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Vestibulo‐ocular reflex gain values in the suppression head impulse test of healthy subjects
Author(s) -
ReyMartinez Jorge,
ThomasArrizabalaga Izaskun,
EspinosaSanchez Juan Manuel,
BatuecasCaletrio Angel,
TrinidadRuiz Gabriel,
MatiñoSoler Eusebi,
PerezFernandez Nicolas
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27107
Subject(s) - impulse (physics) , reflex , medicine , significant difference , vestibulo–ocular reflex , audiology , physics , anesthesia , quantum mechanics
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