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Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
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VOR gain calculation methods in video head impulse recordings.

Ewa Zamaro1, Ali S Saber Tehrani2, Jorge C Kattah3

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Journal of Vestibular Research : Equilibrium & Orientation
|August 18, 2020
PubMed
Summary
This summary is machine-generated.

Different methods for calculating vestibular function using video head impulse tests (HIT) show similar results. Artifacts can impact gains, especially in normal ranges, necessitating multiple tests for accuracy.

Keywords:
HIT deviceVORarea under the curveartifactscalculation methodsgainposition gainregressionregression gainvHITvideo head impulse testvideo-oculography

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Area of Science:

  • Vestibular neurophysiology
  • Ophthalmology
  • Neurology

Background:

  • Lack of international consensus on best practices for calculating and reporting vestibular function.
  • Quantitative vestibulo-ocular reflex (VOR) gain calculation using video head impulse test (HIT) devices can be performed using various methods.

Purpose of the Study:

  • To compare different gain calculation methods for video HIT.
  • To analyze interactions between artifacts and gain calculation methods.

Main Methods:

  • Analysis of 1300 horizontal HIT traces from 26 patients with acute vestibular syndrome.
  • Calculation of 'velocity gain' (ratio of eye/head velocity at specific time points), 'regression gain' (ratio of velocity slopes), and 'position gain' (ratio of de-saccaded area under curves).

Main Results:

  • No significant mean difference between gain at 60 ms and position gain for artifact-free recordings (r2 = 0.77, p < 0.001).
  • Artifacts modestly reduced high, normal-range gains (range -0.06 to -0.11).
  • Artifacts variably impacted abnormal, low gains depending on artifact type.

Conclusions:

  • No single gain calculation method demonstrates clear superiority for video HIT.
  • Artifacts cause small but significant reductions in VOR gains for normal ranges, regardless of calculation method.
  • Artifacts increase measurement noise in abnormal HITs; multiple tests are recommended to confirm abnormal results.