Journal of Vestibular Research - Volume 31, issue 3

Authors: Ward, Bryan K. | van de Berg, Raymond | van Rompaey, Vincent | Bisdorff, Alexandre | Hullar, Timothy E. | Welgampola, Miriam S. | Carey, John P.

Article Type: Research Article

Abstract: This paper describes the diagnostic criteria for superior semicircular canal dehiscence syndrome (SCDS) as put forth by the classification committee of the Bárány Society. In addition to the presence of a dehiscence of the superior semicircular canal on high resolution imaging, patients diagnosed with SCDS must also have symptoms and physiological tests that are both consistent with the pathophysiology of a ‘third mobile window’ syndrome and not better accounted for by another vestibular disease or disorder. The diagnosis of SCDS therefore requires a combination of A) at least one symptom consistent with SCDS and attributable to ‘third mobile window’ pathophysiology …including 1) hyperacusis to bone conducted sound, 2) sound-induced vertigo and/or oscillopsia time-locked to the stimulus, 3) pressure-induced vertigo and/or oscillopsia time-locked to the stimulus, or 4) pulsatile tinnitus; B) at least 1 physiologic test or sign indicating that a ‘third mobile window’ is transmitting pressure including 1) eye movements in the plane of the affected superior semicircular canal when sound or pressure is applied to the affected ear, 2) low-frequency negative bone conduction thresholds on pure tone audiometry, or 3) enhanced vestibular-evoked myogenic potential (VEMP) responses (low cervical VEMP thresholds or elevated ocular VEMP amplitudes); and C) high resolution computed tomography (CT) scan with multiplanar reconstruction in the plane of the superior semicircular canal consistent with a dehiscence. Thus, patients who meet at least one criterion in each of the three major diagnostic categories (symptoms, physiologic tests, and imaging) are considered to have SCDS. Show more

Keywords: Superior canal dehiscence, third mobile window, inner ear, labyrinth

DOI: 10.3233/VES-200004

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 131-141, 2021

Authors: Anton, Kristina | Ernst, Arne | Basta, Dietmar

Article Type: Research Article

Abstract: BACKGROUND: During walking, postural stability is controlled by visual, vestibular and proprioceptive input. The auditory system uses acoustic input to localize sound sources. For some static balance conditions, the auditory influence on posture was already proven. Little is known about the impact of auditory inputs on balance in dynamic conditions. OBJECTIVE: This study is aimed at investigating postural stability of walking tasks in silence and sound on condition to better understand the impact of auditory input on balance in movement. METHODS: Thirty participants performed: walking (eyes open), tandem steps, walking with turning head and walking over …barriers. During each task, acoustic condition changed between silence and presented noise through an earth-fixed loudspeaker located at the end of the walking distance. Body sway velocity was recorded close to the body’s center of gravity. RESULTS: A decreased body sway velocity was significant for walking (eyes open), tandem steps and walking over barriers when noise was presented. Those auditory stimuli did not affect sway velocity while walking with turning head. The posture has probably improved due to the localization ability when walking with the head facing forward, while the localization ability was impaired when turning the head. CONCLUSIONS: The localization ability of a fixed sound source through the auditory system has a significant but limited impact on posture while walking. Show more

Keywords: Auditory influence, mobile posturography, walking conditions, body sway, sound localization

DOI: 10.3233/VES-200015

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 143-149, 2021

Authors: Jacobsen, Chris L. | Abrahamsen, Emil R. | Skals, Regitze K. | Hougaard, Dan D.

