ScholarWorks@중앙대학교

초록

Background and Objectives In the suppression head impulse paradigm (SHIMP), an alter- native protocol to the conventional head impulse paradigm (HIMP) in the video head impulse test (vHIT), covert saccades (CSs) are infrequent, unlike in HIMP. However, some patients with unilateral vestibular loss (UVL) reportedly manifest CSs in SHIMP. This study aimed to evaluate the characteristics of CSs and their role as a compensatory strategy for vestibulopa- thy in patients undergoing SHIMP. Subjects and Method This retrospective study included 30 patients diagnosed with UVL based on vestibuloocular reflex (VOR) testing. vHIT was conducted using two paradigms, HIMP and SHIMP. Statistical analyses were performed to compare the characteristics of CSs between the two paradigms and assess the correlation between CSs and anticompensatory saccades (ACSs) in SHIMP. Results CSs observed in SHIMP exhibited significantly reduced amplitudes and shorter la- tencies than those in HIMP, with a significant correlation between latency in the two para- digms. ACSs in SHIMP were more pronounced in traces exhibiting CSs, with a positive cor- relation between the amplitudes of CS and ACS. Conclusion Our results suggest that CSs observed using SHIMP are associated with the augmentation of ACSs in patients with UVL. This implies that CSs in SHIMP may serve as a rehabilitation strategy, supporting VOR in maintaining forward gaze in patients with UVL. Clinically, the presence of CSs should be considered when interpreting ACSs in SHIMP.

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