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Audiology Research
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Skull Vibration-Induced Nystagmus Test
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Skull Vibration-Induced Nystagmus Test

A special issue of Audiology Research (ISSN 2039-4349).

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 23741

Special Issue Editors

Dr. Georges Dumas

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Guest Editor
1. Department of Otolaryngology-Head and Neck Surgery, Grenoble Alpes University Hospital, 38000 Grenoble, France
2. EA 3450 DevAH, Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-lès-Nancy, France
Interests: otoneurology; vestibular tests; skull vibration induced nystagmus test; Menière’s disease
Prof. Dr. Sébastien Schmerber

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Guest Editor
Department of Otology, Grenoble Alpes University Hospital, Grenoble, France
Interests: cochlear implants; otoneuro-surgery; otology
Prof. Dr. Philippe P. Perrin

E-Mail Website
Guest Editor
1. EA 3450, Development, Adaptation and Handicap (Director), Faculty of Medicine, University of Lorraine, F-54500 Vandoeuvre-lès-Nancy, France
2. Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM) (Head of Department), University Hospital of Nancy, F-54500 Vandoeuvre-lès-Nancy, France
Interests: neurootology; balance control; physiology; vertigo; motion sickness; sports medicine; rehabilitation programs; management of dual-tasking

Special Issue Information

Dear Colleagues,

Background: The skull vibration-induced nystagmus test is a vestibular test introduced into common clinical practice in 1999, mainly used as a first-line examination. Its clinical value has been underlined and developed by numerous groups in Europe (Hamann, Nuti, Manzari, Modugno, Perez, Batuecas, Zamora, Dumas), Asia (Park, Lee, Hang, Koo, Kim, Ohki) and Australia (Karlberg, Curthoys).

Consensus criteria for the test are currently needed: the characteristics of the vibrators vary, the frequencies used are not always clarified, and the protocols and procedures are variable (results are sometimes provided for one side and sometimes for both sides; the location and duration of the stimulus are variable).

The objective of the current issue is to provide a consensual protocol and common criteria for positivity (to improve reproducibility and establish a corner value for the slow phase velocity, as well as to synthesize the current knowledge about its physiological background) to realize its full value in clinical practice (including the exploration of common UVL pathologies such as VN, MD and V Schwannomas, or less common pathologies, with controls after intratympanic gentamicin, surgery or Cochlear implantation).

We aim to demonstrate its potential in distinguishing central from peripheral patients, determining the side of a lesion or indicating incomplete bilateral areflexia with unilaterally very high frequencies.

A few issues remain regarding the main structures involved in the SVIN response: why do we observe a clear VIN at 100 Hz and not at 500 Hz in UVL patients (vestibular neurectomies and translabyrinthine approaches), since canals respond at 100 Hz and the Otolith structures respond at 100 Hz but still more clearly at 500 Hz? Both these structures are stimulated by vibrations at these frequencies as demonstrated in animal models. This question needs to be addressed and further explored (is there a possible role of converging neurons?).

A special chapter will be dedicated to discussing the value of cervical muscle stimulations over cranial vibrations and their possible clinical consequences.

We thank the authors contributing to this Special Issue, who will share their high levels of expertise in the field.

Dr. Georges Dumas
Prof. Dr. Sébastien Schmerber
Prof. Dr. Philippe P. Perrin
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Audiology Research is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Skull vibrations
  • Nystagmus induced by vibrations
  • SVIN criteria of validity
  • Optimal conditions for SVINT
  • SVIN clinical interest
  • SVIN physiological background

Published Papers (9 papers)

