scholarly journals Importance of high-frequency vestibular function in the prognosis of bilateral vestibulopathy

2020 ◽  
Author(s):  
Seonghoon Bae ◽  
Gi Sung Nam ◽  
Sang Hyun Kwak ◽  
Sung Huhn Kim
Keyword(s):  
High Frequency ◽  
Vestibular Function ◽  
Vestibular Rehabilitation ◽  
Composite Score ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Bilateral Vestibulopathy ◽  
Dynamic Posturography ◽  
Vestibulo Ocular Reflex

Objective: To investigate whether preserved vestibular function in the high-frequency range influences the prognosis after vestibular rehabilitation in patients with BVP.Methods: Twenty-four patients followed up with vestibular rehabilitation were recruited. Enrolled patients were divided into two groups according to the preservation of high-frequency vestibulo-ocular reflex (VOR) based on the video head impulse test (vHIT). The results on the computerized dynamic posturography (CDP) and dizziness handicap inventory (DHI) survey collected at baseline and at the 6-month follow-up with vestibular rehabilitation therapy were analysed. Results: Both groups showed significantly increased composite and DHI scores after follow up with vestibular rehabilitation. The high-frequency VOR preserved group showed a better composite score (p = 0.064) and vestibular score (p = 0.008) than the high-frequency VOR loss group at the 6-month follow up. The DHI score was significantly decreased only in the high-frequency VOR loss group (p = 0.047). Among the three vestibular function tests (caloric test, rotary chair test, vHIT) used to diagnose BVP, only vHIT showed a significant correlation (p = 0.015) with favourable prognosis (composite score

scholarly journals Prevalence of Vestibular Disorders in Independent People Over 50 That Experience Dizziness

2021 ◽  
Vol 12 ◽  
Author(s):  
William V. C. Figtree ◽  
Jasmine C. Menant ◽  
Allan T. Chau ◽  
Patrick P. Hübner ◽  
Stephen R. Lord ◽  
...  
Keyword(s):  
Time Constant ◽  
High Frequency ◽  
Constant Velocity ◽  
Vestibular Function ◽  
Community Dwelling ◽  
Whole Body ◽  
Head Impulse Test ◽  
Vestibular Loss ◽  
Vestibulo Ocular Reflex ◽  
The Impact

People aged over 50 are the most likely to present to a physician for dizziness. It is important to identify the main cause of dizziness in order to develop the best treatment approach. Our goal was to determine the prevalence of benign paroxysmal positional vertigo (BPPV), and peripheral and central vestibular function in people that had experienced dizziness within the past year aged over 50. One hundred and ninety three community-dwelling participants aged 51–92 (68 ± 8.7 years; 117 females) were tested using the clinical and video head impulse test (cHIT and vHIT) to test high-frequency vestibular organ function; the head thrust dynamic visual acuity (htDVA) test to test high-frequency visual-stability; the dizziness handicap inventory (DHI) to measure the impact of dizziness; as well as sinusoidal and unidirectional rotational chair testing to test low- to mid-frequency peripheral and central vestibular function. From these assessments we computed the following measures: HIT gain; htDVA score; DHI score; sinusoidal (whole-body; 0.1–2 Hz with 30°/s peak-velocity) vestibulo-ocular reflex (VOR) gain and phase; transient (whole-body, 150°/s2 acceleration to 50°/s constant velocity) VOR gain and time constant; optokinetic nystagmus (OKN) gain and time constant (whole-body, 50°/s constant velocity rotation). Our study showed that BPPV, and peripheral or central vestibular hypofunction were present in 34% of participants, suggesting a vestibular cause to their dizziness. Over half (57%) of these with a likely vestibular cause had BPPV, which is more than twice the percentage reported in other dizzy clinic studies. Our findings suggest that the physical DHI score and VOR time constant were best at detecting those with non-BPPV vestibular loss, but should always be used in conjunction with cHIT or vHIT, and that the htDVA score and vHIT gain were best at detecting differences between ipsilesional and contralesional sides.

