诊断双侧前庭病时抑制性摇头试验（SHIMP）与摇头试验（HIMP）的比较
Suppression Head Impulse Test (SHIMP) versus Head Impulse Test (HIMP) When Diagnosing Bilateral Vestibulopathy.
作者信息
van Dooren Tessa, Starkov Dmitrii, Lucieer Florence, Dobbels Bieke, Janssen Miranda, Guinand Nils, Pérez Fornos Angelica, Kingma Herman, Van Rompaey Vincent, van de Berg Raymond
机构信息
Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands.
Faculty of Physics, Tomsk State Research University, 634050 Tomsk, Russia.
出版信息
J Clin Med. 2022 Apr 26;11(9):2444. doi: 10.3390/jcm11092444.
The Suppression Head Impulse (SHIMP) test was introduced as an alternative to the Head Impulse Paradigm (HIMP) to overcome challenges in VOR gain calculation due to the interference of covert saccades. The objectives of this study were (1) to determine if SHIMP, compared to HIMP, reduces covert saccades in BV patients and (2) to define the agreement on diagnosing BV between SHIMP and HIMP. First, the number of covert saccades was compared between SHIMP and HIMP. Secondly, VOR gain was compared between SHIMP and HIMP. Lastly, the agreement between SHIMP and HIMP on identifying BV (horizontal VOR gain <0.6) was evaluated. A total of 98 BV patients were included. To our knowledge, this is the largest study population on SHIMP testing in BV patients. Covert saccades were significantly reduced, and a lower VOR gain was found during SHIMP compared to HIMP (p < 0.001). However, the clinical relevance of these statistically significant differences is small. In 93% of the patients, an agreement was found between the two paradigms regarding the diagnosis of BV, and both paradigms detect BV in the vast majority of patients.
抑制性摇头试验（SHIMP）作为头脉冲范式（HIMP）的替代方法被引入，以克服由于隐蔽性扫视干扰导致的前庭眼反射（VOR）增益计算中的挑战。本研究的目的是：（1）确定与HIMP相比，SHIMP是否能减少双侧前庭病（BV）患者的隐蔽性扫视；（2）确定SHIMP和HIMP在诊断BV方面的一致性。首先，比较SHIMP和HIMP之间隐蔽性扫视的次数。其次，比较SHIMP和HIMP之间的VOR增益。最后，评估SHIMP和HIMP在识别BV（水平VOR增益<0.6）方面的一致性。共纳入98例BV患者。据我们所知，这是关于BV患者SHIMP测试的最大研究群体。与HIMP相比，SHIMP期间隐蔽性扫视显著减少，且VOR增益更低（p<0.001）。然而，这些统计学上显著差异的临床相关性较小。在93%的患者中，两种范式在BV诊断方面达成一致，且两种范式在绝大多数患者中都能检测到BV。
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