNR. Conclusions Montage N could be a useful alternative to the clinical standard montage: although results are roughly equivalent, montage N requires one less electrode to do so.

show abstract

Four‐hour‐delayed 3D‐FLAIR MRIs in patients with acute unilateral peripheral vestibulopathy

Kim,

Park,

Lee

et al. 2024

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectiveConventionally, MRI aids in differentiating acute unilateral peripheral vestibulopathy/vestibular neuritis (AUPV/VN) from mimickers. Meanwhile, the diagnostic utility of MRIs dedicated to the inner ear remains to be elucidated for diagnosing AUPV/VN.MethodsWe prospectively recruited 53 patients with AUPV/VN (mean age ± SD = 60 ± 15 years, 29 men). Initial MRIs were performed with a standard protocol, and an additional axial 3D‐fluid‐attenuated inversion recovery (3D‐FLAIR) sequence was obtained 4 h after intravenous injection of gadoterate meglumine. Abnormal enhancement was defined as a signal intensity that exceeded the mean + 2SD value on the healthy side. The findings of neurotologic evaluation and MRIs were compared.ResultsOverall, the inter‐rater agreement for gadolinium enhancement was 0.886 (Cohen's kappa coefficient). Enhancement was observed in 26 patients (49%), most frequently in the vestibule (n = 20), followed by the anterior (n = 12), horizontal (HC, n = 8), posterior canal (n = 5), and superior (n = 3) and inferior (n = 1) vestibular nerves. In multivariable logistic regression analysis, the enhancement was associated with decreased HC gain in video head‐impulse tests (p = 0.036), increased interaural difference in ocular vestibular‐evoked myogenic potentials (p = 0.001), and a longer onset‐to‐MRI time span (p = 0.024). The sensitivity and specificity were 92.3% and 81.5%, respectively, with an area under the curve of 0.90 for predicting gadolinium enhancement.InterpretationRobust gadolinium enhancement was observed on 4‐hour‐delayed 3D‐FLAIR images in nearly half of the patients with AUPV/VN, with a good correlation with the results of neurotologic evaluation. The positivity may be determined by the extent of vestibular deficit, timing of imaging acquisition, and possibly by the underlying etiology causing AUPV/VN. MRIs may aid in delineating the involved structures in AUPV/VN.

show abstract

Utricular dysfunction in patients with orthostatic hypotension

Cited by 14 publications

References 89 publications

The role of otolith reflexes in orthostatic intolerance

The role of otolith reflexes in orthostatic intolerance

Measurement of Ocular Vestibular Evoked Myogenic Potentials: Nasion Reference Montage as an Alternative to the Clinical Standard Montage

Four‐hour‐delayed 3D‐FLAIR MRIs in patients with acute unilateral peripheral vestibulopathy

Contact Info

Product

Resources

About