Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Pisa, Italy.
J Vestib Res. 2021;31(6):531-540. doi: 10.3233/VES-210038.
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.
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.
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).
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.
本横断面研究旨在描述急性单侧前庭病变（AUV）中抑制性摇头脉冲试验（SHIMP）的特征，并确定其在预测患者恢复方面的作用。
回顾性分析 30 例诊断为 AUV 的患者。主要观察指标为 AUV 发病后 4-8 周时的眩晕残障程度量表（DHI）评分和视频头脉冲测试参数。将恢复较差的患者（第 1 组）和自发恢复的患者（第 2 组）进行比较。
SHIMP 前庭眼反射（VOR）增益明显低于传统的摇头脉冲试验（HIMP）VOR 增益（P<0.001）。SHIMP VOR 增益与 DHI 呈负相关（P<0.001），与 HIMP VOR 增益（P<0.001）和 SHIMP 显性眼跳（%）呈正相关（P<0.001）。恢复较差的患者具有以下特点：更高的 DHI（P<0.001），SHIMP 和 HIMP VOR 增益更低（P<0.001 和 P=0.007），以及 SHIMP 和更大的 HIMP 显性眼跳发生率值更低（P=0.007 和 P=0.032）。
SHIMP 和 HIMP 有助于改善我们对 AUV 的治疗方法。SHIMP 似乎比 HIMP 更能准确识别 AUV 患者的前庭损伤程度，并能提供有关疾病进程的有趣信息。特别是，分析 SHIMP VOR 增益和显性眼跳发生率可以为患者的恢复提供有用的信息。
