Journal of Vestibular Research-Equilibrium & Orientation最新文献

{"title":"Acute unilateral vestibulopathy and corticosteroid treatment - A randomized placebo-controlled double-blind trial.","authors":"Julia Sjögren, Per-Anders Fransson, Måns Magnusson, Mikael Karlberg, Fredrik Tjernström","doi":"10.1177/09574271241307649","DOIUrl":"https://doi.org/10.1177/09574271241307649","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of corticosteroids for treating acute vestibular neuritis, or acute unilateral vestibulopathy (AUVP), remains controversial.</p><p><strong>Objective: </strong>This study aimed to evaluate whether corticosteroids improve vestibular function and reduce symptoms in both acute and chronic phases of AUVP.</p><p><strong>Methods: </strong>This randomized, placebo-controlled, double-blind trial included patients with AUVP (ages 18-80) from emergency departments at three sites in southern Sweden. Patients were randomly assigned to one of three groups: placebo, 3-day or 10-day corticosteroid treatment. The steroid groups received intravenous betamethasone followed by oral steroids, while the placebo group received intravenous saline followed by oral placebo. The primary outcome was canal paresis (%) after 12 months, measured via caloric testing. Secondary outcomes included vHIT gain, Diary Vertigo score, Dizziness Handicap Inventory, and Hospital Anxiety and Depression Scale. Analyses were conducted on an intention-to-treat basis. The trial was registered with the EU Clinical Trials Register (EudraCT Number: 2014-005484-32) and ClinicalTrials.gov (NCT00802529).</p><p><strong>Results: </strong>From December 2015 to March 2021, 350 patients were screened, and 69 were included: 23 in the 10-day corticosteroid group, 22 in the 3-day corticosteroid group, and 24 in the placebo group. All groups showed significant improvement in caloric function over time (<i>p</i> = .002), with no significant differences between groups at any time point (<i>p</i> = .629). Change in caloric asymmetry from baseline to 12 months did not differ between the treatment groups and the placebo group: mean difference -8.34 (95% CI -25.93 to 9.26; <i>p</i> = .347) in the 10-day steroid group and -6.61 (-24.67 to 11.45; <i>p</i> = .467) in the 3-day steroid group, compared with placebo. Secondary outcomes showed no significant differences between groups. Corticosteroid treatments were well tolerated with no safety concerns.</p><p><strong>Conclusions: </strong>Corticosteroid treatment does not significantly improve caloric recovery, vHIT gain recovery, or subjective well-being in patients with AUVP.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271241307649"},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsaccades during video head impulse test in normal subjects.","authors":"Mingwei Xu, Qin Zhang, Yuan Yao, Qiong Wu, Jun Yang, Yulian Jin, Qing Zhang","doi":"10.1177/09574271241299310","DOIUrl":"10.1177/09574271241299310","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to quantitatively analyze the characteristics of saccades in normal subjects during video head impulse test (vHIT), to establish a reference for clinical practice.</p><p><strong>Methods: </strong>A cohort of 20 healthy individuals (40 ears) was recruited and compared with a matched group of 20 patients (20 ears) suffering from vestibular neuritis (VN), utilizing vHIT to evaluate the functionality of all three semicircular canals (SCCs). This study analyzed the quantitative characteristics of saccades observed in healthy individuals and patients with VN.</p><p><strong>Results: </strong>Significant differences were observed between both groups in terms of lateral saccade frequency, latency, peak velocity, and duration for both the first and second saccades (all <i>p</i> < 0.05, with age as a covariate). Similarly, significant differences were found in vertical SCCs between groups for the frequency, latency, peak velocity, and duration of the first saccade (all <i>p</i> < 0.05, with age as a covariate). However, no significant differences were found in Perez-Rey (PR) scores either in lateral (<i>p</i> = 0.259) or vertical (<i>p</i> = 0.102) SCCs. Within the healthy group, significant differences were observed in the frequency, peak velocity, and duration of the first saccade in lateral and vertical SCCs (all <i>p</i> < 0.05). However, the latency (<i>p</i> = 0.827) and PR scores (<i>p</i> = 0.552) exhibited no significant variation.</p><p><strong>Conclusions: </strong>Microsaccades characterized by prolonged latency and reduced amplitude can occur in healthy individuals during vHIT and are distinct from the saccades seen in patients with VN due to vestibular impairment. This highlights the need to carefully identify and interpret relevant saccades during clinical assessments.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271241299310"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsideration of acute unilateral vestibulopathy/vestibular neuritis: A prospective cohort study with function test-based classification.","authors":"Xunyuan Liu, Xianrong Xu","doi":"10.1177/09574271241300326","DOIUrl":"https://doi.org/10.1177/09574271241300326","url":null,"abstract":"<p><strong>Background: </strong>Vestibular neuritis (VN) has faced various diagnostic challenges despite years of clinical use. This study analyzes 65 cases based on diagnostic criteria for acute unilateral vestibulopathy/vestibular neuritis (AUVP/VN) 2022.