Evidence map›Paper›PMID 40438569›Full record

ArticleFrontiers in neurology2025

Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study.

Nadia Sadok, Gijs Luijten, Fin H Bahnsen, Christina Gsaxner, Lorenz Peters, Theda Eichler, Theresa Rombach, Stephan Lang, Sameh Khattab, Jens Kleesiek and 3 more

Abstract read
In one paragraph

Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
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

13 authors.

Nadia Sadok *Department for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, Germany.
Gijs Luijten *Institute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, Germany.
Fin H BahnsenInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, Germany.
Christina GsaxnerInstitute of Computer Graphics and Vision (ICG), Graz University of Technology, Graz, Austria.
Lorenz PetersInstitute for Medical Education, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital, University of Duisburg-Essen, Essen, Germany.
Theda EichlerDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, Germany.
Theresa RombachDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, Germany.
Stephan LangDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, Germany.
Sameh KhattabInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, Germany.
Jens KleesiekInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, Germany.
Dagny HolleDepartment of Neurology, West German Headache and Vertigo Center, Essen University Hospital (AöR), Essen, Germany.
Moritz MeyerDepartment for Oto-Rhino-Laryngology, Head and Neck Surgery, Essen University Hospital (AöR), University Essen-Duisburg, Essen, Germany.
Jan EggerInstitute for Artificial Intelligence in Medicine (IKIM), Essen University Hospital (AöR), Essen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: In patients with acute vestibular syndrome (AVS) differentiating between benign acute peripheral vestibular disorders and possible life-threatening central, causes such as stroke, can be challenging due to similar symptoms. AVS patients experience dizziness, vertigo, imbalance, nausea, vomiting, and abnormal eye movements. This research evaluates the feasibility of using the eye-tracking capability of a mixed reality optical-see-through head-mounted display (MR-OST-HMD) to detect pathological eye movement patterns in patients with AVS. Methods: Conducted at University Hospital Essen, this study assessed patients with AVS using a MR-OST-HMD during the HINTS-Exam. The feasibility study included 21 healthy subjects, seven patients with acute peripheral vestibular dysfunction and two stroke patients. Eye gaze, head position, and orientation were captured using a MR-OST-HMD and an in-house developed application designed to simulate the HINTS-Exam. The eye-tracking technology determined gaze direction and position, while the internal measurement unit and gyroscope recorded head movements in terms of position and velocity. Results: The MR-OST-HMD detected abnormal eye movements, including nystagmus, saccades, and skew deviation effectively. The device proved effective even for patients with severe nausea and elderly participants, who completed the eye calibration and HINTS-Exam without difficulty. The MR-OST-HMD HINTS-Exam was quick to perform (approximately 5 min) and was easily integrated into clinical practice after a single demonstration for medical staff. Conclusion: MR-OST-HMD can detect pathological eye movements in AVS patients. Future research should validate these findings in larger cohorts and explore machine learning integration to enhance diagnostic accuracy.

Indexed as

acute vestibular syndromeeye movementfeasibility studyhead impulse-nystagmus-test of skewhead-mounted displaymixed reality headsetnystagmusvertigo

Identifiers

PMID40438569
PMCPMC12116368

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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.