Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2025
The Differences in Caloric Test and vHIT Results Between Menière's Disease and Vestibular Migraine: A Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Vosbeek Eleonora G M, Seelen Meinie, Schermer Tjard R, Terwindt Gisela M, Bruintjes Tjasse D
Аннотация
OBJECTIVE: To present an overview of differences in caloric test and video Head Impulse Test (vHIT) results between Menière's disease (MD) and vestibular migraine (VM) patients.
DATABASES REVIEWED: Following PRISMA guidelines, comprehensive searches were conducted in PubMed, Embase, and Medline up to December 2024.
METHODS: Clinical studies comparing caloric and/or vHIT results in MD and VM patients were included. Exclusion criteria were non-English or non-Dutch papers, pediatric studies, and studies using non-standard caloric test protocols. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for analytical cross-sectional studies. Certainty of evidence was assessed according to the Oxford Centre for Evidence-Based Medicine. Meta-analyses of caloric test and vHIT results were performed.
RESULTS: Twenty-one studies, including 8 prospective cohort studies, with 3096 study subjects (1561 MD; 1535 VM), were included. Fourteen studies were assessed as low risk of bias. Results showed that patients with MD were significantly more likely than those with VM to show a canal paresis on caloric testing (OR=7.00, 95% CI: 5.69-8.61, P <0.00001). This indicates that a reduced vestibular response on caloric testing strongly favors a diagnosis of MD over VM. Similarly, MD patients had higher odds of having an abnormal horizontal vHIT (OR=3.38, 95% CI: 2.39-4.78, P <0.00001), and were also more likely to demonstrate corrective (catch-up) saccades during vHIT (OR=3.52, 95% CI: 2.11-5.88, P <0.00001).
CONCLUSIONS: These findings (level 3 evidence) suggest that in clinical practice, evidence of peripheral vestibular dysfunction-detected by either caloric testing or vHIT-can help distinguish MD from VM.
DATABASES REVIEWED: Following PRISMA guidelines, comprehensive searches were conducted in PubMed, Embase, and Medline up to December 2024.
METHODS: Clinical studies comparing caloric and/or vHIT results in MD and VM patients were included. Exclusion criteria were non-English or non-Dutch papers, pediatric studies, and studies using non-standard caloric test protocols. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for analytical cross-sectional studies. Certainty of evidence was assessed according to the Oxford Centre for Evidence-Based Medicine. Meta-analyses of caloric test and vHIT results were performed.
RESULTS: Twenty-one studies, including 8 prospective cohort studies, with 3096 study subjects (1561 MD; 1535 VM), were included. Fourteen studies were assessed as low risk of bias. Results showed that patients with MD were significantly more likely than those with VM to show a canal paresis on caloric testing (OR=7.00, 95% CI: 5.69-8.61, P <0.00001). This indicates that a reduced vestibular response on caloric testing strongly favors a diagnosis of MD over VM. Similarly, MD patients had higher odds of having an abnormal horizontal vHIT (OR=3.38, 95% CI: 2.39-4.78, P <0.00001), and were also more likely to demonstrate corrective (catch-up) saccades during vHIT (OR=3.52, 95% CI: 2.11-5.88, P <0.00001).
CONCLUSIONS: These findings (level 3 evidence) suggest that in clinical practice, evidence of peripheral vestibular dysfunction-detected by either caloric testing or vHIT-can help distinguish MD from VM.