Research Article

Vestibulo-ocular reflex gain and compensatory saccades in three semicircular canals by video head impulse test


Background and Aim: One of the tools for assessing the vestibulo-ocular reflex (VOR) is using video head impulse test (vHIT). In this test by placing the head at different angles and shaking the head, three semicircular canals of the vestibular system in each ear can be examined separately. The purpose of this study was to investigate the relationship between the low and high velocities of the vHIT test with VOR and its compensatory saccades.
Methods: The vHIT test was performed by an examiner in 49 normal individuals aged 23–39 at low and high velocities. All participants had normal hearing, visual, and vestibular systems.
Results: Mean gains in the horizontal, anterior and posterior semicircular canals in the right ear respectively were 0.92, 1 and 0.90 and in the left ear 0.93, 0.99 and 0.95 for low velocity and 0.78, 0.92 and 0.79 in the right ear and 0.80, 0.85 and 0.86 in the left ear for high velocity. Also, the number of compensatory saccade at high velocity was higher than those at the low velocity and the latency of compensatory saccade was lower at the higher velocity.
Conclusion: In the vHIT test, VOR gain decreases at high velocity that is statistically significant. Also, compensatory saccades are more likely to occur at high velocity with smaller delay. Therefore, high-velocity vHIT test is not recommended for the purpose of examining the VOR gain and compensatory saccade.

