Effects of Device on Video Head Impulse Test (vHIT) Gain

Abstract

Background:

Numerous video head impulse test (vHIT) devices are available commercially; however, gain is not calculated uniformly. An evaluation of these devices/algorithms in healthy controls and patients with vestibular loss is necessary for comparing and synthesizing work that utilizes different devices and gain calculations.

Purpose:

Using three commercially available vHIT devices/algorithms, the purpose of the present study was to compare: (1) horizontal canal vHIT gain among devices/algorithms in normal control subjects; (2) the effects of age on vHIT gain for each device/algorithm in normal control subjects; and (3) the clinical performance of horizontal canal vHIT gain between devices/algorithms for differentiating normal versus abnormal vestibular function.

Research Design:

Prospective.

Study Sample:

Sixty-one normal control adult subjects (range 20–78) and eleven adults with unilateral or bilateral vestibular loss (range 32–79).

Data Collection and Analysis:

vHIT was administered using three different devices/algorithms, randomized in order, for each subject on the same day: (1) Impulse (Otometrics, Schaumberg, IL; monocular eye recording, right eye only; using area under the curve gain), (2) EyeSeeCam (Interacoustics, Denmark; monocular eye recording, left eye only; using instantaneous gain), and (3) VisualEyes (MicroMedical, Chatham, IL, binocular eye recording; using position gain).

Results:

There was a significant mean difference in vHIT gain among devices/algorithms for both the normal control and vestibular loss groups. vHIT gain was significantly larger in the ipsilateral direction of the eye used to measure gain; however, in spite of the significant mean differences in vHIT gain among devices/algorithms and the significant directional bias, classification of “normal” versus “abnormal” gain is consistent across all compared devices/algorithms, with the exception of instantaneous gain at 40 msec. There was not an effect of age on vHIT gain up to 78 years regardless of the device/algorithm.

Conclusions:

These findings support that vHIT gain is significantly different between devices/algorithms, suggesting that care should be taken when making direct comparisons of absolute gain values between devices/algorithms.

Key Words

aging - vestibular - video head impulse test

The research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under award number P20GM109023, and by the National Institute on Deafness and Other Communication Disorders under award numbers R03DC015318 and P30DC004662.

K.L.J. provided consulting for Otometrics regarding the clinical use of vestibular evoked myogenic potential testing and video head impulse testing (vHIT) during this time frame. Boys Town Nation Research Hospital was a beta site for the Interacoustics EyeSeeCam. University of Nebraska Lincoln (JAH laboratory) was a beta site for MicroMedical vHIT system and Key opinion site with GN Otometrics.

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