Abstract
PurposeThere is a paucity of age- and vascular risk factor-stratified video head impulse test (vHIT) vestibulo-ocular reflex (VOR) data in the literature. The aim of this study was to investigate the vHIT VOR properties in healthy subjects of different ages and subjects with vascular risk factors.MethodsThis was a prospective observational single-center study at a tertiary referral university hospital in northern Sweden. Healthy participants and subjects with vascular risk factors were investigated with a floor standing external camera vHIT device. Age-stratified mean VOR gain among healthy adults and between group gain and gain asymmetry differences were calculated.ResultsWe included eighty-eight healthy adults with a mean (range) age of 50 (22–85) years and n = 48 stroke ward patients with vascular risk factors (but without vestibular disease) with a mean (range) age of 74 (42–92) years. The mean VOR gain of horizontal canals decreased at higher ages in healthy subjects (r = − 0.32, p < 0.01, n = 167 canals). The age-stratified mean (SD) VOR gains were < 30 years: 0.98 (0.07), 30–39 years: 0.97 (0.07), 40–49 years: 0.98 (0.06), 50–59 years: 0.99 (0.06), 60–69 years: 0.93 (0.08), ≥ 70 years: 0.89 (0.15). No consistent differences between healthy subjects and subjects with vascular risk factors were seen except for a trend towards more pronounced gain asymmetries in the latter group.ConclusionsAge, but not vascular risk factors influence VOR gain. Age-adjusted vHIT-measurements may be useful in acute vertigo stroke risk differentiation.
Highlights
During acute vertigo with spontaneous or unilateral gazeevoked nystagmus the head impulse test (HIT) may aid to differentiate between cerebrovascular disease and vestibular neuritis [1, 2]
This study aims to investigate the impact of vascular risk factors and age on the outcome of video head impulse test (vHIT) investigations, and to report normative values in healthy volunteers for all six
BMI Body mass index’ CHA2DS2VASc = Congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/TIA or thromboembolism, vascular disease, age 65–74 years, sex category’ NIHSS national institute of health stroke scale. n/a not applicable a Data on level of education missing in n = 1 healthy subject and n = 1 subject with vascular risk factors with a median NIHSS score of 1
Summary
During acute vertigo with spontaneous or unilateral gazeevoked nystagmus the head impulse test (HIT) may aid to differentiate between cerebrovascular disease and vestibular neuritis [1, 2]. During the bedside HIT the vestibuloocular reflex is tested by delivering fast unpredictable head rotations in the horizontal plane while the patient tries to maintain gaze on an earth fixed target. If catch-up saccades are noted by the examiner after the head rotation (overt saccades) the test is considered positive, i.e. indicating a. This study aims to investigate the impact of vascular risk factors and age on the outcome of vHIT investigations, and to report normative values in healthy volunteers for all six. SCCs using a floor standing external camera vHIT system from SYNAPSYS, Marseille, France
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