Evaluation of Suppression Head Impulse Paradigm (SHIMP) and the Video Head Impulse Test (vHIT) in Patients with Meniere’s disease with Proven Vestibular and Auditory Loss

Öz

This study aimed to examine the results of the video head impulse test (vHIT), and suppression head impulse paradigm (SHIMP) in adult diagnosed with definite Meniere’s disease (MD). This study was conducted with 20 patients aged 18-45 years with canal paresis and sensorineural type hearing loss in symptomatic ears, who were diagnosed with unilateral definite MD. The subjects were assessed with conventional audiometry (0.125–8 kHz), the bithermal binaural air caloric test, vHIT, and SHIMP. The mean SHIMP vestibulo-ocular reflex (S-VOR) gain of the MD side was 0.69, and that of the healthy side was 0.77. The S-VOR gain values were statistically lower than the mean vHIT VOR gain (V-VOR) values on both sides (p<0.001). There was no significant difference between the MD and healthy sides in terms of the anti-compensatory saccades (ACSs) latency and amplitude and S-VOR gain (p>0.05). In the MD group, the vHIT results were abnormal in 35% (7/20 ears) of the ears, and the SHIMP results were abnormal in 50% (10/20 ears). On the healthy side, the vHIT results were abnormal in 10% (2/20 ears) of the ears, and the SHIMP results were abnormal in 35% (7/20 ears). In this study, the V-VOR and S-VOR gains, vHIT saccades, SHIMP saccade latency, and SHIMP saccade amplitude were not found to be beneficial parameters in differentiating affected and healthy ears in the patients with MD. In other words, contrary to expectations, vHIT and SHIMP tests were not sufficient to detect pathological involvement in Meniere's disease.

Anahtar Kelimeler

• Meniere’s Disease
• Auditory Loss
• Vestibular Loss
• Suppression Head Impulse Paradigm
• Video Head Impulse Test.

Kanıtlanmış Vestibüler ve İşitme Kaybı olan Meniere Hastalarında Supresyon Baş Savurma Paradigması (SHIMP) ve Video Baş Savurma Testinin (vHIT) Değerlendirilmesi

Öz

Bu çalışmada, kesin Meniere hastalığı (MH) tanısı alan erişkinlerde video baş savurma testi (vHIT) ve supresyon baş savurma paradigması (SHIMP) sonuçlarının incelenmesi amaçlandı. Bu çalışma, tek taraflı kesin MH tanısı almış, semptomatik kulaklarında kanal parezi ve sensörinöral tip işitme kaybı olan 18-45 yaş arası 20 hasta ile yapıldı. Bireyler, geleneksel odyometri (0,125–8 kHz), bitermal binaural hava kalorik testi, vHIT ve SHIMP ile değerlendirildi. MH olan tarafın ortalama SHIMP vestibülo-oküler refleks (S-VOR) kazancı 0,69, sağlıklı tarafınki ise 0,77 idi. S-VOR kazanç değerleri her iki tarafta da ortalama vHIT VOR kazanç (V-VOR) değerlerinden istatistiksel olarak düşüktü (p<0,001). Anti-kompansatuar sakkad (AKS) latansı ve genliği ile S-VOR kazancı açısından MH olan ve sağlıklı taraf arasında anlamlı bir fark yoktu (p>0.05). MH olan kulakların; vHIT sonuçları %35'inde (7/20 kulak), SHIMP sonuçları ise %50'sinde (10/20 kulak) anormaldi. Sağlıklı tarafta ise kulakların %10'unda (2/20 kulak) vHIT sonuçları ve %35'inde (7/20 kulak) SHIMP sonuçları anormaldi. Bu çalışmada sonuç olarak V-VOR ve S-VOR kazançları, vHIT sakkadları, SHIMP sakkad latansı ve SHIMP sakkad amplitüdünün Meniere hastalarında etkilenen ve sağlıklı kulakları ayırt etmede faydalı parametreler olmadığı bulunmuştur. Yani beklenenin aksine, Meniere hastalığı’nda patolojik tutulumu tespit etmek için vHIT ve SHIMP testleri yeterli değildi.

Anahtar Kelimeler

• Meniere Hastalığı
• İşitsel Kayıp
• Vestibüler Kayıp
• Supresyon Baş Savurma Paradigması
• Video Baş Savurma Testi.

