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The Effects of Caffeine on Video Head Impulse Test Results University of Northern Colorado Scholarship & Creative Works @ Digital UNC Capstones & Scholarly Projects Student Research 5-3-2020 The effects of caffeine on video head impulse test results Elizabeth Zakrzewski [email protected] Follow this and additional works at: https://digscholarship.unco.edu/capstones Recommended Citation Zakrzewski, Elizabeth, "The effects of caffeine on video head impulse test results" (2020). Capstones & Scholarly Projects. 71. https://digscholarship.unco.edu/capstones/71 This Dissertation/Thesis is brought to you for free and open access by the Student Research at Scholarship & Creative Works @ Digital UNC. It has been accepted for inclusion in Capstones & Scholarly Projects by an authorized administrator of Scholarship & Creative Works @ Digital UNC. For more information, please contact [email protected]. © 2020 ELIZABETH ANNE ZAKRZEWSKI ALL RIGHTS RESERVED UNIVERSITY OF NORTHERN COLORADO Greeley, Colorado The Graduate School THE EFFECTS OF CAFFEINE ON VIDEO HEAD IMPULSE TEST RESULTS A Capstone Research Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Audiology Elizabeth Anne Zakrzewski College of Natural and Health Sciences School of Human Sciences Audiology and Speech-Language Sciences Program May, 2020 This Capstone Research Project by: Elizabeth Anne Zakrzewski Entitled: The Effects of Caffeine on Video Head Impulse Test Results has been approved as meeting the requirement for the Degree of Doctor of Audiology in the College of Natural and Health Sciences, School of Human Sciences, Audiology and Speech-Language Sciences Program Accepted by the Capstone Research Project Committee ______________________________________________________ Tina M. Stoody, Ph.D., Co-Research Advisor ______________________________________________________ Kathryn Bright, Ph.D., Co-Research Advisor ______________________________________________________ Gary Heise, Ph.D., Faculty Representative Accepted by the Graduate School ________________________________________________________________ Cindy Wesley, Ph.D. Interim Associate Provost and Dean Graduate School and International Admissions ABSTRACT Zakrzewski, Elizabeth Anne. The Effects of Caffeine on Video Head Impulse Test Results. Unpublished Doctor of Audiology capstone research project, University of Northern Colorado, 2020. Prior to administering vestibular evaluations, clinicians often instruct their patients to abstain from several different substances including caffeine. Regarding the video head impulse test (vHIT), research addressing the effect of caffeine is lacking. The purpose of this research was to determine what, if any, effect caffeine had on the results of the vHIT. Participants included 19 healthy adults who were divided into two groups. Group 1 was given caffeinated coffee and group 2 was given decaffeinated coffee. The vHIT was performed on each participant at two points in time—after abstaining from caffeine for 24 hours and then again after consuming a 12-ounce cup of coffee. Vestibulo-ocular reflex (VOR) gain values were measured for both groups before and after coffee consumption. Two independent samples t-tests were performed using the difference values from pre- and post-coffee consumption tests to compare the two groups—one test using the absolute values and one not. While the t-test performed using the absolute values showed a significant difference between groups (t(27.435) = 2.751, p = .01), suggesting a greater amount of variability in VOR gain changes in group 1, the results of the t-test performed without absolute values was not significant (t(25.698) = .028, p = 0.978), indicating these changes in VOR gain values were not consistently either increases or decreases in gain. Despite obtaining significant results in the t-test using absolute values, the differences in VOR gain as well as number of saccades iii observed in each group were not clinically significant, i.e., all participants in both groups would have been classified as having normal test results in a clinical setting regardless of coffee consumption. The results of this study suggested abstaining from caffeine might not be necessary when performing the vHIT clinically. The results of this study might be useful in helping those who perform vHIT clinically to know how to best prepare their patients for this vestibular evaluation. iv ACKNOWLEDGEMENTS The completion of this study would not have been possible without the support and encouragement of so many people. Unending gratitude goes toward my research advisors, Dr. Tina Stoody and Dr. Katie Bright, who guided me throughout the entirety of the research process and answered my many questions. I would also like to thank Dr. Gary Heise who acted as the faculty representative on my committee and provided his valuable input. I am forever grateful for my fellow classmates who provided endless advice and encouragement. Lastly, I would like to thank my family and friends whose support throughout every step of this project, as well as my entire academic career, played a crucial role in my successes. v TABLE OF CONTENTS CHAPTER I. STATEMENT OF THE PROBLEM ...................................................... 1 CHAPTER II. REVIEW OF THE LITERATURE........................................................ 5 Introduction ........................................................................................................ 5 The Vestibular System ....................................................................................... 5 Vestibular Pathology Diagnosis ....................................................................... 11 Video Head Impulse Test................................................................................. 17 Caffeine’s Effect on the Body.......................................................................... 23 Summary .......................................................................................................... 28 CHAPTER III. METHODOLOGY ............................................................................. 29 Participants ....................................................................................................... 29 Testing Timeline .............................................................................................. 30 Caffeinated and Decaffeinated Coffee ............................................................. 30 Video Head Impulse Test Equipment .............................................................. 31 Video Head Impulse Test Procedure ............................................................... 31 Data Analysis ................................................................................................... 32 CHAPTER IV. RESULTS ........................................................................................... 34 Sample Characteristics ..................................................................................... 34 Gain Values ...................................................................................................... 34 Caffeine Versus Decaffeinated Gain Value Comparison ................................ 35 Additional Video Head Impulse Test Results .................................................. 39 Gain Asymmetry, Rejected Collections, and Peak Velocity ........................... 44 Summary .......................................................................................................... 46 CHAPTER V. DISCUSSION ...................................................................................... 47 Caffeine Consumption and Vestibular Testing ................................................ 47 Caffeine Consumption and Saccades ............................................................... 50 Caffeine’s Effect on Balance ........................................................................... 52 Differences in Methods .................................................................................... 53 Left Versus Right Ears ..................................................................................... 54 Study Limitations ............................................................................................. 55 Future Research ............................................................................................... 57 Conclusion ....................................................................................................... 57 vi REFERENCES ............................................................................................................ 59 APPENDIX A. INSTITUTIONAL REVIEW BOARD APPROVAL ........................ 68 APPENDIX B. CONSENT FORM FOR HUMAN PARTICIPANTS IN RESEARCH ............................................................................................... 70 APPENDIX C. GAIN VALUES BY SUBJECT ......................................................... 73 vii LIST OF TABLES 1. Distribution of Gain Values by Group ............................................................. 35 2. Results of T-Test for Equality of Means.......................................................... 36 3. Results of T-Test for Equality of Means Using Absolute Values ................... 38 4. Distribution of Gain Asymmetry by Group ..................................................... 45 5. Distribution of Peak Head Velocity by Group ................................................. 46 6. Summary of Literature ..................................................................................... 49 viii LIST OF FIGURES
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