“…It is noteworthy that the recommended range for identifying normal SVV or SVH performance with these devices (±3 degrees) is highly consistent with the quantile distribution of the normative data in Table 1 . Other cutoffs for abnormal SVH in published studies, such as ±2.5 degrees ( 29 ), simply reflect a different likelihood of false negative findings.…”
Objectives:
Judgments of the subjective visual vertical (SVV) and subjective visual horizontal (SVH) while seated upright are commonly included in standard clinical test batteries for vestibular function. We examined SVV and SVH data from retrospective control to assess their statistical distributions and normative values for magnitudes of the preset effect, sex differences, and fixed-head versus head-free device platforms for assessment.
Methods:
Retrospective clinical SVV and SVH data from 2 test platforms, Neuro-otologic Test Center (NOTC) and the Neurolign Dx 100 (I-Portal Portable Assessment System Nystagmograph) were analyzed statistically (SPSS and MATLAB software) for 408 healthy male and female civilians and military service members, aged 18–50 years.
Results:
No prominent age-related effects were observed. The preset angle effects for both SVV and SVH, and their deviations from orthogonality, agree in magnitude with previous reports. Differences attributable to interactions with device type and sex are of small magnitude. Analyses confirmed that common clinical measure for SVV and SVH, the average of equal numbers of clockwise and counterclockwise preset trials, was not significantly affected by the test device or sex of the subject. Finally, distributional analyses failed to reject the hypothesis of underlying Gaussian distributions for the clinical metrics.
Conclusions:
z scores based on these normative findings can be used for objective detection of outliers from normal functional limits in the clinic.
“…It is noteworthy that the recommended range for identifying normal SVV or SVH performance with these devices (±3 degrees) is highly consistent with the quantile distribution of the normative data in Table 1 . Other cutoffs for abnormal SVH in published studies, such as ±2.5 degrees ( 29 ), simply reflect a different likelihood of false negative findings.…”
Objectives:
Judgments of the subjective visual vertical (SVV) and subjective visual horizontal (SVH) while seated upright are commonly included in standard clinical test batteries for vestibular function. We examined SVV and SVH data from retrospective control to assess their statistical distributions and normative values for magnitudes of the preset effect, sex differences, and fixed-head versus head-free device platforms for assessment.
Methods:
Retrospective clinical SVV and SVH data from 2 test platforms, Neuro-otologic Test Center (NOTC) and the Neurolign Dx 100 (I-Portal Portable Assessment System Nystagmograph) were analyzed statistically (SPSS and MATLAB software) for 408 healthy male and female civilians and military service members, aged 18–50 years.
Results:
No prominent age-related effects were observed. The preset angle effects for both SVV and SVH, and their deviations from orthogonality, agree in magnitude with previous reports. Differences attributable to interactions with device type and sex are of small magnitude. Analyses confirmed that common clinical measure for SVV and SVH, the average of equal numbers of clockwise and counterclockwise preset trials, was not significantly affected by the test device or sex of the subject. Finally, distributional analyses failed to reject the hypothesis of underlying Gaussian distributions for the clinical metrics.
Conclusions:
z scores based on these normative findings can be used for objective detection of outliers from normal functional limits in the clinic.
“…Im Gegensatz dazu reflektiert die SVV SVV die statische Utrikulusfunktion statische Utrikulusfunktion und bildet damit überwiegend die Integrität der vestibulären Typ-II-Haarzellen und der Afferenzen mit regulärer Ruheaktivität in der Extrastriola Extrastriola ab. Außerdem ist der Einfluss der zentral-vestibulären Kompensation auf beide Parameter bei einem persistierenden Otolithendefizit unterschiedlich: Während sich die SVV im Laufe der Kompensation normalisiert, sind die oVEMP-Antworten selbst Jahre nach einem Otolithenschaden noch reduziert/ausgefallen [ 12 , 27 , 38 ].…”
ZusammenfassungPatient:innen mit dem Leitsymptom „Schwindel“ stellen häufig eine diagnostische Herausforderung für die betreuenden Hals-Nasen-Ohren-Ärzt:innen dar. Während im ersten Teil dieser Fortbildungsreihe der Fokus auf der Anamnese und klinisch-neurootologischen Untersuchung lag, behandelt der vorliegende zweite Teil wichtige Aspekte der „schwierigen“ apparativen Vestibularisprüfung, insbesondere: Indikationsstellung, Lösungsansätze bei eingeschränkter Kooperationsfähigkeit der Patient:innen, Auswahl der vestibulären Tests in Abhängigkeit von Komorbiditäten, Interpretation von diskrepanten Befunden aus einzelnen Teiluntersuchungen. Des Weiteren wird dargelegt, welche Schlussfolgerungen aus einer normwertigen Vestibularisprüfung gezogen werden können (und welche nicht) und wie dieses Ergebnis den Patient:innen erläutert werden kann.
“…The related concept of verticality (gravitational) perception can be evaluated using several different frameworks. Arguably the most common clinical method of verticality perception is subjective visual vertical (SVV) ( 126 – 129 ); although, subjective visual horizontal testing can also be examined ( 73 , 130 , 131 ). Visual vertical/horizontal perception involves orienting or judging a line with respect to the perceived direction of gravity (or orthogonal to gravity in the case of horizontal estimates) and implies integration of vision and otolithic function ( 127 , 129 , 130 , 132 ).…”
Section: Vestibular Perception: Spatial Orientation and Verticalitymentioning
confidence: 99%
“…Arguably the most common clinical method of verticality perception is subjective visual vertical (SVV) ( 126 – 129 ); although, subjective visual horizontal testing can also be examined ( 73 , 130 , 131 ). Visual vertical/horizontal perception involves orienting or judging a line with respect to the perceived direction of gravity (or orthogonal to gravity in the case of horizontal estimates) and implies integration of vision and otolithic function ( 127 , 129 , 130 , 132 ). These methods are often applied as a solitary line in an otherwise featureless environment ( 133 ), but can also be presented with disorienting visual cues such as a tilted frame or rotating disc to evaluate the degree of visual dependence ( 134 – 137 ).…”
Section: Vestibular Perception: Spatial Orientation and Verticalitymentioning
Not all dizziness presents as vertigo, suggesting other perceptual symptoms for individuals with vestibular disease. These non-specific perceptual complaints of dizziness have led to a recent resurgence in literature examining vestibular perceptual testing with the aim to enhance clinical diagnostics and therapeutics. Recent evidence supports incorporating rehabilitation methods to retrain vestibular perception. This review describes the current field of vestibular perceptual testing from scientific laboratory techniques that may not be clinic friendly to some low-tech options that may be more clinic friendly. Limitations are highlighted suggesting directions for additional research.
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