Etik Beyan

Ethics Committee Approval: The study was approved by Eskişehir Osmangazi University Noninterventional Clinical Research Ethical Committee (Decision no: 38, Date: 29.09.2020).

Kaynakça

1. 1. Lopez-Escamez JA, Carey J, Chung WH, et al. Diagnostic criteria for Menière's disease, J Vestib Res. 2015;25(1):1-7.
2. 2. Nakashima T, Pyykkö I, Arroll MA, et al. Meniere's disease, Nat Rev Dis Primers. 2016;2:1-18
3. 3. Zhang W, Hui L, Zhang B, et al.The correlation between endolymphatic hydrops and clinical features of Meniere disease, Laryngoscope. 2021;131(1):E144-E150
4. 4. MacDougall HG, Weber KP, McGarvie LA, et al. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy, Neurology. 2009;73(14):1134-1141
5. 5. Mangabeira Albernaz PL, Zuma E Maia FC. The video head impulse test, Acta Otolaryngol. 2014;134(12):1245-1250.
6. 6. Hannigan IP,Welgampola MS, Watson SRD, Dissociation of caloric and head impulse tests: a marker of Meniere's disease, J Neurol. 2021;268(2):431-439.
7. 7. McGarvie LA, Curthoys IS, MacDougall HG, Halmagyi GM. What does the head impulse test versus caloric dissociation reveal about vestibular dysfunction in Ménière's disease? Ann N Y Acad Sci. 2015;1343:58-62.
8. 8. Blödow A, Heinze M, Bloching MB, et al. Caloric stimulation and video-head impulse testing in Ménière’s disease and vestibular migraine, Acta Otolaryngol. 2014;134(12):1239-1244.

9. 9. Casani AP, Canelli R, Lazzerini F, et al., Prognosis after acute unilateral vestibulopathy: Usefulness of the suppression head impulse paradigm (SHIMP), J Vestib Res. 2021;31(6):531-540.
10. 10. Manzari L, De Angelis S, Princi AA, et al. The Clinical Use of the Suppression Head Impulse Paradigm in Patients with Vestibulopathy: A Systematic Review. Healthcare (Basel). 2022;10(7):1182.
11. 11. MacDougall HG, McGarvie LA, Halmagyi GM, et al. A new saccadic indicator of peripheral vestibular function based on the video head impulse test. Neurology. 2016;87(4):410-418.
12. 12. Shen Q, Magnani C, Sterkers O, et al., Saccadic velocity in the new suppression head impulse test: a new indicator of horizontal vestibular canal paresis and of vestibular compensation, Frontiers in Neurology . 2016;7:160.
13. 13. McCaslin DL, Rivas A, Jacobson GP, et al. The dissociation of video head impulse test (vHIT) and bithermal caloric test results provide topological localization of vestibular system impairment in patients with "definite" Ménière's disease. Am J Audiol. 2015;24(1):1-10.
14. 14. Jongkees LB, Maas JB, Philipszoon AJ. Clinical nystagmography, A detailed study of electro-nystagmography in 341 patients with vertigo. Pract Otorhinolaryngol (Basel). 1962;24:65-93.
15. 15. Halmagyi GM and Curthoys IS, A clinical sign of canal paresis, Archives of neurology 45 (1988), 737-739.
16. 16. Rey-Martinez J, Thomas-Arrizabalaga I, Espinosa-Sanchez JM, et al. Vestibulo-ocular reflex gain values in the suppression head impulse test of healthy subjects. Laryngoscope. 2018;128(10):2383-2389
17. 17. Rubin F, Simon F,Verillaud B, et al. Comparison of video head impulse test and caloric reflex test in advanced unilateral definite Menière's disease, Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135(3):167-169.
18. 18. Kirazli G, Hepkarsi S, Kirazli T. Evaluation of high frequency horizontal VOR parameters in patients with chronic bilateral and unilateral peripheral vestibulopathy: a preliminary study. Acta Otolaryngol. 2020;140(12):1007-1012.
19. 19. Park JS, Lee JY, Nam W, et al. Comparing the Suppression Head Impulse Paradigm and the Head Impulse Paradigm in Vestibular Neuritis. Otol Neurotol. 2020;41(1):e76-e82.