The correlation of statokinesigram and its parameters with video head impulse test and otolithic reflexes in patients with unilateral peripheral vestibular disorder

Peripheral vestibular disorders are resulted from vestibular labyrinth or vestibular nerve pathologies. In these disorders, it is also possible to observe symptoms such as vertigo, postural instability and poor balance. Some other tests exist for evaluating vestibular system as well as detailed medical history and physical examination. Not finding any studies investigating the relation between these tests in literature created a need to conduct this study. The aim of this study are to examine the level of effect that statokinesigram (SKG) has exposed on patients having Unilateral Peripheral Vestibular Disorder (UPVD), in this context, to investigate the relation between Video Head Impulse Test (VHIT) and Vestibular Evoked Myogenic Potential (VEMP) Test, which contributes diagnosis of UPVD and Static / Dynamic Posturography. This study has been conducted with 30 patients whose ages differ between 40-82 years and diagnosed UPVD, and their symptoms lasting at least 3 months. Static/ Dynamic Sensory Organization Test (SOT) including sub-parameters of SKG, Limits of Stability (LOS) Test, antero-posterior postural stability, medio-lateral postural stability, VHIT including VOR gains and head velocity and cervical-ocular VEMP tests were all administered to patients. Dynamic Posturography assesses postural stability in different conditions, VHIT assesses VOR gains and functions of canals, VEMP assesses otoliths functions. Linear correlation between variations was examined with Pearson Correlation Analysis. Regarding the analysis in this study shows that a negative correlation-moderate degree (r=-0.555; p=0.032) has been found between LOS posterior and posterior SSC peak head velocity, and a positive correlation-moderate degree (r=0.528; p=0.043 / r=0.549; p=0.034) between LOS left and Anterior/ Lateral SSC peak head velocity. In addition to this, a negative correlation-high degree (r=-0.807; p=0.015 / r=-767; p=0.026) between Anterior SSC VOR gain and cervical VEMP Latans, and a positive correlation-high degree (r=0.826; p=0.011) between eyes open SKG area and cervical VEMP N1 Amplitude, and a negative correlation-high degree (r=-0.643; p=0.010) between eyes open antero-posterior postural stability and posterior SSC peak head velocity have been observed. In addition correlations were following; a negative correlation-moderate degree (r=-0.580; p=0.024) between eyes closed antero-posterior postural stability and Anterior SSC VOR gain, and a negaive correlation-high degree (r=-0.661;p=0.007) between eyes closed antero-posterior postural stability and posterior SSC peak head velocity, and a negative correlation-high degree (r=-0.614; p=0.015) v between cobweb antero-posterior postural stability and posterior SSC peak head velocity, and a negative correlation-high degree (r=-0.772; p=0.025 / r=-0.843; p=0.009) cervical VEMP P1 amplitude and cobweb right-left postural stability / lateral SSC peak head velocity have been found. Additionally, a positive correlation-moderate degree (r=0.574; p=0.025) between LOS total area and anterior SSC peak head velocity, and a negative correlation-high degree (r=-0.780; p=0.022; r=-0.722; p=0.043) between lateral SSC VOR gain and cervical VEMP latans, and a positive correlation-moderate degree (r=0.534; p=0.040; r=0.602; p=0.018) between eyes open SKG area and lateral/anterior SSC peak head velocity have been come by. Finally, this study has come up with a positive correlation-moderate degree (r=0.520; p=0.047) between eyes closed antero-posterior postural stability and lateak SSC peak head velocity, and a negative correlation-high degree (r=-0.835; p=0.010) between eyes closed medio-lateral postural stability and cervical VEMP P1 latans, and a positive correlation-moderate degree (r=0.614; p=0.015) between cobweb SKG area and anterior SSC peak head velocity. In line with these findings, this study presents that SKG being sub-parameters of Dynamic Posturography has been affected in various degrees in patients experiencing UPVD, and SKG has a correlation with VHIT and VEMP in various degrees. We strongly suggest these findings to be taken into consideration in planning of vestibular rehabilitation programs. Key words: Dynamic Posturography, Video Head Impulse Test (VHIT), Vestibular Evoked Myogenic Potentials (VEMP), Vestibular Rehabilitation, Statokinesigram (SKG), Limits of Stability (LOS) Test, Peripheral Vestibular Disorders