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Öğe An investigation of the effects of various proprioceptive inputs on vestibuloocular reflex and otolith organs(Taylor & Francis Ltd, 2025) Cengiz, Deniz Ugur; Karababa, Ercan; Sarioglu, Sanem Can; Mazooglu, Busra; Demirel Birisik, Sumeyye; Avsar, Almila; Bozkurt, Hatice KubraBackground The vestibular system is crucial for balance and gaze stability. Proprioceptive inputs from the musculoskeletal system significantly contribute to vestibular processing, especially under postural challenge. Objectives To examine how proprioceptive inputs in various body positions affect the vestibulo-ocular reflex (VOR) and otolith organ function. Materials and methods Thirty healthy adults (18-40 years, no vertiginous symptoms) underwent cervical and ocular vestibular evoked myogenic potentials (c-VEMP, o-VEMP) and video head impulse testing (v-HIT) in four positions: sitting, standing, one-leg standing, and on a balance disk. Primary outcomes included latency, amplitude, and asymmetry for VEMPs; gain and asymmetry for semicircular canals (SCCs) via v-HIT. Results c-VEMP latencies and amplitudes did not differ significantly across positions; however, amplitude asymmetry was significantly different between sitting and other conditions (p = .041). o-VEMP results remained consistent (p > .05). v-HIT revealed progressively reduced SCC gain from sitting to disk stance, with significant decreases in lateral SCCs (p < .05) and vertical SCCs (p < .001); asymmetry remained stable. Conclusions and significance Increased proprioceptive demand reduced VOR gain and modified c-VEMP asymmetry, reflecting enhanced vestibulospinal engagement. These outcomes likely arise from multisensory interactions rather than proprioceptive input alone, underscoring integrated sensory contributions to postural control.Öğe EFFECTS OF GAZE POSITION ON OCULAR VESTIBULAR EVOKED MYOGENIC POTENTIAL (oVEMP)(Dokuz Eylul Univ Inst Health Sciences, 2023) Cengiz, Deniz Ugur; Demir, Ismail; Colak, Sanem Can; Demirel, Sumeyye; Karababa, Ercan; Bayindir, TubaPurpose:To compare ocular vestibular evoked myogenic potential (oVEMP) responses obtained with superomedial and oblique gaze positions. Material and Methods:The oVEMP test was applied in 59 healthy subjects at superomedial, right oblique, and left oblique gaze positions. Stimuli were presented at 110 dB nHL with a frequency of 500 Hz. oVEMP responses were recorded via electrodes placed on the lower eyelids. Results:Higher N1-P1 amplitudes were obtained in oblique gaze positions in the stimulated ear direction compared to the superomedial position (p < 0.05). The asymmetry values obtained in the superomedial gaze position were lower than those obtained in oblique gaze positions (p < 0.05). The asymmetry values obtained in the Superomedial and oblique gaze positions had no effect on the N1, P1, and N1-P1 latencies of the waves obtained from the Conclusion:Superomedial and oblique gaze positions affect oVEMP waves. In patients in whom vestibular hypofunction is suspected, it is recommended to control oVEMP responses in oblique gaze positions as well as in superomedial gaze positions in the evaluation of the residual vestibular functions.Öğe Effects of the Kahramanmaras, Turkey 2023 earthquakes on balance perception, dizziness and post-traumatic stress: A relational screening model between subjective balance problems and post-traumatic stress(Elsevier Sci Ltd, 2024) Cengiz, Deniz Ugur; Inceoglu, Feyza; Karababa, Ercan; Polat, Ani Parabakan; Yilmaz, Tugba; Kuntman, Berna Deniz; Men, Asya FatmaObjective: The aim of the present study was to investigate the effects of the February 6, 2023, earthquakes in Turkey and recurrent aftershocks on balance and post-traumatic stress in surviving victims. Methods: Our study included 1004 participants aged 18 -65 years who were exposed to the February 6 earthquakes and aftershocks in Turkey. After obtaining online consent from all participants, the Vertigo Symptom Scale (VSS), the Dizziness Handicap Index (DHI), and the Posttraumatic Post-Traumatic Disorder Checklist Scale (PCL-5) were administered online, and the interactions between the variable sets were examined using a correlational screening model. Results: As a result of the structural equation model established with the observed variables, it was found that VSS total scores had a statistically significant positive effect on PCL-5 (beta 1 = 0.56; p = 0.001 < 0.05). In