Objective: Patients with peripheral vestibular loss have been shown to have deficits in certain cognitive domains. Herein, we aim to better characterize the type of cognitive impairment in patients with vestibular disorders and determine whether a correlation exists between Patient-Reported Outcome Measures (PROMs) and performance on neuropsychological tests.
Study Design: Cross-sectional cohort.
Setting: Academic medical center.
Patients: Fifty-two age-matched subjects were recruited: 15 patients with bilateral vestibular loss (BVL), 7 patients with unilateral vestibular loss (UVL), 15 patients with vestibular migraine (VM), and 15 healthy control subjects.
Interventions: Subjects completed neuropsychological tasks to assess auditory working memory (Digit Span Test [DST]) and visuospatial working memory (Corsi Block Tapping Test [CBTT]). Subjects also completed PROMs to assess severity of vestibular dysfunction (Dizziness Handicap Inventory [DHI]) and cognitive impairment (Cognitive Failures Questionnaire [CFQ] and Cognitive Function - Quality of Life in Neurological Disorders [CF-Neuro-QOL]).
Main Outcome Measures: Scores on PROMs and performance on neuropsychological tests.
Results: BVL and UVL patients performed significantly worse on the CBTT compared to control subjects and VM patients (p < 0.01 and p<0.05, respectively). All subject cohorts performed similarly on the DST. BVL, UVL, and VM patients scored significantly higher on the DHI compared to normal controls. VM patients scored significantly higher on NeuroQOL surveys compared to normal controls (p < 0.05). PROMs were not significantly correlated with CBTT or DST performance.
Conclusions: Patients with peripheral vestibular loss demonstrate impairments on tasks of visuospatial working memory, but not auditory working memory. Novel surveys are needed to screen for patients with vestibular disorders for cognitive impairment, particularly visuospatial ability. Professional Practice Gap & Educational Need: 1) Lack of in-depth knowledge of cognitive impairment and, in particular, visuospatial working memory deficits, in patients with vestibular disorders. 2) Need for improved screening tools to identify patients with vestibular disorders who are at risk for cognitive impairment.
Learning Objective: 1) Attendees will understand that peripheral vestibular loss, including both bilateral vestibular and unilateral vestibular loss, is associated with deficits in visuospatial ability. 2) Attendees will appreciate that improved screening methods are needed to characterize visuospatial deficits in vestibular disorders
Desired Result: A greater understanding of the degree, severity and type of cognitive impairment in patients with vestibular disorders.