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Subjective visual vertical in multiple sclerosis patients
Paulauskas, Andrius | Kauno technologijos universitetas |
Blažauskas, Tomas | Kauno technologijos universitetas |
Marozas, Vaidotas | Kauno technologijos universitetas |
Kaski, Diego | Department of Clinical and Motor Neuroscience, University College London, United Kingdom |
Date Issued |
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2019-06-13 |
Otoneurology / audiology.
Background Spatial orientation is an inherent ability governed by the complex integration of visual, vestibular and proprioceptive inputs. The degree to which an individual relies upon visual cues, as opposed to the vestibular or proprioceptive cues, is termed visual dependency. Although abnormal visual dependence has been documented in other neurological disorders, it is not known whether MS leads to visual dependence, and whether such dependence is related to disease progression, clinical disability, or neuro-inflammatory burden in the central nervous system. Objective To evaluate SVV and visual dependence using a novel mobile virtual reality-based system for subjective visual vertical assessment (VIRVEST) and evaluate its relationship with the Expanded Disability Scale Score (EDSS), MS course and clinical findings. Methods The study included 59 patients with MS and 59 controls. Four tests were integrated in VIRVEST system and performed by each patient: a static SVV, dynamic SVV with clockwise and counter-clockwise background stimulus rotation, and SVV in a virtual reality background – a boat floating in the waving water - to be adjusted vertically. Visual dependence was evaluated as a function of dynamic SVV. Results Patients with MS manifest larger biases in both static and dynamic SVV than healthy controls. MS patients with an EDSS score >4.5 had larger values of dynamic SVV and SVV in VR when compared to MS patients with lower EDSS scores. Patients with progressive MS disease course demonstrated statistically significantly larger dynamic SVV and SVV in VR values when compared to MS patients with relapsing-remitting disease. Dynamic SVV bias was related to disease severity. The mean System Usability Scores for the VIRVEST system corresponded to a patient perceived adjective rating of “excellent”. Conclusion We have evaluated the application of a novel virtual reality-based SVV test in patients with MS. We identified greater visual dependence [...]