{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:55:41Z","timestamp":1790916941847,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"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>Objective<\/jats:title>\n                    <jats:p>Torsional nystagmus during the Dix\u2013Hallpike maneuver represents a cardinal vestibulo-ocular reflex (VOR) sign in posterior-canal benign paroxysmal positional vertigo (pc-BPPV). This study develops an interpretable framework for automated classification of torsional nystagmus direction and temporal localization of abnormal events from clinical infrared recordings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Infrared Dix\u2013Hallpike videos were processed via You Only Look Once version 8 nano (YOLOv8n) pupil localization, dynamic iris masking, and Recurrent All-Pairs Field Transforms (RAFT) optical flow. Flow vectors were projected into pupil-centered polar coordinates to extract tangential and radial motion features. A bidirectional gated recurrent unit with attention (BiGRU-attention) network performed segment-level three-class classification with sliding-window patient-level inference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five-fold cross-validation yielded segment-level accuracy of 94.19%\u202f\u00b1\u202f0.88% with balanced F1-scores across all three classes. On an independent 45-patient long-video test set, patient-level accuracy reached 97.78% at 60 frames per second (fps) and 100% (45\/45) at 30 fps. Temporal localization achieved mean intersection-over-union (IoU) of 0.899 and 0.896, with hit rates of 96.8 and 100%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The polar-flow framework enables physiologically interpretable and robust classification of pc-BPPV-related torsional-upbeat nystagmus. By explicitly decomposing eye movements into tangential and radial components, it provides reliable lateralization while demonstrating the potential for clinically meaningful temporal localization of abnormal nystagmus events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1963383","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:35:54Z","timestamp":1790915754000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Interpretable polar-flow decomposition for torsional nystagmus lateralization in posterior-canal BPPV"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanjun","family":"Li","sequence":"first","affiliation":[{"name":"School of Disaster and Emergency Medicine, Tianjin University","place":["Tianjin, China"]},{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Xu","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidan","family":"Gao","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiqi","family":"Shao","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Li","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congcong","family":"Sun","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shike","family":"Hou","sequence":"additional","affiliation":[{"name":"School of Disaster and Emergency Medicine, Tianjin University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaokai","family":"Yang","sequence":"additional","affiliation":[{"name":"Affiliated Wenzhou People\u2019s Hospital of Hangzhou Medical College, Wenzhou People\u2019s Hospital, Third Clinical College of Wenzhou Medical University","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1136\/jnnp.2006.100420","article-title":"Epidemiology of benign paroxysmal positional vertigo: a population based study","volume":"78","author":"Von Brevern","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1056\/NEJMcp1309481","article-title":"Clinical practice. 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