Abstract
Subjective visual vertical (SVV) assesses the ability to perceive verticality, which is a measure of vestibular otolithic function. Vestibular lesions influence this perception of verticality. We developed a method using virtual reality (VR) display and an Android software application named ‘Curator SVV’. The virtual reality SVV (Curator SVV) consisted of ten readily identifiable artworks projected by a Samsung phone S6 which is inserted into a virtual reality headset. In the first study, 20 patients had there SVV assessed with two devices: (1) a commercially available SVV measurement device (VestiTest®) and (2) a virtual reality SVV using the Curator SVV application. In a second study, 32 healthy subjects had their SVV assessed by the Curator SVV application whilst sitting in a chair. In the first study, there was no significant difference (p = 0.44, paired t test and p = 0.01, test of equivalence) between results obtained by Curator SVV and the commercially available device. In the second study, the average angle measured for healthy subjects was 0.00° ± 0.85°. The normal range (mean ± 2 SD) was ± 2° in standard upright position. We were able to demonstrate that the Curator SVV can be readily employed as an objective, non-invasive and affordable means of assessing otolith function in the clinical context. We validated this novel methodology by finding strong quantitative parity between a standard commercial SVV unit and the VR Curator SVV method. Our very lightweight and mobile device can be employed in clinical contexts including at the bedside and in different head and body positions.
Similar content being viewed by others
Change history
26 October 2022
This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1007/s10055-022-00709-4
Abbreviations
- F:
-
Female
- M:
-
Male
- SVV:
-
Subjective visual vertical
- uVL:
-
Unilateral vestibular loss
- VR:
-
Virtual reality
- VS:
-
Vestibular schwannoma
References
Batuecas-Caletrio A, Santacruz-Ruiz S, Muñoz-Herrera A, Sousa P, Otero A, Perez-Fernandez N (2013) Vestibular compensation after vestibular schwannoma surgery: normalization of the subjective visual vertical and disability. Acta Otolaryngol 133(5):475–480. https://doi.org/10.3109/00016489.2012.757798
Bergenius J, Tribukait A, Brantberg K (1996) The subjective horizontal at different angles of roll-tilt in patients with unilateral vestibular impairment. Brain Res Bull 40(5–6):385–390 (discussion 390–391)
Brodsky JR, Cusick BA, Kawai K, Kenna M, Zhou G (2015) Peripheral vestibular loss detected in pediatric patients using a smartphone-based test of the subjective visual vertical. Int J Pediatr Otorhinolaryngol 79(12):2094–2098. https://doi.org/10.1016/j.ijporl.2015.09.020
Bronstein AM, Pérennou DA, Guerraz M, Playford D, Rudge P (2003) Dissociation of visual and haptic vertical in two patients with vestibular nuclear lesions. Neurology 61(9):1260–1262
Chiarovano E, Wang W, Rogers SJ, MacDougall HG, Curthoys IS, de Waele C (2017) Balance in virtual reality: effect of age and bilateral vestibular loss. Front Neurol. https://doi.org/10.3389/fneur.2017.00005
Curthoys IS, Dai MJ, Halmagyi GM (1991a) Human ocular torsional position before and after unilateral vestibular neurectomy. Exp Brain Res 85(1):218–225
Curthoys IS, Halmagyi GM, Dai MJ (1991b) The acute effects of unilateral vestibular neurectomy on sensory and motor tests of human otolithic function. Acta Otolaryngol Suppl 481:5–10
Curthoys IS, Vulovic V, Burgess AM, Cornell ED, Mezey LE, Macdougall HG et al (2011) The basis for using bone-conducted vibration or air-conducted sound to test otolithic function. Ann N Y Acad Sci 1233:231–241. https://doi.org/10.1111/j.1749-6632.2011.06147.x