</p><p><strong>Method: </strong>Through medical history, physical examinations, and vestibular function tests, including the caloric test, video-head impulse test (v-HIT), and vestibular evoked myogenic potentials (VEMPs), we thoroughly tested vestibular receptor dysfunction of AUVP/VN cases. Patients were divided into two groups: total vestibular nerve branch dysfunction (tVND) and partial vestibular nerve branch dysfunction (pVND). The tVND group was defined as involving all receptors innervated by the superior and/or inferior vestibular nerve. The pVND group was defined as involving any other combination pattern of vestibular receptors (at least one). Sociodemographic and clinical characteristics were analyzed. All patients were followed up for 6 months. Changes in DHI scale scores and residual or new symptoms were investigated.</p><p><strong>Results: </strong>A total of 65 AUVP/VN patients with vestibular receptor dysfunction were included. There were 51 cases in the pVND group and 14 in the tVND group. Compared to the pVND group, the tVND group showed longer vertigo duration (<i>p</i> < 0.05), higher rates of postural symptoms (<i>p</i> < 0.01), higher rates of abnormal caloric tests (<i>p</i> < 0.05), higher canal paresis values (<i>p</i> < 0.001), and higher rates of deficient vestibulo-ocular reflex (VOR) gain in v-HIT (<i>p</i> < 0.001). After a 6-month follow-up, the pVND group showed lower DHI scores (<i>p</i> < 0.001) and higher cure rate (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In general, patients in the tVND group showed a more severe disease and worse prognosis than those in the pVND group. The substitution of the term AUVP for VN is appropriate and aligns with the clinical characteristics of the cases. However, the diagnosis of AUVP should be further developed to include otolith organ dysfunction.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271241300326"},"PeriodicalIF":2.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic postural stability, symmetry, and smoothness of gait in patients with persistent postural-perceptual dizziness.","authors":"Marco Tramontano, Gianluca Paolocci, Diego Piatti, Giuseppe Attanasio, Laura Casagrande Conti, Elena Bergamini, Leonardo Manzari, Francesco Lacquaniti, Jeffrey P Staab, Gianfranco Bosco, Iole Indovina","doi":"10.1177/09574271241295615","DOIUrl":"https://doi.org/10.1177/09574271241295615","url":null,"abstract":"<p><strong>Background: </strong>Patients with persistent postural-perceptual dizziness (PPPD) exhibit altered postural and gait dynamics, but development of these changes following precipitating illnesses is poorly understood.</p><p><strong>Objective: </strong>To compare posture and gait metrics in patients with PPPD or subacute unilateral vestibulopathies (sAUVP) to healthy controls (HC).</p><p><strong>Methods: </strong>Ten patients with sAUVP, nine with PPPD, and eleven HC completed the 10 Meters Walk Test (10MWT) (an eyes open task) and Fukuda Stepping Test (FST) (an eyes closed task). Gait stability, symmetry, and smoothness were compared among groups and correlated with Dizziness Handicap Inventory (DHI) scores.</p><p><strong>Results: </strong>10MWT - Patients with PPPD had lower pelvis stability and gait symmetry than HCs. Patients with sAUVP had only lower pelvis stability. FST - Patients with PPPD and sAUVP had lower gait smoothness than HCs. Patients with sAUVP also had lower gait symmetry. Among patients with PPPD, DHI scores correlated positively with head stability.</p><p><strong>Conclusions: </strong>PPPD and sAUVP caused abnormal pelvis stability when walking and gait smoothness when stepping but differed in effects on gait symmetry with the presence/absence of visual inputs. For PPPD, visual stimuli had destabilizing effects, whereas for sAUVP vision aided stability. Symptom severity in patients with PPPD was related to head stability.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271241295615"},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of public square dancing combined with serotonin reuptake inhibitors on persistent postural-perceptual dizziness (PPPD) in middle-aged and older women.","authors":"Bo Tang, Wei Jiang, Chuang Zhang, Hong Tan, Minghua Luo, Yuqin He, Xiaojun Yu","doi":"10.3233/VES-230045","DOIUrl":"10.3233/VES-230045","url":null,"abstract":"<p><strong>Background: </strong>Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder that causes chronic dizziness and limits daily activities. Although pharmacology, vestibular rehabilitation, and cognitive behavioral therapy have been proposed to have some efficacy, they have certain limitations. Some patients with PPPD report that public square dancing can effectively relieve the symptoms of dizziness and instability, and their mood improves.