Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2025
Symptom and Handicap Severity in Subacute Dizzy Patients: The Role of Gaze Position Error in Video Head Impulses.
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Korda Athanasia, Wyss Thomas, Zamaro Ewa, Michailidou Efterpi, Gawliczek Tom, Wagner Franca, Caversaccio Marco D, Mantokoudis Georgios
Аннотация
OBJECTIVE: This study aims to investigate the significance of gaze position error (GPE) after rapid head movements in the recovery of symptoms among patients with acute unilateral vestibulopathy (AUVP).
METHODS: We studied 26 patients with AUVP and a control group of 48 healthy subjects. All patients received a video head impulse test (vHIT) during the acute stage and a follow-up vHIT 30 days after symptoms onset. Additionally, they completed a Dizziness Handicap Inventory (DHI) questionnaire.
RESULTS: Based on our normative data, we found a cutoff amplitude of 4 degrees for abnormal GPE. Mean DHI score was 26.7 (±28.9 SD). Seventeen patients had a mild, four had a moderate, and five a severe dizziness handicap. DHI was highly correlated with GPE (adjusted R2 = 0.446) and with the vestibulo-ocular reflex (VOR) gain (adjusted R2 = 0.272). Although age and gender were not significantly associated with DHI, there was a trend toward lower DHI scores in males. In the subscale analysis, we found a marginal correlation between females and emotional DHI subscores and between age and functional DHI subscores (p < 0.05).
CONCLUSIONS: Our study revealed a correlation between gaze position error (GPE) during rapid head movements and subacute symptoms after AUVP, explaining nearly 50% of the variance in Dizziness Handicap Inventory (DHI) scores. Additionally, emotional symptoms exhibited a gender bias, predominantly affecting females, whereas functional symptoms showed a slight dependence on age.
METHODS: We studied 26 patients with AUVP and a control group of 48 healthy subjects. All patients received a video head impulse test (vHIT) during the acute stage and a follow-up vHIT 30 days after symptoms onset. Additionally, they completed a Dizziness Handicap Inventory (DHI) questionnaire.
RESULTS: Based on our normative data, we found a cutoff amplitude of 4 degrees for abnormal GPE. Mean DHI score was 26.7 (±28.9 SD). Seventeen patients had a mild, four had a moderate, and five a severe dizziness handicap. DHI was highly correlated with GPE (adjusted R2 = 0.446) and with the vestibulo-ocular reflex (VOR) gain (adjusted R2 = 0.272). Although age and gender were not significantly associated with DHI, there was a trend toward lower DHI scores in males. In the subscale analysis, we found a marginal correlation between females and emotional DHI subscores and between age and functional DHI subscores (p < 0.05).
CONCLUSIONS: Our study revealed a correlation between gaze position error (GPE) during rapid head movements and subacute symptoms after AUVP, explaining nearly 50% of the variance in Dizziness Handicap Inventory (DHI) scores. Additionally, emotional symptoms exhibited a gender bias, predominantly affecting females, whereas functional symptoms showed a slight dependence on age.