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

Long-term effects of vestibular rehabilitation and head-mounted gaming task procedure in unilateral vestibular hypofunction: a 12-month follow-up of a randomized controlled trial

2018 ◽  
Vol 33 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Andrea Viziano ◽  
Alessandro Micarelli ◽  
Ivan Augimeri ◽  
Domenico Micarelli ◽  
Marco Alessandrini
Keyword(s):  
Power Spectra ◽  
Vestibular Rehabilitation ◽  
Performance Measure ◽  
Self Report ◽  
Long Term Effects ◽  
Ocular Reflex ◽  
Vestibular Hypofunction ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

Objective: To investigate the long-term effects of adding virtual reality–based home exercises to vestibular rehabilitation in people with unilateral vestibular hypofunction. Design: Follow-up otoneurological examination in two randomized groups following a previous one-month trial. Setting: Tertiary rehabilitation center. Subjects: A total of 47 patients with unilateral vestibular hypofunction, one group ( n = 24) undergoing conventional vestibular rehabilitation and the other one ( n = 23) implementing, in addition, head-mounted gaming home exercises, 20 minutes per day for one month. Interventions: One year after completing rehabilitation, patients underwent testing with static posturography, video head impulse test, self-report questionnaires, and a performance measure. Main measures: Vestibulo-ocular reflex gain, posturographic parameters such as length, surface, and fast Fourier transform power spectra, self-report, and gait performance measure scores. Results: Vestibulo-ocular reflex gain was significantly better with respect to pretreatment in both groups. The mixed-method group showed significantly higher gain scores: mean (standard deviation (SD)) at 12 months was 0.71 (0.04), versus 0.64 (0.03) for the vestibular rehabilitation–only group ( P < 0.001). Accordingly, some classical posturography scores such as surface with eyes open and length with eyes closed and low-frequency power spectra were significantly different between groups, with the virtual reality group showing improvement ( P < 0.001). Self-report measures were significantly better in both groups compared to pretreatment, with significant improvement in the mixed-method group as compared to conventional rehabilitation alone: Dizziness Handicap Inventory mean total score was 24.34 (2.8) versus 35.73 (5.88) with a P-value <0.001. Conclusion: Results suggest that head-mounted gaming home exercises are a viable, effective, additional measure to improve long-term vestibular rehabilitation outcomes.

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

2018 ◽  
Vol 23 (5) ◽  
pp. 285-289 ◽  
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.

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

2019 ◽  
Author(s):  
Homa Zarrinkoob ◽  
Hadi Behzad ◽  
Seyed Mehdi Tabatabaee
Keyword(s):  
High Velocity ◽  
Semicircular Canals ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Low Velocity ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain ◽  
The Right

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.

scholarly journals 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

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 &lt; 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.

The Effects of Cochlear Implantation on Vestibular Function

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P60-P60
Author(s):  
Thuy-Anh N. Melvin ◽  
Americo Migliaccio ◽  
John P Carey ◽  
Charles Coleman Della Santina
Keyword(s):  
Cochlear Implantation ◽  
Full Range ◽  
Vestibular Function ◽  
Head Movements ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Head Impulse ◽  
Vestibular Hypofunction ◽  
Before And After ◽  
Vestibulo Ocular Reflex

Objective 1) Measure vestibular function before and after cochlear implantation (CI) using a battery of tests covering the full range of stimulus frequencies over which the normal angular vestibulo-ocular reflex (VOR) stabilizes gaze. Methods Semicircular canal (SCC) function was assayed using head impulse test during 3-dimensional scleral search coil eye movement recordings (HIT), dynamic visual acuity during rapid head movements (DVA), head-shake nystagmus (HSN), and caloric electronystagmography (ENG). Saccular function was determined using vestibular-evoked myogenic potentials (VEMP). Patient self-assessment via the dizziness handicap inventory (DHI) and clinical head impulse testing (cHIT) were also measured. Results One of 28 post-implanted ears (4%) suffered severe loss of vestibular function in all 3 SCCs. HSN revealed no change in 11 subjects. ENG revealed new hypofunction in 1 of 16 ears (6%). Passive DVA revealed no significant change for 16 implanted ears. VEMP revealed significant increase or disappearance in threshold in 5 of 16 ears (31%). DHI scores were variable and correlated poorly with objective tests. The cHIT performed by one otolaryngologist in 14 subjects exhibited 44% sensitivity and 94% specificity for detection of severe hypofunction confirmed via quantitative HIT. Conclusions CI carries a small but nontrivial risk of iatrogenic vestibular hypofunction in the implanted ear. For bilateral simultaneous-CI, the risk of bilateral vestibular hypofunction is ∼0.16%, comparable to the likelihood of meningitis. The cHIT was highly specific for vestibular hypofunction in this study, but likely depends heavily on the examiner's threshold for abnormal.

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

Revista CEFAC ◽  
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.

