Abstract
Background: The Head Impulse Paradigm (HIMP) and Suppression Head Impulse Paradigm (SHIMP) are objective, quantitative methods that directly test the vestibulo-ocular reflex (VOR) and are increasingly becoming a standard in evaluating patients with vestibular disorders.Objective: The main objective was to assess the correlations between HIMP and SHIMP parameters in patients with superior vestibular neuritis (VN) and healthy participants. Additionally, the correlations between the parameters of each method were analyzed.Methods: A retrospective cohort, non-randomized study was designed. HIMP and SHIMP were performed on 40 patients with VN and 20 healthy participants (40 ears). HIMP and SHIMP parameters were measured and calculated. Pearson's or Spearson's correlations were used to establish the associations among them.Results: A strong positive correlation was found between HIMP and SHIMP gain (Pearson's r = 0.957, p = 0.000), while strong negative correlations were detected between HIMP and SHIMP saccade amplitudes (r = −0.637, p = 0.000) and percentages of overt saccades (r = −0.631, p = 0.000). In HIMP, strong and moderate positive correlations were identified between gain and saccade amplitude (R2 = 0.726, p = 0.000) and gain and saccade percentage (R2 = 0.558, p = 0.000), respectively. By contrast, an extremely weak positive correlation was observed between gain and latency (R2 = 0.053, p = 0.040). In SHIMP, strong and moderate positive correlations were found between gain and saccade percentage (R2 = 0.723, p = 0.000) and gain and saccade amplitude (R2 = 0.525, p = 0.000), respectively, but no correlation was detected between gain and latency (R2 = 0.006, p = 0.490).Conclusions: HIMP and SHIMP-related parameters were highly correlated (inter-method). Within each method (intra-method), moderate to strong correlations in VOR assessment were observed. These results further contribute to our understanding of the relationship between HIMP and SHIMP as well as to the diagnosis.
Highlights
The vestibulo-ocular reflex (VOR) stabilizes the position of the eyes in a target space by generating delayed and equivalent eye movements that compensate for head rotations in the opposite direction; it is the basis of many routine vestibular tests [1]
A small number of weak saccades in the left and right sides were observed in the Head Impulse Paradigm (HIMP), while large anticompensatory saccades were detected in the Suppression Head Impulse Paradigm (SHIMP) (Figure 1)
HIMP and SHIMP are important to evaluate in patients with vestibular neuritis [11]
Summary
The vestibulo-ocular reflex (VOR) stabilizes the position of the eyes in a target space by generating delayed and equivalent eye movements that compensate for head rotations in the opposite direction; it is the basis of many routine vestibular tests [1]. The video head impulse test (vHIT), a relatively recent clinical assessment tool, is used to assess the function of the semicircular canals, the angular acceleration detectors that initiate the VOR [2]. Two testing protocols to evaluate the VOR using the vHIT were available: HIMP (Head Impulse Paradigm, or conventional vHIT) and SHIMP (Suppression Head Impulse Paradigm). They can be used complementarily to test semicircular canal function and to determine the level of vestibular function [2]. The Head Impulse Paradigm (HIMP) and Suppression Head Impulse Paradigm (SHIMP) are objective, quantitative methods that directly test the vestibulo-ocular reflex (VOR) and are increasingly becoming a standard in evaluating patients with vestibular disorders
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