Comparison of Suppression Head Impulse and Conventional Head Impulse Test Protocols

Roh, Kyung Jin; Kim, Ju Young; Son, Eun Ju

doi:10.21790/rvs.2019.18.4.91

Cited by 13 publications

(8 citation statements)

References 22 publications

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“…However, there have been studies that had observed covert saccades in SHIMP. These studies observed that covert saccades in SHIMP are far and few in between, and while subjects consistently generated overt saccades (except in acute vestibulopathy), covert saccades are rare ( 12 , 19 , 26 , 27 ). In the current study, a third of the children generated covert saccades in the SHIMP paradigm but they were generated only in 6–10% of the head impulses delivered.…”

Section: Discussionmentioning

confidence: 96%

Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

Dasgupta,

Crunkhorn,

Wong

et al. 2024

Front. Neurol.

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The suppression head impulse paradigm (SHIMP) involves suppression of the vestibulo-ocular reflex (VOR) and anticompensatory saccades generated thereof. SHIMP is gaining importance to understand vestibular compensation with its different parameters (VOR gain/peak saccadic velocity PSV/latency of saccades). SHIMP studies are emerging in adults, but pediatric studies have hardly been performed. This study is a retrospective case note audit over a period of 2 months in a tertiary pediatric vestibular center in the United Kingdom to investigate whether SHIMP is safe/robust to be used in children conforming to existing standards/norms in normal children and whether it yields any meaningful inferences in pediatric vestibular hypofunction. This is the largest pediatric SHIMP study to date. A total of 44 referred children (6–18 years, female children>male children) with a range of complaints from dizziness, imbalance, motor incoordination, postural instability, and hearing loss were included, and their SHIMP parameters were measured. All children underwent comprehensive functional/objective audiovestibular assessments. Two groups were defined—Group A with normal vestibular function and Group B with abnormal vestibular function. The normal population showed an average SHIMP VOR gain of 0.98+/−0.08 and latency of overt saccades at 215.68+/–46.16 milliseconds agreeing with published evidence. The PSV of overt saccades was 315.39+/−56.30/s, and there was a gain asymmetry of 7.42+/−4.68 between the sides. Statistically significant differences with moderate/large effect sizes were observed between the groups in terms of VOR gain and PSV but not in saccade latencies. Covert saccades were rare in SHIMP, while overt saccades were observed in 100% of children. VOR gain difference between the head impulse paradigm (HIMP) and the SHIMP was significant as well. We observed statistically significant differences in side asymmetry of VOR gain between the groups. Furthermore, we identified a group of children with cerebellar lesions where overt saccades in SHIMP were rather low in number. Further research is recommended to investigate pediatric PSV, asymmetry, and inability to generate overt saccades that may suggest useful means to assess compensation and central function. We conclude that SHIMP yields valuable information and is a safe, easy to perform, and a reliable test that should be used in children to supplement HIMP.

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Section: Discussionmentioning

confidence: 96%

Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

Dasgupta,

Crunkhorn,

Wong

et al. 2024

Front. Neurol.

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“…This result concurs with the findings of previous studies that documented a strong correlation between the VOR gain obtained with HIMP and SHIMP. 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

“…This characteristic reduces the error in measuring the VOR resulting from covert saccades and spontaneous nystagmus. 13 , 14 Hence, SHIMP testing provides more accurate information on the horizontal VOR gain than the HIMP. 4 Regarding covert saccades, no correlation was observed between the results obtained with the 2 paradigms ( Figure 2 ); this finding could explain the lower VOR gain measured using the SHIMP in bilateral vestibular loss.…”

Section: Discussionmentioning

confidence: 99%

“…This result is consistent with the finding of a previous study that documented a strong negative correlation between HIMP and SHIMP findings in overt saccade amplitude and percentage. 14 The addition of SHIMPs paradigm declares the value of vestibulo-saccadic interaction as a tool for follow-up of the residual vestibular function in patients with VN. 15 …”

