Diagnostic value of refixation saccades in the Video Head Impulse Test (vHIT) in unilateral definite Meniere's disease

• Published in: Acta oto-laryngologica Vol. 140; no. 7; pp. 537 - 543
• Main Authors: Bharadwaj, Shreyas, Petrak, Michelle R., Bahner, Cammy M., Sharp, Laurin E., Mosey-Claycomb, Sara F., Matsuoka, Akihiro J.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02-07-2020
• Subjects: Adult; Aged; Analysis of Variance; Audiometry, Pure-Tone; balance; Caloric Tests; Case-Control Studies; Female; head impulse test; Head Impulse Test - methods; Humans; Male; Meniere Disease - diagnosis; Meniere Disease - physiopathology; Middle Aged; Reflex, Vestibulo-Ocular; Saccades; vestibular; Vestibular diseases; vestibular function tests; vestibulo-ocular reflex; vHIT; VOR; Vestibular diseases; balance; head impulse test; VOR; vestibulo-ocular reflex; vHIT; vestibular; vestibular function tests
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016489.2020.1744720

Introduction: We currently interpret the video Head Impulse Test (vHIT) results mainly based on the gain value.
Aim: The purpose of this study is to evaluate vHIT results for both gain and re-fixation saccades on unilateral definite Meniere's disease (MD) subjects in comparison with normal healthy subjects.
Materials and Methods: Forty unilateral definite MD subjects and age-matched healthy subjects were recruited. Pure tone audiometry, the caloric test, and the vHIT test were performed on MD subjects. The vHIT test was performed on healthy subjects.
Results: The velocity regression gain (VRG) of the affected ear in patients with MD is significantly lower than of those in healthy subjects. The total percentage of refixation saccades is significantly higher in patients with MD when compared to healthy subjects. VRG values were not well-correlated with the percentage of refixation saccades. VRG asymmetry values are also not well-correlated with the percentage of unilateral canal weakness. A moderately stronger correlation between the percentage of refixation saccades and percentage of unilateral canal weakness, with an r
2
of 0.474.
Conclusions: The present study suggests that while VRGs are still a diagnostic parameter of detecting MD, the presence of refixation saccades can also have diagnostic value, especially with normal VRGs, in detecting MD.