Skip to main content
Log in

Reliability and comparison of gain values with occurrence of saccades in the EyeSeeCam video head impulse test (vHIT)

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The vHIT (video head impulse test) investigates the vestibular function in two ways: a VOR (vestibulo-ocular reflex) gain value and a head impulse diagram. From the diagram covert and overt saccades can be detected. Evaluation of the vestibular function based on vHIT depends on both parameters. There is a lack of knowledge regarding the reliability of the two parameters. The objective was to investigate the reliability of vHIT by comparing gain values between examiners on the same subjects, and to see how differences affected the occurrence of saccades. Subjects: 25 subjects who had undergone cochlear implant (CI) surgery. Subjects were tested using the vHIT by two of four different examiners. Two judges interpreted the occurrence of saccades in the diagram. Main Outcome Measures: VOR gain values and the occurrence of saccades in the diagram. Differences in gain values between examiners varied from 0.2 to 0.58 with an average of 0.14 (95 % CI 0.12–0.16) on the right ear and 0.17 (95 % CI 0.15–0.19) on the left ear. Occurrences of saccades in the same patient were reproduced in 93 % of the cases by all examiners. Kappa’s coefficient on the occurrence of saccades was 0.83. Interclass correlation coefficient (ICC) of the gain values between examiners ranged from 0.62 to 0.70. Differences in gain values amongst examiners did not seem to affect the occurrence of saccades in the same patient. The occurrence of saccades, therefore, seems to be more reliable than the gain value in the evaluation of the vestibular function. Interpretation of vHIT results should, therefore, first depend on the occurrence of saccades and second on the gain value.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Curthoys IS, MacDougall HG, Manzari L, Burgess AM, Bradshaw AP, McGarvie L, Halmagyi GM, Weber KP (2011) Clinical application of a new objective test of semicircular canal dynamic function—the video head impulse test (vHIT)

  2. MacDougall HG, Weber KP, McGarvie LA, Halmagyi GM, Curthoys IS (2009) The Video Head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology 73(14):1134–1141

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Bronstein AM, Patel M, Arshad Q (2015) A brief review of the clinical anatomy of the vestibular-ocular connections—how much do we know? Eye. 29:163–170

    Article  CAS  PubMed  Google Scholar 

  4. Fetter M (2007) Vestibulo-ocular reflex. Dev Ophthalmol 40:35–51

    Article  PubMed  Google Scholar 

  5. Beynon GJ, Jani P, Baguley DM (1998) A clinical evaluation of head impulse testing. Clin Otolaryngol Allied Sci 23(2):117–122

    Article  CAS  PubMed  Google Scholar 

  6. EyeSeeCam booklet. http://www.interacoustics.com/eyeseecam/support. Accessed Nov 2015

  7. MacDougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP (2013) The video head impulse test (vHIT) detects vertical semicircular canal dysfunction. PLoS One 8(4):e61488

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Blöwdow A, Pannasch S, Walther LE (2013) Detection of isolated covert saccades with the video head impulse test in peripheral vestibular disorders. Auris Nasus Larynx 40(4):348–351

    Article  Google Scholar 

  9. Aw ST, Haslwanter T, Halmagyi GM, Curthoys IS, Yavor RA, Todd MJ (1996) Three-dimensional vector analysis of the human vestibuloocular reflex in response to high-acceleration head rotations, I: responses in normal subjects. J Neurophysiol 76:4009–4020

    CAS  PubMed  Google Scholar 

  10. Matiño-Soler E, Esteller-More E, Martin-Sanchez JC, Martinez-Sanchez JM, Perez-Sanchez N (2015) Normative data on angular vestibulo-ocular responses in the yaw axis measured using the video head impulse test. Otol Neurotol 36(3):466–471

    Article  PubMed  Google Scholar 

  11. Mossman B, Mossman S, Purdie G, Schneider E (2015) Age dependent normal horizontal VOR gain of head impulse test as measured with video-oculography. J Otolaryngol Head Neck Surg. 4(44):29

    Article  Google Scholar 

  12. Interacoustics webinar “Video Head Impulse Testing: Interpretation”. http://www.interacoustics.com/webinars#balance. Accessed June 2015

  13. Mabrey H, Murnane O, Pearson A, Byrd S, Akin (2014) Normative data and test-retest reliability of the SYNAPSIS video head impulse test. J Am Acad Audiol 25(3):244–252

    Article  PubMed  Google Scholar 

  14. Ulmer E, Bernard-Demanze L, Lacour M (2011) Statistical study of normal canal deficit variation range. Measurement using the head impulse test video system. Eur Ann Otorhinolaryngol Head Neck Dis 128:278–282

  15. Kidd C, Byrd S, Riska K, Murnane O, Akin F (2015) Intra- and inter-examiner reliability of the video head impulse test. http://www.icsimpulse.com/cases-and-research/Inter-and-Intra-Examiner-Reliability,-sp-,-for-ICS-Impuls. Accessed June 2015

  16. Patterson JN, Bassett AM, Mollak CM, Honaker JA (2015) Effects of hand placement technique on the video head impulse test (vHIT) in younger and older adults. Otol Neurotol. 36(6):1061–1068

    Article  PubMed  Google Scholar 

  17. McGarvie LA, MacDougall HG, Halmagyi GM, Burgess AM, Weber KP, Curthoys IS (2015) The video head impulse test (vHIT) of semicircular canal function—age-dependent normative values of VOR gain in healthy subjects. Front Neurol 6:154. doi:10.3389/fneur.2015.00154

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Leise Elisabeth Hviid Korsager.

Ethics declarations

The study is sponsored by the Oticon Foundation, MED-EL G.m.b.H and Danaflex a/s.

Conflict of interest

The authors declare no other conflict of interest.

All procedures performed in this study were in accordance with the ethical standards of the Regional Committees on Health Research Ethics for Southern Denmark.

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Korsager, L.E.H., Schmidt, J.H., Faber, C. et al. Reliability and comparison of gain values with occurrence of saccades in the EyeSeeCam video head impulse test (vHIT). Eur Arch Otorhinolaryngol 273, 4273–4279 (2016). https://doi.org/10.1007/s00405-016-4183-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-016-4183-2

Keywords

Navigation