Download PDF
J Am Acad Audiol 2022; 33(03): 116-124
DOI: 10.1055/s-0041-1739534
Research Article

Video Head Impulse Test in Persons with Blindness: Feasibility and Outcomes

Raghav Hira Jha
1   Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India
,
Niraj Kumar Singh
2   Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India
,
Prawin Kumar
1   Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Background To achieve balance, persons with blindness (PWB) use proprioceptive and vestibular cues rather than the visual system; however, PWB are equally susceptible to acquire vestibular disorders. Reliable assessments of the vestibular system in PWB are essential to determine the presence or absence of vestibular disorders.

Purpose The saccular and the utricular functioning can be assessed using cervical vestibular-evoked myogenic potential and ocular vestibular-evoked myogenic potential, respectively. Evaluation of the functional integrity of the semicircular canals requires an assessment of the vestibular ocular reflex; however, this can be challenging in PWB. Video head impulse test (vHIT) assesses the vestibular ocular reflex (VOR) elicited against the natural high-frequency head movement in the planes of all six semicircular canals. This study aimed to explore the feasibility and outcomes of administering vHIT in PWB.

Research Design Standard (static) groups comparison.

Study Sample Nineteen young PWB and 23 age-matched adults with “normal” vision (control group) were included in the study.

Data Collection and Analyses PWB underwent vHIT once, while the control group was tested in three conditions; condition 1 was used to simulate blindness for the control group, where vHIT was done in a pitch-dark room without prior instructions; condition 2 included vHIT testing in daylight, without a fixed visual target and any instructions; and condition 3 involved vHIT in daylight in the presence of a set visual target and with standard instructions to maintain visual focus on the visual target.

Results The VOR gain was abnormal in the PWB group for all the canals. Among the PWB, the lateral canals (mean = 0.63) had the best VOR gain, followed by the anterior canals (mean = 0.53) and the posterior canals (mean = 0.31). In the control group, the VOR gain was significantly reduced in condition 1. There was no significant difference between the VOR gain in the PWB group and the control group in condition 1 for the lateral and the anterior canals. A higher proportion of participants in the PWB group had the presence of refixation saccades.

Conclusion VOR is significantly reduced in PWB but not completely absent. There may be a need to develop normative data for blind individuals to decide whether or not a person with blindness has a vestibular dysfunction, specifically a VOR deficit.

Keywords

PWB - simulated blindness - vHIT - VOR gain - saccades

Disclaimer

Any mention of a product, service, or procedure in the Journal of the American Academy of Audiology does not constitute an endorsement of the product, service, or procedure by the American Academy of Audiology.


