Research in Vestibular Science

Original Article

Quantifying the Prevalence of Acute Vestibular Neuritis through Big Data Analysis: Chul Young Yoon, Seulgi Hong, Ji-Yun Park, Young Joon Seo; Res Vestib Sci. 2023;22(3):68-76. Published online September 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.3.68

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Abstract PDF Supplementary Material: Objectives
Big data analytics in healthcare research have gained momentum, offering unprecedented opportunities to investigate complex medical conditions like acute vestibular neuritis (AVN). However, an inappropriate definition can introduce bias and inaccuracies into prevalence estimation, making the results unreliable and hindering cross-study comparisons. The Health Insurance data in South Korea will be used to create a robust operational definition for AVN.
Methods
The study utilized the National Patients Sample dataset from the Health Insurance Review and Assessment Service (HIRA) of the Republic of Korea. The operational definition of AVN was defined using the HIRA data, which includes specific codes for diagnosis, testing, and medications. The revised categorization scheme for AVN was presented as case 1 through case 5, with criteria for each category.
Results
The optimal conditions are deemed to be those that encompass the outcomes of both case 5 and case 1-1, encompassing all conditions. The study also provided prevalence estimates for subgroups based on demographic factors (age, sex), and found a consistent pattern throughout all years, sex, and age.
Conclusions
The study analyzed the prevalence of AVN in case 1 and case 5, which were similar to the reference prevalence of 3.5 per 100,000 people reported in other countries. The study’s results are encouraging for several reasons, including the validity of the operational definitions used, and the agreement between the study’s prevalence estimates and the reference prevalence. The operational definition in statistics, in the context of big data, serves as a precise and standardized criterion.

Video Report

Brun’s Nystagmus with Cerebellopontine Angle Schwannoma: Seulgi Hong, Ji-Yun Park, Seungjin Choi, Min Jee Kim; Res Vestib Sci. 2023;22(2):57-58. Published online June 15, 2023; DOI: https://doi.org/10.21790/rvs.2023.22.2.57

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PDF Supplementary Material

Case Report

Posterior Inferior Cerebellar Artery Stenosis Presenting as Recurrent Orthostatic Dizziness: Seongjin Jeon, Ji-Yun Park, Jong-min Lee, Seulgi Hong; Res Vestib Sci. 2022;21(2):53-56. Published online June 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.2.53

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Abstract PDF: We report a unique case of vertebrobasilar transient ischemic attacks manifesting as isolated, recurrent, orthostatic dizziness with posterior inferior cerebellar artery (PICA) stenosis. A 57-year-old male patient without past medical history, presented with brief orthostatic dizziness for 2 weeks. There was no associated nausea, vomiting, diplopia, or weakness. On neuro-otologic examination, the patient did not show spontaneous, positional, or gaze-evoked nystagmus. Vestibular function tests such as caloric test, head impulse test, video-oculography, and tilt table test were normal. Brain diffusion-weighted images showed multiple small high signal intensities in the bilateral cerebellar hemispheres. Brain magnetic resonance angiography revealed hypoplasia of the right vertebral artery without focal intracranial focal stenosis. Four-vessel cerebral angiogram showed severe stenosis at the right PICA artery. Our patient’s clinical scenario appears unique hemodynamic spells without symptoms or signs of posterior circulation ischemia. Physicians should also consider cerebrovascular ischemic when the patient suffers repeated orthostatic dizziness that is not explained clinically.

Original Article

Rasch Analysis of the Clinimetric Properties of the Korean Dizziness Handicap Inventory in Patients with Parkinson Disease: Da-Young Lee, Hui-Jun Yang, Dong-Seok Yang, Jin-Hyuk Choi, Byoung-Soo Park, Ji-Yun Park; Res Vestib Sci. 2018;17(4):152-159. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.152

