A Tool to Quantify the Functional Impact of Oscillopsia

Abstract

BackgroundIndividuals with bilateral vestibular hypofunction (BVH) often report symptoms of oscillopsia during walking. Existing assessments of oscillopsia are limited to descriptions of severity and symptom frequency, neither of which provides a description of functional limitations attributed to oscillopsia. A novel questionnaire, the Oscillopsia Functional Impact scale (OFI) was developed to describe the impact of oscillopsia on daily life activities. Questions on the OFI ask how often individuals are able to execute specific activities considered to depend on gaze stability in an effort to link functional mobility impairments to oscillopsia for individuals with vestibular loss.MethodsSubjective reports of oscillopsia and balance confidence were recorded for 21 individuals with BVH and 48 healthy controls. Spearman correlation coefficients were calculated to determine the relationship between the OFI and oscillopsia visual analog scale (OS VAS), oscillopsia severity questionnaire (OSQ), and Activities-Specific Balance Confidence scale to demonstrate face validity. Chronbach’s α was calculated to determine internal validity for the items of the OFI. A one-way MANOVA was conducted with planned post hoc paired t-tests for group differences on all oscillopsia questionnaires using a corrected α = 0.0125.ResultsThe OFI was highly correlated with measures of oscillopsia severity (OS VAS; r = 0.69, p < 0.001) and frequency (OSQ; r = 0.84, p < 0.001) and also with the Activities-Specific Balance Confidence scale (r = −0.84, p < 0.001). Cronbach’s α for the OFI was 0.97. Individuals with BVH scored worse on all measures of oscillopsia and balance confidence compared to healthy individuals (p’s < 0.001).ConclusionThe OFI appears to capture the construct of oscillopsia in the context of functional mobility. Combining with oscillopsia metrics that quantify severity and frequency allows for a more complete characterization of the impact of oscillopsia on an individual’s daily behavior. The OFI discriminated individuals with BVH from healthy individuals.

The Functional Head Impulse Test to Assess Oscillopsia in Bilateral Vestibulopathy

“…These questionnaires are designed to classify the disease burden experienced by patients in daily life. Additionally, oscillopsia can be quantified objectively by functional vestibular tests that assess dynamic visual acuity (DVA) (9, 10). Various clinical testing paradigms have been proposed to assess DVA, like walking on a treadmill or passively shaking the head, while reading an optotype chart (8, 11).…”

Pharmacotherapy failure and progression to botulinum toxin injection in vestibular migraine

“…Oscillopsia describes the perceived sensation of a blurring and jumping external world during either active or passive head movements, and is frequently described as a visual target moving to-and-fro in a rapid fashion. [21][22][23] Oscillopsia is the result of inadequate fixation of the retinal image during head movement. Although commonly associated with bilateral loss of vestibular function and the vestibulo-ocular reflex, oscillopsia can have an anatomical basis anywhere along the neural pathway from the labyrinth and vestibular nerve to the basal ganglia and cerebrum.…”

“…Although commonly associated with bilateral loss of vestibular function and the vestibulo-ocular reflex, oscillopsia can have an anatomical basis anywhere along the neural pathway from the labyrinth and vestibular nerve to the basal ganglia and cerebrum. 21,23 Furthermore, oscillopsia can also be caused by vestibular, oculomotor or cortical hyperactivity, which are all proposed pathophysiological mechanisms of vestibular migraine. 2,24 The prevalence of oscillopsia in patients with vestibular migraine is unknown, although recent reports have described that approximately half of vestibular migraine patients report visual disturbance symptoms.…”

Simulation of Oscillopsia in Virtual Reality

“…Regardless of the type of motion and its severity, oscillopsia is often incapacitating, typically resulting in nausea, vertigo and loss of balance; disabling effective interaction with the world around them. Patients with oscillopsia currently have few opportunities for relief: there are no reliable treatment options and as a result, they struggle to live independent lives (Tilikete and Vighetto 2011;Anson et al 2018;Rowe et al 2018;Tse et al 2017). Anecdotally, a frequent complaint among those with oscillopsia is that they feel neglected and struggle to describe the condition and explain the effect it has on their everyday lives.…”