Head Shake Computerized Dynamic Posturography in Peripheral Vestibular Lesions

Abstract

The head shake modification to standard SOT increased the test sensitivity to identification of patients with unilateral, peripheral vestibular hypofunction and those with head movement provoked symptoms. However, this occurred with low specificity, resulting in no significant improvement in overall performance with this head shake protocol. Suggestions for further research to improve the performance of the head shake modification of SOT for clinical application are discussed.

Vestibular functioning and migraine: pilot study comparing those with and without vertigo

“…24 The head shake sensory organisation test was developed partly because of the insensitivity of the sensory organisation test for examining vestibular lesions. 24,25,29,30 The current study revealed no statistically significant difference between the migrainous vertigo group and the migraine without vertigo group on the fixed head shake sensory organisation test. In condition 2 of the sensory organisation test, participants are required to stand on a firm surface with their eyes closed.…”

“…In contrast to these findings, Mirsha et al, in a study comparing participants with normal and abnormal vestibular systems, found good specificity and poor sensitivity for condition 2, but found the opposite for condition 5. 25 The head shake sensory organisation test has not been employed in studies of migraine or migrainous vertigo.…”

“…The utilisation of these tests in those with abnormal vestibular systems, and more specifically migrainous vertigo, has led to various conclusions. 6,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Pritcher et al 19 and Whitney et al 20 performed studies using the gaze stabilisation test. Pritcher et al found that the test results were abnormal in people with vestibular abnormalities, especially during pitch plane movements.…”

“…[16][17][18][19][20][21][22][23][24][25][26][27][28] However, few studies have attempted to define these aspects of the vestibular system in those with migraine, and fewer still have focused specifically on migrainous vertigo.…”

“…14 The vestibular ocular reflex and components of the vestibular spinal reflex have been measured in several different ways in those with abnormal vestibular systems (those with vertigo, postural instability and visual abnormalities), and more specifically in those with migrainous vertigo. 6,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Tests of the vestibular ocular reflex include the gaze stabilisation test, which measures how fast the head can move while maintaining a visual image, and the dynamic visual acuity test, which compares visual acuity with the head still and the head moving. 19 Tests of vestibular spinal reflex components, more specifically balance, include: the sensory organisation test, which examines the influence of the visual, somatosensory and vestibular systems in maintaining balance; and the head shake sensory organisation test, which measures the influence of the somatosensory and vestibular systems in maintaining balance during head movement.…”