TY - JOUR
T1 - Veterans with dizziness recruit compensatory saccades in each semicircular canal plane although VOR gain is normal
AU - Le, Thuy Tien C.
AU - Brewer, Kelly
AU - Serrador, Jorge
AU - Schubert, Michael C.
N1 - Funding Information:
We would like to thank Bishoy Samy for his help with Matlab code editing and troubleshooting, Justyna Michalik and Kamila Migdal for their help with data collection. We would like to thank all veterans who participated in this study. Drs Schubert and Serrador were funded by DOD Grant Awards W81XWH-15-1-0442 and W81XWH-14-2-0012, respectively.
Publisher Copyright:
© 2020-IOS Press and the authors. All rights reserved.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: Exposure to brain injury via blast or blunt mechanisms disrupts multiple sensorimotor systems simultaneously. Large numbers of US Gulf War era and Operation Iraqi/Enduring Freedom veterans with traumatic brain injury (TBI) are suffering the symptom of dizziness-presumed due to 'Multi-Sensory Impairment', a clinical pattern of damage to the auditory, visual and vestibular sensorimotor systems. OBJECTIVE: To describe the oculomotor response to rapid head rotation in a population of veterans with dizziness. We also describe the reliability of using the video head impulse test (vHIT) in a veteran population. METHODS: We used the vHIT to evaluate the vestibular-ocular reflex (VOR) gain and presence of compensatory saccades (CS) in each semicircular canal of 81 veterans (31% TBI) with dizziness. Data was collected using the ICS Otometric™ vHIT. Data was processed using both the Otometric™ software and custom software written in MATLAB™. This data was evaluated through Kruskal-Wallis rank-sum test and analysis of regression. RESULTS: Veterans with dizziness recruit CS in all semicircular canal planes even though their VOR gain is normal. The vHIT is a reliable clinical test to quantify the metrics of the VOR and CS in veterans. CONCLUSION: Veterans with dizziness symptoms use compensatory saccades in all planes of semicircular canal rotation, despite having normal peripheral VOR gain during rapid head rotation. The video head impulse test is a stable measure of vestibular slow phase and metrics of compensatory saccades in veterans with dizziness.
AB - BACKGROUND: Exposure to brain injury via blast or blunt mechanisms disrupts multiple sensorimotor systems simultaneously. Large numbers of US Gulf War era and Operation Iraqi/Enduring Freedom veterans with traumatic brain injury (TBI) are suffering the symptom of dizziness-presumed due to 'Multi-Sensory Impairment', a clinical pattern of damage to the auditory, visual and vestibular sensorimotor systems. OBJECTIVE: To describe the oculomotor response to rapid head rotation in a population of veterans with dizziness. We also describe the reliability of using the video head impulse test (vHIT) in a veteran population. METHODS: We used the vHIT to evaluate the vestibular-ocular reflex (VOR) gain and presence of compensatory saccades (CS) in each semicircular canal of 81 veterans (31% TBI) with dizziness. Data was collected using the ICS Otometric™ vHIT. Data was processed using both the Otometric™ software and custom software written in MATLAB™. This data was evaluated through Kruskal-Wallis rank-sum test and analysis of regression. RESULTS: Veterans with dizziness recruit CS in all semicircular canal planes even though their VOR gain is normal. The vHIT is a reliable clinical test to quantify the metrics of the VOR and CS in veterans. CONCLUSION: Veterans with dizziness symptoms use compensatory saccades in all planes of semicircular canal rotation, despite having normal peripheral VOR gain during rapid head rotation. The video head impulse test is a stable measure of vestibular slow phase and metrics of compensatory saccades in veterans with dizziness.
KW - Traumatic brain injury
KW - compensatory saccade
KW - vestibular-ocular reflex
KW - video head impulse test
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U2 - 10.3233/VES-190692
DO - 10.3233/VES-190692
M3 - Article
C2 - 32083608
AN - SCOPUS:85083299620
SN - 0957-4271
VL - 30
SP - 47
EP - 53
JO - Journal of Vestibular Research: Equilibrium and Orientation
JF - Journal of Vestibular Research: Equilibrium and Orientation
IS - 1
ER -