The association between video-nystagmography and sensory organization test of computerized dynamic posturography in patients with vestibular symptoms

Gofrit, Shany G; Ilan, Ophir; Mayler, Yulia; Eliashar, Ron; Bdolah‐Abram, Tali; M, de Jong; Gross, Menachem

doi:10.1007/s00405-019-05626-y

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…It can provide insight into the presence of postural instability, and helps identify which sensory system is involved although it does not provide a topographic diagnosis. The sensory organization test (SOT) protocol of CDP determines which sensory inputs the patient relies upon most to maintain postural stability, and monitor central compensatory state [17] . The SOT assesses the ability of individuals to evaluate and coordinate information from the somatosensory, visual and vestibular systems as well.…”

Section: Introductionmentioning

confidence: 99%

Assessment of balance after recovery from Covid-19 disease

et al. 2022

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Objective: To answer the question whether balance related systems have been affected in adults who recovered from Covid-19 disease. This is the first case-control study to assess balance objectively and quantitatively in Covid-19 disease. Methods: Thirty-seven patients who recovered from Covid-19 disease and 30 healthy controls were compared using Dizziness Handicap Inventory (DHI), Computerized Dynamic Posturography (CDP), Vestibular Evoked Myogenic Potentials(VEMP) and Video Head Impulse Test (v-HIT). Results: On CDP, the composite and visual general scores of the patients were significantly lower than controls (p<0.01). The v-HIT gains of the patients significantly decreased in the vertical semicircular canals compared to controls (p<0.01).There was a significant difference between the patients and controls regarding the absence of o-VEMPs (p<0.01) while the amplitudes and latencies were similar between the groups (p>0.05). Decreased P1/N1 amplitudes and elongated N1 latencies were found on c-VEMP testing (p<0.05). Anosmia, taste disorder and gender were not associated with subjective and objective test results (p>0.05). Conclusion: The Covid-19 disease can cause dizziness rather that incapacitating vertigo. Dizziness can be seen in almost one-fifth of the adult covid19 out-patients, which may be due to involvement of vestibular and visual systems,ortheir central connections. The squeals created in the balance related systems may be irreversible as they have persisted after the recovery of the patients. It is also plausible to anticipate more severe condition in the older patients who were treated in the intensive care units. In the long term follow up of the survivors, the need for balance rehabilitation programs should be remembered in order to minimize risks of falling down.

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Section: Introductionmentioning

confidence: 99%

Assessment of balance after recovery from Covid-19 disease

et al. 2022

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“…The sensory organization test (SOT) of CDP provides the information about sensory inputs used to maintain postural stability as well as central compensatory state. The SOT measures the capability of evaluating and coordinating the incoming data from somatosensory, visual, and vestibular systems [6]. In this study, we aimed to investigate the peripheral vestibular system involvement in MS and associations with the severity of MS.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Vestibular System Involvement in Multiple Sclerosis and Associations with the Disease Severity

Cantürk¹,

Mutlu²,

Yılmaz³

et al. 2023

ORL

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Introduction: Multiple sclerosis (MS) is an autoimmune disease that can affect balance, gait, and improve fall risk. The aim of this study was to investigate peripheral vestibular system involvement in MS and associations with the disease severity. Methods: Thirty-five adult patients with MS and 14 age- and gender-matched healthy controls were evaluated using video head impulse test (v-HIT), cervical vestibular evoked myogenic potential (c-VEMP), ocular vestibular evoked myogenic potentials (o-VEMPs), and sensory organization test (SOT) of computerized dynamic posturography (CDP). The results of both groups were compared, and association with EDSS scores was evaluated. Results: There was no significant difference between the groups regarding v-HIT and c-VEMP results (p > 0.05). There was no association of the v-HIT, c-VEMP, and o-VEMP results with EDSS scores (p > 0.05). There was no significant difference between the o-VEMP results of the groups (p > 0.05) except for N1-P1 amplitudes (p = 0.01). The amplitudes of N1-P1 were significantly lower in the patients compared to controls (p = 0.01). There was no significant difference between the SOT results of the groups (p > 0.05). However, significant differences were found within and between groups when the patients were categorized according to their EDSS scores with a cutoff point of 3 (p < 0.05). There were negative correlations between the EDSS scores and composite (r = −396, p = 0.02) and somatosensory (SOM) scores (r = −487, p = 0.04) of CDP in the MS group. Conclusion: Although central and peripheral balance-related systems are affected in MS, the impact of disease on the peripheral vestibular end organ is subtle. In particular, the v-HIT, which was mentioned previously as a detector of brainstem dysfunction could not be a reliable tool in the detection of brainstem pathologies in MS patients. The o-VEMP amplitudes may be affected in the early stages of the disease, possibly due to the crossed ventral tegmental tract, oculomotor nuclei, or interstitial nucleus of Cajal involvements. An EDSS score >3 seems a cutoff level indicating abnormalities in balance integration.

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“…3 For example, CDP results correlate poorly with other vestibular tests, yielding only 50% sensitivity on meta-analysis for detecting confirmed vestibulopathies. 1,4,5 A cornerstone of US healthcare policy is the deimplementation of low-value services that provide little benefit, cause harm, or inflict unnecessary costs. 6 We aimed to quantify CDP utilization, by geographic region, and provider specialty to inform efforts to optimize health services for dizziness.…”

mentioning

confidence: 99%

“…CDP is not uniformly covered by US commercial insurers who justify exclusion based on weak evidence of benefit on patient‐relevant outcomes 3 . For example, CDP results correlate poorly with other vestibular tests, yielding only 50% sensitivity on meta‐analysis for detecting confirmed vestibulopathies 1,4,5 …”

mentioning

confidence: 99%

Nationwide Utilization of Computerized Dynamic Posturography in an Era of Deimplementation

Chieffe

Zuniga

Marmor

et al. 2023

Otolaryngol.--head neck surg.

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Computerized dynamic posturography (CDP) provides multisensory assessment of balance. Consensus is lacking regarding CDP utility and coverage determinations vary. To inform best practices and policy, this cross‐sectional study quantifies provider use of CDP among Medicare beneficiaries over time (2012‐2017), by geographic region (hospital referral region [HRR]), and specialty. We observed 195,267 beneficiaries underwent 212,847 CDP tests totaling $15,780,001 in payments. Number of CDPs billed per 100,000 beneficiaries varied 534‐fold across HRRs. Over 6 years, CDP use grew by 84% despite stagnant reimbursement. More utilization was attributable to primary care clinicians than specialties focused on care for dizziness and balance disorders. The observed growth and variation illustrate the potential for policy and provider preferences to drive unexpected practice patterns and underscore the need to engage a broad network of providers to develop optimal guidelines for use. CDP may offer a use case for deimplementation of low‐value diagnostic services.

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The association between video-nystagmography and sensory organization test of computerized dynamic posturography in patients with vestibular symptoms

Cited by 5 publications

References 12 publications

Assessment of balance after recovery from Covid-19 disease

Assessment of balance after recovery from Covid-19 disease

Peripheral Vestibular System Involvement in Multiple Sclerosis and Associations with the Disease Severity

Nationwide Utilization of Computerized Dynamic Posturography in an Era of Deimplementation

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