Abstract

An increasing number of studies highlight the role of saccadic remodulation in compensatory mechanisms following vestibular injury, and the reappearance of SHIMP saccades correlates with symptom improvement measured by the Dizziness Handicap Inventory (DHI). To investigate the influence of attentional processes and working memory on visuo-vestibular interaction, three independent but interrelated experiments were conducted.

In the first two experiments, healthy subjects and patients with unilateral or bilateral vestibular deficits underwent vHIT in SHIMP mode and the Functional Head Impulse Test (fHIT), performed first separately and subsequently simultaneously. Mean latency and clustering of SHIMP saccades, together with Landolt C recognition rates, were analyzed. Differences between separate and combined protocols were assessed, and, in patients, correlated with symptom severity measured by the DHI, to determine whether the near-simultaneous execution of tasks mediated by shared parietal cortical substrates influenced performance.

In the third experiment, vHIT in HIMP mode and fHIT were performed using separate and combined protocols to evaluate whether recognition-related cognitive load affected recovery saccade latency and clustering.

Results suggest that visual recognition modulates visuo-vestibular interaction, supporting integrated dual-task protocols for ecological balance assessment and helping explain clinical discrepancies.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This research received no external funding.

Author Declarations

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AVEN ehtic committee gave ethical approval for this work (792/2021/OSS/AUSLRE)

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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Data Availability

All data generated or analyzed during this study are included in this published article. Supplementary information is available on request from the corresponding author.

AbbreviationsDHIDizziness Handicap inventoryvHITvideo Head Impulse TestSHIMPSuppression Head Impulse ProtocolHIMPHead Impulse ProtocolfHITfunctional Head Impulse TestVORvestibulo-ocular reflexMMSEMini-Mental State ExaminationHSChorizontal semicircular canalsSSCsuperior semicircular canalsPSCposterior semicircular canalsPRPerez and ReyAVDacute vestibular deficitBVDbilateral vestibular deficitVGYMVOR gymPFCprefrontal cortexACCanterior cingulate cortexNAnot applicablePPPDpersistent postural-perceptual dizziness