Prediction of vestibulo-autonomic symptoms during the caloric test: evaluation of autonomic activity by spectral analysis of the electrocardiographic R-R interval.
CONCLUSIONS
If the high-frequency (HF) component of the R-R interval spectrum of the electrocardiogram (ECG) increases after the first stimulation during a bithermal caloric test, subsequent repeated stimulations may be likely to induce autonomic symptoms such as nausea.


OBJECTIVE
Nausea often occurs as a vestibulo-autonomic symptom during the caloric test. However, there have been only a few clinical studies of autonomic activity during this test. To determine whether certain factors can predict the development of nausea, we performed an autonomic function test by means of R-R interval spectral analysis of the ECG during caloric testing.


METHODS
The study subjects were 53 healthy volunteers aged 22-39 years (41 males, 12 females; mean age 25.3 years) and a 35-year-old male patient with a labyrinthine defect. The caloric test was performed in 43 subjects using an air caloric apparatus with bithermal stimulation of alternate ears. After each stimulation, the subjects were asked about autonomic symptoms. Serial ECG records were obtained and R-R interval spectral analysis was performed.


RESULTS
Severe nausea was observed in 12 subjects (28%). In the group with severe nausea, the HF component of the R-R interval spectrum increased after the first caloric stimulation when autonomic symptoms had not yet become marked.
Yasumura
Satsuki
S
Department of Otolaryngology, Toyama Medical and Pharmaceutical University, Toyama, Japan. satsuki@ms.toyama-mpu.ac.jp
Shojaku
Hideo
H
Watanabe
Yukio
Y
D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology*; D002150:Caloric Tests; D016022:Case-Control Studies; D007758:Ear, Inner / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D009325:Nausea / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012016:Reference Values; D012680:Sensitivity and Specificity; D014839:Vomiting / Q000209:etiology / Q000503:physiopathology