The Head Impulse Test in the Screening of Vestibular Function

NCT01426932 | Unknown

• 1 other identifier: HITVNG
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The alternate binaural bithermal caloric test (ABBT) is a well established examination in the evaluation of the dizzy patient. ABBT is useful in detecting the side of peripheral vestibulopathy by stimulating each ear separately, it contributes to the diagnosis of bilateral vestibular involvement when all responses to cold and warm stimuli are reduced, and adds to the differentiation of peripheral from central vestibular involvement by measuring the fixation-induced inhibition of the caloric response. In spite of these benefits, ABBT is the most time-consuming part of the electronystagmography/Videonystagmography (ENG/VNG) test battery, and frequently causes significant inconvenience to the patient due to the repeated extreme vestibular stimuli. The head impulse test (HIT) assesses vestibular function by brisk, passive rotations of the head in the plane of the examined semicircular canals. Whenever the vestibulo-ocular reflex (VOR) is deficient, this maneuver would produce catch-up saccades aiming to the re-fixation of the eyes on the target. Hence, both residual VOR and catch-up saccades act synergistically to stabilize gaze. The HIT requires only several minutes and might cause minimal discomfort only. The study hypothesis is that the HIT recorded by standard VNG equipment of the VNG system would provide diagnostic information on the side of vestibular involvement matching that of the ABBT.

Conditions

Vertigo

Keywords

Vestibular Function Tests; Caloric Test; Electronystagmography; Prediction

Outcome Measures

Primary Outcomes (2)

• Sensitivity of the recorded HIT results in the prediction of the caloric test lateralization parameter

  Sensitivity would be calculated according to the following formula: Number of participants in whom catch-up saccades would be recorded and caloric test lateralization would be greater than 25% divided by the sum of number of participants in whom catch-up saccades would be recorded and caloric test lateralization would be greater than 25% plus the number of participants in whom no catch-up saccades would be recorded and caloric test lateralization would be greater than 25% (number of true positives /(number of true positives + number of false negatives))

  18 months

• Specificity of the VNG recorded HIT results in the prediction of the caloric test lateralization parameter

  Specificity would be calculated according to the following formula: Number of participants in whom no catch-up saccades would be recorded and caloric test lateralization would be smaller than 25% divided by the sum of number of participants in whom no catch-up saccades would be recorded and caloric test lateralization would be smaller than 25% plus the number of participants in whom catch-up saccades would be recorded and caloric test lateralization would be smaller than 25% (number of true negatives /(number of true negatives + number of false positives))

  18 months

Secondary Outcomes (2)

• Sensitivity of the bed-side HIT examination results in the prediction of the caloric test lateralization parameter

  18 months

• Specificity of the bed-side HIT examination results in the prediction of the caloric test lateralization parameter

  18 months

Interventions

Video recording of Head Impulse Test OTHER

Video recording of Head Impulse Test

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Tertiary center patients

You may qualify if:

• Age \> 18 years
• Videonystagmography(VNG) test battery is indicated for the diagnosis of dizziness or vertigo

You may not qualify if:

• Signs of retrocochlear lesion or central vestibular pathology in bed-side otoneurological examination or audiometry or ENG/VNG
• Age \< 18 years
• Otitis externa
• Otitis media
• Tympanic membrane perforation
• Status Post Mastoidectomy
• Limitations of neck movements in the horizontal plain

Sponsors & Collaborators

• Meir Medical Center: lead
• Clalit Health Services, Haifa and West Galilee: collaborator

Study Sites (1)

Otoneurology Unit, Lin Medical Center, 35 Rotchild Avenue

Haifa, 35152, Israel

Location

MeSH Terms

Conditions

Vertigo

Condition Hierarchy (Ancestors)

Vestibular Diseases; Labyrinth Diseases; Ear Diseases; Otorhinolaryngologic Diseases; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 27, 2011
• First Posted: September 1, 2011
• Study Start: October 1, 2011
• Primary Completion: December 1, 2013
• Study Completion: December 1, 2013
• Last Updated: July 1, 2013

Record last verified: 2012-02

Locations

IL (1)