Worldwide survey on laboratory testing of vestibular function.


Journal

Neurology. Clinical practice
ISSN: 2163-0402
Titre abrégé: Neurol Clin Pract
Pays: United States
ID NLM: 101577149

Informations de publication

Date de publication:
Oct 2020
Historique:
received: 16 05 2019
accepted: 26 08 2019
entrez: 10 12 2020
pubmed: 11 12 2020
medline: 11 12 2020
Statut: ppublish

Résumé

The function of the peripheral vestibular system can nowadays be quantified. The video head impulse test (vHIT) and caloric irrigation are used for the semicircular canals, cervical vestibular evoked myogenic potentials (cVEMP) for the sacculus, and ocular vestibular evoked myogenic potentials (oVEMP) for the utriculus. Because there is no agreement on normal and pathologic values, we performed a worldwide survey. A web-based standardized survey questionnaire was used to collect data on "reference values" and "cutoff" values. Thirty-eight centers from all continents (except Africa) replied. "Reference values": vHIT: mean for the vestibulo-ocular reflex gain of the left horizontal canal 0.91 (range: 0.7-1.01) and of the left horizontal canal 0.92 (0.7-1.05); side difference 0.15 (0.25-0.3). Caloric irrigation: mean peak slow phase velocity of caloric-induced nystagmus for warm (44°C) water 18.65°/s (12-30°/s); cold (30°C) water 18.21°/s (10-25°/s). cVEMP: P13-N23 amplitude mean for the lower limit 28.67 μV (16-50 μV); upper limit 200 μV (50-350 μV). "Cutoff values": vHIT: side difference 0.26 (0.1-0.4), bilateral vestibulopathy <0.61 (0.3-0.8); unilateral vestibulopathy (UVP) <0.68 (0.4-0.8). Caloric irrigation pathologic side difference mean 25.93% (17.7%-40%) or 12°/sec (5-30°/s); side difference UVP 26.73% (20%-40%) or 29.8°/s (5-100°/s). cVEMP: P13/N23 amplitude mean lower cutoff 32.5 μV (15-50 μV), mean upper cutoff 125 μV (50-200 μV), asymmetry 36.08 μV (20-50 μV). This worldwide survey showed a large variability in terms of reference and pathologic cutoff values in the 38 centers included. Therefore, standardization of how to achieve these values and agreement on which values should be used is highly warranted to guarantee a high quality of vestibular testing and interpretation of clinical and scientific results.

Sections du résumé

BACKGROUND BACKGROUND
The function of the peripheral vestibular system can nowadays be quantified. The video head impulse test (vHIT) and caloric irrigation are used for the semicircular canals, cervical vestibular evoked myogenic potentials (cVEMP) for the sacculus, and ocular vestibular evoked myogenic potentials (oVEMP) for the utriculus. Because there is no agreement on normal and pathologic values, we performed a worldwide survey.
METHODS METHODS
A web-based standardized survey questionnaire was used to collect data on "reference values" and "cutoff" values. Thirty-eight centers from all continents (except Africa) replied.
RESULTS RESULTS
"Reference values": vHIT: mean for the vestibulo-ocular reflex gain of the left horizontal canal 0.91 (range: 0.7-1.01) and of the left horizontal canal 0.92 (0.7-1.05); side difference 0.15 (0.25-0.3). Caloric irrigation: mean peak slow phase velocity of caloric-induced nystagmus for warm (44°C) water 18.65°/s (12-30°/s); cold (30°C) water 18.21°/s (10-25°/s). cVEMP: P13-N23 amplitude mean for the lower limit 28.67 μV (16-50 μV); upper limit 200 μV (50-350 μV). "Cutoff values": vHIT: side difference 0.26 (0.1-0.4), bilateral vestibulopathy <0.61 (0.3-0.8); unilateral vestibulopathy (UVP) <0.68 (0.4-0.8). Caloric irrigation pathologic side difference mean 25.93% (17.7%-40%) or 12°/sec (5-30°/s); side difference UVP 26.73% (20%-40%) or 29.8°/s (5-100°/s). cVEMP: P13/N23 amplitude mean lower cutoff 32.5 μV (15-50 μV), mean upper cutoff 125 μV (50-200 μV), asymmetry 36.08 μV (20-50 μV).
CONCLUSION CONCLUSIONS
This worldwide survey showed a large variability in terms of reference and pathologic cutoff values in the 38 centers included. Therefore, standardization of how to achieve these values and agreement on which values should be used is highly warranted to guarantee a high quality of vestibular testing and interpretation of clinical and scientific results.

Identifiants

pubmed: 33299665
doi: 10.1212/CPJ.0000000000000744
pii: NEURCLINPRACT2019040881
pmc: PMC7717631
doi:

Types de publication

Journal Article

Langues

eng

Pagination

379-387

Informations de copyright

© 2019 American Academy of Neurology.

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Auteurs

Michael Strupp (M)

Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands.

Joy Grimberg (J)

Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands.

Julian Teufel (J)

Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands.

Göran Laurell (G)

Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands.

Herman Kingma (H)

Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands.

Eva Grill (E)

Department of Neurology and German Center for Vertigo and Balance Disorders (MS, JT), Ludwig Maximilians University, Munich, Campus Grosshadern, Germany; Institute for Medical Information Processing (JG, EG), Biometrics and Epidemiology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany; Department of Surgical Sciences (GL), Uppsala University, Sweden; and Department of Otolaryngology (HK), Maastricht University Medical Centre, The Netherlands.

Classifications MeSH