No description available.

The observation or measurement of eye movement can aid in the detection and localization of vestibular pathology due to the relationship between the function of the vestibular sensory receptors in the inner ear and the eye movements produced by the vestibulo-ocular reflex (VOR). The majority of bedside and laboratory tests of vestibular function involve the observation or measurement of horizontal eye movements (i.e., horizontal VOR) produced by stimuli that activate the horizontal semicircular canals (SCCs) and the superior vestibular nerve. The video head impulse test (vHIT) is a new clinical test of dynamic SCC function that uses a high-speed digital video camera embedded in light-weight goggles to record head and eye movement during passive head rotations. An important precursor to the clinical use of a new diagnostic test is the evaluation of test reproducibility. If test reproducibility is poor, then the test is unlikely to be clinically useful. Currently, there are no published data concerning both inter- and intra-examiner reliability of the vHIT. The purpose of this study was to assess the test-retest reliability of the horizontal SCC vHIT in young healthy adult participants using the Otometrics Impulse vHIT device using a prospective repeated measures design. Forty-four young adults with normal hearing, normal caloric test results, and a negative history of vestibular disorder, neurological disease, open or closed head injury, or cervical spine injury participated in the study. Each examiner underwent one hour of training on the vHIT device prior to the initiation of the study. The vHIT was administered to each participant by each of two different examiners on two different days. Inter-session interval ranged from 1 to 10 days and examiner order was randomized. Each examiner manually rotated each participant’s head in leftward and rightward directions, and VOR gain (eye velocity/head velocity) was calculated for the left and right horizontal SCCs. The effects of examiner, session, and SCC (left horizontal versus right horizontal) on the magnitude of VOR gain were assessed using repeated measures analysis of variance. The intra-class correlation (ICC) coefficient was used to assess intra- and inter-examiner reliability. Preliminary findings obtained in 30 participants indicated that the main effects of examiner, session, and SCC on VOR gain were not significant. The ICCs for both inter-examiner (.847) and intra-examiner reliability (.813 for Examiner 1 and .845 for Examiner 2) were good. Testing was well-tolerated and completed in most participants in ~5 minutes. The vHIT has some important advantages relative to more established laboratory tests of horizontal SCC function including the ability to assess the vertical SCCs, lower cost, shorter test time, greater portability, minimal space requirements, and increased patient comfort. Additional data should be obtained from older participants with normal vestibular function and from patients with vestibular disorders. Within-subject comparisons between the results of the vHIT and the traditional tests of horizontal SCC function (caloric and rotary chair tests) will be important in determining the role of the vHIT in the vestibular test battery.

The otoliths are vestibular organs that act as gravito-inertial force sensors and contribute to the perception of spatial orientation (earth verticality). The subjective visual vertical (SVV) is a psychophysical measure of the angle between perceptual vertical and true (gravitational) vertical. The otoliths contribute to the estimation of the physical vertical orientation, and individuals with normal vestibular function align the SVV within 2 degrees of true vertical (0 degrees). Impaired SVV has been documented in patients with unilateral vestibular disorders. Most research has focused on measuring the static SVV (head upright and stationary); however, more recently, methods have been developed to measure the SVV during stimulation of the otolith organs using on-axis yaw rotation (bilateral centrifugation), off-axis eccentric rotation (unilateral centrifugation), or head tilt for tests of bilateral or unilateral otolith function. The SVV test may be a useful method to assess utricular function in patients complaining of dizziness and/or imbalance and identify stages of recovery for otolith involvement.

Sensory Organization Test (SOT) quantifies contributions of three sensory systems to postural stability and identifies fall risk. This study evaluated reliability and validity of SOT on a newly available computerized dynamic posturography system (Bertec) compared to the gold standard (NeuroCom). Forty-three adults with normal vestibular function completed testing on both systems over two sessions. Bertec SOT is valid and reliable in this population, but differences in composite scores between Bertec and NeuroCom suggest the systems are not interchangeable.

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The angular vestibulo-ocular reflex (VOR) ensures gaze stability during head rotations by generating eye movements that are equal and opposite to head rotation. The gain of the VOR (eye velocity/head velocity) for natural head movements, therefore, approaches unity in healthy individuals. The VOR has four main anatomic components: the semicircular canals (SCCs) and vestibular nerve in the peripheral vestibular system, the vestibular and ocular motor nuclei in the brainstem, and the extraocular muscles. The SCCs are positioned in three nearly orthogonal planes within the head thereby allowing for the detection of head rotation about any axis in space. The SCCs function as angular accelerometers in a push-pull fashion with two coplanar canals on each side of the head working together, i.e., left and right horizontal SCCs, the right anterior and left posterior SCCs or RALP, and the left anterior and right posterior SCCs or LARP. The observation or measurement of eye movement can aid in the detection and localization of vestibular pathology due to the relationship between the function of the vestibular sensory receptors in the inner ear and the eye movements produced by the VOR. The video head impulse test (vHIT) is a relatively new clinical test of dynamic SCC function that uses a high-speed digital video camera embedded in light-weight goggles to record head and eye movement during passive head rotations in the horizontal and vertical planes. An important precursor to the clinical use of a new diagnostic test is the evaluation of test reproducibility. If test reproducibility is poor, then the test is unlikely to be clinically useful. There are no published data concerning both inter- and intra-examiner reliability of the vHIT. The purpose of this study was to establish normal reference intervals and assess the test-retest reliability of the vHIT in young healthy adult participants using the Micromedical vHIT device, two examiners, and a prospective repeated measures design. Each examiner underwent five hours of training on the vHIT device prior to the initiation of the study. The vHIT was administered to each participant (n = 35) by each examiner on two different days. Inter-session interval ranged from 1 to 30 days and examiner order was alternated for successive subjects; canal-plane order was randomized. At each session, participants underwent head impulse testing in each plane resulting in the stimulation of each of the six SCCs. The dependent variable was VOR gain (eye velocity/head velocity) and the effects of examiner, session, eye, and SCC on the magnitude of VOR gain were assessed using repeated measures analysis of variance. The intra-class correlation (ICC) coefficient was used to assess intra- and inter-examiner reliability. The cut-offs (5th percentiles) for normal VOR gain were 0.76 (right and left horizontal SCCs), 0.68 (right anterior SCC), 0.70 (left anterior SCC), 0.69 (right posterior SCC), and 0.75 (left posterior SCC). There was no significant effect of examiner on VOR gain and the ICCs indicated fair-to-good inter- and intra-examiner reliability with better reliability for the horizontal SCCs than for the posterior and anterior SCCs

The measurement of eye movement can aid in the detection and localization of vestibular pathology due to the relationship between the function of the vestibular sensory receptors in the inner ear and the eye movements produced by the vestibulo-ocular reflex (VOR). The majority of tests of vestibular function involve the measurement of horizontal eye movements produced by stimuli that activates the horizontal semicirculuar canals (hSCCs). The video head impulse test (vHIT) is a new clinical test of dynamic SCC function that uses a high-speed digital video camera embedded in light-weight goggles to record head and eye movement during passive head rotations. There are no published data concerning the examiner reliability of the vHIT. A prospective repeated measures design was used to assess test-retest reliability of the hSCC vHIT in young healthy adult participants (n=44). The vHIT was administered to each participant by each of two different examiners on two different days. A repeated measures analysis of variance was used to determine the effects of examiner, session, and hSCC on the magnitude of VOR gain (eye velocity/head velocity). The intra-class correlation coeffecient and the coefficient of repeatability were used to assess intra- and inter-examiner reliability.

No description available.

No description available.