This cross-sectional study aims to describe the features of the suppression head impulse paradigm (SHIMP) in acute unilateral vestibulopathy (AUV) and to define its role in predicting the recovery of patients.
METHODS:
Thirty patients diagnosed with AUV were retrospectively analyzed. The dizziness handicap inventory score and video head impulse test parameters performed 4–8 weeks from the AUV onset constituted the main outcome measures. Patients with a worse recovery (Group 1) and patients who recovered spontaneously (Group 2) were compared.
RESULTS:
The SHIMP vestibulo-ocular reflex (VOR) gain was statistically significantly lower than the conventional head impulse paradigm (HIMP) VOR gain (P < 0.001). The SHIMP VOR gain was negatively correlated with the DHI (P < 0.001) and was positively correlated with the HIMP VOR gain (P < 0.001) and the SHIMP overt saccades (%) (P < 0.001). Patients with a worse recovery exhibited the following: higher DHI (P < 0.001), lower SHIMP and HIMP VOR gain (P < 0.001 and P = 0.007, respectively), and lower SHIMP and greater HIMP overt saccade prevalence values (P = 0.007 and P = 0.032, respectively).
CONCLUSIONS:
The SHIMP and HIMP help in improving our approach to AUV. SHIMP appears to better identify the extent of the vestibular damage in patient suffering from AUV than HIMP and could provide interesting information about the course of the disease. Particularly, the analysis of SHIMP VOR gain and overt saccade prevalence would provide useful information about the recovery of patients.
AdamecI., Krbot SkoricM., OzreticD. and HabekM., Predictors of development of chronic vestibular insufficiency after vestibular neuritis, J Neurol Sci347 (2014), 224–228.
2.
AllumJ.H.J. and HoneggerF., Relation between head impulse tests, rotating chair tests, and stance and gait posturography after an acute unilateral peripheral vestibular deficit, Otol Neurotol34 (2013), 980–990.
Baloh and PerolsO., Vestibular neuritis: A follow-up study, Acta Otolaryngol119 (1999), 895–899.
5.
BjerlemoB., KollénL., BoderosI., KreuterM. and MöllerC., Recovery after early vestibular rehabilitation in patients with acute unilateral vestibular loss, Audiological Medicine4 (2006), 117–123.
6.
CerchiaiN., NavariE., Sellari-FranceschiniS., ReC. and CasaniA.P., Predicting the Outcome after Acute Unilateral Vestibulopathy: Analysis of Vestibulo-ocular Reflex Gain and Catch-up Saccades, Otolaryngol Head Neck Surg158 (2018), 527–533.
7.
ChenL. and HalmagyiG.M., Video Head Impulse Testing: from bench to bedside, Semin Neurol40 (2020), 5–17.
8.
CohenH.S., Disability and rehabilitation the dizzy patient, Curr Opin Neurol19 (2006), 49–54.
9.
ColnaghiS., RezzaniC., GnesiM., ManfrinM., QuaglieriS., NutiD., MandaláM., MontiM.C. and VersinoM., Validation of the Italian Version of the Dizziness Handicap Inventory, the Situational Vertigo Questionnaire, and the Activity-Specific Balance Confidence Scale for Peripheral and Central Vestibular Symptoms, Front Neurol8 (2017), 528.
10.
CousinsS., KaskiD., CutfieldN., ArshadQ., AhmadH., GrestyM.A., SeemungalB.M., GoldingJ. and BronsteinA.M., Predictors of clinical recovery from vestibular neuritis: a prospective study, Ann Clin Transl Neurol22 (2017), 340–346.
11.
CousinsS., CutfieldN.J., KaskiD., PallaA., SeemungalB.M., GoldingJ.F. and StaabJ.P., Visual dependency and dizziness after vestibular neuritis, PLoS One9 (2014), e105426.
12.
De BrouwerS., MissalM., BarnesG. and LefèvreP., Quantitative analysis of catch-up saccades during sustained pursuit, J Neurophysiol87 (2002), 1772–1780.
13.
Eza-NuñezP., Fariñas-AlvarezC. and FernandezN.P., Comparison of three diagnostic tests in detecting vestibular deficit in patients with peripheral vestibulopathy, J Laryngol Otol130 (2016), 145–150.
