Symptoms in unilateral vestibular hypofunction are associated with number of catch-up saccades and retinal error: results from the population-based KORA FF4 study.

Autor:	Aubele M; Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.; German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany., Grill E; German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.; Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany., Eggert T; German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany., Schneider E; Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany., Strobl R; German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.; Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany., Jahn K; German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.; Department of Neurology, Schoen Clinic Bad Aibling, Bad Aibling, Germany., Müller M; Nursing Science and Interprofessional Care, Department for Primary Care and Health Services Research, Medical Faculty, Heidelberg University, Heidelberg, Germany., Holle R; Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany., Linkohr B; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany., Heier M; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.; KORA Study Center, University Hospital Augsburg, Augsburg, Germany., Ladwig KH; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany., Lehnen N; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.; Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2023 Nov 28; Vol. 14, pp. 1292312. Date of Electronic Publication: 2023 Nov 28 (Print Publication: 2023).
DOI:	10.3389/fneur.2023.1292312
Abstrakt:	Objective: The presence and intensity of symptoms vary in patients with unilateral vestibular hypofunction. We aimed to determine which saccadic and vestibulo-ocular reflex parameters best predict the presence of symptoms in unilateral vestibular hypofunction in order to better understand vestibular compensation and its implications for rehabilitation therapy. Methods: Video head impulse test data were analyzed from a subpopulation of 23 symptomatic and 10 currently symptom-free participants with unilateral vestibular hypofunction, embedded in the KORA (Cooperative Health Research in the Region of Augsburg) FF4 study, the second follow-up of the KORA S4 population-based health survey (2,279 participants). Results: A higher number of catch-up saccades, a higher percentage of covert saccades, and a larger retinal error at 200 ms after the onset of the head impulse were associated with relevant symptoms in participants with unilateral vestibular hypofunction ( p  = 0.028, p  = 0.046, and p  = 0.038, respectively). After stepwise selection, the number of catch-up saccades and retinal error at 200 ms remained in the final logistic regression model, which was significantly better than a null model ( p  = 0.014). Age, gender, saccade amplitude, saccade latency, and VOR gain were not predictive of the presence of symptoms. Conclusion: The accuracy of saccadic compensation seems to be crucial for the presence of symptoms in unilateral vestibular hypofunction, highlighting the role of specific gaze stabilization exercises in rehabilitation. Early saccades, mainly triggered by the vestibular system, do not seem to compensate accurately enough, resulting in a relevant retinal error and the need for more as well as more accurate catch-up saccades, probably triggered by the visual system. Competing Interests: ES is the general manager and a shareholder of EyeSeeTec GmbH. NL is a shareholder and paid consultant of EyeSeeTec GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (Copyright © 2023 Aubele, Grill, Eggert, Schneider, Strobl, Jahn, Müller, Holle, Linkohr, Heier, Ladwig and Lehnen.)
Databáze:	MEDLINE
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