Video Head Impulse Test (vHIT): Value of Gain and Refixation Saccades in Unilateral Vestibular Neuritis

Psillas, George; Petrou, Ioanna; Printza, Athanasia; Sfakianaki, Ioanna; Binos, Paris; Anastasiadou, Sofia; Constantinidis, J.

doi:10.3390/jcm11123467

Cited by 13 publications

(12 citation statements)

References 33 publications

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“…In our study, the RS were more obviously detected in the lateral SCC plane compared to the vertical canal planes. This has been previously demonstrated in other studies 35 , 36 .…”

Section: Discussionsupporting

confidence: 87%

Vestibulo-ocular reflex dynamics with head-impulses discriminates Usher patients type 1 and 2

Amorim,

Ramada,

Lopes

et al. 2024

Sci Rep

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Usher Syndrome classification takes into account the absence of vestibular function but its correlation with genotype is not well characterized. We intend to investigate whether video Head Impulse Test (vHIT) is useful in screening and to differentiate Usher Syndrome types. 29 Usher patients (USH) with a genetically confirmed diagnosis and 30 healthy controls were studied with vHIT and dizziness handicap inventory questionnaire (DHI). Statistical significant differences between USH1, USH2 and controls were found in the vestibulo-ocular-reflex (VOR) gain of all SCCs, with USH1 patients consistently presenting smaller gains. VOR gain of the right lateral SCC could discriminate controls from USH1, and USH2 from USH1 with an overall diagnostic accuracy of 90%. USH1 DHI correlated with VOR (ρ = − 0,971, p = 0.001). Occurrence rate of covert and overt lateral semicircular canals refixation saccades (RS) was significantly different between groups, being higher in USH1 patients (p < 0.001). USH1 peak velocity of covert and overt saccades was higher for lateral semicircular canals (p < 0.05 and p = 0.001) compared with USH2 and controls. Covert saccades occurrence rate for horizontal SCCs could discriminate USH1 from USH2 patients and controls with a diagnostic accuracy of 85%. vHIT is a fast and non-invasive instrument which allowed us to screen and distinguish Usher patients from controls with a high precision. Importantly, its use allowed further discrimination between USH1 from USH2 groups. Moreover, VOR gain seems to correlate with vertigo-related quality of life in more severe phenotypes.

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“…In our study, the RS were more obviously detected in the lateral SCC plane compared to the vertical canal planes. This has been previously demonstrated in other studies 35 , 36 .…”

Section: Discussionsupporting

confidence: 87%

Vestibulo-ocular reflex dynamics with head-impulses discriminates Usher patients type 1 and 2

Amorim,

Ramada,

Lopes

et al. 2024

Sci Rep

View full text Add to dashboard Cite

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“…Considering that the disease duration in our VN patients was relatively long (median = 20 days)，and most voluntary head movements in daily activities are in the horizontal plane，it is likely that vestibular compensation has already happened and the VOR gain has begun to recover. Previous longitudinal follow-up studies have shown that restoration of VOR gain in VN patients was faster than the saccades during vestibular compensation ( Esteban-Sanchez and Martin-Sanz, 2022 ; Psillas et al, 2022 ), and saccades were most prevalent in horizontal SCC among the three SCCs during follow-up ( Psillas et al, 2022 ).…”

Section: Discussionmentioning

confidence: 89%

Discrepancies of video head impulse test results in patients with idiopathic sudden sensorineural hearing loss with vertigo and vestibular neuritis

