Ethanol consumption impairs vestibulo-ocular reflex function measured by the video head impulse test and dynamic visual acuity

Abstract

Ethanol affects many parts of the nervous system, from the periphery to higher cognitive functions. Due to the established effects of ethanol on vestibular and oculomotor function, we wished to examine its effect on two new tests of the vestibuloocular reflex (VOR): the video head impulse test (vHIT) and dynamic visual acuity (DVA). We tested eight healthy subjects with no history of vestibular disease after consumption of standardized drinks of 40% ethanol. We used a repeated measures design to track vestibular function over multiple rounds of ethanol consumption up to a maximum breath alcohol concentration (BrAC) of 1.38 per mil. All tests were normal at baseline. VOR gain measured by vHIT decreased by 25% at the highest BrAC level tested in each subject. Catch-up saccades were negligible at baseline and increased in number and size with increasing ethanol consumption (from 0.13 • to 1.43 • cumulative amplitude per trial). DVA scores increased by 86% indicating a deterioration of acuity, while static visual acuity (SVA) remained unchanged. Ethanol consumption systematically impaired the VOR evoked by high-acceleration head impulses and led to a functional loss of visual acuity during head movement.

Dose‐dependent sensorimotor impairment in human ocular tracking after acute low‐dose alcohol administration

“…The impairment of eye movements by EtOH has been previously described across the entire gamut of voluntary and reflexive human oculomotor behaviours: saccades (Vorstius et al 2008;Roche & King, 2010;Silva et al 2017), smooth pursuit (Lehtinen et al 1982;Blekher et al 1997;Fransson et al 2010), vergence (Miller et al 1986;Miller, 1991), eccentric fixation (Romano et al 2017), the vestibulo-ocular reflex (Takahashi et al 1989;Post et al 1994;Roth et al 2014) and optokinetic nystagmus (Mizoi et al 1969). Previous studies showed that steady-state, closed-loop pursuit gain during tracking of sinusoidal or step-ramp target motion was significantly decreased at levels ranging from 0.04 to 0.10% BAC (Fransson et al 2010;Roche & King, 2010).…”

Current diagnostic procedures for diagnosing vertigo and dizziness

“…Current studies could show that e.g. even alcohol and drugs may influence the results [ 178 ], [ 179 ], [ 180 ]. Furthermore, it became obvious that the highly-frequent hVOR is early impaired by gentamicin.…”

“…They are the measure for the assessment. Regarding the evaluation of the findings, also ENT specific reporting has to take into account that for example alcohol and drugs may influence the result of modern diagnostics [ 178 ], [ 179 ], [ 180 ].…”

Moderne Schwindeldiagnostik

“…Aktuelle Studien haben gezeigt, dass z. B. auch Alkohol und Medikamente das Ergebnis beeinflussen können [178][179][180]. Darüber hinaus zeigt sich, dass der hochfrequente hVOR durch Gentamicin frühzeitig beeinträchtigt wird.…”

“…Bei der Bewertung der Befunde muss auch im Rahmen der HNO-Begutachtung berücksichtigt werden, dass z. B. Alkohol und Medikamente das Ergebnis moderner Diagnostik beeinflussen können [178][179][180].…”