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Using Eye-tracking to Assess the Relative Importance of Visual and Vestibular Input to Subcortical Motion Processing in the Roll Plane
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Covert anti-compensatory quick eye movements during head impulses.

Maria Heuberger1, Murat Sağlam2, Nicholas S Todd2

  • 1German Center for Vertigo and Balance Disorders, Munich University Hospital, Munich, Germany; Department of Neurology, Munich University Hospital, Munich, Germany.

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|April 16, 2014
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Summary

Covert anti-compensatory quick eye movements (CAQEM) are common in patients with vestibular disorders. These eye movements can help differentiate vestibular migraine from Menière's disease.

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Vestibular System

Background:

  • Catch-up saccades compensate for a deficient vestibulo-ocular reflex (VOR) during head movements.
  • Covert anti-compensatory quick eye movements (CAQEM) are observed in older individuals, moving in the direction of head movement.

Purpose of the Study:

  • Characterize CAQEM, their pathophysiology, and clinical relevance during head impulse testing (HIT).
  • Investigate the utility of CAQEM in differentiating vestibular disorders.

Main Methods:

  • Retrospective analysis of video head impulse test (vHIT) data from 266 tertiary vertigo center patients.
  • Included patients with vestibular migraine (n=43) and Menière's disease (n=35).

Main Results:

  • CAQEM occurred in 38% of patients, with a mean occurrence rate of 11±10%.
  • CAQEM latency was 83±30 ms and followed saccade main sequence characteristics.
  • CAQEM were associated with lower contralateral VOR gain and helped distinguish Menière's disease from vestibular migraine.

Conclusions:

  • CAQEM are a common phenomenon likely caused by saccadic mechanisms due to gain asymmetries.
  • CAQEM can aid in differentiating vestibular migraine and Menière's disease, two common causes of recurrent vertigo.