addition, statistically significant positive high-level correlations were found between VSS and DHI (cov(VSS-DH)I = 0.71), and a positive low level correlation with the number of days with dizziness (cov(VSS-number of days with dizziness) = 0.34), and a positive low level correlation with frequency of days with dizziness (cov VSS-frequency of days with dizziness = 0.37). A statistically significant positive low-level relationship was found between DHI and the number of days with dizziness (cov(DHI-number of days with dizziness) = 0.34) and a positive low-level correlation between DHI and the frequency of days with dizziness (cov(DHI-frequency of days with dizziness) = 0.29). Conclusion: The structural equation modeling analysis showed that post-traumatic stress disorder had a significant effect on balance and dizziness.Öğe Evaluation of vestibulo-ocular reflex with functional head impulse test in healthy individuals: normative values(Frontiers Media Sa, 2023) Cengiz, Deniz Ugur; Erbek, Hatice Seyra; Colak, Sanem Can; Kurtcu, Busra; Demirel Birisik, Sumeyye; Karababa, Ercan; Kusman, BusraObjectives: This study aimed to determine the normative values of the functional head impulse test (fHIT) test in healthy young adults.Materials and methods: The study included 100 individuals, 58 females and 42 males, aged 20-25 years. Beon Solution Zero Branco (TV) fHIT test was applied to all participants. FHIT results were analyzed in terms of lateral-posterior-anterior semicircular canals (SSCs), gender, and right-left ear.Results: In the fHIT test, for the lateral SSC the mean percent correct answer (%CA) values for 4,000-6,000 degrees/s(2) and 1,000-7,000 degrees/s(2) were 88.52 +/- 9.04 and 89.91 +/- 6.95, respectively; for the posterior SSC, the mean %CA values for SSC 3000-6,000 degrees/s(2) and 1,000-7,000 degrees/s(2) were 90.63 +/- 8.69 and 91.16 +/- 7.42, respectively; for the anterior SSC, the mean %CA values for 3,000-6,000 degrees/s(2) and 1,000-7,000 degrees/s(2) were 91.21 +/- 7.96 and 91.49 +/- 7.13, respectively. There was no statistically significant difference between the right and left ear in %CA values at all accelerations in all SSCs (p > 0.05). There was a statistically significant difference between genders in the mean %CA values for 6,000-7,000 degrees/s(2), 4,000-6,000 degrees/s(2), and 1,000-7,000 degrees/s(2) in the lateral SSC and 3,000-6,000 degrees/s(2) in the anterior SSC (p < 0.05).Conclusion: The FHIT is a noninvasive test battery that functionally evaluates the VOR of the six semicircular canals. In clinical use, the determination of normative values at all accelerations (1,000-7,000 degrees/s(2)) constitutes an important database for future studies to distinguish pathologic results.Öğe Psychometric properties of the Turkish version of the Vestibular Migraine Patient Assessment Tool and Handicap Inventory(Tubitak Scientific & Technological Research Council Turkey, 2024) Cengiz, Deniz Ugur; Inceoglu, Feyza; Karababa, Ercan; Satar, Buelent; Erbek, Hatice Seyra; Bayindir, Tuba; Kurtcu, BuesraBackground/aim: There are insufficient tools to assist in the diagnosis and treatment of vestibular migraine. Hence, the aim of this study was to perform the Turkish adaptation of the Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI). Materials and methods: After the language and content validity was completed, a pilot study was conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to test construct validity, and as a result of the validity analyses, Cronbach's alpha internal consistency coefficient and test-retest analyses were conducted for reliability. Results: In the study, in which 289 participants were evaluated, the Kaiser-Meyer-Olkin coefficient was calculated as 0.903. The percentage of variance explained by the EFA was 67.246% and the range of factor load change was 0.433-0.828. The scale structure was tested with CFA and the model was confirmed with adequate goodness of fit index values. The Cronbach's alpha internal consistency coefficient of the scale was 0.931. Conclusion: The VM-PATHI is a valid and reliable tool for the subjective evaluation of vestibular migraine in T & uuml;rkiye.