Journal of Vestibular Research - Volume 30, issue 3

Authors: Murofushi, Toshihisa | Tsubota, Masahito | Tsuda, Yukiko | Yoshimura, Eriko

Article Type: Research Article

Abstract: BACKGROUND: There are only a few reports concerning cervical vestibular evoked myogenic potential (cVEMP) using chirp sound, and clinical indications/advantages of it are still unclear. OBJECTIVE: To compare cVEMP using CE-chirp LS® with cVEMP using 500 Hz and 1000 Hz tone bursts (TB) and to investigate clinical indications/advantages of CE-chirp LS® for recording cVEMP. METHODS: Sixteen patients with vestibular disorders (2men and 14 women) (18∼62, mean 42.9 years of age) were enrolled in this study. Participants underwent cVEMP testing using 500 Hz and 1000 Hz tone bursts (TB) and CE-chirp LS® . Response rate of P1-N1, corrected/normalized amplitude …of P1-N1, latencies of P1 and N1, asymmetry ratio, and correlation of P1 latency to SLOPE in tuning property test (an index of endolymphatic hydrops) were compared. RESULTS: Corrected/normalized amplitude of P1-N1 to CE-chirp LS® was smaller than corrected/normalized amplitude of P1-N1 to 500 Hz TB. Peak latencies to CE-chirp LS® were the shortest among the 3 types of stimulation. EH-positive ears according to the tuning property test had tendency of prolonged P1 latencies to CE-chirp LS® . CONCLUSION: CE-chirp LS® is applicable for recording cVEMP with a similar diagnostic accuracy to TB. Prolongation of P1 latency in CE-chirp LS® might be an indicator of endolymphatic hydrops in the saccule. Show more

Keywords: Cervical vestibular evoked myogenic potential, chirp, tuning property, endolymphatic hydrops, latency, Meniere’s disease

DOI: 10.3233/VES-200704

Citation: Journal of Vestibular Research, vol. 30, no. 3, pp. 153-158, 2020

Authors: Govender, Sendhil | Colebatch, James G.

Article Type: Research Article

Abstract: BACKGROUND: The ocular vestibular evoked myogenic potential is otolith-dependent and has been suggested to be a manifestation of the linear vestibulo-ocular reflex (L-VOR). A characteristic feature of the translational LVOR (t-LVOR) is its dependence on the distance of a target. OBJECTIVE: To assess if viewing distance affects amplitude and latency properties of the ocular vestibular evoked myogenic potential (oVEMPs). METHODS: Bone- and air-conducted (BC and AC) stimuli were used to evoke oVEMPs in 10 healthy subjects. BC stimuli consisted of impulsive accelerations applied at the mastoids, AFz, Oz and Iz. AC stimuli consisted of 500 Hz tones …delivered unilaterally to each ear. Target distances of 40 cm (near), 190 cm (intermediate) and 340 cm (far) were used for all stimuli. RESULTS: The largest amplitude oVEMP was obtained from Iz and the latency for AFz was shorter than for BC stimulation at other sites. We found no significant effect of target distance on oVEMP amplitudes for any of the stimuli used. There was a small but significant effect on latency with the nearest target having a longer latency (overall 12.4 ms vs 12.0 ms for the 2 more distant sites). CONCLUSIONS: Previously reported differences between latencies and stimulus sites for midline BC stimulation were confirmed. Target distance had no significant effect on oVEMP amplitude, which suggests it is not modified like other components of the t-LVOR. Show more

Keywords: oVEMP, viewing distance, VOR

DOI: 10.3233/VES-200705

Citation: Journal of Vestibular Research, vol. 30, no. 3, pp. 159-164, 2020

Authors: Mittelstaedt, Justin Maximilian

Article Type: Research Article

Abstract: BACKGROUND: Individuals seem to be differently susceptible to motion-related sickness (motion sickness, visually induced sickness etc.). Investigations of the reasons for these different susceptibilities have revealed many potential factors that could predict individual susceptibility to motion-related sickness. OBJECTIVE: This paper attempts to conduct a comprehensive literature review on inter-individual predictors of susceptibility to motion-related sickness using systematic approaches. METHODS: After a systematic literature research, titles and abstracts of 1778 publications were screened for relevance. Reference lists of selected publications were searched for additional studies. This procedure yielded 184 relevant publications. RESULTS: The identified predictors …were clustered into demographic, physiological and psychological aspects. Among these predictors, the factors gender, length of velocity storage and anxiety showed the greatest predictive power. In addition, individual susceptibility to motion-related sickness is also to a large extent dependent on the degree of habituation to the aversive stimulus. CONCLUSIONS: Some of the identified influencing factors seem to have different effects on physically and visually induced motion sickness. More research is needed to close gaps, especially on predictive factors of visually induced motion sickness. Show more

Keywords: Motion sickness susceptibility, visually induced motion sickness, cybersickness, individual predictors

DOI: 10.3233/VES-200702

Citation: Journal of Vestibular Research, vol. 30, no. 3, pp. 165-193, 2020

Authors: Jafarov, Sabuhi | Hizal, Evren | Bahcecitapar, Melike | Ozluoglu, Levent N.