Study of Pursuit and Vestibulo-Ocular Cancellation

1986 ◽  
Vol 95 (5) ◽  
pp. 589-591 ◽  
Author(s):  
M. Mai ◽  
V.S. Dayal ◽  
R.D. Tomlinson ◽  
J. Farkashidy
Keyword(s):  
Single Dose ◽  
High Frequency ◽  
Vestibular Function ◽  
Sedative Effect ◽  
Drug Intake ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Analysis Of Results ◽  
Time Courses

This present study, a follow-up of our earlier investigation, further examines the time courses of recovery of oculomotor and vestibular function while patients are under the sedative effect of a single dose of secobarbital (Seconal). The assessment included tests for saccade and smooth pursuit, and the vestibulo-ocular reflex and its cancellation, as evaluated by sinusoidal and pseudorandom rotation in a high-frequency hydraulic chair (up to 5 Hz). Analysis of results showed that the vestibulo-ocular reflex (VOR) gain, depressed soon after drug intake, recovered substantially after a few hours. Changes in VOR gain were more pronounced with higher frequencies of rotation at 2 and 3 Hz, and greater with pseudorandom than sinusoidal stimulation. Under barbiturate influence, pursuit and VOR cancellation followed distinctly different time courses of recovery. This dissociation between VOR cancellation and pursuit supports the theory that these two systems are subserved by different mechanisms. Saccadic hypermetria was also observed after drug intake.

scholarly journals Bilateral vestibulopathy decreases self-motion perception

2021 ◽  
Author(s):  
Lisa van Stiphout ◽  
Florence Lucieer ◽  
Maksim Pleshkov ◽  
Vincent Van Rompaey ◽  
Josine Widdershoven ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Motion Perception ◽  
Vestibular Function ◽  
Trial Registration ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Video Head Impulse Test ◽  
Bilateral Vestibulopathy ◽  
Control Subjects ◽  
Self Motion

Abstract Objective Current diagnostic criteria for bilateral vestibulopathy (BV) primarily involve measurements of vestibular reflexes. Perceptual self-motion thresholds however, are not routinely measured and their clinical value in this specific population is not yet fully determined. Objectives of this study were (1) to compare perceptual self-motion thresholds between BV patients and control subjects, and (2) to explore patterns of self-motion perception performance and vestibular function in BV patients. Methods Thirty-seven BV patients and 34 control subjects were included in this study. Perceptual self-motion thresholds were measured in both groups using a CAREN platform (Motek Medical BV, Amsterdam, The Netherlands). Vestibular function was evaluated (only in BV patients) by the caloric test, torsion swing test, video head impulse test of all semicircular canals, and cervical- and ocular vestibular-evoked myogenic potentials. Differences in thresholds between both groups were analyzed. Hierarchical cluster analysis was performed to visualize patterns between self-motion perception and vestibular function within the group of BV patients. Results Perceptual self-motion thresholds were significantly higher in BV patients compared to control subjects, regarding nearly all rotations and translations (depending on the age group) (p ≤ 0.001). Cluster analysis showed that within the group of BV patients, higher perceptual self-motion thresholds were generally associated with lower vestibular test results (significant for yaw rotation, caloric test, torsion swing test, and video head impulse test (p ≤ 0.001)). Conclusion Self-motion perception is significantly decreased in BV patients compared to control subjects regarding nearly all rotations and translations. Furthermore, decreased self-motion perception is generally associated with lower residual vestibular function in BV patients. Trial registration Trial registration number NL52768.068.15/METC

Influence of vestibular rehabilitation on the recovery of all vestibular receptor organs in patients with unilateral vestibular hypofunction