Section: Discussionmentioning

confidence: 99%

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The Conventional Head Impulse Test Versus the Suppression Head Impulse Test: A Clinical Comparative Study

Elsherif

2023

Int Adv Otol

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Background: The suppression head impulse test is a new paradigm of the head impulse test, recently introduced for clinical use. The aim of this study was to assess the importance of the suppression head impulse paradigm in evaluating vestibular function. Methods: This comparative study was conducted from June 2020 to June 2022. The ears of the participants were divided into 2 groups: (i) ears with vestibular weakness and (ii) healthy controls. All participants underwent video head impulse tests at the time of presentation with both conventional head impulse paradigm and suppression head impulse paradigm, performed by the same examiner. The results of the 2 tests were compared, and the correlation between the corresponding parameters obtained (vestibulo-ocular reflex gain and saccades) was examined. Results: Ninety-five participants were included in the study (190 ears) with a mean age of 42.2 ± 12.6 years. Forty-six ears had vestibular weakness, and 144 were healthy controls. The suppression head impulse paradigm test showed a significantly lower vestibulo-ocular reflex gain than the head impulse paradigm in both groups. A positive correlation emerged between the vestibulo-ocular reflex gain measured with both paradigms. Regarding the saccades, a negative correlation was observed between the overt saccades latency and amplitude measured with both paradigms. Conclusion: The new suppression head impulse paradigm complements the head impulse paradigm for a better evaluation of the vestibular function. The inconsistency of covert saccades in suppression head impulse paradigm makes it superior to head impulse paradigm in measuring vestibulo-ocular reflex gain, especially in patients with vestibular loss.

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“…When performing video-nystagmography, slippage occurs because of the heavy weight of the device or quick changes in posture when performing the diagnosis [31][32][33] , causing motion artifacts in the pupil trajectory. As device slippage occurs at a high frequency, signi cant efforts have been made to prevent slipping in the diagnostic stage 34,35 . According to our research, studies on removing motion artifacts from the perspective of signal processing have not been conducted.…”

Section: Introductionmentioning

confidence: 99%

ANyEye: A nystagmus extraction system optimized in video-nystagmography using artificial intelligence for diagnostic assistance of benign paroxysmal positional vertigo

Lee

Han

et al. 2023

Preprint

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Benign paroxysmal positional vertigo (BPPV), the most common vestibular disorder, is diagnosed by an examiner changing the posture of the examinee and inducing nystagmus. Among the diagnostic methods used to observe nystagmus, video-nystagmography has been widely used recently because it is non-invasive. A specialist with professional knowledge and training in vertigo diagnosis is needed to diagnose BPPV accurately, but the ratio of vertigo patients to specialists is too high, thus necessitating the need for automated diagnosis of BPPV. In this paper, a convolutional neural network-based nystagmus extraction system, ANyEye, optimized for video-nystagmography data is proposed in the first study on automating BPPV diagnosis. A pupil was segmented to track the exact pupil trajectory from real-world data obtained during field inspection. A deep convolutional neural network model was trained with the new video-nystagmography dataset for the pupil segmentation task, and a compensation algorithm was designed to correct pupil position. In addition, a slippage detection algorithm based on moving averages was designed to eliminate the motion artifacts induced by goggle slippage. ANyEye outperformed other eye-tracking methods including learning and non-learning based algorithms with five-pixel error detection rate of 91.26%.

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Comparison of Suppression Head Impulse and Conventional Head Impulse Test Protocols

Cited by 13 publications

References 22 publications

Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

Suppression head impulse test in children—experiences in a tertiary paediatric vestibular centre

The Conventional Head Impulse Test Versus the Suppression Head Impulse Test: A Clinical Comparative Study

ANyEye: A nystagmus extraction system optimized in video-nystagmography using artificial intelligence for diagnostic assistance of benign paroxysmal positional vertigo

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