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    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, Hanifi
    PurposeTo 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.
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    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, Bulent
    Purpose 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.

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