{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:24:57Z","timestamp":1787117097246,"version":"build-2736575974"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Apart from conventional head-impulse tests (i.e., passive HITs), patency of the vestibulo-ocular reflex (VOR) can also be evaluated through self-generated HITs (i.e., active HITs). We aimed to evaluate the usefulness of active (self-generated) HITs in patients with acute unilateral vestibulopathy\/vestibular neuritis (AUVP\/VN) during the acute stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively recruited 24 patients with AUVP\/VN and 30 healthy participants from January 2019 to June 2026. All subjects underwent passive as well as active HITs. We compared the latency and amplitude of corrective saccades during active and passive HITs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During active HITs, patients with AUVP\/VN exhibited shorter latency (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and larger amplitude (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) of their 1st corrective saccade compared with healthy participants. The latency of 1st corrective saccades during active HITs showed a positive correlation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), whereas the amplitude showed a negative correlation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) with the VOR gain during passive HITs. To differentiate patients with AUVP\/VN from healthy participants, the sensitivity and specificity were 83.3 and 86.4%, respectively, at a cut-off latency of 242\u202fms for the 1st corrective saccade during active HITs with an area-under-the-curve (AUC) of 0.907. The sensitivity was 91.7% and the specificity was 93.3% at a cut-off value of 8.15\u00b0 for amplitude of 1st corrective saccades, with an AUC of 0.971.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Detection of short-latency (\u2264 242\u202fms) and large (\u2265 8.15\u00b0) corrective saccades may help identify AUVP\/VN during active HITs. Active HITs may provide complementary information for detecting acute unilateral vestibular hypofunction, although further validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1870852","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:37:10Z","timestamp":1787114230000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Active head-impulse tests may help detect acute unilateral vestibulopathy: a preliminary study"],"prefix":"10.3389","volume":"17","author":[{"given":"Sung-Hwan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurology, Korea University Medical Center","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euyhyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine","place":["Seoul, Republic of Korea"]},{"name":"Neurotology and Neuro-ophthalmology Laboratory, Korea University Medical Center","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun-Uk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Korea University Medical Center","place":["Seoul, Republic of Korea"]},{"name":"Neurotology and Neuro-ophthalmology Laboratory, Korea University Medical Center","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong-Yoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul National University College of Medicine","place":["Seoul, Republic of Korea"]},{"name":"Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung-Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Korea University Medical Center","place":["Seoul, Republic of Korea"]},{"name":"BK21 FOUR Program in Learning Health Systems, Korea University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul National University College of Medicine","place":["Seoul, Republic of Korea"]},{"name":"Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1001\/archneur.1988.00520310043015","article-title":"A clinical sign of canal paresis","volume":"45","author":"Halmagyi","year":"1988","journal-title":"Arch Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1136\/jnnp.2006.109512","article-title":"Accuracy of the bedside head impulse test in detecting vestibular hypofunction","volume":"78","author":"Jorns-H\u00e4derli","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"258","DOI":"10.3389\/fneur.2017.00258","article-title":"The video head impulse test","volume":"8","author":"Halmagyi","year":"2017","journal-title":"Front Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1001\/archneur.62.2.290","article-title":"The active head-impulse test in unilateral peripheral vestibulopathy","volume":"62","author":"Black","year":"2005","journal-title":"Arch Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e310","DOI":"10.1097\/MAO.0000000000000539","article-title":"Pilot study of a new rehabilitation tool: improved unilateral short-term adaptation of the human angular vestibulo-ocular reflex","volume":"35","author":"Migliaccio","year":"2014","journal-title":"Otol Neurotol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1007\/s10162-018-00689-w","article-title":"Human vestibulo-ocular reflex adaptation training: time beats quantity","volume":"19","author":"Muntaseer Mahfuz","year":"2018","journal-title":"J Assoc Res Otolaryngol"},{"key":"ref7","doi-asserted-by":"crossref","DOI":"10.1093\/med\/9780199969289.001.0001","volume-title":"The Neurology of Eye Movements","author":"Leigh","year":"2015"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"979","DOI":"10.3389\/fneur.2018.00979","article-title":"Functional head impulse testing might be useful for