TY - GEN A1 - Heuberger, Maria A1 - Grill, Eva A1 - Saglam, Murat A1 - Ramaioli, Cecilia A1 - Müller, Martin A1 - Strobl, Ralf A1 - Holle, Rolf A1 - Peters, Annette A1 - Schneider, Erich A1 - Lehnen, Nadine T1 - Usability of the Video Head Impulse Test: Lessons from the Population-Based Prospective KORA Study T2 - Frontiers in Neurology Y1 - 2018 U6 - https://doi.org/10.3389/fneur.2018.00659 SN - 1664-2295 VL - 9 ER - TY - GEN A1 - Grill, Eva A1 - Heuberger, Maria A1 - Strobl, Ralf A1 - Saglam, Murat A1 - Holle, Rolf A1 - Linkohr, Birgit A1 - Ladwig, Karl-Heinz A1 - Peters, Annette A1 - Schneider, Erich A1 - Jahn, Klaus A1 - Lehnen, Nadine T1 - Prevalence, determinants, and consequences of vestibular hypofunction. results from the kora-ff4 survey T2 - Frontiers in Neurology N2 - Objective: Uni- or bilateral vestibular hypofunction (VH) impairs balance and mobility, and may specifically lead to injury from falls and to disability. The extent of this problem in the general population is still unknown and most likely to be underestimated. Objective of this study was to determine the prevalence, determinants, and consequences of VH in the general population. Methods: Data originates from the cross-sectional second follow-up (FF4) in 2013/14 of the KORA (Cooperative Health Research in the Region of Augsburg)-S4 study (1999–2001) from Southern Germany. This was a random sample of the target population consisting of all residents of the region aged 25–74 years in 1999. We included all participants who reported moderate or severe vertigo or dizziness during the last 12 months and a random sub-sample of participants representative for the general population without vertigo or dizziness during the last 12 months were tested. VH was assessed with the Video-Head Impulse Test (vHIT). Trained examiners applied high-acceleration, small-amplitude passive head rotations (“head impulses”) to the left and right in the plane of the horizontal semicircular canals while participants fixated a target straight ahead. During head impulses, head movements were measured with inertial sensors, eye movements with video-oculography (EyeSeeCam vHIT). Results: A total of 2,279 participants were included (mean age 60.8 years, 51.6% female), 570 (25.0%) with moderate or severe vertigo or dizziness during the last 12 months. Of these, 450 were assessed with vHIT where 26 (5.8%) had unilateral VH, and 16 (3.6%) had bilateral VH. Likewise, 190 asymptomatic participants were tested. Of these 5 (2.6%) had unilateral VH, and 2 (1.1%) had bilateral VH. Prevalence of uni- or bilateral VH among tested symptomatic participants was 2.4% in those < 48 years, and 32.1% in individuals aged 79 and over. Age-adjusted prevalence was 6.7% (95% CI 4.8%; 8.6%). VH was associated with worse health, falls, hearing loss, hearing impairment, and ear pressure. Conclusion: VH may affect between 53 and 95 million adults in Europe and the US. While not all affected persons will experience the full spectrum of symptoms and consequences, adequate diagnostic and therapeutic measures should become standard of care to decrease the burden of disease. Y1 - 2018 U6 - https://doi.org/10.3389/fneur.2018.01076 SN - 1664-2295 VL - 9 ER - TY - GEN A1 - Aubele, Maria A1 - Grill, Eva A1 - Eggert, Thomas A1 - Schneider, Erich A1 - Strobl, Ralf A1 - Jahn, Klaus A1 - Müller, Martin A1 - Holle, Rolf A1 - Linkohr, Birgit A1 - Heier, Margit A1 - Ladwig, Karl-Heinz A1 - Lehnen, Nadine T1 - Symptoms in unilatral vestibular hypofunction are associated with number of catch-up saccades and retinal errors: results from the population-based KORA FF4study T2 - Frontiers in Neurology N2 - 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. KW - video head impulse test, vHIT, catch-up saccades, unilateral vestibular hypofunction, retinal error, vestibulo-ocular reflex, VOR, population-based survey Y1 - 2023 UR - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715252/ SN - 1664-2295 VL - 2023 IS - 14 ER -