2020 ◽  
Vol 47 (2) ◽  
pp. 227-235
Author(s):  
Anamarija Sestak ◽  
Sinisa Maslovara ◽  
Zeljko Zubcic ◽  
Andrijana Vceva
Keyword(s):  
Vestibular Function ◽  
Vestibular Rehabilitation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Vestibular Hypofunction ◽  
Sf 36 ◽  
Significant Difference ◽  
Different Types ◽  
Vestibular Receptor

BACKGROUND: Only a few studies in the literature demonstrate the effect of vestibular rehabilitation (VR) on all vestibular receptor organs. Furthermore, very little evidence of the effect of VR on isolated otolith dysfunction (IOD) is available. OBJECTIVE: The study aimed to investigate the effect of VR on all vestibular receptor organs in patients with different types of unilateral vestibular hypofunction (UVH). METHODS: We enrolled 80 patients with three different types of UVH; combined and isolated loss of semicircular canal and otolith organ function. All patients performed a 12-week customized program of VR and received a full battery of vestibular function tests, before and after the VR. The DHI and SF-36 were performed before, after 6 weeks, and 12 weeks of the VR. RESULTS: Parameters of the caloric test, video head impulse test, ocular and cervical vestibular evoked myogenic potentials were significantly improved after VR. A total of 59 (74%) patients fully recovered, with no significant difference in recovery regarding the type (p = 0.13) and stage of UVH (p = 0.13). All patients reported significantly lower disability and a better quality of life after the VR based on the DHI and SF-36 score. CONCLUSIONS: Vestibular rehabilitation has a positive effect on the recovery of all vestibular receptor organs and it should be used in patients with IOD.

scholarly journals Vestibular Rehabilitation after Vestibulopathy Focusing on the Application of Virtual Reality

2021 ◽  
Vol 2 (2) ◽  
pp. 5
Author(s):  
Masashi Matsumura ◽  
Toshihisa Murofushi
Keyword(s):  
Virtual Reality ◽  
Balance Training ◽  
Sensory Information ◽  
Vestibular Function ◽  
Vestibular Rehabilitation ◽  
The Body ◽  
Drop Out ◽  
Bilateral Vestibulopathy ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Human postural control is regulated by the vestibular, somatosensory, and visual systems. These types of sensory information are integrated in the central nervous system to ascertain the body’s position in space. Proper functioning of the vestibular, somatosensory, and visual senses is necessary for the body to maintain equilibrium. Bilateral vestibulopathy (BVP) is a condition in which bilateral peripheral vestibular function is reduced. Its treatment includes vestibular rehabilitation (VeR), balance training, counseling, treating the underlying cause, and avoiding further damage to the vestibular system. As VeR is often tedious for patients, patient motivation is required or patients may drop out of the program. To solve this problem, in recent years, there have been increasing reports of VeR using virtual reality, which increases vestibulo-ocular reflex gain and decreased dizziness by inducing adaptation. In this review, we discuss VeR, particularly for BVP, and VeR using virtual reality.

scholarly journals Clinical dynamic visual acuity in patients with cerebellar ataxia and vestibulopathy

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255299
Author(s):  
Michaela Dankova ◽  
Jaroslav Jerabek ◽  
Dylan J. Jester ◽  
Alena Zumrova ◽  
Jaroslava Paulasova Schwabova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Dynamic Visual Acuity ◽  
Bilateral Vestibulopathy ◽  
Caloric Irrigation ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Cerebellar Ataxias ◽  
Central Adaptation