14.
Guajardo-VergaraC. and Perez FernandezN., A new and faster method to assess vestibular compensation: a cross-sectional study, Laryngoscope130 (2020), E901–E917. DOI: 10.1002/lary.28505
15.
HallC.D., HerdmanS.J., WhitneyS.L., CassS.P., ClendanielR.A., FifeT.D., FurmanJ.M., GetchiusT.S., GoebelJ.A., ShepardN.T. and WoodhouseS.N., Vestibular Rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline: from the American physical therapy association neurology section, J Neurol Phys Ther40 (2016), 124–156.
16.
HalmagyiG.M., WeberK.P. and CurthoysI.S., Vestibular function after acute vestibular neuritis, Restor Neurol Neurosci28 (2010), 37–46.
17.
HalmagyiG.M., ChenL., HG MacDougallL., WeberK.P., Mc GarvieL.A. and CurthoysI.S., The Video Head Impulse Test, Front Neurol8 (2017), 258.
18.
HegemannS.C.A. and WenzelA., Diagnosis and treatment of vestibular neuritis/neuronitis or peripheral vestibulopathy (PVP)? Open questions and possible answers, Otol Neurotol38 (2017), 626–631.
19.
HotsonJ.R. and BalohR.W., Acute vestibular syndrome, New Engl J Med339 (1998), 680–685.
20.
KammerlindA.S., LedinT.E., SkargrenE.I. and OdkvistL., Long-term follow-up after acute unilateral vestibular loss and comparison between subjects with and without remaining symptoms, Acta Otolaryngol125 (2005), 946–953.
LacourM., HelmchenC. and VidalP.P., Vestibular compensation: The neuro-otologist’s best friend, J Neurol263 (2016), S54–S64.
23.
LacourM., TardivetL. and ThityA., Rehabilitation of dynamic visual acuity in patients with unilateral vestibular hypofunction: earlier is better, Eur Arch Otorhinolaryngol277 (2020), 103–113.
24.
LeeJ.Y., ParkJ.S. and KimM.B., Clinical characteristics of acute vestibular neuritis according to the involvement site, Otol Neurotol40 (2020), 797–805.
25.
MacDougallH.G., McGarvieL.A., HalmagyiG.M., RogersS.J., ManzariL., BurgessA.M., CurthoysI.S. and WeberK.P., A new saccadic indicator of peripheral vestibular function based on the video head impulse test, Neurology87 (2016), 410–418.
26.
MagliuloG., GagliardiS., Ciniglio AppianiM, IannellaG. and GagliardiM., Selective vestibular neurolabyrinthitis of the lateral and superior semicircular canal ampulla and ampullary nerves, Ann Otol Rhinol Laryngol121 (2012), 640–644.
27.
MandaláM., NutiD., BromanA.T. and ZeeD.S., Effectiveness of careful bedside examination in assessment, diagnosis, and prognosis of vestibular neuritis, Arch Otolaryngol Head Neck Surg134 (2008), 1–6.
28.
MantokoudisG., SchubertM., Saber TehraniA., WongA.L. and Agrawal AY., Early Adaptation and Compensation of Clinical Vestibular Responses After Unilateral Vestibular Deafferentation Surgery, Otol Neurotol35 (2014), 148–154.
29.
ManzariL. and TramontanoM., Suppression head impulse paradigm (SHIMP) in evaluating the vestibulo-saccadic interaction in patients with vestibular neuritis, Eur Arch Otolaryngol277 (2020), 3015–3012.
30.
Matino-SolerE., Rey-MartinezJ, Trinidad-RuizG., Batuecas-CaletrioA. and Perez FernandezN., A new method to im-prove the imbalance in chronic unilateral vestibular loss: the organization of refixation saccades, Acta Otolaryngol136 (2016), 894–900.
31.
MbongoF., Tran Ba HuyP., VidalP.P. and de WaeleC., Relationship between dynamic balance and self-reported handicap in patients who have unilateral peripheral vestibular loss, Otol Neurotol28 (2007), 905–910.
32.
