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. 2022 Nov-Dec;88 Suppl 1(Suppl 1):S91-S96.
doi: 10.1016/j.bjorl.2021.04.006. Epub 2021 May 7.

Vestibular recruitment: new application for an old concept

Roseli Saraiva Moreira Bittar  1 , Raquel Mezzalira  2 , Alice Carolina Mataruco Ramos  1 , Gabriel Henrique Risso  1 , Danilo Martin Real  1 , Signe Schuster Grasel  1
Affiliations

Vestibular recruitment: new application for an old concept

Roseli Saraiva Moreira Bittar et al. Braz J Otorhinolaryngol. 2022 Nov-Dec.

Abstract

Introduction: Vestibular recruitment is a sign of hyperexcitability of central vestibular neurons and may be characteristic of peripheral vestibular damage.

Objective: To define the post-caloric recruitment index and its ability to predict the stage of vestibular compensation and peripheral lesion.

Methods: First of all, we demonstrated that larger values in the cold post-caloric stimulation compared to warm stimulation were equivalent to vestibular recruitment observed during the sinusoidal harmonic acceleration test. In the next step, patients with vestibular complaints and asymptomatic controls were submitted to the caloric test. We calculated post-caloric recruitment index for the control group. Among the study group, we analyzed the relation between post-caloric recruitment and unilateral weakness as well as the types of vestibular diagnoses.

Results: Mean post-caloric recruitment was 17.06% and 33.37% among the control and study group, respectively. The ratio between post-caloric recruitment and unilateral weakness was 1.3 in the study group. Among recruiting subjects, no significant difference of unilateral weakness from the lesioned or healthy side was observed. We found no differences in vestibular diagnoses between recruiting and non-recruiting subjects.

Conclusion: Post-caloric recruitment index identified asymmetric vestibular tonus and central compensation. The normal value was established at 17.06%.

Keywords: Caloric test; Vestibular compensation; Vestibular recruitment.

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Figures

Figure 1
Figure 1
VOR gain at frequencies of 0.04 and 0.16 Hz in healthy individuals and dizzy patients submitted to sinusoidal harmonic acceleration test (SHAT).
Figure 2
Figure 2
Box plot showing PCRI (%) distribution of 133 healthy individuals (median: 13.51) and 381 patients (median: 28.88), (p < 2.2e-16, 95% CI).
See this image and copyright information in PMC

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