DISCOHAT: An Acronym to Describe the Spectrum of Symptoms Related to Bilateral Vestibulopathy.

Objective: To assess the prevalence of each symptom listed in the acronym DISCOHAT (worsening of symptoms in Darkness and/or uneven ground, Imbalance, Supermarket effect, Cognitive complaints, Oscillopsia, Head movements worsen symptoms, Autonomic complaints, and Tiredness) in patients with bilateral vestibulopathy (BVP), compared to patients with unilateral vestibulopathy (UVP). Methods: A descriptive case-control study was performed on BVP and UVP patients who were evaluated for their vestibular symptoms by two of the authors (RvdB, MCG) at a tertiary referral center, between 2017 and 2020. During history taking, the presence of each DISCOHAT symptom was checked and included in the electronic health record. Presence of a symptom was categorized into: "present," "not present," and "missing." Results: Sixty-six BVP patients and 144 UVP patients were included in this study. Prevalence of single DISCOHAT symptoms varied from 52 to 92% in BVP patients and 18-75% in UVP patients. Patients with BVP reported "worsening of symptoms in darkness," "imbalance," "oscillopsia," and "worsening of symptoms with fast head movements" significantly more than UVP patients (p ≤ 0.004). Conclusion: The DISCOHAT acronym is able to capture a wide spectrum of symptoms related to vestibulopathy, while it is easy and quickly to use in clinic. Application of this acronym might facilitate a more thorough and uniform assessment of bilateral vestibulopathy, within and between vestibular clinics worldwide.

Vibrotactile feedback improves balance and mobility in patients with severe bilateral vestibular loss.

The impact of vibrotactile feedback of the gravity vector, provided by a "balance" belt worn around the waist, was evaluated in 39 patients with a severe bilateral vestibular loss, confirmed by extensive laboratory testing and suffering from a low quality of life, mainly due to imbalance. The mobility and balance score (MBS) of all patients prior to the use of the belt was equal or less than 5 out of a scale of 10. Thirty-one out of the 39 patients experienced the effect of the belt on their balance and mobility as positive in a preselection trial of 2 h in the hospital. The 31 positive responders then used the belt for 1 month in daily life. The average MBS increased significantly from 4.2 to 7.9 (paired T test, T = 9.82, p < 0.00001). Twenty-three out of 31 patients reported a benefit ranging from an improvement of 60-200% in their MBS. Eight patients did not experience any benefit. In summary, 23 out of 39 patients with a severe imbalance due to a bilateral vestibular loss experienced a clear benefit of vibrotactile feed = back in daily life. We conclude that vibrotactile feedback via the waist can serve as an effective prothesis for patients with severe bilateral vestibular loss to improve the quality of life.