Effect of Gaze Angle During the Vertical Video Head Impulse Test Across Two Devices in Healthy Adults and Subjects With Vestibular Loss.

OBJECTIVE

To evaluate the effect of gaze angle on vertical vestibulo-ocular reflex (VOR) gain using two different video head impulse (vHIT) devices in healthy adults and subjects with bilateral vestibular loss (BVL).

STUDY DESIGN

Prospective study.

SETTING

Hospital research laboratory.

SUBJECTS

Twenty-four healthy adults (mean [standard deviation {SD}] age = 32 [4.8]; 23-42; 8 men) and four subjects with previously diagnosed BVL (mean age [SD] = 32 [8.2]; 21-40; 3 men) participated.

INTERVENTION

Vertical canal vHIT was administered with two different devices using three gaze angles (-45 degrees, 0 degree, +45 degrees). These devices have different gain calculation algorithms and different head and gaze angle protocols.

MAIN OUTCOME MEASURES

Vertical canal gain and presence or absence of reset saccades.

RESULTS

A significant stepwise reduction in vHIT gain was noted as gaze moved away from the plane of the canals stimulated (from -45 degrees to 0 degree, to +45 degrees) for both healthy adults and subjects with BVL. vHIT gain was able to separate the two groups using gaze angles -45 degrees and 0 degree.

CONCLUSIONS

In spite of their differences in gain algorithm and recommended head position and gaze angle, each device was able to appropriately separate healthy adults from subjects with BVL with high sensitivity/specificity.