Deterioration of dynamic visual acuity (DVA) as a result of impaired vestibulo-ocular reflex (VOR) has been well described in peripheral vestibulopathies, however, changes in DVA in patients with degenerative cerebellar ataxias (CA) and its relation to VOR impairment in these patients has not yet been evaluated. Our aim was to assess the alterations of DVA in CA and to evaluate its relation to vestibular function. 32 patients with CA and 3 control groups: 13 patients with unilateral and 13 with bilateral vestibulopathy and 21 age matched healthy volunteers were examined by clinical DVA test, VOR was assessed by video Head Impulse Test and caloric irrigation. The severity of ataxia in CA was assessed by Scale for the assessment and rating of ataxia (SARA). Relationship between DVA and vestibular function in CA patients was examined by linear regressions. DVA impairment was highly prevalent in CA patients (84%) and its severity did not differ between CA and bilateral vestibulopathy patients. The severity of DVA impairment in CA was linked mainly to VOR impairment and only marginally to the degree of ataxia. However, DVA impairment was present also in CA patients without significant vestibular lesion showing that central mechanisms such as impairment of central adaptation of VOR are involved. We suggest that the evaluation of DVA should be a standard part of clinical evaluation in patients with progressive CA, as this information can help to target vestibular and oculomotor rehabilitation.

scholarly journals Relationship between vestibulo-ocular reflex gain and dizziness handicap inventory score to predict effectiveness of vestibular rehabilitation

2021 ◽  
Author(s):  
Morteza Hamidi Nahrani ◽  
Mehdi Akbari ◽  
Mohammad Maarefvand
Keyword(s):  
Vestibular Rehabilitation ◽  
Head Impulse Test ◽  
Dizziness Handicap Inventory ◽  
Strong Negative Correlation ◽  
Ocular Reflex ◽  
Vestibular Hypofunction ◽  
Before And After ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Background and Aim: Evaluating the effective­ness of vestibular rehabilitation (VR) in patients with vestibular lesions has always been a challe­nge. The questionnaires that are used for this pur­pose mostly show the degree of vestibular dis­ability rather than providing information about improvement of vestibular dysfunction. This study aimed to evaluate whether video head imp­ulse test (vHIT) that is used for the examination of vestibulo-ocular reflex (VOR), is a useful method for predicting the effectiveness of VR and has a correlation with dizziness handicap inventory (DHI) score. Methods: Participants were 42 patients with unilateral peripheral vestibular hypofunction (UPVH) undergoing VR. Patients were assessed before and after rehabilitation by the vHIT in all ipsilesional and contralesional semicircular can­als (SCCs) and the DHI. The changes in DHI score and VOR gain before and after rehabili­tation, were shown as ΔDHI and ΔVOR and their correlation was evaluated. Results: VOR gain from ipsilesional and contra­lesional SCCs was improved significantly after VR. There was a significant strong negative correlation between ΔVOR gain from ipsile­sional SCCs and ΔDHI score but no significant correlation was found between the ΔDHI score and ΔVOR gain from contralesional SCCs. Conclusion: vHIT test is a useful tool to evaluate the effectiveness of VR. VOR gain is correlated with the DHI score. Therefore, the improvement in vHIT results in all three SCCs after VR may be a good predictor of the degree of improvement in dizziness-related disability. Keywords: Vestibular rehabilitation; follow-up; unilateral vestibular hypofunction; video head impulse test; dizziness handicap inventory

scholarly journals Vestibular Function Measured Using the Video Head Impulse Test in Congenital Nystagmus and Vertigo: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Antonio Denia-Lafuente ◽  
Belén Lombardero
Keyword(s):  
Vestibular Function ◽  
Semicircular Canals ◽  
Head Impulse Test ◽  
Congenital Nystagmus ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Vertical Semicircular Canals

In patients with congenital nystagmus (CN), the study of vestibular function is complicated by many factors related to the measurement of the vestibulo-ocular reflex (VOR) by means of caloric testing and the video head impulse test (vHIT), and to date no such studies have successfully employed the vHIT to evaluate vestibular function in these patients. We present a case with CN and vertigo in which peripheral vestibular function was evaluated using the vHIT system, including head impulse testing and the suppression head impulse protocol. We show that it is possible (a) to identify lateral VOR changes such as abnormalities resembling those produced by bilateral vestibular lesions, though not necessarily related to the same mechanism; (b) to identify peripheral VOR lesions of the vertical semicircular canals (SCC); and (c) to document compensation and recovery subsequent to these peripheral lesions during follow-up of patients with CN. vHIT is a useful tool that should be used to study vestibular function in patients with CN and vertigo, which could constitute a new clinical application of this technique.

