Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome
Abstract Introduction A significant portion of patients with acute vestibular syndrome (AVS) due to posterior circulation infarction (PCI) is free of non-vestibular signs. A differential diagnosis of this form from that due to vestibular neuritis (VN) can be challenging. We herein aimed to understan...
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BMC
2025-08-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-03046-9 |
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| author | Mi-Mi Jin Xin-Lei Mao Yu-Lian Song Yang-Yang Zhou Dao-Lu Zhang Qing-Qing Zhuang Xiang-Dong Huang Si-Liang Zhu Si-Si He Wei Chen Xiong Zhang Jian-Hong Zhu |
| author_facet | Mi-Mi Jin Xin-Lei Mao Yu-Lian Song Yang-Yang Zhou Dao-Lu Zhang Qing-Qing Zhuang Xiang-Dong Huang Si-Liang Zhu Si-Si He Wei Chen Xiong Zhang Jian-Hong Zhu |
| author_sort | Mi-Mi Jin |
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| description | Abstract Introduction A significant portion of patients with acute vestibular syndrome (AVS) due to posterior circulation infarction (PCI) is free of non-vestibular signs. A differential diagnosis of this form from that due to vestibular neuritis (VN) can be challenging. We herein aimed to understand whether quantitative eye movement signature could be used to assist such a diagnosis. Methods A total of 56 patients with AVS due to PCI free of non-vestibular signs, 71 patients with AVS due to VN, and 127 controls were selected retrospectively into the study from our hospital database. Demographic, clinical data, and videooculography results were extracted. Results Patients with PCI or VN differed from controls in most eye movement metrics. Patients with PCI also differed from those with VN in multiple metrics, including contralesional speed of horizontal saccade, gain of downward saccade, speed and gain of upward saccade, contralesional gain and gain asymmetry of smooth pursuit, and ipsilesional gain of optokinetic nystagmus. A detection model, built on the basis of age, hypertension, gain of upward saccade, and gain asymmetry of smooth pursuit, distinguished PCI from VN with area under the curve at 0.964 (0.929, 0.998) and 0.961 (0.915, 1.000) in the training and test sessions, respectively. Conclusion We demonstrate that eye movements are differentially impaired in patients with PCI free of non-vestibular signs and those with VN. The detection model built on smooth pursuit gain asymmetry and upward saccade gain may assist the differentiation between PCI and VN in AVS patients by trained clinicians. |
| format | Article |
| id | doaj-art-bafbfaddf9ac4648899c8f807db17734 |
| institution | Kabale University |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-bafbfaddf9ac4648899c8f807db177342025-08-24T11:15:07ZengBMCEuropean Journal of Medical Research2047-783X2025-08-0130111010.1186/s40001-025-03046-9Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndromeMi-Mi Jin0Xin-Lei Mao1Yu-Lian Song2Yang-Yang Zhou3Dao-Lu Zhang4Qing-Qing Zhuang5Xiang-Dong Huang6Si-Liang Zhu7Si-Si He8Wei Chen9Xiong Zhang10Jian-Hong Zhu11Department of Neurology, Wenzhou Central HospitalDepartment of Neurology, Wenzhou Central HospitalInstitute of Nutrition and Diseases and Center for Research, School of Public Health, Wenzhou Medical UniversityInstitute of Nutrition and Diseases and Center for Research, School of Public Health, Wenzhou Medical UniversityInstitute of Nutrition and Diseases and Center for Research, School of Public Health, Wenzhou Medical UniversityDepartment of Neurology, Wenzhou Central HospitalDepartment of Neurology, Wenzhou Central HospitalDepartment of Neurology, Wenzhou Central HospitalDepartment of Neurology, Wenzhou Central HospitalDepartment of Neurology, Wenzhou Central HospitalDepartment of Neurology and Institute of Geriatric Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical UniversityInstitute of Nutrition and Diseases and Center for Research, School of Public Health, Wenzhou Medical UniversityAbstract Introduction A significant portion of patients with acute vestibular syndrome (AVS) due to posterior circulation infarction (PCI) is free of non-vestibular signs. A differential diagnosis of this form from that due to vestibular neuritis (VN) can be challenging. We herein aimed to understand whether quantitative eye movement signature could be used to assist such a diagnosis. Methods A total of 56 patients with AVS due to PCI free of non-vestibular signs, 71 patients with AVS due to VN, and 127 controls were selected retrospectively into the study from our hospital database. Demographic, clinical data, and videooculography results were extracted. Results Patients with PCI or VN differed from controls in most eye movement metrics. Patients with PCI also differed from those with VN in multiple metrics, including contralesional speed of horizontal saccade, gain of downward saccade, speed and gain of upward saccade, contralesional gain and gain asymmetry of smooth pursuit, and ipsilesional gain of optokinetic nystagmus. A detection model, built on the basis of age, hypertension, gain of upward saccade, and gain asymmetry of smooth pursuit, distinguished PCI from VN with area under the curve at 0.964 (0.929, 0.998) and 0.961 (0.915, 1.000) in the training and test sessions, respectively. Conclusion We demonstrate that eye movements are differentially impaired in patients with PCI free of non-vestibular signs and those with VN. The detection model built on smooth pursuit gain asymmetry and upward saccade gain may assist the differentiation between PCI and VN in AVS patients by trained clinicians.https://doi.org/10.1186/s40001-025-03046-9StrokePeripheral originRetrospective analysisSide of lesionDiagnosis modeling |
| spellingShingle | Mi-Mi Jin Xin-Lei Mao Yu-Lian Song Yang-Yang Zhou Dao-Lu Zhang Qing-Qing Zhuang Xiang-Dong Huang Si-Liang Zhu Si-Si He Wei Chen Xiong Zhang Jian-Hong Zhu Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome European Journal of Medical Research Stroke Peripheral origin Retrospective analysis Side of lesion Diagnosis modeling |
| title | Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome |
| title_full | Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome |
| title_fullStr | Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome |
| title_full_unstemmed | Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome |
| title_short | Eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome |
| title_sort | eye movement features for assisting differentiation between posterior circulation infarction and vestibular neuritis in patients of acute vestibular syndrome |
| topic | Stroke Peripheral origin Retrospective analysis Side of lesion Diagnosis modeling |
| url | https://doi.org/10.1186/s40001-025-03046-9 |
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