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2 Crossref

Abstract PDF

Objectives
The Korean Dizziness Handicap Inventory (KDHI), which includes 25 patient-reported items, has been used to assess self-reported dizziness in Korean patients with Parkinson disease (PD). Nevertheless, few studies have examined the KDHI based on item-response theory within this population. The aim of our study was to address the feasibility and clinimetric properties of the KDHI instrument using polytomous Rasch measurement analysis.
Methods
The unidimensionality, scale targeting, separation reliability, item difficulty (severity), and response category utility of the KDHI were statistically assessed based on the Andrich rating scale model. The utilities of the orderedresponse categories of the 3-point Likert scale were analyzed with reference to the probability curves of the response categories. The separation reliability of the KDHI was assessed based on person separation reliability (PSR), which is used to measure the capacity to discriminate among groups of patients with different levels of balance deficits.
Results
Principal component analyses of residuals revealed that the KDHI had unidimensionality. The KHDI had satisfactory PSR and there were no disordered thresholds in the 3-point rating scale. However, the KDHI showed several issues for inappropriate scale targeting and misfit items (items 1 and 2) for Rasch model. Conclusions: The KDHI provide unidimensional measures of imbalance symptoms in patients with PD with adequate separation reliability. There was no statistical evidence of disorder in polytomous rating scales. The Rasch analysis results suggest that the KDHI is a reliable scale for measuring the imbalance symptoms in PD patients, and identified parts for possible amendments in order to further improve the linear metric scale.

Citations

Citations to this article as recorded by

Validation and Reliability of the Cataract-related Visual Function Questionnaire (CVFQ)
Eun Jin Koh, Jong Min Lee, Dong Hui Lim, Danbee Kang, Juhee Cho, Min Kyung Song, In Kwon Chung, Hun Jin Choi, Ji Woong Chang, Jong Hyun Lee, Tae Young Chung, Young Sub Eom, Yeoun Sook Chun, So Hyang Chung, Eun Chul Kim, Joon Young Hyon, Do Hyung Lee
Journal of the Korean Ophthalmological Society.2023; 64(11): 1030. CrossRef
Dizziness in patients with early stages of Parkinson's disease: Prevalence, clinical characteristics and implications
Kyum‐Yil Kwon, Suyeon Park, Mina Lee, Hyunjin Ju, Kayeong Im, Byung‐Euk Joo, Kyung Bok Lee, Hakjae Roh, Moo‐Young Ahn
Geriatrics & Gerontology International.2020; 20(5): 443. CrossRef

Rasch analysis of the clinimetric properties of the Korean Dizziness Handicap Inventory in patients with Parkinson's disease: Da-Young Lee, Hui-Jun Yang, Ji-Yun Park, Dong-Seok Yang, Jin-Hyuk Choi, Byoung-Soo Park; Received November 30, 2018 Accepted December 3, 2018 Published online December 3, 2018; [Accepted]

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Abstract: Objectives
The Korean Dizziness Handicap Inventory (KDHI), which includes 25 patient-reported items, has been used to assess self-reported dizziness in Korean patients with Parkinson's disease (PD). Nevertheless, few studies have examined the KDHI based on item-response theory within this population. The aim of the present study was to assess the feasibility and clinimetric properties of the KDHI instrument using polytomous Rasch measurement analysis.
Methods
The unidimensionality, local independence, scale precision, item difficulty (severity), and response category utility of the KDHI were statistically assessed using WINSTEPS version 4.0.1 (Winsteps Inc.; Chicago, IL, USA) based on the Andrich rating scale model. The utilities of the ordered response categories of the three-point Likert scale were analyzed with reference to the probability curves of the response categories. The separation reliability of the KDHI was assessed based on person separation reliability, which is used to measure the capacity to discriminate among groups of patients with different levels of balance deficits.
Results
Principal component analyses of residuals revealed that the KDHI had unidimensionality. The KHDI had satisfactory PSR and there were no disordered thresholds in the three-point rating scale. However, the KDHI showed several issues for inappropriate scale targeting and misfit items (item 1 and 2) for Rasch model.
Conclusions
The KDHI provide unidimensional measures of imbalance symptoms in patients with PD with adequate separation reliability. There was no statistical evidence of disorder in polytomous rating scales. The Rasch analysis results suggest that the KDHI is a reliable scale for measuring the imbalance symptoms in PD patients, and identified

Original Article

Classification of Chronic Dizziness in Elderly People and Relation with Falls: Dong-Suk Yang, Da-Young Lee, Sun-Young Oh, Ji-Yun Park; Res Vestib Sci. 2018;17(1):13-17. Published online March 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.1.13

