Vestibulo-ocular reflex gain and compensatory saccades in three semicircular canals by video head impulse test

Background and Aim: One of the tools for assessing the vestibulo-ocular reflex (VOR) is using video head impulse test (vHIT). In this test by placing the head at different angles and shaking the head, three semicircular canals of the vestibular system in each ear can be examined separately. The purpose of this study was to investigate the relationship between the low and high velocities of the vHIT test with VOR and its compensatory saccades. Methods: The vHIT test was performed by an examiner in 49 normal individuals aged 23–39 at low and high velocities. All participants had normal hearing, visual, and vestibular systems. Results: Mean gains in the horizontal, anterior and posterior semicircular canals in the right ear respectively were 0.92, 1 and 0.90 and in the left ear 0.93, 0.99 and 0.95 for low velocity and 0.78, 0.92 and 0.79 in the right ear and 0.80, 0.85 and 0.86 in the left ear for high velocity. Also, the number of compensatory saccade at high velocity was higher than those at the low velocity and the latency of compensatory saccade was lower at the higher velocity. Conclusion: In the vHIT test, VOR gain decreases at high velocity that is statistically significant. Also, compensatory saccades are more likely to occur at high velocity with smaller delay. Therefore, high-velocity vHIT test is not recommended for the purpose of examining the VOR gain and compensatory saccade.

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Evaluation of Interexaminer Variability in Video Head Impulse Test Results

Journal of the American Academy of Audiology ◽

10.1055/s-0040-1717124 ◽

2020 ◽

Vol 31 (08) ◽

pp. 613-619

Author(s):

Başak Mutlu ◽

Sıdıka Cesur ◽

Merve Torun Topçu ◽

Cennet Reyyan Geçici ◽

Öyküm Esra Aşkın ◽

...

Keyword(s):

Repeated Measures ◽

Semicircular Canals ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Lateral Canal ◽

Ocular Reflex ◽

Left Posterior ◽

Vestibulo Ocular Reflex ◽

The Right

Abstract Objective The video head impulse test (vHIT) is a diagnostic tool to assess the function of the semicircular canals and branches of the vestibular nerve. The aim of this study was to analyze the interexaminer variability of vHIT results in healthy subjects. Materials and Methods A total of 21 healthy participants were included in the study. vHIT responses were collected by four clinicians. Variability of the vHIT results between examiners was analyzed statistically. Results The vestibulo-ocular reflex (VOR) velocity regression values were from 0.99 to 1.09 degrees per second for the lateral canals. For the vertical canals, VOR velocity regression values were from 0.87 to 1.21 degrees per second. According to repeated measures analysis of variance, the normality assumptions for the velocity regression of the left lateral canal (p = 0.002) and the right anterior canal (p < 0.01) were met and the differences were statistically significant. The normality assumptions were not met for 40, 60, and 80 ms median gain of the right lateral canal (p = 0.016, p = 0.038, and p = 0.001, respectively); 40 and 60 ms median gain of the left lateral canal (p < 0.001 and p = 0.008, respectively); and the velocity regression of the left posterior canal (p < 0.00). These differences were found to be statistically significant by using the Friedman test. Conclusion The interexaminer differences of the VOR gain values for the vHIT were statistically significant. Serial vHIT testing should be performed by the same examiner to reduce the effects of interexaminer variability.

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Viewing Target Distance Influences the Vestibulo-Ocular Reflex Gain when Assessed Using the Video Head Impulse Test

Audiology and Neurotology ◽

10.1159/000493845 ◽

2018 ◽

Vol 23 (5) ◽

pp. 285-289 ◽

Cited By ~ 2

Author(s):

Patricia Castro ◽

Sara Sena Esteves ◽

Florencia Lerchundi ◽

David Buckwell ◽

Michael A. Gresty ◽

...