1. Maurer C, Mergner T, Bolha B, Hlavacka F. Vestibular, visual, and somatosensory contributions to human control of upright stance. Neurosci Lett. 2000;281(2-3):99-102. doi: 10.1016/S0304-3940(00)00814-4
2. Fernández L, Breinbauer HA, Delano PH. Vertigo and dizziness in the elderly. Front Neurol. 2015;6:144. doi: 10.3389/fneur.2015.00144
3. Rutka JA, Barber HO. Recurrent vestibulopathy: third review. J Otolaryngol. 1986;15(2):105-7.
4. Aw ST, Haslwanter T, Halmagyi GM, Curthoys IS, Yavor RA, Todd MJ. Three-dimensional vector analysis of the human vestibuloocular reflex in response to high-acceleration head rotations. I. Responses in normal subjects. J Neurophysiol. 1996;76(6):4009-20. doi: 10.1152/jn.1996.76.6.4009
5. Collewijn H, Smeets JB. Early components of the human vestibulo-ocular response to head rotation: latency and gain. J Neurophysiol. 2000;84(1):376-89. doi: 10.1152/jn.2000.84.1.376
6. Curthoys IS, MacDougall HG, McGarive LA, Weber KP, Szmulewicz D, Manzari L, et al. The video head impulse test (vHIT). In: Jacobson GP, Shephard NT, editors. Balance function assessment and management. 2nd ed. San Diego, CA: Plural Publishing, Inc.; 2016. p. 391-430.
7. Hullar TE, Della Santina CC, Hirvonen T, Lasker DM, Carey JP, Minor LB. Responses of irregularly discharging chinchilla semicircular canal vestibular-nerve afferents during high-frequency head rotations. J Neurophysiol. 2005;93(5):2777-86. doi: 10.1152/jn.01002.2004
8. Hoshowsky B, Tomlinson D, Nedzelski J. The horizontal vestibulo-ocular reflex gain during active and passive high-frequency head movements. Laryngoscope. 1994;104(2):140-5. doi: 10.1288/00005537-199402000-00004
9. Ulmer E, Chays A. [Curthoys and Halmagyi head impulse test: an analytical device]. Ann Otolaryngol Chir Cervicofac. 2005;122(2):84-90. French. doi: 10.1016/S0003-438X(05)82329-1
10. Wuyts F. Principle of the head impulse (thrust) test or Halmagyi head thrust test (HHTT). B-ENT. 2008;4(8):23-5.
11. Alhabib SF, Saliba I. Video head impulse test: a review of the literature. Eur Arch Otorhinolaryngol. 2017;274(3):1215-22. doi: 10.1007/s00405-016-4157-4
12. Wiener-Vacher SR, Wiener SI. Video head impulse tests with a remote camera system: normative values of semicircular canal vestibulo-ocular reflex gain in infants and children. Front Neurol. 2017;8:434. doi: 10.3389/fneur.2017.00434
13. Weber KP, Aw ST, Todd MJ, McGarvie LA, Curthoys IS, Halmagyi GM. Head impulse test in unilateral vestibular loss: vestibulo-ocular reflex and catch-up saccades. Neurology. 2008;70(6):454-63. doi: 10.1212/01.wnl.0000299117.48935.2e
14. Ramat S, Leigh RJ, Zee DS, Optican LM. What clinical disorders tell us about the neural control of saccadic eye movements. Brain. 2007;130(Pt 1):10-35. doi: 10.1093/brain/awl309
15. Finocchio DV, Preston KL, Fuchs AF. Infant eye movements: quantification of the vestibulo-ocular reflex and visual-vestibular interactions. Vision Res. 1991;31(10):1717-30. doi: 10.1016/0042-6989(91)90022-W
16. MacDougall HG, Weber KP, McGarvie LA, Halmagyi GM, Curthoys IS. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology. 2009;73(14):1134-41. doi: 10.1212/WNL.0b013e3181bacf85
17. Murnane O, Mabrey H, Pearson A, Byrd S, Akin F. Normative data and test-retest reliability of the synapsys video head impulse test. J Am Acad Audiol. 2014;25(3):244-52. doi: 10.3766/jaaa.25.3.3
18. Yang CJ, Lee JY, Kang BC, Lee HS, Yoo MH, Park HJ. Quantitative analysis of gains and catch-up saccades of video-head-impulse testing by age in normal subjects. Clin Otolaryngol. 2016;41(5):532-8. doi: 10.1111/coa.12558
19. Naderi N, Hajiabolhassan F, Farahani S, Yazdani N, Jalaie S. Normative vestibulo-ocular reflex data in yaw and pitch axes using the video head-impulse test. Aud Vestib Res. 2016;25(1):39-48.
20. Matiño-Soler E, Esteller-More E, Martin-Sanchez JC, Martinez-Sanchez JM, Perez-Fernandez N. Normative data on angular vestibulo-ocular responses in the yaw axis measured using the video head impulse test. Otol Neurotol. 2015;36(3):466-71. doi: 10.1097/MAO.0000000000000661
21. Engström H, Bergström B, Rosenhall U. Vestibular sensory epithelia. Arch Otolaryngol. 1974;100(6):411-8.
22. Anson ER, Bigelow RT, Carey JP, Xue QL, Studenski S, Schubert MC, et al. Aging increases compensatory saccade amplitude in the video head impulse test. Front Neurol. 2016;7:113. doi: 10.3389/fneur.2016.00113
23. Schubert MC. Vestibulo-ocular reflex adaptation. In: Herdman SJ, Clendaniel R, editors. Vestibular rehabilitation. 4th ed. Philadelphia, PA: F. A. Davis Company; 2014. p. 20-8.
24. Wall C 3rd, Black FO, Hunt AE. Effects of age, sex and stimulus parameters upon vestibulo-ocular responses to sinusoidal rotation. Acta Otolaryngol. 1984;98(3-4):270-8.
25. McGarvie LA, MacDougall HG, Halmagyi GM, Burgess AM, Weber KP, Curthoys IS. The video head impulse test (vHIT) of semicircular canal function - age-dependent normative values of VOR gain in healthy subjects. Front Neurol. 2015;6:154. doi: 10.3389/fneur.2015.00154
26. Maheu M, Houde MS, Landry SP, Champoux F. The effects of aging on clinical vestibular evaluations. Front Neurol. 2015;6:205. doi: 10.3389/fneur.2015.00205
27. Mossman B, Mossman S, Purdie G, Schneider E. Age dependent normal horizontal VOR gain of head impulse test as measured with video-oculography. J Otolaryngol Head Neck Surg. 2015;44:29. doi: 10.1186/s40463-015-0081-7
IssueVol 28 No 1 (2019) QRcode
SectionResearch Article(s)
Video head impulse test; vestibulo-ocular reflex gain; compensatory saccade

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How to Cite
Zarrinkoob H, Behzad H, Tabatabaee SM. Vestibulo-ocular reflex gain and compensatory saccades in three semicircular canals by video head impulse test. Aud Vestib Res. 2018;28(1):42-48.