Evidence map›Paper›PMID 40047375›Full record

ArticleAnnals of the New York Academy of Sciences2025

Sex differences in caloric nystagmus intensity: Should reference values be updated?

Johannes Gerb, Sandra Becker-Bense, Doreen Huppert, Konstanze Dunker, Valerie Schöb, Denis Grabova, Karoline Steinmetz, Ralf Strobl, Andreas Zwergal

Abstract read
In one paragraph

Article in Annals of the New York Academy of Sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Johannes GerbGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.ORCID 0000-0002-5053-1462
Sandra Becker-BenseGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.
Doreen HuppertGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.
Konstanze DunkerGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.
Valerie SchöbGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.
Denis GrabovaGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.
Karoline SteinmetzGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.
Ralf StroblGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.
Andreas ZwergalGerman Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, LMU Munich, Munich, Germany.

Funding

Bundesministerium für Bildung und ForschungDeutsche Stiftung Neurologie
6 · The paper itself

Abstract

Bithermal caloric irrigation of the horizontal semicircular canals is a key method of neurotological diagnostics, allowing the detection of peripheral vestibular hypofunction in the low-frequency range. Current diagnostic criteria for unilateral vestibulopathy (UVP), bilateral vestibulopathy (BVP), and presbyvestibulopathy (PVP) rely on gender-neutral absolute or relative metrics. Here, we analyzed all bithermal water caloric examinations performed in the German Center for Vertigo and Balance Disorders (DSGZ) between 07/2018 and 01/2024 and calculated the total caloric reactivity (TR). Patient age and sex were collected as covariates. For UVP, BVP, and PVP diagnoses, international diagnostic criteria were applied. In total, 11,332 patients (6219 females, mean age 55.97±17.52 years) were included. Females displayed a higher TR (mean difference: 6.41°/s, p<0.001). The frequency of UVP, BVP, and PVP diagnoses based on absolute cut-off values showed a significant male predominance (UVP: n = 1144, 548 females, odd ratio [OR] -0.32, p<0.001; BVP: n = 305, 138 females, OR -0.40, p<0.001; PVP: n = 813, 378 females, OR -0.37, p<0.001). However, the rate of UVP based on relative asymmetries showed no sex differences (n = 2971, 1595 females, OR -0.08, p = 0.06). Diagnostic criteria for UVP, BVP, or PVP, which utilize absolute caloric excitability cut-offs, might need to be updated to address sex-specific differences of caloric excitability.

Indexed as

Caloric TestsNystagmus, PathologicVestibular DiseasesAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedReference ValuesSex CharacteristicsSex FactorsVertigogender medicineneurotologyvertigovestibulo‐ocular reflexvestibulopathywater calorics

Identifiers

PMID40047375
PMCPMC11998476

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.