</p><p><strong>Objective: </strong>To evaluate the effects of combining public square dancing with serotonin reuptake inhibitors (SSRIs/SNRIs) on the subjective sensations of dizziness, balance enhancement, anxiety, and depressive symptom regulation in middle-aged and older women with PPPD.</p><p><strong>Materials and methods: </strong>In this trial, 124 patients diagnosed with PPPD were enrolled. Among them, 64 patients were randomly assigned to the experimental group (EG), where they received square dance training combined with serotonin reuptake inhibitors. The remaining 60 cases were randomly assigned to the control group (CG), where they received only serotonin reuptake inhibitors and did not participate in organized sports activities, allowing them freedom in their daily lives. Data from the Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS), Active-specific Balance Confidence Scale (ABC), and Vestibular Disorder Activities of Daily Living Scale (VADL) were collected and compared at the beginning, 3 months, and 6 months of the trial to evaluate the effect of public square dancing on middle-aged and older women with PPPD.</p><p><strong>Results: </strong>There were no significant differences between the EG and CG before the trial. Compared with baseline measures, DHI, HADS, ABC, and VADL scores improved as the experiment progressed, and the improvements were more pronounced in the EG.</p><p><strong>Conclusion: </strong>Public square dancing combined with serotonin reuptake inhibitors has a positive impact on the subjective sensations of dizziness, balance enhancement, anxiety, and depressive symptom regulation in middle-aged and older women with PPPD.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"63-72"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of saccade metrics and VOR gain in detecting a vestibular stroke.","authors":"Efterpi Michailidou, Athanasia Korda, Thomas Wyss, Stanislav Bardins, Erich Schneider, Miranda Morrison, Franca Wagner, Marco D Caversaccio, Georgios Mantokoudis","doi":"10.3233/VES-230083","DOIUrl":"10.3233/VES-230083","url":null,"abstract":"<p><strong>Objective: </strong>A normal video Head Impulse Test is the gold standard in the emergency department to rule-in patients with an acute vestibular syndrome and a stroke. We aimed to compare the diagnostic accuracy of vHIT metrics regarding the vestibulo-ocular reflex gain and the corrective saccades in detecting vestibular strokes.</p><p><strong>Methods: </strong>Prospective cross-sectional study (convenience sample) of patients presenting with acute vestibular syndrome in the emergency department of a tertiary referral centre between February 2015 and May 2020. We screened 1677 patients and enrolled 76 patients fulfilling the inclusion criteria of acute vestibular syndrome. All patients underwent video head impulse test with automated and manual data analysis. A delayed MRI served as a gold standard for vestibular stroke confirmation.</p><p><strong>Results: </strong>Out of 76 patients, 52 were diagnosed with acute unilateral vestibulopathy and 24 with vestibular strokes. The overall accuracy of detecting stroke with an automated vestibulo-ocular reflex gain was 86.8%, compared to 77.6% for cumulative saccade amplitude and automatic saccade mean peak velocity measured by an expert and 71% for cumulative saccade amplitude and saccade mean peak velocity measured automatically. Gain misclassified 13.1% of the patients as false positive or false negative, manual cumulative saccade amplitude and saccade mean peak velocity 22.3%, and automated cumulative saccade amplitude and saccade mean peak velocity 28.9% respectively.</p><p><strong>Conclusions: </strong>We found a better accuracy of video head impulse test for the diagnosis of vestibular strokes when using the vestibulo-ocular reflex gain than using saccade metrics. Nevertheless, saccades provide an additional and important information for video head impulse test evaluation. The automated saccade detection algorithm is not yet perfect compared to expert analysis, but it may become a valuable tool for future non-expert video head impulse test evaluations.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"49-61"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sound and postural control during stance tasks in abnormal subjective haptic vertical.","authors":"Kristina Anton, Arne Ernst, Dietmar Basta","doi":"10.3233/VES-230079","DOIUrl":"10.3233/VES-230079","url":null,"abstract":"<p><strong>Background: </strong>Patients with vestibular impairment often suffer from postural instability. This could be compensated by other sensory systems such as the auditory system.</p><p><strong>Objective: </strong>The aim of this study was to investigate whether auditory input improves postural stability in patients with abnormal subjective haptic vertical (SHV).</p><p><strong>Methods: </strong>Participants (n = 13) with normal hearing and vision, but abnormal SHV participated. Participants performed standing on firm ground and foam support (eyes open/closed) and Tandem Romberg test (eyes closed) in quiet (reference), noise and with plugged ears. All tasks were conducted in a soundproofed and reverberant room. Postural stability was recorded close to the body's center of gravity. Reference conditions were compared with a control group.