Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal
ObjectivesPersistent direction-changing positional nystagmus (DCPN) and null point (NP) are characteristic of cupulopathy of the horizontal semicircular canal (HSC). The cupulopathy can manifest as HSC-light cupula (HSC-Lcu) (geotropic DCPN) and HSC-heavy cupula (HSC-Hcu) (apogeotropic DCPN) in the...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-08-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1620972/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850070572295258112 |
|---|---|
| author | Xueyan Zhang Jiao Xu Tao Zhou Xue Yu Jin Xu Heng Yu Guangjie Song Lingli Wei Xu Yang Mei Hu Liying Chang |
| author_facet | Xueyan Zhang Jiao Xu Tao Zhou Xue Yu Jin Xu Heng Yu Guangjie Song Lingli Wei Xu Yang Mei Hu Liying Chang |
| author_sort | Xueyan Zhang |
| collection | DOAJ |
| description | ObjectivesPersistent direction-changing positional nystagmus (DCPN) and null point (NP) are characteristic of cupulopathy of the horizontal semicircular canal (HSC). The cupulopathy can manifest as HSC-light cupula (HSC-Lcu) (geotropic DCPN) and HSC-heavy cupula (HSC-Hcu) (apogeotropic DCPN) in the supine roll test (SRT). Whether the affected side of cupulopathy could be based on the nystagmus intensity in the SRT is controversial. This study aims to explore the differences in clinical characteristics and the HSC function between the HSC-Lcu and HSC-Hcu.MethodsIn this retrospective study, the disease histories of patients were collected, including those of peripheral vestibular disorders, otological diseases, and neurological diseases. We compared the nystagmus characteristics and canal paresis (CP) between the two groups. A multivariable logistic regression analysis was performed to identify predictors of cupulopathy subtype classification.ResultsWe included 52 patients with HSC-Lcu (17 males; mean age: 66.6 years) and 47 patients with HSC-Hcu (24 males; mean age: 68.0 years). A history of sudden sensorineural hearing loss (SSNHL) was more common in patients with HSC-Lcu (n = 8) than in those with HSC-Hcu (n = 0) (p = 0.005). There was no significant difference in NP1, NP2, or NP3 between the groups. The NP2 is present in all patients with HSC-Hcu. The side with stronger nystagmus intensity during the supine roll test (SRT) was consistent with the NP side in 38 patients with HSC-Lcu and 21 patients with HSC-Hcu. CP was more frequent in patients with HSC-Lcu (n = 29) than in those with HSC-Hcu (n = 16) (p = 0.030). However, when evaluated within a multivariable logistic regression model, the presence of CP was not found to be statistically significantly associated with the outcome (p > 0.05).ConclusionA history of SSNHL specifically associates with HSC-Lcu, rather than HSC-Hcu. Determining the affected side of HSC-Lcu and HSC-Hcu based on nystagmus intensity during the SRT was unreliable. HSC-Lcu shows higher rates of CP, indicating that the function of HSC-Lcu was more impaired than that of HSC-Hcu. Clinicians should consider SSNHL history and perform caloric testing when evaluating suspected HSC-Lcu, and rely on the NP for lateralization. |
| format | Article |
| id | doaj-art-313ca90f1ef74fa685a7242d4f5a1134 |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-313ca90f1ef74fa685a7242d4f5a11342025-08-20T02:47:29ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.16209721620972Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canalXueyan Zhang0Jiao Xu1Tao Zhou2Xue Yu3Jin Xu4Heng Yu5Guangjie Song6Lingli Wei7Xu Yang8Mei Hu9Liying Chang10Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Peking University First Hospital, Beijing, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaDepartment of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, ChinaObjectivesPersistent direction-changing positional nystagmus (DCPN) and null point (NP) are characteristic of cupulopathy of the horizontal semicircular canal (HSC). The cupulopathy can manifest as HSC-light cupula (HSC-Lcu) (geotropic DCPN) and HSC-heavy cupula (HSC-Hcu) (apogeotropic DCPN) in the supine roll test (SRT). Whether the affected side of cupulopathy could be based on the nystagmus intensity in the SRT is controversial. This study aims to explore the differences in clinical characteristics and the HSC function between the HSC-Lcu and HSC-Hcu.MethodsIn this retrospective study, the disease histories of patients were collected, including those of peripheral vestibular disorders, otological diseases, and neurological diseases. We compared the nystagmus characteristics and canal paresis (CP) between the two groups. A multivariable logistic regression analysis was performed to identify predictors of cupulopathy subtype classification.ResultsWe included 52 patients with HSC-Lcu (17 males; mean age: 66.6 years) and 47 patients with HSC-Hcu (24 males; mean age: 68.0 years). A history of sudden sensorineural hearing loss (SSNHL) was more common in patients with HSC-Lcu (n = 8) than in those with HSC-Hcu (n = 0) (p = 0.005). There was no significant difference in NP1, NP2, or NP3 between the groups. The NP2 is present in all patients with HSC-Hcu. The side with stronger nystagmus intensity during the supine roll test (SRT) was consistent with the NP side in 38 patients with HSC-Lcu and 21 patients with HSC-Hcu. CP was more frequent in patients with HSC-Lcu (n = 29) than in those with HSC-Hcu (n = 16) (p = 0.030). However, when evaluated within a multivariable logistic regression model, the presence of CP was not found to be statistically significantly associated with the outcome (p > 0.05).ConclusionA history of SSNHL specifically associates with HSC-Lcu, rather than HSC-Hcu. Determining the affected side of HSC-Lcu and HSC-Hcu based on nystagmus intensity during the SRT was unreliable. HSC-Lcu shows higher rates of CP, indicating that the function of HSC-Lcu was more impaired than that of HSC-Hcu. Clinicians should consider SSNHL history and perform caloric testing when evaluating suspected HSC-Lcu, and rely on the NP for lateralization.https://www.frontiersin.org/articles/10.3389/fneur.2025.1620972/fulllight cupulaheavy cupulasudden sensorineural hearing lossnull pointcanal paresis |
| spellingShingle | Xueyan Zhang Jiao Xu Tao Zhou Xue Yu Jin Xu Heng Yu Guangjie Song Lingli Wei Xu Yang Mei Hu Liying Chang Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal Frontiers in Neurology light cupula heavy cupula sudden sensorineural hearing loss null point canal paresis |
| title | Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal |
| title_full | Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal |
| title_fullStr | Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal |
| title_full_unstemmed | Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal |
| title_short | Clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal |
| title_sort | clinical characteristics and caloric testing in patients with light or heavy cupula of the horizontal semicircular canal |
| topic | light cupula heavy cupula sudden sensorineural hearing loss null point canal paresis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1620972/full |
| work_keys_str_mv | AT xueyanzhang clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT jiaoxu clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT taozhou clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT xueyu clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT jinxu clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT hengyu clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT guangjiesong clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT lingliwei clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT xuyang clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT meihu clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal AT liyingchang clinicalcharacteristicsandcalorictestinginpatientswithlightorheavycupulaofthehorizontalsemicircularcanal |