The Role of the Functional Head Impulse Test with and without Optokinetic Stimuli in Vestibular Migraine and Acute Unilateral Vestibulopathy: Discovering a Dynamic Visual Dependence

(1) Background: Visually induced vertigo (i.e., vertigo provoked by moving visual scenes) can be considered a noticeable feature of vestibular migraines (VM) and can be present in patients suffering from acute unilateral vestibulopathy (AUV). Hypersensitivity to moving or conflicting visual stimulation is named visual dependence. (2) Methods: Visuo-vestibular interactions were analyzed via the functional Head Impulse Test (fHIT) with and without optokinetic stimulation (o-fHIT) in 25 patients with VM, in 20 subjects affected by AUV, and in 20 healthy subjects. We calculated the percentage of correct answers (%CA) without and with the addition of the optokinetic background (OB). (3) In VM groups, the %CA on the fHIT was 92.07% without OB and 73.66% with OB. A significant difference was found between %CA on the deficit side and that on the normal side in AUV, both without OB and with OB. (4) Conclusions: The fHIT results in terms of %CA with and without OB could be useful to identify the presence of a dynamic visual dependence, especially in patients suffering from VM. The difference in %CA with and without OB could provide instrumental support to help correctly identify subjects suffering from VM. We propose the use of the fHIT in clinical practice whenever there is a need to highlight a condition of dynamic visual dependence.

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The Role of Functional Head Impulse Test With and Without Optokinetic Stimuli in Vestibular Migraine and Acute Unilateral Vestibulopathy: Discovering a Visual Dependence?

10.21203/rs.3.rs-449538/v1 ◽

2021 ◽

Author(s):

Augusto-Pietro Casani ◽

Francesco Lazzerini ◽

Nicola Ducci ◽

Ottavia Marconi ◽

Nicola Vernassa

Keyword(s):

Vestibular Migraine ◽

Head Impulse Test ◽

Head Impulse ◽

Functional Head ◽

Significant Difference ◽

The Difference ◽

Unilateral Vestibulopathy ◽

Acute Unilateral Vestibulopathy ◽

Visual Dependence

Abstract Visually induced vertigo (i.e., vertigo provoked by moving visual scenes) could be considered as a noticeable feature of Vestibular Migraine (VM) and could be present in patients suffering from Acute Unilateral Vestibulophaty (AUV). The hypersensitivity to moving or conflicting visual stimulations is named Visual Dependence. The visuo-vestibular interactions were analyzed using functional Head Impulse Test (fHIT) with and without optokinetic stimulation (o-fHIT) in 25 patients with VM and 20 subjects affected by AUV. We calculated the percentage of correct answer (%CA) without and with the addition of confounding screen (CS). In VM groups the %CA at fHIT was 92,07% without CS and 73,66% with CS. A significant difference has been found between %CA on the deficit side and the normal side in AUV, both without CS and with CS). The results of fHIT in term of %CA with and without CS could be very useful to identify the presence of visual dependence especially in patients suffering from VM. The difference of %CA with and without CS could provide an instrumental support to correctly identify patients with VM. We propose the use of fHIT in clinical practice whenever there is a need to highlight a condition of visual dependence.

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Prognosis after acute unilateral vestibulopathy: Usefulness of the suppression head impulse paradigm (SHIMP)

Journal of Vestibular Research ◽

10.3233/ves-210038 ◽

2021 ◽

pp. 1-10

Author(s):

Augusto Pietro Casani ◽

Rachele Canelli ◽

Francesco Lazzerini ◽

Elena Navari

Keyword(s):