</p><p><strong>Results: </strong>In only two tasks sway increased significantly when noise was presented during challenging tasks in the soundproofed room. Sway of the reference conditions did not differ significantly between control and study group.</p><p><strong>Conclusions: </strong>This study shows no influence of applied auditory stimulation on posture in participants with abnormal SHV in a reverberant room, but an adverse effect on balance during difficult tasks in the soundproofed room. Noise possibly masked auditory information that was helpful in improving posture in the quiet condition. Futhermore, noise might have distracted participants from maintaining balance.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"93-102"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dizziness-related disability in persons with post-COVID condition: A cross sectional study.","authors":"Elin Östlind, Elisabeth Ekstrand, Iben Axén, Christina Brogårdh, Agneta Malmgren Fänge, Kjerstin Stigmar, Eva Ekvall Hansson","doi":"10.3233/VES-230064","DOIUrl":"10.3233/VES-230064","url":null,"abstract":"<p><strong>Background: </strong>Dizziness is a common symptom in post-COVID condition (PCC) which may have a large impact on several life domains. However, knowledge on dizziness-severity and disability in PCC is sparse.</p><p><strong>Objective: </strong>The aim was to describe the severity of dizziness-related disability in individuals with PCC, and how it is manifested in daily life.</p><p><strong>Methods: </strong>A questionnaire regarding symptoms of PCC, health, and dizziness-related handicap was administered online, and 524 persons with PCC and dizziness were included.</p><p><strong>Results: </strong>Mean score of the Dizziness Handicap Inventory was 35.2 (24.0) and 51.8%, were classified as having moderate/severe dizziness-related disability. The percentage of maximum value for the subscales were: Physical manifestation, 48%, Emotional Impact, 36% and Catastrophic Impact, 17%. The greatest influence on physical movements was when bending forward, head shaking or doing strenuous physical activities or household chores.</p><p><strong>Conclusions: </strong>Half had moderate or severe dizziness-related disability and the physical manifestations occurred mostly during specific or strenuous body movements. This indicate a vestibular impairment that may be effectively managed with vestibular rehabilitation. Assessment and treatment of dizziness might be an essential part in PCC rehabilitation and future research should continue to explore the potential causal pathways of dizziness in PCC.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"185-193"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Journal of Vestibular Research vol. 34 issue 1.","authors":"Joseph M Furman","doi":"10.3233/VES-241001","DOIUrl":"10.3233/VES-241001","url":null,"abstract":"","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"34 1","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of benign paroxysmal positional vertigo in a population-based setting among 75-year-olds.","authors":"Ellen Lindell, Caterina Finizia, Hugo Davidsson, Lena Kollen, Silke Kern, Ingmar Skoog, Lina Rydén","doi":"10.3233/VES-240027","DOIUrl":"https://doi.org/10.3233/VES-240027","url":null,"abstract":"<p><strong>Background: </strong>Benign paroxysmal positional vertigo (BPPV) is one of the most frequently diagnosed cause of dizziness among older adults.</p><p><strong>Objective: </strong>To investigate the prevalence of BPPV and positional symptoms of dizziness and nystagmus among 75-year-olds and to identify factors associated with BPPV and positional dizziness and nystagmus.</p><p><strong>Methods: </strong>In this cross-sectional population-based study of 75-78-year-olds in Gothenburg, 887 participants were examined with questions regarding dizziness and health and social factors. A total of 681 participants underwent the Dix-Hallpike test or the side-lying test for BPPV using Video Frenzel goggles.</p><p><strong>Results: </strong>In total 32% reported problems with dizziness (n = 887). The prevalence of BPPV was 4% in the unweighted and 4.5% in the weighted analyses, compensating for selective attrition of women and participants with previous positional dizziness. Positional dizziness without nystagmus was found in 2% and nystagmus without dizziness was found in 9%. Individuals with BPPV and positional dizziness experienced more dizziness in everyday life compared with those with normal tests, while those with positional nystagmus did not.</p><p><strong>Conclusions: </strong>The estimated prevalence of BPPV among 75-year-olds was 4.5%. Despite weighted analyses, the true prevalence may be higher since many participants with dizziness refused testing. Dizziness was associated with fear and discomfort so strong that around 20% of the participants declined testing.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"34 4","pages":"195-204"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}