assessing vestibular compensation after unilateral vestibular loss","volume":"9","author":"Sj\u00f6gren","year":"2018","journal-title":"Front Neurol"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.695064","article-title":"Short-latency covert saccades-the explanation for good dynamic visual performance after unilateral vestibular loss?","volume":"12","author":"Sj\u00f6gren","year":"2021","journal-title":"Front Neurol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"389","DOI":"10.3233\/VES-220201","article-title":"Acute Unilateral Vestibulopathy\/Vestibular Neuritis: diagnostic criteria","volume":"32","author":"Strupp","year":"2022","journal-title":"J Vestib Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e744","DOI":"10.1097\/MAO.0000000000002645","article-title":"Evolution in the findings of head-impulse tests during the attacks of Meni\u00e8re's disease","volume":"41","author":"Lee","year":"2020","journal-title":"Otol Neurotol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1007\/s00415-018-8868-x","article-title":"Lower brainstem melanocytoma masquerading as vestibular paroxysmia","volume":"265","author":"Lee","year":"2018","journal-title":"J Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1001\/archotol.128.9.1044","article-title":"Comparison of head thrust test with head autorotation test reveals that the vestibulo-ocular reflex is enhanced during voluntary head movements","volume":"128","author":"Della Santina","year":"2002","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1152\/jn.1993.70.2.828","article-title":"Firing behavior of brain stem neurons during voluntary cancellation of the horizontal vestibuloocular reflex. 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Neurophysiol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1093\/brain\/121.4.699","article-title":"Semicircular canal plane head impulses detect absent function of individual semicircular canals","volume":"121","author":"Cremer","year":"1998","journal-title":"Brain"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"3504","DOI":"10.1161\/STROKEAHA.109.551234","article-title":"HINTS to diagnose stroke in the acute vestibular syndrome three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging","volume":"40","author":"Kattah","year":"2009","journal-title":"Stroke"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"659","DOI":"10.3389\/fneur.2018.00659","article-title":"Usability of the video head impulse test: lessons from the population-based prospective KORA study","volume":"9","author":"Heuberger","year":"2018","journal-title":"Front 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therapeutics and telemedicine for benign paroxysmal positional vertigo and other vestibular disorders: a review","volume":"23","author":"Choi","year":"2024","journal-title":"Res Vestib Sci"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1097\/WCO.0000000000001017","article-title":"Current concepts in acute vestibular syndrome and video-oculography","volume":"35","author":"Mantokoudis","year":"2021","journal-title":"Curr Opin Neurol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1212\/WNL.0000000000010980","article-title":"Opinion and special articles: remote evaluation of acute vertigo: strategies and technological considerations","volume":"96","author":"Green","year":"2021","journal-title":"Neurology"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"63","DOI":"10.21790\/rvs.2024.009","article-title":"Smartphones versus goggles for video-oculography: current status and future 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A nationwide, population-based study with video-head impulse test","volume":"36","author":"Lee","year":"2026","journal-title":"J Vestib Res"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"e2409","DOI":"10.1212\/WNL.0000000000010653","article-title":"Ictal downbeat nystagmus in M\u00e9ni\u00e8re disease: a cross-sectional study","volume":"95","author":"Lee","year":"2020","journal-title":"Neurology"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1007\/s00415-011-6375-4","article-title":"Inferior vestibular neuritis","volume":"259","author":"Kim","year":"2012","journal-title":"J Neurol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2972","DOI":"10.1007\/s00415-021-10885-z","article-title":"Head-impulse tests aid in differentiation of multiple system atrophy from Parkinson\u2019s disease","volume":"269","author":"Kim","year":"2021","journal-title":"J Neurol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12311-021-01356-2","article-title":"Ocular motor findings aid in differentiation of spinocerebellar ataxia type 17 from Huntington\u2019s disease","volume":"22","author":"Lee","year":"2022","journal-title":"Cerebellum"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"161","DOI":"10.3988\/jcn.2025.0105","article-title":"Usefulness of nystagmus patterns in distinguishing peripheral from central acute vestibular syndromes at the bedside: a critical review","volume":"21","author":"Lee","year":"2025","journal-title":"J Clin Neurol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1870852\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:37:24Z","timestamp":1787114244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1870852\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":37,"alternative-id":["10.3389\/fneur.2026.1870852"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1870852","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]},"article-number":"1870852"}}