Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study
BackgroundIn patients with acute vestibular syndrome (AVS) differentiating between benign acute peripheral vestibular disorders and possible life-threatening central, causes such as stroke, can be challenging due to similar symptoms. AVS patients experience dizziness, vertigo, imbalance, nausea, vom...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1576959/full |
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| author | Nadia Sadok Gijs Luijten Gijs Luijten Gijs Luijten Fin H. Bahnsen Christina Gsaxner Lorenz Peters Theda Eichler Theresa Rombach Stephan Lang Sameh Khattab Jens Kleesiek Jens Kleesiek Jens Kleesiek Jens Kleesiek Jens Kleesiek Dagny Holle Moritz Meyer Jan Egger Jan Egger Jan Egger Jan Egger Jan Egger |
| author_facet | Nadia Sadok Gijs Luijten Gijs Luijten Gijs Luijten Fin H. Bahnsen Christina Gsaxner Lorenz Peters Theda Eichler Theresa Rombach Stephan Lang Sameh Khattab Jens Kleesiek Jens Kleesiek Jens Kleesiek Jens Kleesiek Jens Kleesiek Dagny Holle Moritz Meyer Jan Egger Jan Egger Jan Egger Jan Egger Jan Egger |
| author_sort | Nadia Sadok |
| collection | DOAJ |
| description | BackgroundIn patients with acute vestibular syndrome (AVS) differentiating between benign acute peripheral vestibular disorders and possible life-threatening central, causes such as stroke, can be challenging due to similar symptoms. AVS patients experience dizziness, vertigo, imbalance, nausea, vomiting, and abnormal eye movements. This research evaluates the feasibility of using the eye-tracking capability of a mixed reality optical-see-through head-mounted display (MR-OST-HMD) to detect pathological eye movement patterns in patients with AVS.MethodsConducted at University Hospital Essen, this study assessed patients with AVS using a MR-OST-HMD during the HINTS-Exam. The feasibility study included 21 healthy subjects, seven patients with acute peripheral vestibular dysfunction and two stroke patients. Eye gaze, head position, and orientation were captured using a MR-OST-HMD and an in-house developed application designed to simulate the HINTS-Exam. The eye-tracking technology determined gaze direction and position, while the internal measurement unit and gyroscope recorded head movements in terms of position and velocity.ResultsThe MR-OST-HMD detected abnormal eye movements, including nystagmus, saccades, and skew deviation effectively. The device proved effective even for patients with severe nausea and elderly participants, who completed the eye calibration and HINTS-Exam without difficulty. The MR-OST-HMD HINTS-Exam was quick to perform (approximately 5 min) and was easily integrated into clinical practice after a single demonstration for medical staff.ConclusionMR-OST-HMD can detect pathological eye movements in AVS patients. Future research should validate these findings in larger cohorts and explore machine learning integration to enhance diagnostic accuracy. |
| format | Article |
| id | doaj-art-acdb3a2220aa4a5ebf25710a9cb48aef |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-acdb3a2220aa4a5ebf25710a9cb48aef2025-08-20T03:49:22ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15769591576959Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility studyNadia Sadok0Gijs Luijten1Gijs Luijten2Gijs Luijten3Fin H. Bahnsen4Christina Gsaxner5Lorenz Peters6Theda Eichler7Theresa Rombach8Stephan Lang9Sameh Khattab10Jens Kleesiek11Jens Kleesiek12Jens Kleesiek13Jens Kleesiek14Jens Kleesiek15Dagny Holle16Moritz Meyer17Jan Egger18Jan Egger19Jan Egger20Jan Egger21Jan Egger22Department for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, GermanyInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, GermanyInstitute of Computer Graphics and Vision (ICG), Graz University of Technology, Graz, AustriaCenter for Virtual and Extended Reality in Medicine (ZvRM), University Hospital Essen, Essen, GermanyInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, GermanyInstitute of Computer Graphics and Vision (ICG), Graz University of Technology, Graz, AustriaInstitute for Medical Education, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital, University of