Assessment of Vestibulo-ocular Reflex Gain and Catch-up Saccades During Vestibular Rehabilitation

2018 ◽  
Vol 39 (10) ◽  
pp. e1111-e1117 ◽  
Author(s):  
Elena Navari ◽  
Niccolò Cerchiai ◽  
Augusto Pietro Casani
Keyword(s):  
Vestibular Rehabilitation ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain ◽  
Catch Up

scholarly journals The Relationship of Vestibulo-Ocular Reflex With Self-Reported Dizziness Handicap in Patients With Vestibular Deafferentation

2019 ◽  
pp. 014556131988002
Author(s):  
Fakih Cihat Eravcı ◽  
Metin Yılmaz ◽  
Mehmet Birol Uğur ◽  
Hakan Tutar ◽  
Recep Karamert ◽  
...  
Keyword(s):  
Head Impulse Test ◽  
P Value ◽  
Vestibular Neurectomy ◽  
Ocular Reflex ◽  
Vestibular Tests ◽  
Long Term Follow Up ◽  
Vestibulo Ocular Reflex ◽  
Corrective Saccades ◽  
The Relationship

The relationship between objective vestibular tests and subjective vestibular tests is a controversial topic. In this study, to contribute to this issue, the vestibulo-ocular reflex features and their relationship with balance perception at long-term follow-up in vestibular neurectomy (VN) and total labyrentectomy patients were evaluated. Prospectively, 19 VN and 18 labyrinthectomy patients were enrolled in this study. Patients underwent video head impulse test (VHIT) as objective vestibular test and dizziness handicap inventory (DHI) as subjective vestibular test when they attended to their control visit follow-up between March and September 2017. Lateral canal corrective saccades were classified as organized pattern and deorganized (scattered) pattern. In our results, the saccade pattern analysis (between organized and deorganized saccades) regarding the DHI scores gave P value as .039 for covert saccade pattern and .050 for overt saccade pattern. Therefore, we conclude that the presence of saccades, their patterns, and amplitudes provide extra information at assessing the results of the VHIT test, and the organized pattern of saccades is related to a stable vestibular system and better balance perception.

Report of oscillopsia in ataxia patients correlates with activity, not vestibular ocular reflex gain

2021 ◽  
pp. 1-9
Author(s):  
Jennifer L. Millar ◽  
Michael C. Schubert
Keyword(s):  
Cerebellar Ataxia ◽  
Head Rotation ◽  
Gait Velocity ◽  
Head Impulse Test ◽  
Healthy Controls ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibular Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain

BACKGROUND: Patients with cerebellar ataxia report oscillopsia, “bouncy vision” during activity, yet little is known how this impacts daily function. The purpose of this study was to quantify the magnitude of oscillopsia and investigate its relation to vestibulo-ocular reflex (VOR) function and daily activity in cerebellar ataxia. METHODS: 19 patients diagnosed with cerebellar ataxia and reports of oscillopsia with activity were examined using the video head impulse test (vHIT), Oscillopsia Functional Index (OFI), and clinical gait measures. Video head impulse data was compared against 40 healthy controls. RESULTS: OFI scores in ataxia patients were severe and inversely correlated with gait velocity (r = –0.55, p <  0.05), but did not correlate with VOR gains. The mean VOR gain in the ataxic patients was significantly reduced and more varied compared with healthy controls. All patients had abnormal VOR gains and eye/head movement patterns in at least one semicircular canal during VHIT with passive head rotation. CONCLUSIONS: Patients with cerebellar ataxia and oscillopsia have impaired VOR gains, yet severity of oscillopsia and VOR gains are not correlated. Patients with cerebellar ataxia have abnormal oculomotor behavior during passive head rotation that is correlated with gait velocity, but not magnitude of oscillopsia.

Predicting the Outcome after Acute Unilateral Vestibulopathy: Analysis of Vestibulo-ocular Reflex Gain and Catch-up Saccades

2017 ◽  
Vol 158 (3) ◽  
pp. 527-533 ◽  
Author(s):  
Niccolò Cerchiai ◽  
Elena Navari ◽  
Stefano Sellari-Franceschini ◽  
Chiara Re ◽  
Augusto Pietro Casani
Keyword(s):  
High Velocity ◽  
Case Series ◽  
Vestibular Rehabilitation ◽  
Rehabilitation Program ◽  
Head Impulse Test ◽  
Dizziness Handicap Inventory ◽  
Reflex Gain ◽  
Catch Up ◽  
Unilateral Vestibulopathy ◽  
Acute Unilateral Vestibulopathy

Objectives (1) To describe the relationships among the main instrumental features characterizing an acute unilateral vestibulopathy and (2) to clarify the role of the video head impulse test in predicting the development of chronic vestibular insufficiency. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods Sixty patients suffering from acute unilateral vestibulopathy were retrospectively analyzed: 30 who recovered spontaneously (group 1) and 30 who needed a vestibular rehabilitation program (group 2). The main outcome measures included Dizziness Handicap Inventory score, canal paresis, high-velocity vestibulo-oculomotor reflex gain, and catch-up saccade parameters. The tests were all performed between 4 and 8 weeks from the onset of symptoms. Results The high-velocity vestibulo-oculomotor reflex gain correlated with the Dizziness Handicap Inventory score ( P = .004), with the amplitude of covert and overt saccades ( P < .001), and with the prevalence of overt saccades ( P < .001). Patients in need for vestibular rehabilitation programs had a significantly lower gain ( P < .001) and a higher prevalence and amplitude of overt saccades ( P = .002 and P = .008, respectively). Conversely, we found no differences in terms of response to the caloric test ( P = .359). Conclusions Lower values of high-velocity vestibulo-oculomotor reflex gain and a high prevalence of overt saccades are related to a worse prognosis after acute unilateral vestibulopathy. This is of great interest to clinicians in identifying which patients are less likely to recover and more likely to need a vestibular rehabilitation program.

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