et al. 2023

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ObjectiveSudden sensorineural hearing loss with vertigo (SHLV) and vestibular neuritis (VN) remain frequent causes of acute vestibular syndrome (AVS). The aim of study was to compare the results of video head impulse test (vHIT) in patients with SHLV and VN. The characteristics of high-frequency vestibule-ocular reflex (VOR) and the differences of the pathophysiological mechanisms underlying these two AVS were explored.MethodsFifty-seven SHLV patients and 31 VN patients were enrolled. vHIT was conducted at the initial presentation. The VOR gains and occurrence of corrective saccades (CSs) of anterior, horizontal, and posterior semicircular canals (SCCs) in two groups were analyzed. Pathological vHIT results refer to impaired VOR gains and presence of CSs.ResultsIn SHLV group, pathological vHIT results was most prevalent in the posterior SCC on the affected side (30/57, 52.63%), followed by horizontal (12/57, 21.05%) and anterior SCC (3/57, 5.26%). In VN group, pathological vHIT preferentially affected horizontal SCC (24/31, 77.42%), followed by anterior (10/31, 32.26%) and posterior SCC (9/31, 29.03%) on the affected side. As for anterior and horizontal SCC on the affected side, the incidences of pathological vHIT results in VN group were significantly higher than those in SHLV group (β = 2.905, p < 0.01; β = 2.183, p < 0.001). There were no significant differences in the incidence of pathological vHIT result in posterior SCC between two groups.ConclusionComparison of vHIT results in patients with SHLV and VN revealed discrepancies in the pattern of SCCs impairments, which may be explained by different pathophysiological mechanisms underlying these two vestibular disorders presenting as AVS.

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“…In addition, the data from the caloric test are available for evaluation of the function of the horizontal semicircular canal. Since the appearance rate of CS is different between each semicircular canal ( 40 ), different results will be obtained by analysis of the vertical canals. Last, we only recruited patients who showed CS with normal VOR gain unilaterally.…”

Section: Discussionmentioning

confidence: 99%

Presence of corrective saccades in patients with normal vestibulo-ocular reflex gain in video head impulse test

et al. 2023

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BackgroundThe video head impulse test (vHIT) is a valuable clinical tool that can help identify dysfunction of the semicircular canals. While in cases with semicircular canal dysfunction, both decreased vestibulo-ocular reflex (VOR) gain and corrective saccades (CS) are usually observed, there are cases which show CS despite normal VOR gain in vHIT.ObjectiveThis study aimed to investigate the clinical characteristics of patients who showed CS with normal VOR gain in vHIT.Materials and methodsAmong 390 patients who underwent vHIT, 51 patients (20 males and 31 females, age 31–87 years, average 61.3 years old) who showed CS with normal VOR gain unilaterally during horizontal vHIT were included. All patients had normal vHIT (normal VOR gain and absent CS) on the contralateral side.The VOR gain of vHIT, the maximum slow phase velocity in the caloric test, and the amplitude of cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) were analyzed.ResultsThe VOR gain on the affected side (0.95 ± 0.08) was significantly smaller than that on the contralateral side (1.03 ± 0.13) in horizontal vHIT (p < 0.001). The maximum slow phase velocity in the caloric test on the affected side (17.9 ± 17.8 degrees/s) was significantly smaller than that on the contralateral side (21.3 ± 16.6 degrees/s, p = 0.020). There were no significant differences in the amplitude of cVEMPs or oVEMPs between the affected side and the contralateral side (p = 0.096 for cVEMP; p = 0.770 for oVEMP).ConclusionThe side that showed CS with normal VOR gain in horizontal vHIT showed significantly smaller VOR gain as well as smaller caloric responses compared to the contralateral side. Having CS with normal VOR gain could be a sensitive indicator of mild dysfunction of the semicircular canals.

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Video Head Impulse Test (vHIT): Value of Gain and Refixation Saccades in Unilateral Vestibular Neuritis

Cited by 13 publications

References 33 publications

Vestibulo-ocular reflex dynamics with head-impulses discriminates Usher patients type 1 and 2

Vestibulo-ocular reflex dynamics with head-impulses discriminates Usher patients type 1 and 2

Discrepancies of video head impulse test results in patients with idiopathic sudden sensorineural hearing loss with vertigo and vestibular neuritis

Presence of corrective saccades in patients with normal vestibulo-ocular reflex gain in video head impulse test

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