Keyword(s):

Head Movements ◽

Target Distance ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Gaze Stabilization ◽

Head Impulse ◽

Ocular Reflex ◽

Significant Difference ◽

Vestibulo Ocular Reflex ◽

Reflex Gain

Gaze stabilization during head movements is provided by the vestibulo-ocular reflex (VOR). Clinical assessment of this reflex is performed using the video Head Impulse Test (vHIT). To date, the influence of different fixation distances on VOR gain using the vHIT has not been explored. We assessed the effect of target proximity on the horizontal VOR using the vHIT. Firstly, we assessed the VOR gain in 18 healthy subjects with 5 viewing target distances (150, 40, 30, 20, and 10 cm). The gain increased significantly as the viewing target distance decreased. A second experiment on 10 subjects was performed in darkness whilst the subjects were imagining targets at different distances. There were significant inverse relationships between gain and distance for both the real and the imaginary targets. There was a statistically significant difference between light and dark gains for the 20- and 40-cm distances, but not for the 150-cm distance. Theoretical VOR gains for different target distances were calculated and compared with those found in light and darkness. The increase in gain observed for near targets was lower than predicted by geometrical calculations, implying a physiological ceiling effect on the VOR. The VOR gain in the dark, as assessed with the vHIT, demonstrates an enhancement associated with a reduced target distance.

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Normative values of vestibulo-ocular reflex gain obtained through Video Head Impulse Test: an integrative literature review

Revista CEFAC ◽

10.1590/1982-0216/20202264320 ◽

2020 ◽

Vol 22 (6) ◽

Author(s):

Patricia Oyarzún Díaz ◽

Sebastián Rivera Retamal ◽

Sergio Jiménez Cofré ◽

Hugo Segura Pujol

Keyword(s):

Cochrane Library ◽

Normative Values ◽

Head Impulse Test ◽

Original Research ◽

Video Head Impulse Test ◽

Head Impulse ◽

Ocular Reflex ◽

Object Distance ◽

Vestibulo Ocular Reflex ◽

Reflex Gain

ABSTRACT Purpose: to identify and analyze the available evidence on the reference values of the vestibulo-ocular reflex gain obtained with the video head impulse test. Methods: an integrative review based on the PRISMA protocol, searching the ProQuest, EBSCO, PubMed, ScienceDirect, Cochrane Library, LILACS, and SciELO databases with keywords. The studies included were original research articles, systematic reviews, and meta-analyses published since 2009, involving humans, written in English, Spanish and/or Portuguese. Results: 10,250 studies related to the keywords were found. Of these, 10 articles met the inclusion criteria and were analyzed following the CADE protocol. On the horizontal plane, the values ranged from 0.80 to 1.06, while on the right anterior/left posterior and on the left anterior/right posterior planes, the values ranged from 0.80 to 1.03. Other relevant data for obtaining the gain were analyzed, such as the number of impulses, the assessor’s experience, the patient-object distance, and the percentage of asymmetry. Conclusion: little research on the theme, recently developed and published, mostly in European countries, was found. This shows the need for a greater number of studies to strengthen the scientific evidence.

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Efficacy of vestibulo-ocular reflex gain and refixation saccades of video head impulse test in identifying vestibular pathologies

Indian Journal of Otology ◽

10.4103/indianjotol.indianjotol_76_17 ◽

2017 ◽

Vol 23 (4) ◽

pp. 247 ◽

Cited By ~ 1

Author(s):

NirajKumar Singh ◽

Rajeshwari Govindaswamy ◽

Nirmala Jagadish

Keyword(s):

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Ocular Reflex ◽

Vestibulo Ocular Reflex ◽

Reflex Gain

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Does vestibulo-ocular reflex gain measured by video head impulse test decrease with age?

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211561 ◽

2021 ◽

Vol 7 (5) ◽

pp. 712

Author(s):

Yijin Jereme Gan ◽

Yih Meei Heng ◽

Shailesh Khode ◽

Aruni Seneviratna ◽

Annabelle Leong

Keyword(s):

Semicircular Canal ◽

Semicircular Canals ◽

Community Dwelling ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Ocular Reflex ◽

