Oculographic, Clinical Test of Sensory Integration and Balance and Computerized Dynamic Posturography Findings in Patients With Psoriatic Arthritis
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Published on: December 11, 2013
Juan Carlos Amor-Dorado1, Maria P Barreira-Fernandez, Javier Llorca
1*Otolaryngology Division of Can Misses and Formentera Hospital, Balearic Islands †Otolaryngology Division, Hospital Universitario Lucus Augusti, Lugo ‡Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander, CIBER Epidemiología y Salud Pública (CIBERESP) §School of Medicine, University of Cantabria, Santander ||Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
Objective:
To assess the frequency and characteristics of the oculographic findings and the usefulness of the clinical test of sensory integration and balance (CTSIB) for the evaluation of balance in patients with psoriatic arthritis (PsA) by comparing this test with the computerized dynamic posturography (CDP).
Study Design:
A series of consecutive patients that fulfilled the Moll and Wright criteria for PsA and matched controls were studied.
Setting:
The study was performed at the Otolaryngology Division of a tertiary reference center.
Intervention:
Vestibular evaluation including CTSIB followed by CDP was performed to all patients and age, sex, and ethnically frequency-matched controls.
Main Outcome Measure:
Patterns of CTSIB and CDP (gold standard) were assessed and compared.
Patients:
Sixty PsA patients (63.3% women) and 60 matched controls.
Results:
PsA patients had higher frequency of abnormal oculocephalic response (13.3%) and abnormal caloric test (26.7%) than controls (0% in both cases) (p = 0.006 and p < 0.001, respectively). Benign paroxysmal positional vertigo (BPPV) was diagnosed in two (3.4%) patients and none of the controls (p = 1). Significantly increased frequency of abnormal CTSIB test with vestibular loss pattern (33.3%) in patients compared with controls (6%) was observed (p = 0.002). Significantly increased frequency of abnormal CDP was also observed in PsA patients (14 [23.3%] versus 0 [0%] of controls) (p < 0.001). CTSIB yielded 100% sensitivity, 73% specificity, 48% positive predictive value, and 100% negative predictive value.
Conclusions:
This study indicates that oculographic findings are common in PsA. CTSIB is useful for assessing balance disorder screening in the routine clinical practice in these patients.
