Stability of the aVOR to Repeat Head Impulse Testing

Objective: The angular vestibulo-ocular reflex (aVOR) is known to be influenced by factors such as arousal and cognition during traditional vestibular function testing. However, the inherent variability of the aVOR to head impulse testing has not been explicitly examined. The purpose of this study was to determine the variability of the aVOR to active and passive head impulses using the gold standard scleral search coil method to record head and eye rotation. Study Design: Descriptive. Setting: Tertiary referral center. Patients: Twenty six healthy control subjects agreed to active and passive horizontal head impulse testing on at least two separate sessions from two unique institutions. An additional 27 individuals with cochlear implantation (CI) underwent passive horizontal and vertical semicircular canal plane head impulse testing. Test sessions were separated from 3 to 210 days in the normal subjects and from 49 to 537 days in the subjects with CI. Main Outcome Measure(s): Reliability of the angular VOR gain (eye velocity/head velocity) over time. Results: In the healthy control subjects, there was no difference in aVOR gain between right and left ears, between session one and session two, or between active (self-generated, 0.99 ± 0.08) or passive (imposed, 1.0 ± 0.08) head impulses. In the patients, we also found the aVOR gain very stable over time. However, the aVOR gains of the patients were different across the semicircular canal planes tested (p 

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