Video Head Impulse Test Coherence Predicts Vertigo Recovery in Sudden Sensorineural Hearing Loss With Vertigo

Area of Science:

• Neuroscience
• Otolaryngology
• Vestibular System Research

Background:

• Labyrinthitis significantly impairs quality of life in sudden sensorineural hearing loss with vertigo (SSNHLV) patients due to persistent vestibular symptoms.
• Current diagnostic and prognostic tools for SSNHLV may not fully capture the nuances of vestibular dysfunction and recovery.
• The video head impulse test (vHIT) is a key tool for assessing the vestibulo-ocular reflex (VOR).

Purpose of the Study:

• To investigate the utility of a novel coherence analysis in vHIT for predicting vertigo outcomes in SSNHLV patients.
• To identify specific vHIT coherence parameters associated with the timing and completeness of vertigo recovery.
• To compare the predictive sensitivity of vHIT coherence analysis versus traditional time series analysis for vertigo prognosis.

Main Methods:

• Retrospective analysis of 48 SSNHLV patients treated with high-dose steroids and prospective enrollment of 38 healthy volunteers.
• Measurement of magnitude-squared wavelet coherence between eye and head velocities during vHIT to assess frequency band correlations.
• Multivariable Cox regression analysis to determine factors associated with vertigo recovery, defined by a visual analog scale (VAS) score of 0 at 2 weeks and 2 months.

Main Results:

• Higher coherent frequencies in the horizontal and posterior semicircular canals (SCCs), and combined SCCs, correlated with early vertigo remission (2 weeks).
• Minimal coherent frequency among the three SCCs was identified as an independent predictor of early vertigo relief (HR, 2.040).
• At 2 months, VOR abnormalities, SCC gains, saccade parameters, and coherent frequencies were significantly related to complete vertigo relief.

Conclusions:

• The highest minimal coherent frequency across the three SCCs is a significant contributor to accelerated vertigo relief in SSNHLV.
• vHIT coherence analysis demonstrates superior sensitivity compared to time series analysis for predicting vertigo prognosis in SSNHLV.
• This novel coherence analysis offers a promising, more sensitive method for assessing vestibular function and predicting recovery trajectories.