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Beitragstitel Accuracy of detecting saccades in clinical horizontal head impulses
Beitragscode O20
  1. Athanasia Korda Inselspital Bern Präsentierende:r
  2. John Carey Johns Hopkins University School of Medicine, Baltimore
  3. Ewa Zamaro Inselspital Bern, Switzerland
  4. Marco Caversaccio Inselspital, Universitätsspital Bern
  5. Georgios Mantokoudis Inselspital
Präsentationsform Vortrag
  • SGORL FV 2019
Abstract-Text Background: Clinicians performing a horizontal head impulse test (HIT) are looking for a corrective saccade. The detection of such saccades is a challenge. The aim of this study is to assess an expert’s likelihood of detecting corrective saccades in subjects with vestibular hypofunction.
Methods: In a prospective cohort observational study, we assessed 365 horizontal HITs performed clinically by an expert neurootologist in seven patients with unilateral deficient VOR. All HITs were recorded simultaneously by videooculography, as a gold standard. We evaluated saccades latency and amplitude, head velocity and gain in order to identify relevant parameters and cut-offs for optimal saccade detection by an expert physician.
Results: The probability of saccade detection was 8 times higher for HIT towards the pathological side (P = 0.029). In addition, an increase in saccade amplitude resulted in an increased probability of detection (Odds ratio (OR) 1.77 (1.31 - 2.40) per degree, P < 0.001). The sensitivity to detect a saccade amplitude of 1 degree was 92.9%, specificity 79 %. Saccade latency and VOR gain did not significantly influence the probability of the physician identifying a saccade (OR 1.02 (0.94 - 1.11) per 10 ms latency and OR 0.84 (0.60 - 1.17) per 0.1 VOR gain increase).
Conclusions: The saccade amplitude is the most important factor for accurate saccade detection in clinically performed head impulse tests. Contrary to current knowledge, saccade latency and VOR gain play a minor role in saccade detection. The role of saccade latency in relation to the head movement should be further investigated in future studies.