Vestibular semicircular canal function as detected by video Head Impulse Test (vHIT) is essentially unchanged in people with Parkinson’s disease compared to healthy controls

2021 ◽  
pp. 1-9
Author(s):  
Kim E. Hawkins ◽  
Elodie Chiarovano ◽  
Serene S. Paul ◽  
Ann M Burgess ◽  
Hamish G. MacDougall ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Semicircular Canal ◽  
Neurodegenerative Disorder ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Healthy Controls ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Vestibulo Ocular Reflex

BACKGROUND: Parkinson’s disease (PD) is a common multi-system neurodegenerative disorder with possible vestibular system dysfunction, but prior vestibular function test findings are equivocal. OBJECTIVE: To report and compare vestibulo-ocular reflex (VOR) gain as measured by the video head impulse test (vHIT) in participants with PD, including tremor dominant and postural instability/gait dysfunction phenotypes, with healthy controls (HC). METHODS: Forty participants with PD and 40 age- and gender-matched HC had their vestibular function assessed. Lateral and vertical semicircular canal VOR gains were measured with vHIT. VOR canal gains between PD participants and HC were compared with independent samples t-tests. Two distinct PD phenotypes were compared to HC using Tukey’s ANOVA. The relationship of VOR gain with PD duration, phenotype, severity and age were investigated using logistic regression. RESULTS: There were no significant differences between groups in vHIT VOR gain for lateral or vertical canals. There was no evidence of an effect of PD severity, phenotype or age on VOR gains in the PD group. CONCLUSION: The impulsive angular VOR pathways are not significantly affected by the pathophysiological changes associated with mild to moderate PD.

scholarly journals Restoring the High-Frequency Dynamic Visual Acuity with a Vestibular Implant Prototype in Humans

2019 ◽  
Vol 25 (Suppl. 1-2) ◽  
pp. 91-95 ◽  
Author(s):  
Dmitrii Starkov ◽  
Nils Guinand ◽  
Florence Lucieer ◽  
Maurizio Ranieri ◽  
Samuel Cavuscens ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Frequency ◽  
Horizontal Plane ◽  
Head Impulse Test ◽  
Dynamic Visual Acuity ◽  
Bilateral Vestibulopathy ◽  
Vestibular Implant ◽  
Functional Benefit ◽  
Head Impulses ◽  
Near Future

Introduction: The vestibular implant could become a clinically useful device in the near future. This study investigated the feasibility of restoring the high-frequency dynamic visual acuity (DVA) with a vestibular implant, using the functional Head Impulse Test (fHIT). Methods: A 72-year-old female, with bilateral vestibulopathy and fitted with a modified cochlear implant incorporating three vestibular electrodes (MED-EL, Innsbruck, Austria), was available for this study. Electrical stimulation was delivered with the electrode close to the lateral ampullary nerve in the left ear. The high-frequency DVA in the horizontal plane was tested with the fHIT. After training, the patient underwent six trials of fHIT, each with a different setting of the vestibular implant: (1) System OFF before stimulation; (2) System ON, baseline stimulation; (3) System ON, reversed stimulation; (4) System ON, positive stimulation; (5) System OFF, without delay after stimulation offset; and (6) System OFF, 25 min delay after stimulation offset. The percentage of correct fHIT scores for right and left head impulses were compared between trials. Results: Vestibular implant stimulation improved the high-frequency DVA compared to no stimulation. This improvement was significant for “System ON, baseline stimulation” (p = 0.02) and “System ON, positive stimulation” (p < 0.001). fHIT scores changed from 19 to 44% (no stimulation) to maximum 75–94% (System ON, positive stimulation). Conclusion: The vestibular implant seems capable of improving the high-frequency DVA. This functional benefit of the vestibular implant illustrates again the feasibility of this device for clinical use in the near future.

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