{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:30:55Z","timestamp":1753878655325,"version":"3.41.2"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T00:00:00Z","timestamp":1705795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_PC_21046","MR\/S002065\/1"],"award-info":[{"award-number":["MC_PC_21046","MR\/S002065\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012317","name":"UCLH Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012317","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022186","name":"Lily Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022186","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR302201"],"award-info":[{"award-number":["NIHR302201"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Identifying vestibular causes of dizziness and unsteadiness in multi\u2010sensory neurological disease can be challenging, with problems typically attributed to central or peripheral nerve involvement. Acknowledging vestibular dysfunction as part of the presentation provides an opportunity to access targeted vestibular rehabilitation, for which extensive evidence exists. A diagnostic framework was developed and validated to detect vestibular dysfunction, benign paroxysmal positional vertigo or vestibular migraine. The specificity and sensitivity of the diagnostic framework was tested in patients with primary mitochondrial disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adults with a confirmed diagnosis of primary mitochondrial disease were consented, between September 2020 and February 2022. Participants with and without dizziness or unsteadiness underwent remote physiotherapy assessment and had in\u2010person detailed neuro\u2010otological assessment. The six framework question responses were compared against objective neuro\u2010otological assessment or medical notes. The output was binary, with sensitivity and specificity calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010four adults completed the study: age range 20\u201381\u2009years (mean 48\u2009years, \u00b1SD 15.05\u2009years); ratio 2:1 female to male. The framework identified a vestibular diagnosis in 35 participants, with seven having two diagnoses. The framework was able to identify vestibular diagnoses in adults with primary mitochondrial disease, with a moderate (40\u201359) to very high (90\u2013100) sensitivity and positive predictive value, and moderate to high (60\u201374) to very high (90\u2013100) specificity and negative predictive value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, the clinical framework identified common vestibular diagnoses with a moderate to very high specificity and sensitivity. This presents an opportunity for patients to access effective treatment in a timely manner, to reduce falls and improve quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16216","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T06:50:32Z","timestamp":1705906232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A diagnostic framework to identify vestibular involvement in multi\u2010sensory neurological disease"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5508-908X","authenticated-orcid":false,"given":"Amanda J.","family":"Male","sequence":"first","affiliation":[{"name":"SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah L.","family":"Holmes","sequence":"additional","affiliation":[{"name":"NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases The National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nehzat","family":"Koohi","sequence":"additional","affiliation":[{"name":"SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Dudziec","sequence":"additional","affiliation":[{"name":"Department of Neuromuscular Diseases UCL Queen Square Institute of Neurology  London UK"},{"name":"Queen Square Centre for Neuromuscular Diseases The National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael G.","family":"Hanna","sequence":"additional","affiliation":[{"name":"NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases The National Hospital for Neurology and Neurosurgery  London UK"},{"name":"Department of Neuromuscular Diseases UCL Queen Square Institute of Neurology  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gita M.","family":"Ramdharry","sequence":"additional","affiliation":[{"name":"Department of Neuromuscular Diseases UCL Queen Square Institute of Neurology  London UK"},{"name":"Queen Square Centre for Neuromuscular Diseases The National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Pizzamiglio","sequence":"additional","affiliation":[{"name":"NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases The National Hospital for Neurology and Neurosurgery  London UK"},{"name":"Department of Neuromuscular Diseases UCL Queen Square Institute of Neurology  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6123-4551","authenticated-orcid":false,"given":"Robert D. S.","family":"Pitceathly","sequence":"additional","affiliation":[{"name":"NHS Highly Specialised Service for Rare Mitochondrial Disorders, Queen Square Centre for Neuromuscular Diseases The National Hospital for Neurology and Neurosurgery  London UK"},{"name":"Department of Neuromuscular Diseases UCL Queen Square Institute of Neurology  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-646X","authenticated-orcid":false,"given":"Diego","family":"Kaski","sequence":"additional","affiliation":[{"name":"SENSE Research Unit, Department of Clinical and Movement Neurosciences, Institute of Neurology University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000126"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2018-319267"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10921-y"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/NPT.0000000000000382"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11640-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200240"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2017.1335438"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2022.120417"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000632"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0000000000000340"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T04:42:40Z","timestamp":1712551360000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,21]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/ene.16216"],"URL":"https:\/\/doi.org\/10.1111\/ene.16216","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"type":"print","value":"1351-5101"},{"type":"electronic","value":"1468-1331"}],"subject":[],"published":{"date-parts":[[2024,1,21]]},"assertion":[{"value":"2023-10-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16216"}}