Cross Sectional Study ◽

Head Impulse Test ◽

Cross Sectional ◽

Head Impulse ◽

Ocular Reflex ◽

Vestibulo Ocular Reflex ◽

Group 2 ◽

Unilateral Vestibulopathy ◽

Vestibular Damage ◽

Acute Unilateral Vestibulopathy

OBJECTIVES: This cross-sectional study aims to describe the features of the suppression head impulse paradigm (SHIMP) in acute unilateral vestibulopathy (AUV) and to define its role in predicting the recovery of patients. METHODS: Thirty patients diagnosed with AUV were retrospectively analyzed. The dizziness handicap inventory score and video head impulse test parameters performed 4–8 weeks from the AUV onset constituted the main outcome measures. Patients with a worse recovery (Group 1) and patients who recovered spontaneously (Group 2) were compared. RESULTS: The SHIMP vestibulo-ocular reflex (VOR) gain was statistically significantly lower than the conventional head impulse paradigm (HIMP) VOR gain (P < 0.001). The SHIMP VOR gain was negatively correlated with the DHI (P < 0.001) and was positively correlated with the HIMP VOR gain (P < 0.001) and the SHIMP overt saccades (%) (P < 0.001). Patients with a worse recovery exhibited the following: higher DHI (P < 0.001), lower SHIMP and HIMP VOR gain (P < 0.001 and P = 0.007, respectively), and lower SHIMP and greater HIMP overt saccade prevalence values (P = 0.007 and P = 0.032, respectively). CONCLUSIONS: The SHIMP and HIMP help in improving our approach to AUV. SHIMP appears to better identify the extent of the vestibular damage in patient suffering from AUV than HIMP and could provide interesting information about the course of the disease. Particularly, the analysis of SHIMP VOR gain and overt saccade prevalence would provide useful information about the recovery of patients.

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May Video Head Impulse Test and Cervical Myogenic Potentials Contribute to Caloric Test in the Diagnosis of Acute Unilateral Vestibulopathy?

kulak burun boğaz ve baş boyun cerrahisi dergisi ◽

10.24179/kbbbbc.2020-79024 ◽

2021 ◽

Vol 29 (2) ◽

pp. 81-85

Author(s):

Gözde AKIN ◽

Osman H. ÇAM ◽

Pelin KOÇDOR ◽

Levent N. ÖZLÜOĞLU

Keyword(s):

Head Impulse Test ◽

Caloric Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Unilateral Vestibulopathy ◽

Acute Unilateral Vestibulopathy

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Vestibular Functioning in Children with Neurodevelopmental Disorders Using the Functional Head Impulse Test

Brain Sciences ◽

10.3390/brainsci10110887 ◽

2020 ◽

Vol 10 (11) ◽

pp. 887

Author(s):

Simona Caldani ◽

Moetez Baghdadi ◽

Ana Moscoso ◽

Eric Acquaviva ◽

Christophe-Loïc Gerard ◽

...

Keyword(s):

Vestibular System ◽

Neurodevelopmental Disorders ◽

Preliminary Evidence ◽

Autism Spectrum ◽

Head Impulse Test ◽

Head Impulse ◽

Functional Head ◽

Reading Impairment ◽

Potential Biomarker ◽

Significant Difference

Several studies in children with neurodevelopmental disorders (NDDs) including autism spectrum disorders (ASDs), reading impairment, or attention deficit/hyperactive disorder (ADHD) pointed toward a potential dysfunction of the vestibular system, specifically in its complex relationship with the cerebellum. The aim of the present study was to test the functional vestibulo-ocular reflex (VOR) responses in children with NDDs to measure functional performance of the vestibular system. The VOR is specifically involved in this stabilization of the image on the retina during rapid movements of the head. To perform this study, four groups of children with ASD, ADHD, reading impairment, and with neurotypical development (TD) were enrolled (n = 80). We performed the functional head impulse test (fHIT), which measured the percentage of correct responses by asking the child to identify an optotype briefly presented during passive head impulse in each direction of each semicircular canal plane. We observed significantly lower correct answers in children with NDDs compared with those with TD (p < 0.0001). Surprisingly, there was no significant difference between the three groups of children with NDDs. Our study fostered preliminary evidence suggesting altered efficiency of vestibular system in children with NDDs. VOR abnormalities estimated using the fHIT could be used as a proxy of NDD impairments in children, and represent a potential biomarker.

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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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Bilateral Vestibular Hypofunction in the Time of the Video Head Impulse Test

Audiology and Neurotology ◽

10.1159/000504286 ◽

2019 ◽

Vol 25 (Suppl. 1-2) ◽

pp. 72-78

Author(s):

Nicolás Pérez-Fernández ◽

Laura Alvarez-Gomez ◽

Raquel Manrique-Huarte

Keyword(s):