Supplementary Material



Publication History

Received: 13 March 2021

Accepted: 24 September 2021

Article published online:
10 October 2022

© 2022. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Grace Gaerlan M, Alpert PT, Cross C, Louis M, Kowalski S. Postural balance in young adults: the role of visual, vestibular and somatosensory systems. J Am Acad Nurse Pract 2012; 24 (06) 375-381
    CrossrefPubMedGoogle Scholar
  • 2 Anand V, Buckley JG, Scally A, Elliott DB. Postural stability changes in the elderly with cataract simulation and refractive blur. Invest Ophthalmol Vis Sci 2003; 44 (11) 4670-4675
    CrossrefPubMedGoogle Scholar
  • 3 Schwartz S, Segal O, Barkana Y, Schwesig R, Avni I, Morad Y. The effect of cataract surgery on postural control. Invest Ophthalmol Vis Sci 2005; 46 (03) 920-924
    CrossrefPubMedGoogle Scholar
  • 4 Friedrich M, Grein HJ, Wicher C. et al. Influence of pathologic and simulated visual dysfunctions on the postural system. Exp Brain Res 2008; 186 (02) 305-314
    CrossrefPubMedGoogle Scholar
  • 5 Abou-Gareeb I, Lewallen S, Bassett K, Courtright P. Gender and blindness: a meta-analysis of population-based prevalence surveys. Ophthalmic Epidemiol 2001; 8 (01) 39-56
    CrossrefPubMedGoogle Scholar
  • 6 Maberley DAL, Hollands H, Chuo J. et al. The prevalence of low vision and blindness in Canada. Eye (Lond) 2006; 20 (03) 341-346
    CrossrefPubMedGoogle Scholar
  • 7 Stevens GA, White RA, Flaxman SR. et al; Vision Loss Expert Group. Global prevalence of vision impairment and blindness: magnitude and temporal trends, 1990-2010. Ophthalmology 2013; 120 (12) 2377-2384
    PubMedGoogle Scholar
  • 8 Daoudi C, Boutimzine N, Haouzi SE. et al. Le syndrome d'Usher: à propos d'une observation. Pan Afr Med J 2017; 27: 217
    CrossrefPubMedGoogle Scholar
  • 9 Lima Neto AC, Bittar R, Gattas GS. et al. Pathophysiology and diagnosis of vertebrobasilar insufficiency: a review of the literature. Int Arch Otorhinolaryngol 2017; 21 (03) 302-307
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Ferrer-Blasco T, González-Méijome JM, Montés-Micó R. Age-related changes in the human visual system and prevalence of refractive conditions in patients attending an eye clinic. J Cataract Refract Surg 2008; 34 (03) 424-432
    CrossrefPubMedGoogle Scholar
  • 11 Welgampola MS, Carey JP. Waiting for the evidence: VEMP testing and the ability to differentiate utricular versus saccular function. Otolaryngol Head Neck Surg 2010; 143 (02) 281-283
    CrossrefPubMedGoogle Scholar
  • 12 Curthoys IS, Iwasaki S, Chihara Y, Ushio M, McGarvie LA, Burgess AM. The ocular vestibular-evoked myogenic potential to air-conducted sound; probable superior vestibular nerve origin. Clin Neurophysiol 2011; 122 (03) 611-616
    CrossrefPubMedGoogle Scholar
  • 13 Orhan EK, Yayla V, Cebeci Z, Baslo MB, Ovalı T, Öge AE. Excitability changes at brainstem and cortical levels in blind subjects. Clin Neurophysiol 2011; 122 (09) 1827-1833
    CrossrefPubMedGoogle Scholar
  • 14 Gauthier GM, Hofferer JM. Eye tracking of self-moved targets in the absence of vision. Exp Brain Res 1976; 26 (02) 121-139
    CrossrefPubMedGoogle Scholar
  • 15 Gottlob I, Wizov SS, Reinecke RD. Head and eye movements in children with low vision. Graefes Arch Clin Exp Ophthalmol 1996; 234 (06) 369-377
    CrossrefPubMedGoogle Scholar
  • 16 Bayram A, Kalkan M, Ünsal N, Kale A, Küçük B, Mutlu C. Does blindness affect ocular vestibular evoked myogenic potentials?. Am J Otolaryngol 2018; 39 (03) 290-292
    CrossrefPubMedGoogle Scholar
  • 17 Gonshor A, Jones GM. Proceedings: changes of human vestibulo-ocular response induced by vision-reversal during head rotation. J Physiol 1973; 234 (02) 102P-103P
    PubMedGoogle Scholar
  • 18 Adel Ghahraman M, Shomeil Shushtari S, Sedaie M, Jalaie S, Tavakkoli M. Effect of late-onset blindness on cervical vestibular evoked myogenic potentials. Am J Otolaryngol 2020; 41 (05) 102575
    CrossrefPubMedGoogle Scholar
  • 19 Guerra Jiménez G, Pérez Fernández N. Reduction in posterior semicircular canal gain by age in video head impulse testing. Observational study [in English]. Acta Otorrinolaringol Esp 2016; 67 (01) 15-22
    PubMedGoogle Scholar
  • 20 Lerchundi F, Laffue AH, Olivier M, Gualtieri FJ. Bilateral posterior semicircular canal dysfunction: a new finding with video head impulse test. J Neurol 2020; 267 (08) 2347-2352
    CrossrefPubMedGoogle Scholar
  • 21 Byun H, Chung JH, Lee SH. Clinical implications of posterior semicircular canal function in idiopathic sudden sensorineural hearing loss. Sci Rep 2020; 10 (01) 8313
    CrossrefPubMedGoogle Scholar
  • 22 Walther LE, Nath V, Krombach GA, Di Martino E. Bilateral posterior semicircular canal aplasia and atypical paroxysmal positional vertigo: a case report. Acta Otorhinolaryngol Ital 2008; 28 (02) 79-82
    PubMedGoogle Scholar
  • 23 Castellucci A, Pepponi E, Bertellini A. et al. Case report: filling defect in posterior semicircular canal on MRI with balanced steady-state gradient-echo sequences after labyrinthine ischemia in the common cochlear artery territory as an early sign of fibrosis. Front Neurol 2021; 11 (January): 608838
    CrossrefPubMedGoogle Scholar
  • 24 Kömpf D, Piper HF. Eye movements and vestibulo-ocular reflex in the blind. J Neurol 1987; 234 (05) 337-341
    CrossrefPubMedGoogle Scholar
  • 25 Schneider RM, Thurtell MJ, Eisele S, Lincoff N, Bala E, Leigh RJ. Neurological basis for eye movements of the blind. PLoS One 2013; 8 (02) e56556
    CrossrefPubMedGoogle Scholar
  • 26 Leigh RJ, Thurston SE, Tomsak RL, Grossman GE, Lanska DJ. Effect of monocular visual loss upon stability of gaze. Invest Ophthalmol Vis Sci 1989; 30 (02) 288-292
    PubMedGoogle Scholar