The proposed study, a response to PA-06-257, will develop tests for use in epidemiologic studies of vestibular and balance function, and other applications in which comprehensive vestibular testing is not possible. This study will meet the requirements of the Program Announcement with the following specific aims: 1) Equipment and test development. Develop a battery of screening tests that are sensitive and specific to vestibular disorders. To meet the practical needs of future population-based epidemiologic studies, this test battery will be brief, i.e., taking less than 15 minutes, and will be performed in a space no more than 8 X 1 m. Tests of standing and walking balance and dynamic visual acuity will be included. We will develop new versions of existing tests, and will include technological development, i.e., programming new software for tests and use of head-mounted sensors, testing all apparatus for safety. We will also develop norms for all tests.
This aim i s largely technologically driven, not hypothesis driven. 2) Validate the new battery of screening tests. 2A) Determine if these screening tests differentiate normals from the same normals when they are given galvanic vestibular stimulation to simulate acute vestibular impairment. 2B) Determine if normals who are well trained to perform at a high level despite distraction and discomfort, i.e., United States Marines, show differences on the new test battery when tested with and without galvanic vestibular stimulation. 2C) Determine if these screening tests differentiate normals from patients with known vestibular impairments. 2D) Determine if these balance tests differentiate patients with vestibular impairments from patients with lower extremity peripheral neuropathies. 3) Estimate prevalence of vestibular impairment in two adult populations and determine if the new screening battery, i.e., the 3 screening tests plus 2 other well-validated tests, detects vestibular disorders in those populations. 3A) Determine prevalence of vestibular disorders and sensitivity of the screening battery in a sample of the general population recruited from a general medical clinic. 3B) Determine prevalence of vestibular disorders and sensitivity of the screening battery in a sample of high-functioning people in high-risk occupations recruited in a military health clinic. 4) Determine if these screening tests are sensitive to change after vestibular rehabilitation. Subjects will be tested before and after a month of vestibular rehabilitation. The vestibular system may be assessed with a wide range of objective diagnostic tests in laboratories in hospitals, tertiary care centers or even smaller clinician's offices, when space, complex equipment and staff may be available to accommodate the physician's request for diagnostic data and the unique needs of each patient. Sometimes, however, such a comprehensive test battery cannot be given due to constraints of funding, space, and/ or time. In this study we will develop and validate screening tests of the vestibular system that will be useful to testing large numbers of people by busy staff who will not be vestibular or balance specialists and whose work will be constrained by limited time, space for testing, and funds for equipment.

Public Health Relevance

The vestibular system may be assessed with a wide range of objective diagnostic tests in laboratories in hospitals, tertiary care centers or even smaller clinician's offices, when space, complex equipment and staff may be available to accommodate the physician's request for diagnostic data and the unique needs of each patient. Sometimes, however, such a comprehensive test battery cannot be given due to constraints of funding, space, and/ or time. In this study we will develop and validate screening tests of the vestibular system that will be useful to testing large numbers of people by busy staff who will not be vestibular or balance specialists and whose work will be constrained by limited time, space for testing, and funds for equipment.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC009031-05
Application #
8246508
Study Section
Neurological, Aging and Musculoskeletal Epidemiology (NAME)
Program Officer
Hoffman, Howard J
Project Start
2008-04-01
Project End
2014-03-31
Budget Start
2012-04-01
Budget End
2014-03-31
Support Year
5
Fiscal Year
2012
Total Cost
$290,298
Indirect Cost
$62,613
Name
Baylor College of Medicine
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
051113330
City
Houston
State
TX
Country
United States
Zip Code
77030
Cohen, Helen S; Sangi-Haghpeykar, Haleh; Ricci, Natalia A et al. (2014) Utility of Stepping, Walking, and Head Impulses for Screening Patients for Vestibular Impairments. Otolaryngol Head Neck Surg 151:131-136
Todai, Janvi K; Congdon, Sharon L; Sangi-Haghpeykar, Haleh et al. (2014) Ocular vestibular evoked myogenic potentials in response to three test positions and two frequencies. Laryngoscope 124:E237-40
Cohen, Helen S; Mulavara, Ajitkumar P; Sangi-Haghpeykar, Haleh et al. (2014) Screening people in the waiting room for vestibular impairments. South Med J 107:549-53
Cohen, Helen S; Mulavara, Ajitkumar P; Peters, Brian T et al. (2014) Standing balance tests for screening people with vestibular impairments. Laryngoscope 124:545-50
Mulavara, Ajitkumar P; Cohen, Helen S; Peters, Brian T et al. (2013) New analyses of the sensory organization test compared to the clinical test of sensory integration and balance in patients with benign paroxysmal positional vertigo. Laryngoscope 123:2276-80
Cohen, Helen S; Mulavara, Ajitkumar P; Peters, Brian T et al. (2013) Sharpening the tandem walking test for screening peripheral neuropathy. South Med J 106:565-9
Cohen, Helen S (2011) Assessment of functional outcomes in patients with vestibular disorders after rehabilitation. NeuroRehabilitation 29:173-8