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Binocular video head impulse test: Normative data study.

Maja Striteska^1,2, Martin Chovanec², Tobias Steinmetzer³

¹Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czechia.

Frontiers in Neurology

|May 19, 2023

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This summary is machine-generated.

Simultaneous binocular video head impulse testing (bvHIT) reveals higher vestibulo-ocular reflex (VOR) gains in the adducting eye compared to the abducting eye. This method provides normative data and a novel ratio for assessing VOR conjugacy.

Area of Science:

Neurology
Ophthalmology
Vestibular System Research

Background:

The video head impulse test (vHIT) is crucial for evaluating the vestibulo-ocular reflex (VOR).
Traditionally, vHIT records from a single eye, potentially limiting comprehensive VOR assessment.
Emerging vHIT technologies enable simultaneous binocular recording for enhanced VOR quantification.

Purpose of the Study:

To investigate the advantages of simultaneous binocular vHIT (bvHIT) in detecting differences in VOR gains between adducting and abducting eyes.
To establish normative values for bvHIT VOR gains in adducting and abducting eyes.
To introduce and validate a VOR dysconjugacy ratio (vorDR) for bvHIT analysis.

Main Methods:

A cross-sectional, prospective study with repeated-measures design was conducted on 44 healthy adults.

Keywords:

abduction adduction binocular video head impulse test conjugate gaze ductional VOR asymmetry index dysconjugacy ratio monocular VOR asymmetry index vestibuloocular reflex

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Simultaneous bvHIT was performed using the EyeSeeCam Sci 2 device, recording from both eyes during horizontal head impulses.

Test-retest reliability was assessed to ensure measurement consistency.

Main Results:

Pooled bvHIT retest gains were significantly higher for the adducting eye (1.08 ± 0.06) than the abducting eye (0.95 ± 0.06).
Adduction and abduction gains exhibited comparable variability, indicating similar precision for VOR asymmetry assessment.
The novel pooled vorDR for bvHIT was found to be 1.13 ± 0.05, with a test-retest repeatability coefficient of 0.06.

Conclusions:

The study provides normative values for horizontal bvHIT, reflecting eye movement conjugacy in healthy individuals.
Findings align with previous research using scleral search coils, confirming greater VOR gains in the adducting eye.
A novel bvHIT dysconjugacy ratio is proposed for assessing VOR-induced eye movement conjugacy, and a binocular ductional VOR asymmetry index is recommended to avoid monocular bias.