Head Impulse Test ◽

Video Head Impulse Test ◽

Test Results ◽

Bilateral Vestibulopathy ◽

Similar Time ◽

Head Impulse ◽

Vestibular Hypofunction ◽

Number Of Patients ◽

Significant Difference ◽

Bilateral Vestibular Hypofunction

Objectives: Bilateral vestibulopathy is a clinical syndrome in which laboratory testing plays a crucial diagnostic role. We aimed to establish the frequency of detection of that finding in a tertiary level hospital considering the new methods of laboratory vestibular examination nowadays in use, with respect to the conventional caloric and rotatory chair test approaches. Design: Two similar time periods (5 years) were retrospectively evaluated, and the demographic, clinical data and test results from 4,576 patients were reviewed. In the first period, the diagnosis was based on caloric and rotatory chair tests and, in the second, on the video head impulse test. Results: Of the patients included, 3.77% in the first period and 4.58% in the second met the criteria for bilateral vestibular hypofunction; there was no significant difference between both periods. Conclusions: The functional vestibular evaluation to detect bilateral deficiency makes no significant difference to the number of patients diagnosed with a bilateral vestibulopathy. New diagnostic categories probably depend not only on the availability and accessibility of complete vestibular and visual-vestibular evaluation, but also on recent advances in defining vestibular disorders. Bilateral vestibular hypofunction manifests with very different patterns. Progress in more detailed definition (clinical and laboratory) is needed, in particular when all 6 semicircular canals and both maculae are available for testing.

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Acute vertigo in the ENT emergency

Otorinolaryngologie a foniatrie ◽

10.48095/ccorl2021146 ◽

2021 ◽

Vol 70 (3) ◽

pp. 146-155

Author(s):

Václav Albrecht ◽

Lukáš Školoudík ◽

Peter Sila ◽

Jan Mejzlík ◽

Michal Janouch ◽

...

Keyword(s):

Emergency Department ◽

Vestibular Function ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Video Assisted ◽

Vestibular Testing ◽

Group A ◽

The Difference ◽

Group B

Summary Introduction: Acute vertigo ranks among the common reasons for visiting the emergency department. The aim of this study was to evaluate the rate of peripheral vestibular syndrome (PVS) in patients with acute vertigo examined at the ENT emergency department and to compare the agreement of physical ENT examination with video-assisted vestibular testing. Methods: Patients eamined at the ENT emergency department from January to December 2019 were evaluated retrospectively. The patients who underwent basic ENT examination without video-assisted vestibular testing form group A. The patients who underwent basic ENT examination which was followed by video head impulse test (vHIT) and videonystagmography in the next four days form group B. Results: A total of 117 patients with acute vertigo were included in group A, PVS was found in 31 patients (27%). In total, 50 patients were included in group B; PVS was found in 15 patients (30%), vestibular neuronitis was diagnosed most often (10 patients). The difference in the diagnosis of PVS by basic ENT examination (27 patients, 54%) and by video-assisted vestibular testing (15 patients, 30%) was statistically significant (P = 0.0030). The gain of the lateral (P = 0.0101) and superior (P = 0.0043) semicircular canal proved to be statistically significant, while vHIT was lower in PVS in comparison to other causes of vertigo. Conclusion: After basic ENT examination, PVS as a cause of acute vertigo was diagnosed in 27%. Video-assisted vestibular testing proved a statistically significant lower incidence of PVS in comparison to basic ENT examination. Accessibility of video- -assisted vestibular testing in the emergency department might allow for higher accuracy in the diagnosis of acute vertigo. Key words acute vertigo – vestibular function tests – video head impulse test – videonystagmography

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Store Brand Purchase in the Italian Market

International Journal of Business and Management ◽

10.5539/ijbm.v13n7p126 ◽

2018 ◽

Vol 13 (7) ◽

pp. 126

Author(s):

Guido Cristini ◽

Cristina Zerbini

Keyword(s):

Brand Management ◽

Store Brand ◽

Product Evaluations ◽

Telephone Interviews ◽

Italian Market ◽

Significant Difference ◽

Managerial Implications ◽

The Difference ◽

Structured Questionnaire

The paper analyzes the degree of importance of Store Brand purchase determinants for the consumer. In particular, the research focuses on two specific shopper segments (hypermarket shopper and supermarket shopper) in order to evaluate the existence of any significant differences between their product evaluations. Telephone interviews, based on a structured questionnaire, were conducted with a sample of consumers responsible for family purchases and buyers of Store Brand products. For the majority of the purchasing determinants investigated, the results show a significant difference in opinion between those buying Store Brand products in hypermarkets and those in supermarkets. The difference found between shopper profiles has significant managerial implications that could be useful for determining Store Brand management policies. This paper also contributes to the academic debate on the role of Store Brand in the retail market.

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