Duisburg-Essen, Essen, GermanyDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, GermanyDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, GermanyDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, GermanyInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, GermanyInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, GermanyCancer Research Center Cologne Essen (CCCE), West German Cancer Center Essen, University Hospital Essen (AöR), Essen, GermanyGerman Cancer Consortium (DKTK), Essen, GermanyDepartment of Physics, TU Dortmund University, Dortmund, GermanyFaculty of Computer Science, University of Duisburg-Essen, Essen, Germany0Department of Neurology, West German Headache and Vertigo Center, Essen University Hospital (AöR), Essen, GermanyDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, GermanyInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, GermanyInstitute of Computer Graphics and Vision (ICG), Graz University of Technology, Graz, AustriaCenter for Virtual and Extended Reality in Medicine (ZvRM), University Hospital Essen, Essen, GermanyCancer Research Center Cologne Essen (CCCE), West German Cancer Center Essen, University Hospital Essen (AöR), Essen, GermanyFaculty of Computer Science, University of Duisburg-Essen, Essen, GermanyBackgroundIn patients with acute vestibular syndrome (AVS) differentiating between benign acute peripheral vestibular disorders and possible life-threatening central, causes such as stroke, can be challenging due to similar symptoms. AVS patients experience dizziness, vertigo, imbalance, nausea, vomiting, and abnormal eye movements. This research evaluates the feasibility of using the eye-tracking capability of a mixed reality optical-see-through head-mounted display (MR-OST-HMD) to detect pathological eye movement patterns in patients with AVS.MethodsConducted at University Hospital Essen, this study assessed patients with AVS using a MR-OST-HMD during the HINTS-Exam. The feasibility study included 21 healthy subjects, seven patients with acute peripheral vestibular dysfunction and two stroke patients. Eye gaze, head position, and orientation were captured using a MR-OST-HMD and an in-house developed application designed to simulate the HINTS-Exam. The eye-tracking technology determined gaze direction and position, while the internal measurement unit and gyroscope recorded head movements in terms of position and velocity.ResultsThe MR-OST-HMD detected abnormal eye movements, including nystagmus, saccades, and skew deviation effectively. The device proved effective even for patients with severe nausea and elderly participants, who completed the eye calibration and HINTS-Exam without difficulty. The MR-OST-HMD HINTS-Exam was quick to perform (approximately 5 min) and was easily integrated into clinical practice after a single demonstration for medical staff.ConclusionMR-OST-HMD can detect pathological eye movements in AVS patients. Future research should validate these findings in larger cohorts and explore machine learning integration to enhance diagnostic accuracy.https://www.frontiersin.org/articles/10.3389/fneur.2025.1576959/fullacute vestibular syndromemixed reality headsethead-mounted displayeye movementnystagmusvertigo |
| spellingShingle | Nadia Sadok Gijs Luijten Gijs Luijten Gijs Luijten Fin H. Bahnsen Christina Gsaxner Lorenz Peters Theda Eichler Theresa Rombach Stephan Lang Sameh Khattab Jens Kleesiek Jens Kleesiek Jens Kleesiek Jens Kleesiek Jens Kleesiek Dagny Holle Moritz Meyer Jan Egger Jan Egger Jan Egger Jan Egger Jan Egger Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study Frontiers in Neurology acute vestibular syndrome mixed reality headset head-mounted display eye movement nystagmus vertigo |
| title | Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study |
| title_full | Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study |
| title_fullStr | Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study |
| title_full_unstemmed | Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study |
| title_short | Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study |
| title_sort | performing the hints exam using a mixed reality head mounted display in patients with acute vestibular syndrome a feasibility study |
| topic | acute vestibular syndrome mixed reality headset head-mounted display eye movement nystagmus vertigo |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1576959/full |
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