Department of Otorhinolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea.
J Int Adv Otol. 2024 May 23;20(3):236-240. doi: 10.5152/iao.2024.231340.
There is a lack of comparative studies examining changes in vestibulo-ocular reflex (VOR) gain with head velocity in the video head impulse test (vHIT) of patients with vestibular neuritis (VN). Thus, the purpose of present study was to identify the effect of head impulse velocity on the gain of the VOR during the vHIT in patients with VN. Head impulse velocities ranging from 100%-200°/s [158.08 ± 23.00°/s in the horizontal canal (HC), 124.88 ± 14.80°/s in the anterior canal (AC), and 122.92 ± 14.26°/s in the posterior canal (PC) were used during vHIT trials of 32 patients with VN. Differences in VOR gain on the ipsilesional and contralesional sides according to head velocity were analyzed. The mean VOR gains in ipsilesional side were decreased to 0.47 in the HC and 0.56 in the AC, leading to marked asymmetry compared to the contralesional side; PC gain was relatively preserved at 0.82 in the ipsilesional side. The mean head impulse velocity applied during vHIT trials in each semicircular canal plane did not differ bilaterally. On the contralesional side, VOR gain was negatively correlated with head impulse velocity (R2=0.25, P=.004 in HC; R2=0.17, P=.021 in AC; R2=0.24, P=.005 in PC), while VOR gain on the ipsilesional sides of the HC and AC was not. Head impulse velocity may have a differential impact on VOR gain, depending on the degree of deficit. Increasing head velocity in vHIT may be considered to identify subtle deficits on the contralesional side of patients with VN.
目前尚缺乏比较研究来观察前庭神经炎（VN）患者视频头脉冲试验（vHIT）中前庭眼反射（VOR）增益随头速的变化。因此，本研究旨在确定在 VN 患者的 vHIT 中头脉冲速度对 VOR 增益的影响。在 32 例 VN 患者的 vHIT 试验中，使用的头脉冲速度范围为 100%-200°/s[水平半规管（HC）为 158.08 ± 23.00°/s，前半规管（AC）为 124.88 ± 14.80°/s，后半规管（PC）为 122.92 ± 14.26°/s]。根据头速分析同侧和对侧 VOR 增益的差异。同侧 HC 的 VOR 增益平均降至 0.47，AC 降至 0.56，与对侧相比差异显著；同侧 PC 的增益相对保留在 0.82。每个半规管平面的 vHIT 试验中应用的平均头脉冲速度在双侧均无差异。在对侧，VOR 增益与头脉冲速度呈负相关（HC 中 R2=0.25，P=.004；AC 中 R2=0.17，P=.021；PC 中 R2=0.24，P=.005），而 HC 和 AC 的同侧 VOR 增益则无相关性。头脉冲速度可能会根据缺陷程度对 VOR 增益产生不同的影响。在 vHIT 中增加头速度可以考虑用于识别 VN 患者对侧的细微缺陷。