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11 pages, 486 KiB  
Article
Correlation of SVINT and Sensory Organization Test in Children with Hearing Loss
by Solara Sinno, Fadi Najem, Georges Dumas, Kim Smith Abouchacra, Art Mallinson and Philippe Perrin
Audiol. Res. 2022, 12(3), 316-326; https://doi.org/10.3390/audiolres12030033 - 06 Jun 2022
Cited by 1 | Viewed by 1857
Abstract
Objective: The skull vibration-induced-nystagmus test (SVINT) is a noninvasive and effective screening tool for the function of the otolith and canal structures in children. It can instantaneously assess vestibular asymmetry. This study aimed to analyze the SVINT results of healthy children vs. [...] Read more.
Objective: The skull vibration-induced-nystagmus test (SVINT) is a noninvasive and effective screening tool for the function of the otolith and canal structures in children. It can instantaneously assess vestibular asymmetry. This study aimed to analyze the SVINT results of healthy children vs. children with hearing loss (HL) and to correlate it with sensory organization test (SOT) results as a functional balance evaluation tool. Design: This case-controlled study compared the results of SVINT to the results of the SOT of the computerized dynamic posturography (CDP) in a control group of 120 healthy normal-hearing children (i.e., NH group) vs. hearing loss (HL) group of 60 children, including 30 children with hearing aids (HAs) and 30 children with a unilateral cochlear implant (CI). The SVINT results were compared to the caloric test (CaT) and video head impulse test (vHIT) and associated with SOT scores. Results: Thirty-one children in the HL group had normal SVINT and normal SOT results. A total of 21 children in the HL group had SVINT-negative and abnormal results in the SOT (possibly due to bilateral vestibular loss (BVL)). Eight children in the HL group had positive SVINT and abnormal SOT results. However, none of the children had only positive SVINT with normal SOT findings. Moreover, 52% of children had a normal result on both the SOT and CaT, whereas 27% had abnormal results on both tests (17% bilateral weakness and 10% unilateral), and 22% had the only result of the SOT suggesting a functional abnormality. Similarly, when associating the result to vHIT, 51% had normal results on both tests, and 25% had abnormal results (13% bilateral and 12% unilateral weakness). Conclusions: SVINT findings can be correlated with SOT findings in the case of the unilateral vestibular lesion (UVL), which adds a diagnostic value in these pediatric cases but may differ in the case of the bilateral vestibular lesion (BVL). However, SVINT findings need to be cautiously interpreted in light of other test findings such as the SOT, CaT, and vHIT. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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10 pages, 2301 KiB  
Article
Skull Vibration-Induced Nystagmus and High Frequency Ocular Vestibular-Evoked Myogenic Potentials in Superior Canal Dehiscence
by Ángel Batuecas-Caletrío, Alejandra Jara, Victor Manuel Suarez-Vega, Susana Marcos-Alonso, Hortensia Sánchez-Gómez and Nicolas Pérez-Fernández
Audiol. Res. 2022, 12(2), 202-211; https://doi.org/10.3390/audiolres12020023 - 14 Apr 2022
Cited by 5 | Viewed by 2307
Abstract
Background: Although diagnostic criteria have been established for superior canal dehiscence syndrome, cases in which the diagnosis is not easy are frequent. On those occasions, some tests such as vibration-induced nystagmus or vestibular-evoked myogenic potentials can offer invaluable help due to their high [...] Read more.
Background: Although diagnostic criteria have been established for superior canal dehiscence syndrome, cases in which the diagnosis is not easy are frequent. On those occasions, some tests such as vibration-induced nystagmus or vestibular-evoked myogenic potentials can offer invaluable help due to their high sensitivity and specificity. Methods: We studied 30 patients showing superior canal dehiscence or “near-dehiscence” in a CT scan. Skull vibration-induced nystagmus and high frequency ocular vestibular-evoked myogenic potentials are performed in each patient. The aim of the study is to determine how useful both tests are for detection of superior canal dehiscence or near-dehiscence. Results: Of the 60 temporal bones studied, no dehiscence was the result in 22, near-dehiscence in 17 and a definite finding in 21. In 10/30 patients, there was no SVIN (Skull vibration induced nystagmus) during otoneurological testing, while in 6/30, induced nystagmus was mainly horizontal, and in 14/30 there was vertical up-beating. All patients had a positive oVEMP (Ocular vestibular evoked myiogenic potentials) at 0.5 kHz in both ears and the HFoVEMP (High frequency ocular vestibular evoked myiogenic potentials) response was positive in 25/60 (41.6%) of the ears studied and in 19/30 of the patients evaluated (in 6 it was positive in both ears). Up-beat SVIN will point to a SCD (Superior Canal Dehiscence) mainly when HFoVEMP are present, and when this is negative there is a high probability that it is not a SCD. Conclusions: When SVIN and HFoVEMP results are added (or combined), they not only improve the possibilities of detecting SCD, but also the affected side. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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11 pages, 2260 KiB  
Article
Is Skull-Vibration-Induced Nystagmus Modified with Aging?