Article Type: Research Article

Abstract: BACKGROUND: Positional nystagmus elicited by the Dix-Hallpike maneuver often reverses its direction as the patient is re-seated from the provoking head hanging position. The incidence of reverse nystagmus and its association with prognosis in posterior canal benign paroxysmal positional vertigo (pcBPPV) is not clear. OBJECTIVE: To determine the incidence of upright positioning-related reverse nystagmus and its association with the success of canalith repositioning (Epley) maneuver (CRM) treatment in pcBPPV. METHODS: The records of patients that had been tested with video-nystagmography in a tertiary care center, between October 2016 and March 2019, were reviewed. Data were obtained …from detailed analysis of video recordings of 321 patients with typical pcBPPV. RESULTS: Reverse nystagmus was determined in 85% of the patients with pcBPPV. The number of CRMs required for treatment was lower in patients with reverse nystagmus (1.32±0.68) compared to patients without reverse nystagmus (1.81±0.98) (p  < 0.001). There was not a statistically significant relationship between reverse nystagmus and recurrence (p  = 0.623). CONCLUSIONS: The absence of reverse nystagmus on upright positioning during the Dix-Hallpike test predicts poor success for the CRM, as repetitive repositioning maneuvers might be required to achieve successful treatment in pcBPPV. Show more

Keywords: Benign paroxysmal positional vertigo, posterior semicircular canal, Dix-Hallpike test, nystagmus, reverse nystagmus, prognosis

DOI: 10.3233/VES-200700

Citation: Journal of Vestibular Research, vol. 30, no. 3, pp. 195-201, 2020

Authors: Lee, Jung-Yup | Lee, Yong Woo | Chang, Sun O. | Kim, Min-Beom

Article Type: Research Article

Abstract: BACKGROUND: A considerable number of patients with sudden sensorineural hearing loss (SSNHL) have been reported to have dizziness. OBJECTIVE: To analyze vestibular functions and identify the clinical characteristics of SSNHL with dizziness METHODS: 71 patients with SSNHL who complained of dizziness were investigated retrospectively. The patients underwent vestibular function tests consisting of video-nystagmography, video head impulse test and vestibular evoked myogenic potentials. RESULTS: Among 35 patients with spontaneous nystagmus (SN), 21 showed ipsilesional posterior canal gain deficit, 11 showed a gain deficit in the posterior canal only and 9 showed both horizontal and posterior …canal gain deficit in video head impulse test. In only one subject with bilateral horizontal canal gain deficit with contralesional SN, AICA infarction was observed. Among 36 patients without SN, 10 were diagnosed as benign paroxysmal positional vertigo and 5 had ipsilesional canal paresis in caloric test. Other 21 patients showed no abnormal signs in vestibular function tests. CONCLUSIONS: In VFT analysis of SSNHL with dizziness, diverse patterns were identified. In the absence of SN, no definite vestibular organ involvement was the most frequent. But in the case with SN, posterior canal deficit was most common and cerebellar ischemic stroke was rare. Show more

Keywords: Sudden sensorineural hearing loss, vestibular function test

DOI: 10.3233/VES-200703

Citation: Journal of Vestibular Research, vol. 30, no. 3, pp. 203-212, 2020

Authors: van de Berg, Raymond | Ramos, Angel | van Rompaey, Vincent | Bisdorff, Alexandre | Perez-Fornos, Angelica | Rubinstein, Jay T. | Phillips, James O. | Strupp, Michael | Della Santina, Charles C. | Guinand, Nils

Article Type: Research Article

Abstract: This opinion statement proposes a set of candidacy criteria for vestibular implantation of adult patients with bilateral vestibulopathy (BVP) in a research setting. The criteria include disabling chronic symptoms like postural imbalance, unsteadiness of gait and/or head movement-induced oscillopsia, combined with objective signs of reduced or absent vestibular function in both ears. These signs include abnormal test results recorded during head impulses (video head impulse test or scleral coil technique), bithermal caloric testing and rotatory chair testing (sinusoidal stimulation of 0.1 Hz). Vestibular implant (VI) implantation criteria are not the same as diagnostic criteria for bilateral vestibulopathy. The major difference between …VI-implantation criteria and the approved diagnostic criteria for BVP are that all included vestibular tests of semicircular canal function (head impulse test, caloric test, and rotatory chair test) need to show significant impairments of vestibular function in the implantation criteria. For this, a two-step paradigm was developed. First, at least one of the vestibular tests needs to fulfill stringent criteria, close to those for BVP. If this is applicable, then the other vestibular tests have to fulfill a second set of criteria which are less stringent than the original criteria for BVP. If the VI-implantation is intended to excite the utricle and/or saccule (otolith stimulation), responses to cervical and ocular vestibular evoked myogenic potentials must be absent in addition to the above mentioned abnormalities of semicircular canal function. Finally, requirements for safe and potentially effective stimulation should be met, including implanting patients with BVP of peripheral origin only, and assessing possible medical and psychiatric contraindications. Show more

Keywords: Vestibular implant, vestibular prosthesis, implantation criteria, bilateral vestibulopathy, bilateral vestibular hypofunction, electrical stimulation, vestibular system, vestibulo-ocular reflex, VOR, bilateral vestibular loss, bilateral vestibular areflexia

DOI: 10.3233/VES-200701

Citation: Journal of Vestibular Research, vol. 30, no. 3, pp. 213-223, 2020