Article Type: Research Article

Abstract: BACKGROUND: Several different video Head Impulse Test (vHIT) systems exist. The function of each individual semicircular canal (SCC) may be determined by performing this test. All vHIT systems provide information about the function of the vestibular ocular reflex by means of two modalities: SACCADES and GAIN. However, different gain calculation methods exist. OBJECTIVE: Primary endpoint: • Is instantaneous gain or regression gain the most reproducible and reliable gain value when performing vHIT with testing of the lateral SCCs? Secondary endpoints: • Comparison of each of the instantaneous gain values at 40, …60, and 80ms with the regression gain. • Examination of any intra- and inter examiner variability. • Mean instantaneous gain values, and at different velocities, compared with regression gain values of the lateral SCCs. METHODS: 60 subjects between 18–65 years were included. All patients filled out the Dizziness Handicap Inventory (DHI) questionnaire and underwent four separate vHIT tests, two by an experienced neurotologist and two by an inexperienced examiner. RESULTS/CONCLUSIONS: 240 datasets were obtained, displaying both regression and instantaneous gain values. Regression gain was more reproducible than instantaneous gain. The experienced examiner provided the most reproducible results. When comparing instantaneous gain, we found the gain at 40 ms to be the least reproducible. There was no significant difference between 60 ms and 80 ms.For both examiners no significant intra examiner variability was found. Show more

Keywords: vHIT, gain, video head impulse test. EyeSeeCam, vestibular ocular reflex, regression gain, Instantaneous gain

DOI: 10.3233/VES-180669

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 151-162, 2021

Authors: Jacobsen, Chris L. | Abrahamsen, Emil R. | Skals, Regitze K. | Hougaard, Dan D.

Article Type: Research Article

Abstract: BACKGROUND: Several different video Head Impulse Test (vHIT) systems exist. The function of each individual semicircular canal (SCC) may be determined by performing this test. All vHIT systems provide information about the function of the vestibular ocular reflex by means of two modalities: SACCADES and GAIN. However, different gain calculation methods exist. OBJECTIVE: Primary endpoint: • Is instantaneous gain or regression gain the most reproducible and reliable gain value when performing vHIT with testing of the lateral SCCs? Secondary endpoints: • Comparison of each of the instantaneous gain values at 40, …60, and 80ms with the regression gain. • Examination of any intra- and inter examiner variability. • Mean instantaneous gain values, and at different velocities, compared with regression gain values of the lateral SCCs. METHODS: 60 subjects between 18–65 years were included. All patients filled out the Dizziness Handicap Inventory (DHI) questionnaire and underwent four separate vHIT tests, two by an experienced neurotologist and two by an inexperienced examiner. RESULTS/CONCLUSIONS: 240 datasets were obtained, displaying both regression and instantaneous gain values. Regression gain was more reproducible than instantaneous gain. The experienced examiner provided the most reproducible results. When comparing instantaneous gain, we found the gain at 40 ms to be the least reproducible. There was no significant difference between 60 ms and 80 ms.For both examiners no significant intra examiner variability was found. Show more

Keywords: vHIT, gain, video head impulse test. EyeSeeCam, vestibular ocular reflex, regression gain, Instantaneous gain

DOI: 10.3233/VES-180639

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 151-162, 2021

Authors: Yu, Shen | Wang, Jizhe | Shen, Shuang | Tang, Yuanyuan | Sun, Xiuzhen | Liu, Yingxi

Article Type: Research Article

Abstract: Abstract. From a biomechanical point of view, the process of Benign paroxysmal positional vertigo (BPPV) includes 2 fluid¯solid coupling effects: the interaction between particles and endolymph and the interaction between endolymph and cupula. The interaction between the canaliths and the wall would affect the coupling effects. This study aimed to investigate the entire process of cupula motion caused by canaliths motion and the influence of canalith particles composition. A biomechanical numerical model was established to simulate the canalith falling process and study the influence of canalith diameter, number, and initial falling position on cupula movement. Simultaneously, the relationship between cupula …displacement and the nystagmus signal was analyzed in BPPV patients. The results revealed that the particle velocity was proportional to the particle diameter. The pressure difference between the two sides of the cupula was directly proportional to the canalith diameter and number. The degree of vertigo was positively related to the slow angular velocity of the nystagmus and, therefore, reflected canalith number and diameter. The BPPV latent period and vertigo duration were inversely related to particle diameter. Thus, the number of particles, particle radius, and initial falling position affected cupula movement, which was reflected in the nystagmus. Show more

