Mutual evaluation of Caloric Test and video Head Impulse Test

Abstract

　The head impulse test (HIT) and caloric test are important tests when examining for vestibular deficits. The HIT has a moderate sensitivity (35-45%) and high specificity (90%) compared with the caloric test. In 2009, the video Head Impulse Test (vHIT) was developed that can detect covert catch up saccades which can hardly be seen with the naked eye and has better sensitivity and specificity than the HIT. However, no studies have been conducted to evaluate the performance of vHIT in a Japanese population.
　In the caloric test, the monothermal stimulation technique is widely used in Japan. On the other hand, the bithermal stimulation technique is used worldwide with the exception of Japan.
　The objective of the present study was to evaluate the performance of the vHIT and monothermal cool caloric test (MCCT) mutually in a Japanese population. The sensitivity of the vHIT was 62.6% and specificity was 86.2%. The area under the receiver operating characteristic curve in the MCCT was 0.892 using VOR gain as the dependent variable, and 0.849 using CUS as the dependent variable.
　The vHIT is a specific and fast test to detect vestibular deficits using angular acceleration stimulation, and MCCT decreases test time and side effects without reducing sensitivity of the caloric test in bithermal stimulation.