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@ARTICLE{Sadok:301727,
      author       = {N. Sadok and G. Luijten and F. H. Bahnsen and C. Gsaxner
                      and L. Peters and T. Eichler and T. Rombach and S. Lang and
                      S. Khattab and J. Kleesiek$^*$ and D. Holle and M. Meyer and
                      J. Egger},
      title        = {{P}erforming the {HINTS}-exam using a mixed-reality
                      head-mounted display in patients with acute vestibular
                      syndrome: a feasibility study.},
      journal      = {Frontiers in neurology},
      volume       = {16},
      issn         = {1664-2295},
      address      = {Lausanne},
      publisher    = {Frontiers Research Foundation},
      reportid     = {DKFZ-2025-01119},
      pages        = {1576959},
      year         = {2025},
      abstract     = {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.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.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.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.},
      keywords     = {acute vestibular syndrome (Other) / eye movement (Other) /
                      feasibility study (Other) / head impulse-nystagmus-test of
                      skew (Other) / head-mounted display (Other) / mixed reality
                      headset (Other) / nystagmus (Other) / vertigo (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40438569},
      pmc          = {pmc:PMC12116368},
      doi          = {10.3389/fneur.2025.1576959},
      url          = {https://inrepo02.dkfz.de/record/301727},
}