Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient Groups

BackgroundVisually enhanced vestibulo–ocular reflex (VVOR) is a well-known bedside clinical test to evaluate visuo–vestibular interaction, with clinical applications in patients with neurological and vestibular dysfunctions. Owing to recently developed diagnostic technologies, the possibility to per...

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Main Authors: Jorge Rey-Martinez, Angel Batuecas-Caletrio, Eusebi Matiño, Gabriel Trinidad-Ruiz, Xabier Altuna, Nicolas Perez-Fernandez
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-02-01
Series:Frontiers in Neurology
Subjects:
Online Access:http://journal.frontiersin.org/article/10.3389/fneur.2018.00069/full
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author Jorge Rey-Martinez
Angel Batuecas-Caletrio
Eusebi Matiño
Gabriel Trinidad-Ruiz
Xabier Altuna
Nicolas Perez-Fernandez
author_facet Jorge Rey-Martinez
Angel Batuecas-Caletrio
Eusebi Matiño
Gabriel Trinidad-Ruiz
Xabier Altuna
Nicolas Perez-Fernandez
author_sort Jorge Rey-Martinez
collection DOAJ
description BackgroundVisually enhanced vestibulo–ocular reflex (VVOR) is a well-known bedside clinical test to evaluate visuo–vestibular interaction, with clinical applications in patients with neurological and vestibular dysfunctions. Owing to recently developed diagnostic technologies, the possibility to perform an easy and objective measurement of the VVOR has increased, but there is a lack of computational methods designed to obtain an objective VVOR measurement.ObjectivesTo develop a method for the assessment of the VVOR to obtain a gain value that compares head and eye velocities and to test this method in patients and healthy subjects.MethodsTwo computational methods were developed to measure the VVOR test responses: the first method was based on the area under curve of head and eye velocity plots and the second method was based on the slope of the linear regression obtained for head and eye velocity data. VVOR gain and vestibulo–ocular reflex (VOR) gain were analyzed with the data obtained from 35 subjects divided into four groups: healthy (N = 10), unilateral vestibular with vestibular neurectomy (N = 8), bilateral vestibulopathy (N = 12), and cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) (N = 5).ResultsIntra-class correlation index for the two developed VVOR analysis methods was 0.99. Statistical differences were obtained by analysis of variance statistical method, comparing the healthy group (VVOR mean gain of 1 ± 0) with all other groups. The CANVAS group exhibited (VVOR mean gain of 0.4 ± 0.1) differences when compared to all other groups. VVOR mean gain for the vestibular bilateral group was 0.8 ± 0.1. VVOR mean gain in the unilateral group was 0.6 ± 0.1, with a Pearson’s correlation of 0.52 obtained when VVOR gain was compared to the VOR gain of the operated side.ConclusionTwo computational methods to measure the gain of VVOR were successfully developed. The VVOR gain values appear to objectively characterize the VVOR alteration observed in CANVAS patients, and also distinguish between healthy subjects and patients with some vestibular disorders.
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spelling doaj.art-851c13abfa194dc687ab1f39a6e7d7c82022-12-22T02:06:25ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-02-01910.3389/fneur.2018.00069329103Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient GroupsJorge Rey-Martinez0Angel Batuecas-Caletrio1Eusebi Matiño2Gabriel Trinidad-Ruiz3Xabier Altuna4Nicolas Perez-Fernandez5Otorhinolaringology, Hospital Universitario Donostia, San Sebastian, SpainComplejo Hospitalario de Salamanca, Salamanca, SpainHospital General de Catalunya, Barcelona, SpainUniversity Hospital of Badajoz, Badajoz, SpainOtorhinolaringology, Hospital Universitario Donostia, San Sebastian, SpainClínica Universidad de Navarra, Madrid, SpainBackgroundVisually enhanced vestibulo–ocular reflex (VVOR) is a well-known bedside clinical test to evaluate visuo–vestibular interaction, with clinical applications in patients with neurological and vestibular dysfunctions. Owing to recently developed diagnostic technologies, the possibility to perform an easy and objective measurement of the VVOR has increased, but there is a lack of computational methods designed to obtain an objective VVOR measurement.ObjectivesTo develop a method for the assessment of the VVOR to obtain a gain value that compares head and eye velocities and to test this method in patients and healthy subjects.MethodsTwo computational methods were developed to measure the VVOR test responses: the first method was based on the area under curve of head and eye velocity plots and the second method was based on the slope of the linear regression obtained for head and eye velocity data. VVOR gain and vestibulo–ocular reflex (VOR) gain were analyzed with the data obtained from 35 subjects divided into four groups: healthy (N = 10), unilateral vestibular with vestibular neurectomy (N = 8), bilateral vestibulopathy (N = 12), and cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) (N = 5).ResultsIntra-class correlation index for the two developed VVOR analysis methods was 0.99. Statistical differences were obtained by analysis of variance statistical method, comparing the healthy group (VVOR mean gain of 1 ± 0) with all other groups. The CANVAS group exhibited (VVOR mean gain of 0.4 ± 0.1) differences when compared to all other groups. VVOR mean gain for the vestibular bilateral group was 0.8 ± 0.1. VVOR mean gain in the unilateral group was 0.6 ± 0.1, with a Pearson’s correlation of 0.52 obtained when VVOR gain was compared to the VOR gain of the operated side.ConclusionTwo computational methods to measure the gain of VVOR were successfully developed. The VVOR gain values appear to objectively characterize the VVOR alteration observed in CANVAS patients, and also distinguish between healthy subjects and patients with some vestibular disorders.http://journal.frontiersin.org/article/10.3389/fneur.2018.00069/fullVisually enhanced VORvisual–vestibular interactionCANVASvestibular schwannomagaindessaccade
spellingShingle Jorge Rey-Martinez
Angel Batuecas-Caletrio
Eusebi Matiño
Gabriel Trinidad-Ruiz
Xabier Altuna
Nicolas Perez-Fernandez
Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient Groups
Frontiers in Neurology
Visually enhanced VOR
visual–vestibular interaction
CANVAS
vestibular schwannoma
gain
dessaccade
title Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient Groups
title_full Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient Groups
title_fullStr Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient Groups
title_full_unstemmed Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient Groups
title_short Mathematical Methods for Measuring the Visually Enhanced Vestibulo–Ocular Reflex and Preliminary Results from Healthy Subjects and Patient Groups
title_sort mathematical methods for measuring the visually enhanced vestibulo ocular reflex and preliminary results from healthy subjects and patient groups
topic Visually enhanced VOR
visual–vestibular interaction
CANVAS
vestibular schwannoma
gain
dessaccade
url http://journal.frontiersin.org/article/10.3389/fneur.2018.00069/full
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