Diagnostic value of refixation saccades in the Video Head Impulse Test (vHIT) in unilateral definite Meniere’s disease

Abstract

Introduction: We currently interpret the video Head Impulse Test (vHIT) results mainly based on the gain value.

Aim: The purpose of this study is to evaluate vHIT results for both gain and re-fixation saccades on unilateral definite Meniere's disease (MD) subjects in comparison with normal healthy subjects.

Materials and Methods: Forty unilateral definite MD subjects and age-matched healthy subjects were recruited. Pure tone audiometry, the caloric test, and the vHIT test were performed on MD subjects. The vHIT test was performed on healthy subjects.

Results: The velocity regression gain (VRG) of the affected ear in patients with MD is significantly lower than of those in healthy subjects. The total percentage of refixation saccades is significantly higher in patients with MD when compared to healthy subjects. VRG values were not well-correlated with the percentage of refixation saccades. VRG asymmetry values are also not well-correlated with the percentage of unilateral canal weakness. A moderately stronger correlation between the percentage of refixation saccades and percentage of unilateral canal weakness, with an r² of 0.474.

Conclusions: The present study suggests that while VRGs are still a diagnostic parameter of detecting MD, the presence of refixation saccades can also have diagnostic value, especially with normal VRGs, in detecting MD.

Chinese abstract

简介：目前, 我们主要根据增益值来解释视频头脉冲测试（vHIT）结果。

目的：本研究的目的是, 通过与正常健康受试者相比, 评估单侧明确性梅尼埃病（MD）受试者获得和重新固定扫视的vHIT结果。

材料与方法：招募了40名单侧明确MD受试者和年龄相配的健康受试者。对MD受试者进行纯音测听、卡路里测试和vHIT测试。对健康受试者进行vHIT测试。

结果：MD患者患病耳的速度回归增益（VRG）明显低于健康受试者。与健康受试者相比, MD患者的固定扫视的总百分比明显更高。 VRG值与固定扫视百分比没有很好的相关性。 VRG不对称值也与单侧耳道弱的百分比没有很好的相关性。固定扫视的百分比与单侧耳道弱的百分比之间的相关性较强, r 2为0.474。

结论：本研究表明, 尽管VRG仍是检测MD的诊断参数, 但固定扫视的存在, 尤其是具有正常VRG, 对MD的检测也具有诊断价值。

Keywords:

• Vestibular diseases
• vestibular function tests
• vestibular
• vestibulo-ocular reflex
• VOR
• vHIT
• head impulse test
• balance

Acknowledgements

Authors thank Natasha Wadna, B.S. and Michelle Hall, Au.D. for the initial phase of the study design and data collection; Caroline Price, B.S. (NU) for study coordination, obtaining consents, and IRB regulatory work; Alan G. Micco, M.D., FACS, Courtney J. Voelker, M.D., Ph.D., and Lauren Caselli, PA-C for recruiting study participants. Drs. Sumitrajit Dhar and Kristine Riley for mentorship in Capstone project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Funding was provided by Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, School of Communication, and Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University.