Keywords: Benign paroxysmal positional vertigo, biomechanics, semicircular duct of inner ear, nystagmus, cupula

DOI: 10.3233/VES-201547

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 163-172, 2021

Authors: Al-Sharif, Doaa S. | Roehm, Pamela | Lindemann, T. Logan | Dumenci, Levent | Keshner, Emily A.

Article Type: Research Article

Abstract: BACKGROUND: Dizziness affects 20–30%of the general population. A subgroup of dizzy patients with chronic migraine suffers vertigo implying that the migraine has a vestibular component. Vestibular migraine remains a diagnosis of exclusion based on history. OBJECTIVE: A link between headaches and dizziness suggests that these individuals would demonstrate dizziness and instability in complex, dynamic visual environments as a result of an inability to correctly process conflicting visual and vestibular signals. METHODS: A convenience sample of 74 patients (22 men and 52 women; average age 56.2 years) who presented with complaints of dizziness participated. Effects of Visual-Vestibular …Mismatch (VVM) were measured using a modified VVM questionnaire. Visual dependence was measured as the error to subjective visual vertical using a computerized Rod and Frame test. RESULTS: Forty-two participants (56.8%) tested positive for VVM. Of these, 68.9%were patients with concomitant complaints of headaches. Visual dependence was present in 41.5%of all patients but showed no significant correlation with headache. 22.2%of patients had visual dependence and complained of headaches. CONCLUSIONS: These results demonstrate that sensory reweighting occurs in patients experiencing dizziness and headache, supports the role of vestibular involvement in this disorder, and provides future direction for novel interventions. Show more

Keywords: Migraine, dizziness, visual dependence, rod and frame, vertigo

DOI: 10.3233/VES-201539

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 173-180, 2021

Authors: Ardıç, Fazıl Necdet | Alkan, Hakan | Tümkaya, Funda | Ardıç, Füsun

Article Type: Research Article

Abstract: BACKGROUND: The efforts to achieve better functional results in vestibular rehabilitation have been continued by using different visual and somatosensory stimuli for a long time. Whole-body vibration (WBV) is a mechanical vertical stimulation that provides high frequency vibration stimulus to the proprioceptive receptors. Biofeedback provides continuous information to the subject regarding postural changes. These techniques may aid to improve vestibular rehabilitation. OBJECTIVE: We aimed to investigate the effect of adding WBV or biofeedback postural training (BPT) to standard rehabilitation exercises in patients with chronic unilateral vestibular weakness. METHODS: Ninety patients were randomized into three groups. Group …1 had WBV and Group 2 BPT in addition to the standard rehabilitation exercises. Group 3 only carried out the home-based exercises and served as the control. Outcome measures such as static posturography, Berg Balance Scale, Timed Up-and-Go test, Visual Analog Scale, and Dizziness Handicap Inventory (DHI) were used for comparison. RESULTS: Statistically significant gains were achieved in all groups with all parameters at the end of treatment when compared to baseline (p  < 0.05). The patients in Group 1 (WBV), however, were significantly better than those in Groups 2 and 3 at the static posturographic stability score, Berg Balance Scale, and DHI (p  < 0.05). CONCLUSION: Adding WBV to a rehabilitation program may be an effective strategy to improve postural stability and achieve better physical, functional and emotional outcomes. Show more

Keywords: Vestibular rehabilitation, vestibular weakness, whole body vibration, biofeedback, posturography

DOI: 10.3233/VES-190753

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 181-190, 2021

Article Type: Abstract

DOI: 10.3233/VES-200006

Citation: Journal of Vestibular Research, vol. 31, no. 3, pp. 191-241, 2021