ArticleFrontiers in neurology
Decoding the bilateral vestibulopathy spectrum: etiology-based phenotypes, clinical profiles and pathways to implant candidacy.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Clinical-functional dissociation in bilateral vestibulopathy: determinants of disability beyond peripheral vestibular loss.Journal of neurology · 2026Article
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8 authors.
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Abstract
Introduction: Bilateral vestibulopathy (BVP) is a chronic, disabling disorder characterized by bilateral loss of vestibular function, leading to imbalance, oscillopsia, and falls. Despite established diagnostic criteria, clinical expression and rehabilitation potential vary widely across etiologies. Understanding these functional signatures is crucial for tailoring future neurostimulation strategies. The main objective of this study is to decode the etiological and functional heterogeneity of BVP and define clinical-functional profiles guiding vestibular or cochleo-vestibular implant candidacy. Methods: A multicenter retrospective study included 119 adults fulfilling Bárány Society criteria for definite BVP (>1 year). Comprehensive audiovestibular testing comprised pure-tone audiometry (PTA), video head impulse test (vHIT), vestibular evoked myogenic potentials (VEMPs), and dynamic posturography (SOT, LOS). Group comparisons used Kruskal-Wallis and Dunn-Bonferroni tests; oscillopsia predictors were analyzed by binary logistic regression. Results: Etiologies included idiopathic (29.41%), Ménière's disease (26.89%), iatrogenic (18.49%), post-infectious (14.29%), cerebellar ataxia/CANVAS (6.72%), and post-traumatic (4.20%). Oscillopsia was reported by 48.74% and falls by 22.69%. Significant inter-etiological differences were found for semicircular canal gains ( Conclusion: BVP comprises etiology-specific phenotypes. Oscillopsia is driven mainly by VOR performance and PR index in LSC. Integrating auditory status, canal-otolith function, and compensation quality supports precision selection for vestibular versus cochleo-vestibular implantation.
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