McDonnellM.N. and HillierS.L., Vestibular rehabilitation for unilateral peripheral vestibular dysfunction, Cochrane Database of Systematic Reviews (2015), CD005397.
33.
NavariE. and CasaniA.P., Lesion Patterns and Possible Implications for Recovery in Acute Unilateral Vestibulopathy, Otol Neurotol41 (2020), e250–e255.
34.
NavariE., CerchiaiN. and CasaniA.P., Assessment of Vestibulo-ocular Reflex Gain and Catch-up Saccades During Vestibular Rehabilitation, Otol Neurotol39 (2018), e1111–e1117.
35.
Newman-TokerD.E., KerberK.A., HsiehY.H., PulaJ.H., OmronR., Saber TehraniA., MantokoudisG., HanleyD.F., ZeeD.S. and KattahJ.C., HINTS out- performes ABCD2 to screen for stroke in acute continuous vertigo and dizziness, Acad Emerg Med20 (2013), 986–996.
36.
PallaA., StraumannD. and BronsteinA.M., Vestibular neuritis: vertigo and the high- acceleration vestibulo-ocular reflex, J Neurol255 (2008), 1479–1482.
37.
ParkJ.S., LeeJ.Y., NamW., NohS., ChangS.O. and KimM.B., Comparing the Suppression Head Impulse Paradigm and the Head Impulse Paradigm in Vestibular Neuritis, Otol Neurotol41 (2020), e76–e82.
38.
PatelM., ArshadQ., RobertsR.E., AhmadH. and BronsteinA.M., Chronic symptoms after vestibular neuritis and the high-velocity vestibulo-ocular reflex, Otol Neurotol37 (2016), 179–184.
39.
Perez-FernandezN. and Eza-NunezP., Normal gain of VOR with refixation saccades in patients with unilateral vestibulopathy, J Int Adv Otol11 (2015), 133–137.
40.
Rey-MartinezJ.R., Batuecas-CaletrioA., MatiñoE. and Perez FernandezN., HITCal: a software tool for analysis of video head impulse test responses, Acta Otolaryngol135 (2015), 886–894.
41.
Rey-MartinezJ.R., YanesJ., EstebanJ., SanzR. and Martin-SanzE., The Role of Predictability in Saccadic Eye Responses in the Suppression Head Impulse Test of Horizontal Semicircular Canal Function, Front Neurol8 (2017), 536.
42.
Schmid-PriscoveanuA., BöhmerA., ObzinaH. and StraumannD., Caloric and search-coil head-impulse testing in patients after vestibular neuritis, J Assoc Res Otolaryngol2 (2001), 72–78.
43.
ShenQ., MagnaniC., SterkersO., LamasG., VidalP.P., SadounJ., CurthoysI.S. and de WaeleC., Saccadic Velocity in the New Suppression Head Impulse Test: A New Indicator of Horizontal Vestibular Canal Paresis and of Vestibular Compensation, Front Neurol7 (2016), 160.
44.
TarnutzerA.A., BockischC.J., BuffoneE. and WeberK.P., Vestibular mapping in patients with unilateral peripheral-vestibular deficits, Neurology95 (2020), e2988–e3001.
45.
TaylorR.L., McGarvieL.A., ReidN., YoungA.S., HalmagyiG.M. and WelgampolaM.S., Vestibular neuritis affects both superior and inferior vestibular nerves, Neurology87 (2016), 1704–1712.
46.
Van EschB.F., Nobel-HoffG.E., van BenthemP.P., van der Zaag-LoonenH.J. and BruintjesT.D., Determining vestibular hypofunction: start with the video-head impulse test, Eur Arch Otorhinolaryngol273 (2016), 3733–3739.
47.
WettsteinV.G., WeberK.P., BockischC.J. and HegemannS.C., Compensatory Saccades in Head Impulse Testing Influence the Dynamic Visual Acuity of Patients with Unilateral Peripheral Vestibulopathy, J Vest Res26 (2016), 395–402.
48.
WhitneyS.L., SpartoP.J. and FurmanJ.M., Vestibular rehabilitation and factors that can affect outcome, Semin Neurol40 (2020), 165–172.