by Giampiero Neri, Letizia Neri, Klajdi Xhepa and Andrea Mazzatenta
Audiol. Res. 2022, 12(2), 132-142; https://doi.org/10.3390/audiolres12020016 - 04 Mar 2022
Viewed by 2234
Abstract
Background: Despite clinical practice utilizing the Dumas test (SVINT), some questions remain unanswered, including the age-related changes in frequency (FN) and slow-phase angular velocity (SPAV). This study aims to retrospectively evaluate their variations in subjects affected by unilateral peripheral vestibular loss (UPVL). Methods: [...] Read more.
Background: Despite clinical practice utilizing the Dumas test (SVINT), some questions remain unanswered, including the age-related changes in frequency (FN) and slow-phase angular velocity (SPAV). This study aims to retrospectively evaluate their variations in subjects affected by unilateral peripheral vestibular loss (UPVL). Methods: We evaluated the selected samples based on the results of the SVINT, the results of the vestibular-evoked potentials (C-VEMP and O-VEMP), and the results of the head impulse test (HIT) and we compared the results against the age of the patients. We calculated the timing between the onset of UPVL and clinical evaluation in days. The presence or absence of VEMP indicated the UPVL severity. UPVL and BPPV patients with spontaneous or pseudo-spontaneous nystagmus were compared. Results: Statistical analysis showed changes in the FN and SPAV depending on age and the side of the application of the stimulus. We also observed that, in the UPVL, the severity of the disease modifies the SPAV, but not the frequency. Conclusions: The SVINT is a simple, reliable, and straightforward test that, if evaluated instrumentally, can show significant differences with aging. Further studies need to be performed to refine the clinical significance of the test and clarify its physiological background. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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6 pages, 1450 KiB  
Article
Is Skull Vibration-Induced Nystagmus Useful in Vestibular Neuritis Follow Up?
by Ma Piedad García Díaz, Lidia Torres-García, Enrique García Zamora, Ana Belén Castilla Jiménez and Vanesa Pérez Guillén
Audiol. Res. 2022, 12(2), 126-131; https://doi.org/10.3390/audiolres12020015 - 26 Feb 2022
Viewed by 2032
Abstract
The aim of this study was to evaluate the vestibulo-ocular reflex (VOR) gain and the saccade regrouping pattern PR score of the Video Head Impulse Test (vHIT) and its relationship with the slow-phase velocity (SPV) of skull vibration-induced nystagmus (SVIN) in recovery after [...] Read more.
The aim of this study was to evaluate the vestibulo-ocular reflex (VOR) gain and the saccade regrouping pattern PR score of the Video Head Impulse Test (vHIT) and its relationship with the slow-phase velocity (SPV) of skull vibration-induced nystagmus (SVIN) in recovery after a unilateral vestibular loss (UVL). A total of 36 patients suffering from vestibular neuritis (VN) were recruited and followed up for twelve months. In every visit, horizontal vHIT and an SVIN were performed, as well as VOR gain; PR score and the SPV of SVIN were measured. We observed a positive association between the VOR gain difference and the SPV of SVIN over time (probability greater than 0.86). Additionally, we obtained a positive association between the SPV of SVIN and the PR score in successive visits (odds ratio (OR) = −0.048; CI [0.898, 1.01]), with a probability of 0.95. Our results confirm that SPV of SVIN; VOR gain difference; and PR score decrease over time after a UVL. Both tests are useful in the follow-up of VN, as they could reflect its clinical compensation or partial recovery. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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11 pages, 1472 KiB  
Article
Skull Vibration Induced Nystagmus Test: Correlations with Semicircular Canal and Otolith Asymmetries
by Christol Fabre, Haoyue Tan, Georges Dumas, Ludovic Giraud, Philippe Perrin and Sébastien Schmerber
Audiol. Res. 2021, 11(4), 618-628; https://doi.org/10.3390/audiolres11040056 - 15 Nov 2021
Cited by 5 | Viewed by 2801
Abstract
Background: To establish in patients with peripheral vestibular disorders relations between skull vibration-induced nystagmus (SVIN) different components (horizontal, vertical, torsional) and the results of different structurally related vestibular tests. Methods: SVIN test, canal vestibular test (CVT: caloric test + video head impulse test: [...] Read more.
Background: To establish in patients with peripheral vestibular disorders relations between skull vibration-induced nystagmus (SVIN) different components (horizontal, vertical, torsional) and the results of different structurally related vestibular tests. Methods: SVIN test, canal vestibular test (CVT: caloric test + video head impulse test: VHIT), otolithic vestibular test (OVT: ocular vestibular evoked myogenic potential oVEMP + cervical vestibular evoked myogenic potential cVEMP) performed on the same day in 52 patients with peripheral vestibular diseases (age < 65 years), and 11 control patients were analyzed. Mixed effects logistic regression analysis was performed to assert whether the presence of nystagmus in SVIN (3D analysis) have an association with the presence of peripheral vestibular dysfunction measured by vestibular explorations (CVT or OVT). Results: We obtained different groups: Group-Co (control group), Group-VNT (dizzy