Symptom and Handicap Severity in Subacute Dizzy Patients: The Role of Gaze Position Error in Video Head Impulses

This study aims to investigate the significance of gaze position error (GPE) after rapid head movements in the recovery of symptoms among patients with acute unilateral vestibulopathy (AUVP).

We studied 26 patients with AUVP and a control group of 48 healthy subjects. All patients received a video head impulse test (vHIT) during the acute stage and a follow-up vHIT 30 days after symptoms onset. Additionally, they completed a Dizziness Handicap Inventory (DHI) questionnaire.

Based on our normative data, we found a cutoff amplitude of 4 degrees for abnormal GPE. Mean DHI score was 26.7 (±28.9 SD). Seventeen patients had a mild, four had a moderate, and five a severe dizziness handicap. DHI was highly correlated with GPE (adjusted R2 = 0.446) and with the vestibulo-ocular reflex (VOR) gain (adjusted R2 = 0.272). Although age and gender were not significantly associated with DHI, there was a trend toward lower DHI scores in males. In the subscale analysis, we found a marginal correlation between females and emotional DHI subscores and between age and functional DHI subscores (p < 0.05).

Our study revealed a correlation between gaze position error (GPE) during rapid head movements and subacute symptoms after AUVP, explaining nearly 50% of the variance in Dizziness Handicap Inventory (DHI) scores. Additionally, emotional symptoms exhibited a gender bias, predominantly affecting females, whereas functional symptoms showed a slight dependence on age.