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Abstract：
OBJECTIVE: This study compared adults with peripheral vestibular hypofunction (VH) to healthy controls and assessed the sensitivity and specificity of the Cervical Torsion Test (CTT) and the Head-Neck Differentiation Test (HNDT). This study aimed to determine whether neck problems affected primary outcomes.
METHODS: This cross-sectional study included adults from a specialist consultation for dizziness. VH had been diagnosed with the video Head Impulse Test. Exclusion criteria were conditions following head or neck trauma and diseases of the central nervous system. The sensitivity and specificity of the index tests were calculated, and regression analyses were performed to test for contributing factors.
RESULTS: A total of 19 patients with VH and a historical cohort of 19 matched healthy controls were included. Most patients with VH (84.2%) experienced symptoms in at least 1 test component, compared to 5.2% of the control group. Of patients with VH, 78.9% had symptoms during the HNDT \"en bloc\" (en bloc = head and trunk rotated together), whereas only 26.3% reported symptoms during the CTT en bloc. The best discriminatory validity was found for the HNDT en bloc, with a sensitivity of 0.79 (95% CI = 0.54-0.94), a specificity of 0.86 (95% CI = 0.65-0.97), and a positive likelihood ratio of 5.79 (95% CI = 1.97-17.00). The number of symptoms of CTT \"in torsion\" (in torsion = trunk rotated actively with fixed head) was increased by a factor of 1.13 (95% CI = 1.01-1.27) for every additional point on the Neck Disability Index.
CONCLUSIONS: The CTT and HNDT can serve as non-laboratory tests for patients with dizziness. The HNDT en bloc has the best discriminatory validity, finding those with and those without VH. Symptom reproduction during torsion may help to identify when neck problems may contribute to dizziness.
CONCLUSIONS: The HNDT en bloc may be useful for ruling VH in or out in patients with dizziness. Positive CTT and HNDT in torsion components may verify the likelihood of additional neck involvement.
METHODS: This cross-sectional study included adults from a specialist consultation for dizziness. VH had been diagnosed with the video Head Impulse Test. Exclusion criteria were conditions following head or neck trauma and diseases of the central nervous system. The sensitivity and specificity of the index tests were calculated, and regression analyses were performed to test for contributing factors.
RESULTS: A total of 19 patients with VH and a historical cohort of 19 matched healthy controls were included. Most patients with VH (84.2%) experienced symptoms in at least 1 test component, compared to 5.2% of the control group. Of patients with VH, 78.9% had symptoms during the HNDT \"en bloc\" (en bloc = head and trunk rotated together), whereas only 26.3% reported symptoms during the CTT en bloc. The best discriminatory validity was found for the HNDT en bloc, with a sensitivity of 0.79 (95% CI = 0.54-0.94), a specificity of 0.86 (95% CI = 0.65-0.97), and a positive likelihood ratio of 5.79 (95% CI = 1.97-17.00). The number of symptoms of CTT \"in torsion\" (in torsion = trunk rotated actively with fixed head) was increased by a factor of 1.13 (95% CI = 1.01-1.27) for every additional point on the Neck Disability Index.
CONCLUSIONS: The CTT and HNDT can serve as non-laboratory tests for patients with dizziness. The HNDT en bloc has the best discriminatory validity, finding those with and those without VH. Symptom reproduction during torsion may help to identify when neck problems may contribute to dizziness.
CONCLUSIONS: The HNDT en bloc may be useful for ruling VH in or out in patients with dizziness. Positive CTT and HNDT in torsion components may verify the likelihood of additional neck involvement.
摘要：
目的：本研究比较了患有外周前庭功能减退（VH）的成年人与健康对照，并评估了颈扭转试验（CTT）和头颈分化试验（HNDT）的敏感性和特异性。这项研究旨在确定颈部问题是否会影响主要结局。
方法：这项横断面研究包括来自头晕专家咨询的成年人。VH已被诊断为视频头部冲动测试。排除标准是头颈部外伤和中枢神经系统疾病后的状况。计算指标测试的敏感性和特异性，并进行回归分析以检验影响因素.
结果：共纳入19名VH患者和19名匹配健康对照的历史队列。大多数VH患者（84.2%）在至少一个测试成分中出现症状，与对照组的5.2％相比。VH患者，78.9％的人在HNDT“整体”期间出现症状（整体=头部和躯干一起旋转），而只有26.3％的人在CTT整体期间出现症状。HNDTen集团发现了最佳的歧视性有效性，灵敏度为0.79(95%CI=0.54-0.94)，特异性为0.86(95%CI=0.65-0.97)，正似然比为5.79（95%CI=1.97-17.00）。颈部残疾指数上每增加一点，CTT“扭转”（扭转=躯干用固定头主动旋转）的症状数量增加1.13倍（95％CI=1.01-1.27）。
结论：CTT和HNDT可作为头晕患者的非实验室检查。HNDTen集团具有最佳的歧视性有效性，找到有VH的和没有VH的。扭转过程中的症状再现可能有助于识别何时颈部问题可能导致头晕。
结论：整体HNDT可能有助于排除头晕患者的VH。扭转部位的CTT和HNDT阳性可以验证额外颈部受累的可能性。
方法：这项横断面研究包括来自头晕专家咨询的成年人。VH已被诊断为视频头部冲动测试。排除标准是头颈部外伤和中枢神经系统疾病后的状况。计算指标测试的敏感性和特异性，并进行回归分析以检验影响因素.
结果：共纳入19名VH患者和19名匹配健康对照的历史队列。大多数VH患者（84.2%）在至少一个测试成分中出现症状，与对照组的5.2％相比。VH患者，78.9％的人在HNDT“整体”期间出现症状（整体=头部和躯干一起旋转），而只有26.3％的人在CTT整体期间出现症状。HNDTen集团发现了最佳的歧视性有效性，灵敏度为0.79(95%CI=0.54-0.94)，特异性为0.86(95%CI=0.65-0.97)，正似然比为5.79（95%CI=1.97-17.00）。颈部残疾指数上每增加一点，CTT“扭转”（扭转=躯干用固定头主动旋转）的症状数量增加1.13倍（95％CI=1.01-1.27）。
结论：CTT和HNDT可作为头晕患者的非实验室检查。HNDTen集团具有最佳的歧视性有效性，找到有VH的和没有VH的。扭转过程中的症状再现可能有助于识别何时颈部问题可能导致头晕。
结论：整体HNDT可能有助于排除头晕患者的VH。扭转部位的CTT和HNDT阳性可以验证额外颈部受累的可能性。