patients with no vestibular tests alterations), Group-O (OVT alterations only), Group-C (CVT alterations only), Group-M (mixed alterations). SVIN-SPV horizontal component was significantly higher in Group-M than in the other groups (p = 0.005) and correlated with alterations of lateral-VHIT (p < 0.001), caloric test (p = 0.002) and oVEMP (p = 0.006). SVIN-SPV vertical component was correlated with the anterior-VHIT and oVEMP alterations (p = 0.007; p = 0.017, respectively). SVIN-SPV torsional component was correlated with the anterior-VHIT positivity (p = 0.017). SVIN was the only positive test for 10% of patients (83% of Group-VNT). Conclusion: SVIN-SPV analysis in dizzy patients shows significant correlation to both CVT and OVT. SVIN horizontal component is mainly relevant to both vestibular tests exploring lateral canal and utricle responses. SVIN-SPV is significantly higher in patients with combined canal and otolith lesions. In some patients with dizziness, SVIN may be the only positive test. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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6 pages, 245 KiB  
Article
Skull Vibration-Induced Nystagmus Test (SVINT) in Vestibular Migraine and Menière’s Disease
by Roberto Teggi, Omar Gatti, Marco Familiari, Iacopo Cangiano and Mario Bussi
Audiol. Res. 2021, 11(4), 603-608; https://doi.org/10.3390/audiolres11040054 - 08 Nov 2021
Cited by 3 | Viewed by 2898
Abstract
Background: Vestibular migraine (VM) and Menière’s disease (MD) are the two most frequent episodic vertigo apart from Benign Paroxysmal Positional Vertigo (BPPV) differential diagnosis for them may be troublesome in the early stages. SVINT is a newly proposed vestibular test, which demonstrated to [...] Read more.
Background: Vestibular migraine (VM) and Menière’s disease (MD) are the two most frequent episodic vertigo apart from Benign Paroxysmal Positional Vertigo (BPPV) differential diagnosis for them may be troublesome in the early stages. SVINT is a newly proposed vestibular test, which demonstrated to be fast and reliable in diagnoses above all of peripheral vestibular deficits. Methods: We retrieved clinical data from two groups of subjects (200 VM and 605 MD), enrolled between 2010 and 2020. Among others, these subjects were included when performing a SVINT. The purpose of the study is to assess if SVINT can be useful to differentiate the two episodic disorders. Results: 59.2% of MD subjects presented as positive with SVINT while only 6% did so with VM; among other tests, only video HIT demonstrated a different frequency in the two groups (13.1% and 0.5%, respectively), but the low sensitivity in these subjects makes the test unaffordable for diagnostic purposes. Conclusions: Since SVINT demonstrated to be positive in a peripheral vestibular deficit in previous works, we think that our data are consistent with the hypothesis that, in the pathophysiology of VM attacks, the central vestibular pathways are mainly involved. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
12 pages, 1989 KiB  
Article
Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging
by Georges Dumas, Christol Fabre, Anne Charpiot, Lea Fath, Hella Chaney-Vuong, Philippe Perrin and Sébastien Schmerber
Audiol. Res. 2021, 11(3), 301-312; https://doi.org/10.3390/audiolres11030028 - 24 Jun 2021
Cited by 4 | Viewed by 2269
Abstract
Background/Aim: the aim of this study was to assess the skull vibration-induced nystagmus test (SVINT) results and vestibular residual function after horizontal semicircular canal (HSCC) plugging. Methods: In this retrospective chart review performed in a tertiary referral center, 11 patients who underwent unilateral [...] Read more.
Background/Aim: the aim of this study was to assess the skull vibration-induced nystagmus test (SVINT) results and vestibular residual function after horizontal semicircular canal (HSCC) plugging. Methods: In this retrospective chart review performed in a tertiary referral center, 11 patients who underwent unilateral horizontal semicircular canal plugging (uHSCCP) for disabling Menière’s disease (MD) were included. The skull vibration-induced nystagmus (SVIN) slow-phase velocity (SPV) was compared with the results of the caloric test (CaT), video head impulse test (VHIT), and cervical vestibular-evoked myogenic potentials (cVEMP) performed on the same day. Results: Overall, 10 patients had a strong SVIN beating toward the intact side (Horizontal SVIN-SPV: 8.8°/s ± 5.6°/s), 10 had a significant or severe ipsilateral CaT hypofunction, 10 had an ipsilateral horizontal VHIT gain impairment, and 3 had altered cVEMP on the operated side. Five had sensorineural hearing worsening. SVIN-positive results were correlated with CaT and horizontal VHIT (HVHIT) results (p < 0.05) but not with cVEMP. SVIN-SPV was correlated with CaT hypofunction in % (p < 0.05). Comparison of pre- and postoperative CaT % hypofunction showed a significant worsening (p = 0.028). Conclusion: SVINT results in a human model of horizontal canal plugging are well correlated with vestibular tests exploring horizontal canal function, but not with cVEMP. SVINT always showed a strong lesional nystagmus beating away from the lesion side. SVIN acts as a good marker of HSCC function. This surgical technique showed invasiveness regarding horizontal canal vestibular function. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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Review

