The video head impulse tests in the Parkinsonian disorders

Parkinson's disease (PD), dementia with Lewy body (DLB), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD) and multiple system atrophy (MSA) belong to a group of neurodegenerative diseases called parkinsonian syndromes. They share several clinical, neuropathological and genetic features. Neurodegenerative diseases are characterized by the progressive dysfunction of specific populations of neurons, determining clinical presentation. Neuronal loss is associated with extra- and intracellular accumulation of misfolded proteins. The parkinsonian diseases affect distinct areas of the brain. PD and MSA belong to a group of synucleinopathies that are characterized by the presence of fibrillary aggregates of α-synuclein protein in the cytoplasm of selected populations of neurons and glial cells. PSP is a tauopathy associated with the pathological aggregation of the microtubule associated tau protein. Although PD is common in the world's aging population and has been extensively studied, the exact mechanisms of the neurodegeneration are still not fully understood. Growing evidence indicates that parkinsonian disorders to some extent share a genetic background, with two key components identified so far: the microtubule associated tau protein gene (MAPT) and the α-synuclein gene (SNCA). The main pathways of parkinsonian neurodegeneration described in the literature are the protein and mitochondrial pathways. The factors that lead to neurodegeneration are primarily environmental toxins, inflammatory factors, oxidative stress and traumatic brain injury.

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Repeated video head impulse testing in patients is a stable measure of the passive vestibulo-ocular reflex

Journal of Otology ◽

10.1016/j.joto.2020.12.002 ◽

2020 ◽

Author(s):

M. Muntaseer Mahfuz ◽

Jennifer L. Millar ◽

Michael C. Schubert

Keyword(s):

Stable Measure ◽

Head Impulse ◽

Ocular Reflex ◽

Vestibulo Ocular Reflex

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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

Journal of Vestibular Research ◽

10.3233/ves-201626 ◽

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.

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Diagnostic accuracy of dual-phase 18F-FP-CIT PET imaging for detection and differential diagnosis of Parkinsonism

Scientific Reports ◽

10.1038/s41598-021-94040-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Minyoung Oh ◽

Narae Lee ◽

Chanwoo Kim ◽

Hye Joo Son ◽

Changhwan Sung ◽

...

Keyword(s):

Differential Diagnosis ◽

Clinical Diagnosis ◽

Fdg Pet ◽

Brain Activity ◽

Visual Assessment ◽

Dual Phase ◽

Regional Brain ◽

Parkinsonian Disorders ◽

Regional Brain Activity ◽

Delayed Phase

AbstractDelayed phase 18F-FP-CIT PET (dCIT) can assess the striatal dopamine transporter binding to detect degenerative parkinsonism (DP). Early phase 18F-FP-CIT (eCIT) can assess the regional brain activity for differential diagnosis among parkinsonism similar with 18F-FDG PET. We evaluated the diagnostic performance of dual phase 18F-FP-CIT PET (dual CIT) and 18F-FDG PET compared with clinical diagnosis in 141 subjects [36 with idiopathic Parkinson’s disease (IPD), 77 with multiple system atrophy (MSA), 18 with progressive supranuclear palsy (PSP), and 10 with non-DP)]. Visual assessment of eCIT, dCIT, dual CIT, 18F-FDG and 18F-FDG PET with dCIT was in agreement with the clinical diagnosis in 61.7%, 69.5%, 95.7%, 81.6%, and 97.2% of cases, respectively. ECIT showed about 90% concordance with non-DP and MSA, and 8.3% and 27.8% with IPD and PSP, respectively. DCIT showed ≥ 88% concordance with non-DP, IPD, and PSP, and 49.4% concordance with MSA. Dual CIT showed ≥ 90% concordance in all groups. 18F-FDG PET showed ≥ 90% concordance with non-DP, MSA, and PSP, but only 33.3% concordance with IPD. The combination of 18F-FDG and dCIT yielded ≥ 90% concordance in all groups. Dual CIT may represent a powerful alternative to the combination of 18F-FDG PET and dCIT for differential diagnosis of parkinsonian disorders.

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Does the video head impulse test replace caloric testing in the assessment of patients with chronic dizziness? A systematic review and meta-analysis

Brazilian Journal of Otorhinolaryngology ◽

10.1016/j.bjorl.2021.01.002 ◽

2021 ◽

Author(s):

Maria Gabriela Bonilha Vallim ◽

Guilherme Paiva Gabriel ◽

Raquel Mezzalira ◽

Guita Stoler ◽

Carlos Takahiro Chone

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Caloric Testing ◽

Chronic Dizziness

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Vestibular function assessment of Susac syndrome patients by the video head impulse test and cervical vestibular-evoked myogenic potentials

Journal of Vestibular Research ◽

10.3233/ves-200007 ◽

2020 ◽

Vol 30 (6) ◽

pp. 393-399

Author(s):

Yahav Oron ◽

Ophir Handzel ◽

Zohar Habot-Wilner ◽

Keren Regev ◽

Arnon Karni ◽

...

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Vestibular Function ◽

Pure Tone Audiometry ◽

Sensorineural Hearing ◽

Vestibular Evoked Myogenic Potentials ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Susac Syndrome

BACKGROUND: Susac syndrome (retino-cochleo-cerebral vasculopathy, SuS) is an autoimmune endotheliopathy characterized by the clinical triad of encephalopathy, branch retinal artery occlusions and sensorineural hearing loss. In contrast to data regarding auditory function, data measuring vestibular function is sparse and the cervical vestibular-evoked myogenic potentials (cVEMPs). OBJECTIVE: To determine whether the video head impulse test (vHIT) can serve as a confirmatory assessment of vestibulocochlear dysfunction in cases of suspected SuS. METHODS: Seven patients diagnosed with SuS underwent pure tone audiometry, a word recognition test, cVEMPs and the vHIT. RESULTS: Five patients were diagnosed with definite SuS, and two with probable SuS. Two patients were asymptomatic for hearing loss or tinnitus, and no sensorineural hearing loss was detected by audiograms. Four patients complained of tinnitus, and three patients reported experiencing vertigo. Three patients had abnormal cVEMPs results. All seven patients’ vHIT results were normal, except for patient #2, who was one of the three who complained of vertigo. The calculated gain of her left anterior semicircular canal was 0.5, without saccades. CONCLUSIONS: This is the first study to describe the results of the vHIT and cVEMPs among a group of patients with SuS. The results suggest that the vHIT should not be the only exam used to assess the function of the vestibular system of SuS patients.

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