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Laryngoscope. 2018 Oct;128(10):2383-2389. doi: 10.1002/lary.27107. Epub 2018 Feb 15.

Vestibulo-ocular reflex gain values in the suppression head impulse test of healthy subjects.

Author information

1
Otorhinolaryngology Department, Hospital Universitario Donostia, San Sebastián, Spain.
2
Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain.
3
ENT Department, University Hospital of Salamanca, Ibsal, University of Salamanca, Salamanca, Spain.
4
Neurotology Unit, Department of Otorhinolaryngology, University Hospital of Badajoz, Badajoz, Spain.
5
Department of Otorhinolaryngology, Hospital General de Catalunya, Barcelona, Spain.
6
Department of Otorhinolaryngology, Clínica Universidad de Navarra, Madrid, Spain.

Abstract

OBJECTIVE:

To assess whether there are differences in vestibulo-ocular reflex (VOR) gain for suppression head impulse (SHIMP) and head impulse (HIMP) video head impulse test paradigms, and if so, what are their causes.

METHODS:

Prospective multicenter observational double-blind nonrandomized clinical study was performed by collecting 80 healthy subjects from four reference hospitals. SHIMP data was postprocessed to eliminate impulses in which early SHIMP saccades were detected. Differences between HIMP and SHIMP VOR gain values were statistically evaluated. Head impulse maximum velocity, gender, age, direction of impulse, and hospital center were considered as possible influential factors.

RESULTS:

A small significant statistical difference between HIMP and SHIMP VOR gain values was found on repeated measures analysis of variance (-0.05 ± 0.006, P < 0.001). Optimized linear model showed a significant influence of age variable on the observed differences for HIMP and SHIMP gain values and did not find influence between gain values differences and maximum head impulse velocity. Both HIMP and SHIMP VOR gain values were significant lower (-0.09, P < 0.001) when the impulses were performed to the left side.

CONCLUSION:

We had observed a difference in SHIMP and HIMP gain values not adequately explained by known gain modification factors. The persistence of this slight but significant difference indicates that there are more factors causing lower SHIMP VOR gain values. This difference must to be considered in further studies as well as in the clinical SHIMP testing protocols. We hypothesized that VOR phasic response inhibition could be the underlying cause of this difference.

LEVEL OF EVIDENCE:

2b. Laryngoscope, 128:2383-2389, 2018.

KEYWORDS:

SHIMP; VOR; gain; suppression; vHIT

PMID:
29447427
DOI:
10.1002/lary.27107
[Indexed for MEDLINE]

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