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12 pages, 650 KiB  
Review
Fifty Years of Development of the Skull Vibration-Induced Nystagmus Test
by Solara Sinno, Sébastien Schmerber, Philippe Perrin and Georges Dumas
Audiol. Res. 2022, 12(1), 10-21; https://doi.org/10.3390/audiolres12010002 - 30 Dec 2021
Cited by 1 | Viewed by 2662
Abstract
This review enumerates most of the studies on the Skull Vibration-Induced Nystagmus Test (SVINT) in the past 50 years from different research groups around the world. It is an attempt to demonstrate the evolution of this test and its increased interest around the [...] Read more.
This review enumerates most of the studies on the Skull Vibration-Induced Nystagmus Test (SVINT) in the past 50 years from different research groups around the world. It is an attempt to demonstrate the evolution of this test and its increased interest around the globe. It explores clinical studies and animal studies, both permitting a better understanding of the importance of SVINT and its pathophysiology. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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10 pages, 2590 KiB  
Review
The Neural Basis of Skull Vibration Induced Nystagmus (SVIN)
by Ian S. Curthoys
Audiol. Res. 2021, 11(4), 557-566; https://doi.org/10.3390/audiolres11040050 - 14 Oct 2021
Cited by 10 | Viewed by 3126
Abstract
I list a summary of the major clinical observations of SVIN in patients with total unilateral vestibular loss (TUVL) and show how basic results from neurophysiology can explain these clinical observations. The account integrates results from single neuron recordings of identified semicircular canal [...] Read more.
I list a summary of the major clinical observations of SVIN in patients with total unilateral vestibular loss (TUVL) and show how basic results from neurophysiology can explain these clinical observations. The account integrates results from single neuron recordings of identified semicircular canal and otolith afferent neurons in guinea pigs in response to low frequency skull vibration with evidence of the eye movement response in cats to selective semicircular canal stimulation (both individual and combined) and a simple model of nystagmus generation to show how these results explain most of the major characteristics of SVIN. Full article
(This article belongs to the Special Issue Skull Vibration-Induced Nystagmus Test)
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