Age Dependent ◽

Vestibulo Ocular Reflex ◽

The Mean

Backgrounds: The Video Head Impulse Test (vHIT) is used to test the function of each of the six semicircular canals. Each semicircular canal is tested by measuring eye rotation in response to head movements in the plane of the canal and is calculated as the Vestibulo-ocular reflex (VOR) gain. The aims of the study were firstly, to determine age-dependent normative values of VOR gain for the vHIT of semicircular canal function in healthy Asian subjects in each decade year of life. Secondly, to investigate if vHIT measured VOR gain decreases with age.Methods: A prospective cohort study of 60 healthy voluntary community-dwelling subjects, between 21 to 80 years of age. Subjects with prior history of vertigo were excluded. vHIT was conducted on each subject and analysed with the Interacoustics (EyeSeeCam) video goggles by the senior audiologist. The VOR gain for all six semicircular canals were calculated for each subject.Results: The mean (SD) vHIT (VOR) gain of all the 6 semicircular canals for the entire population were 1.18 (0.19). The mean of the VOR gain for each of the six semicircular canals were analysed to develop a normative guide. The mean VOR gain per decade year did not vary significantly with age (p=0.417). The correlation between age and mean VOR values was negligible (pearson’s r=0.121).Conclusions: We propose that our normative age-dependent data guide be used to improve the differentiation between normal and abnormal values of VOR gain in an Asian population. Our study shows that VOR gain is not associated with aging.

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

Frontiers in Neurology ◽

10.3389/fneur.2021.690402 ◽

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.

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Vestibulo-ocular reflex assessed with Video Head Impulse Test in children with Vestibular Migraine: Our experience

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2020.110161 ◽

2020 ◽

Vol 137 ◽

pp. 110161

Author(s):

Rosana Rodríguez-Villalba ◽

Miguel Caballero-Borrego ◽

Vanessa Villarraga ◽

Victoria Rivero de Jesús ◽

Maria Antonia Claveria ◽

...

Keyword(s):

Vestibular Migraine ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Ocular Reflex ◽

Vestibulo Ocular Reflex

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The Effect of Different Head Movement Paradigms on Vestibulo-Ocular Reflex Gain and Saccadic Eye Responses in the Suppression Head Impulse Test in Healthy Adult Volunteers

Frontiers in Neurology ◽

10.3389/fneur.2021.729081 ◽

2021 ◽

Vol 12 ◽

Author(s):

Dmitrii Starkov ◽

Bernd Vermorken ◽

T. S. Van Dooren ◽

Lisa Van Stiphout ◽

Miranda Janssen ◽

...

Keyword(s):

Healthy Subjects ◽

Healthy Adult ◽

Head Movements ◽

Head Impulse Test ◽

Head Impulse ◽

Ocular Reflex ◽

Vestibulo Ocular Reflex ◽

Reflex Gain ◽

Head Impulses ◽

Adult Volunteers

Objective: This study aimed to identify differences in vestibulo-ocular reflex gain (VOR gain) and saccadic response in the suppression head impulse paradigm (SHIMP) between predictable and less predictable head movements, in a group of healthy subjects. It was hypothesized that higher prediction could lead to a lower VOR gain, a shorter saccadic latency, and higher grouping of saccades.Methods: Sixty-two healthy subjects were tested using the video head impulse test and SHIMPs in four conditions: active and passive head movements for both inward and outward directions. VOR gain, latency of the first saccade, and the level of saccade grouping (PR-score) were compared among conditions. Inward and active head movements were considered to be more predictable than outward and passive head movements.Results: After validation, results of 57 tested subjects were analyzed. Mean VOR gain was significantly lower for inward passive compared with outward passive head impulses (p < 0.001), and it was higher for active compared with passive head impulses (both inward and outward) (p ≤ 0.024). Mean latency of the first saccade was significantly shorter for inward active compared with inward passive (p ≤ 0.001) and for inward passive compared with outward passive head impulses (p = 0.012). Mean PR-score was only significantly higher in active outward than in active inward head impulses (p = 0.004).Conclusion: For SHIMP, a higher predictability in head movements lowered gain only in passive impulses and shortened latencies of compensatory saccades overall. For active impulses, gain calculation was affected by short-latency compensatory saccades, hindering reliable comparison with gains of passive impulses. Predictability did not substantially influence grouping of compensatory saccades.

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