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Related Concept Videos

Equilibrium and Balance01:15

Equilibrium and Balance

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The inner ear assumes dual functionalities of auditory perception and equilibrium maintenance. The vestibule is the organ responsible for balance. This organ contains mechanoreceptors, specifically hair cells, endowed with stereocilia, which aid in deciphering information regarding the position and motion of our heads. Two intrinsic components, the utricle and saccule, help perceive head position, while the semicircular canals track head movement. Neurological messages initiated in the...
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The Vestibular System01:29

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The vestibular system is a set of inner ear structures that provide a sense of balance and spatial orientation. This system is comprised of structures within the labyrinth of the inner ear, including the cochlea and two otolith organs—the utricle and saccule. The labyrinth also contains three semicircular canals—superior, posterior, and horizontal—that are oriented on different planes.
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Related Experiment Video

Updated: Apr 3, 2026

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
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Functional head impulse testing for detection and quantification of vestibular dysfunction in multiple sclerosis.

Francesco Neri1,2, Alessia Bianchi3,4, Ludovico Luchetti5

  • 1Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Siena, Italy. francesco.neri3@unisi.it.

Journal of Neurology
|April 2, 2026
PubMed
Summary
This summary is machine-generated.

The functional head impulse test (fHIT) effectively identifies vestibular dysfunction (VD) in multiple sclerosis (MS) patients. Poorer fHIT performance correlates with higher lesion burden and symptom scores in MS, aiding early VD diagnosis.

Keywords:
Functional head impulse testMultiple sclerosisRelapsing–remitting multiple sclerosisVestibular dysfunction

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Area of Science:

  • Neurology
  • Neuro-ophthalmology
  • Vestibular System

Background:

  • Multiple sclerosis (MS) is a leading cause of neurological disability in young adults.
  • Vestibular dysfunction (VD) is common in MS patients, significantly impacting daily life.
  • Early diagnosis of VD is crucial for effective MS management.

Purpose of the Study:

  • To evaluate the functional head impulse test (fHIT) for assessing VD in relapsing-remitting MS (RRMS) patients.
  • To correlate fHIT performance with clinical vestibular symptoms and MRI-based lesion load.

Main Methods:

  • 36 RRMS patients were assessed for VD using the Vestibular Symptoms Classification (VSC) and fHIT.
  • fHIT performance was quantified by the percentage of correct optotype identification during head rotations.
  • Brain MRI was used to measure lesion load, including total number, volume, and regional counts.

Main Results:

  • Patients with VD (VD-RRMS) showed significantly poorer fHIT performance compared to asymptomatic patients (A-RRMS).
  • A negative correlation was found between VSC scores and fHIT performance.
  • Increased lesion burden, particularly total and periventricular counts, predicted worse fHIT outcomes.

Conclusions:

  • The fHIT is a safe, rapid, and noninvasive tool for detecting VD in RRMS patients.
  • fHIT performance correlates with clinical symptom severity (VSC) and neurological damage (lesion load).
  • Longitudinal fHIT studies could help monitor VD progression and inform therapeutic strategies in MS.