Öğe Role of the functional head impulse test in evaluating vestibulo-ocular reflex abnormalities in individuals with Parkinson's disease(Wiley, 2023) Karababa, Ercan; Sonkaya, Ali Riza; Satar, Bulent; Korkmaz, HanifiPurposeTo assess vestibular-ocular reflex (VOR) function in patients with Parkinson's disease (PD) using a new method called functional head impulse test (fHIT).Study DesignCase-control study.SettingTertiary medical center.ParticipantsTwenty individuals with PD were recruited for PD group, and twenty healthy individuals for the control group. Ages of both groups ranged from 47 to 76 years.Main Outcome MeasuresAccording to the modified Hoehn-Yahr score, PD group was classified as an early stage with a range of 1-2.5 and a mid-late stage with a range of 3-5. Percentage of correct answers (%CA) was calculated using fHIT for lateral, anterior and posterior semicircular canal (SCC) planes.ResultsPD group had statistically lower fHIT %CA in the right lateral, left lateral, and left posterior SCC planes compared to control group (p < .05). There was no statistical difference between two PD severity groups and functional VOR abnormality.ConclusionIt was concluded that the functional VOR in the right lateral and left lateral and left posterior SCC plane was affected in individuals with PD. Our results show that impaired VOR and reduced dynamic visual acuity should be considered in individuals with PD for vestibular rehabilitation exercises.Öğe The importance of the bow and lean test as an initial positional test for diagnosing BPPV(Springer, 2025) Karababa, Ercan; Sarioglu, Sanem Can; Ocal, Fatma Ceyda Akin; Cengiz, Deniz Ugur; Arslan, Mehmet; Satar, BulentPurpose This study aimed to evaluate the diagnostic potential of nystagmus direction observed during bow and lean tests (BLTs) in patients with posterior canal canalolithiasis BPPV (P-BPPV), lateral canal canalolithiasis BPPV (Lca-BPPV), and lateral canal cupulolithiasis BPPV (Lcu-BPPV). Methods A total of 62 patients (40 women, 22 men; aged 24-70 years) with clinically suspected BPPV were enrolled. Diagnoses included 39 cases of P-BPPV, 15 of Lca-BPPV, and 8 of Lcu-BPPV. Each participant underwent the Dix-Hallpike Test (DH), Head Roll Test (HRT), and bow and lean tests for diagnostic assessment. The primary outcome was the presence and direction of nystagmus during BLTs, in relation to BPPV subtype. Results Nystagmus was detected in 77.4% of subjects during the bow test and in 46.8% during the lean test. A statistically significant difference was found in nystagmus direction across BPPV subtypes (p < 0.05). Right-beating horizontal nystagmus during the bow test was significantly more frequent in right-sided Lca-BPPV. Right down-beating torsional nystagmus during the bow test occurred exclusively in left P-BPPV, while left down-beating torsional nystagmus was seen only in right P-BPPV. Right up-beating torsional nystagmus was significantly associated with right P-BPPV, and left up-beating torsional nystagmus with left P-BPPV (p < 0.05). Conclusions In P-BPPV, DH-induced nystagmus direction was opposite in the bow position but matched in the lean position. These findings underscore the diagnostic value of BLTs, particularly the bow test, in identifying the affected canal in posterior and lateral canal BPPV.Öğe vHIT results with the synapsis system according to clinicians' dominant hand use(Ios Press, 2023) Emekci, Tugba; Dundar, Mehmet Akif; Kirazli, Gulce; Inceoglu, Feyza; Cengiz, Deniz Ugur; Kilinc, Fatma Men; Karababa, ErcanBACKGROUND/OBJECTIVE: There exists limited information in the literature on dominant hand preference in relation with vHIT applications. The present study aimed to examine the relationship between the clinician's dominant use of rightor left-hand and vHIT results. METHODS: A Synapsys vHIT Ulmer device was used in the study. The tests were administered by 3 clinicians experienced in vHIT, 2 of whom were right-handed and 1 left-handed. The test was applied to the 94 participants three times, one week apart. RESULTS: In this study, the correlation between right-handed clinicians and left-handed clinicians was examined, and in all SCCs, namely RA, LA, RL, LL, RP and LP, a moderate positive significant correlation was found between right-handed1 and right-handed2, between right-handed1 and left-handed, and between right-handed2 and left-handed. CONCLUSIONS: In this study, these findings suggested that measures were reliable across test sessions regardless of hand dominancy (right or left). Based on the vHIT results we obtained with three different right- or left-handed clinicians, the clinician should evaluate the results according to the dominant side. Keywords: Hand-dominance, left-hand dominance, right-hand dominance,