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Abstract PDF: Objectives
Fall is a major cause of morbidity and mortality among older adults. Falls result from many various causes, and dizziness is important risk for falls, especially in the elderly. Research on the relationship between chronic dizziness and falls in elderly people has been rarely performed and these were no studies that analyzed the risk of falls according to subtypes of chronic dizziness.
Methods
We conducted a prospective study of the association between subtypes of chronic dizziness and falls in the elderly between 65 to 75 years. We divided dizzy patients into 5 groups according to the results of symptom, vestibular and autonomic function test. Falls and new events (acute dizziness or other medical conditions) were checked monthly by telephone or out patient department follow-up for 6 months.
Results
Thirty-four patients were enrolled and all completed follow-up for 6 months. Nine patients classified as the falling groups and 34 patients as nonfalling group. Whereas the frequencies of orthostatic hypotension (n=6, 67%) and vestibular dysfunction (n=1, 11%) were higher in fall group, psychogenic dizziness (n=12, 35%), and vestibular migraine (n=3, 9%) were more frequent in nonfall group.
Conclusions
The presence of dizziness in the elderly is a strong predictor of fall, especially orthostatic hypotension is an important predictor of fall. In order to lower the risk of falls in the elderly, an approach based on the cause of dizziness is needed.

Classification of chronic dizziness in elderly people and relation with falls: Dong-Suk Yang, Da-Young Lee, Sun-Young Oh, Ji-Yun Park; Received February 26, 2018 Accepted March 8, 2018 Published online March 8, 2018; [Accepted]

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Abstract: Purpose
Fall is a major cause of morbidity and mortality among older adults. Falls result from many various causes, and dizziness is important risk for falls, especially in the elderly. Research on the relationship between chronic dizziness and falls in elderly people has been rarely performed and these were no studies that analyzed the risk of falls according to subtypes of chronic dizziness.
Methods
We conducted a prospective study of the association between subtypes of chronic dizziness and falls in the elderly between 65 to 75 years. We divided dizzy patients into 5 groups according to the results of symptom, vestibular and autonomic function test.. Falls and new events (acute dizziness or other medical conditions) were checked monthly by telephone or OPD follow-up for 6 months.
Results
34 patients were enrolled and all completed follow-up for 6 months. Nine patients in the fall group and 34 patients in the non - fall group. Whereas the frequencies of orthostatic hypotension (n=6, 67%) and vestibular dysfunction (n=1, 11%) were higher in fall group, psychogenic dizziness (n=12, 35%) and vestibular migraine (n=3, 9%) were more frequent in non-fall group.
Conclusion
The presence of dizziness in the elderly is a strong predictor of falls, especially orthostatic hypotension is an important predictor of fall. In order to lower the risk of falls in the elderly, an approach based on the cause of dizziness is needed.

Case Report

Brain Hypometabolism in Cerebellar Ataxia, Neuropathy, Vestibular Areflexia Syndrome: Byoung-Min Jeong, Byoung-Soo Shin, Man-Wook Seo, Ji-Yun Park, Hwan-Jeong Jeong, Sun-Young Oh; Res Vestib Sci. 2017;16(4):156-160. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.156

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Abstract PDF: Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is a slowing progressive ataxic disorder characterized by bilateral vestibulopathy, cerebellar ataxia and somatosensory impairment. Autonomic dysfunction is recently considered as a core feature in CANVAS in addition to these symptoms. In most cases, patients with CANVAS show cerebellar atrophy in brain imaging, but some cases show minimal or no atrophy of cerebellum. Brain (18F)-fluoro-2-deoxy-D-glucose positron emission tomography (¹⁸F-FDG PET) study can be a complimentary tool to diagnosis CANVAS in cases of no structural abnormality such as cerebellar atrophy. Hereby, we present a case of CANVAS with minimal atrophy of cerebellum but showing a prominent hypometabolism in cerebellum, thalamus and posterior cingulate cortex in ¹⁸F-FDG PET.

Cerebellar ataxia, Neuropathy, Vestibular Areflexia Syndrome (CANVAS) 환자에서 뇌 대사감소: Byoung-Min Jeong, Byoung-Soo Shin, Man-Wook Seo, Ji-Yun Park, Hwan-Jeong Jeong, Sun-Young Oh; Received November 4, 2017 Accepted November 29, 2017 Published online November 29, 2017; [Accepted]

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Abstract: Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is a slowing progressive ataxic disorder characterized by bilateral vestibulopathy, cerebellar ataxia and somatosensory impairment. Autonomic dysfunction is recently considered as a core feature in CANVAS in addition to these symptoms. In most cases, patients with CANVAS show cerebellar atrophy in brain imaging, but some cases show minimal or no atrophy of cerebellum. Brain 18F-FDG PET study can be a complimentary tool to diagnosis CANVAS in cases of no structural abnormality such as cerebellar atrophy. Hereby, we present a case of CANVAS with minimal atrophy of cerebellum but showing a prominent hypometabolism in cerebellum, thalamus and posterior cingulate cortex in 18F-FDG PET.

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