Dai MJ, Curthoys IS, Halmagyi GM (1989) Linear acceleration perception in the roll plane before and after unilateral vestibular neurectomy. Exp Brain Res 77(2):315–328
Fernandez C, Goldberg JM, Abend WK (1972) Response to static tilts of peripheral neurons innervating otolith organs of the squirrel monkey. J Neurophysiol 35(6):978–987
Ferreira MM, Cunha F, Ganança CF, Ganança MM, Caovilla HH (2016) Subjective visual vertical with the bucket method in Brazilian healthy individuals. Braz J Otorhinol 82(4):442–446. https://doi.org/10.1016/j.bjorl.2015.08.027
Hafström A, Fransson P-A, Karlberg M, Magnusson M (2004) Idiosyncratic compensation of the subjective visual horizontal and vertical in 60 patients after unilateral vestibular deafferentation. Acta Otolaryngol 124(2):165–171
Lopez C, Lacour M, Léonard J, Magnan J, Borel L (2008) How body position changes visual vertical perception after unilateral vestibular loss. Neuropsychologia 46(9):2435–2440. https://doi.org/10.1016/j.neuropsychologia.2008.03.017
Luyat M, Ohlmann T, Barraud PA (1997) Subjective vertical and postural activity. Acta Physiol (Oxf) 95(2):181–193
MacDougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP (2013) The video head impulse test (vHIT) detects vertical semicircular canal dysfunction. PLoS ONE 8(4):e61488. https://doi.org/10.1371/journal.pone.0061488
Mittelstaedt H (1999) The role of the otoliths in perception of the vertical and in path integration. Ann N Y Acad Sci 871:334–344
Ogawa Y, Hayashi M, Otsuka K, Shimizu S, Inagaki T, Hagiwara A et al (2010) Subjective visual vertical in patients with ear surgery. Acta Otolaryngol 130(5):576–582. https://doi.org/10.3109/00016480903352967
Saj A, Honoré J, Davroux J, Coello Y, Rousseaux M (2005) Effect of posture on the perception of verticality in neglect patients. Stroke 36(10):2203–2205. https://doi.org/10.1161/01.STR.0000182236.73502.19
Sun DQ, Zuniga MG, Davalos-Bichara M, Carey JP, Agrawal Y (2014) Evaluation of a bedside test of utricular function—the bucket test—in older individuals. Acta Otolaryngol 134(4):382–389. https://doi.org/10.3109/00016489.2013.867456
Tesio L, Longo S, Rota V (2011) The subjective visual vertical: validation of a simple test. Int J Rehabil Res 34(4):307–315. https://doi.org/10.1097/MRR.0b013e32834c45bc
Zwergal A, Rettinger N, Frenzel C, Dieterich M, Brandt T, Strupp M (2009) A bucket of static vestibular function. Neurology 72(19):1689–1692. https://doi.org/10.1212/WNL.0b013e3181a55ecf
Acknowledgements
We thank Pam Reynolds and all the physiotherapists (Carina Salvemini, Kim Hawkins, Lisa Johnson, and Merryn Moffat) for their participation in this study. We are grateful for the support of NH&MRC of Australia and the Garnett Passe and Rodney Williams Memorial Foundation.
Funding
HGM is currently receiving a project grant from NHMRC of Australia and from the Garnett Passe and Rodney Williams Memorial Foundation.
Author information
Authors and Affiliations
Contributions
EC recorded subjects, conducted the analyses and wrote much of the paper; LM and DS recorded subjects and wrote some of the paper; HGM developed the methods and wrote some of the paper.
Corresponding author
Ethics declarations
Conflict of interest
HGM is unpaid consultant to GN Otometrics.
About this article
Cite this article
Chiarovano, E., McGarvie, L.A., Szmulewicz, D. et al. RETRACTED ARTICLE: Subjective visual vertical in virtual reality (Curator SVV): validation and normative data. Virtual Reality 22, 315–320 (2018). https://doi.org/10.1007/s10055-018-0336-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10055-018-0336-5