Visuospatial Cognitive Dysfunction in Patients with Vestibular Loss

ObjectiveTo characterize visuospatial and nonvisuospatial cognitive domains affected by vestibular loss and determine whether patient-reported outcomes measures (PROMs) correlate with performance on neuropsychological tests.Study DesignCross-sectional study.SettingUniversity-based tertiary medical center.PatientsSixty-nine age-matched subjects: 25 patients with bilateral vestibular loss (BVL), 14 patients with unilateral vestibular loss (UVL), and 30 normal controls (NC).InterventionsNeuropsychological tests used to assess visuospatial and auditory short-term and working memory, number magnitude representation, executive function, and attention. Validated PROMs used to evaluate quality of life and subjective cognitive impairment.Main Outcome MeasuresPerformance on neuropsychological tests and scores on PROM surveys.ResultsBVL and UVL patients performed significantly worse than NC subjects on tasks requiring visuospatial representation compared with NC subjects (p < 0.01). BVL patients demonstrated decreased performance on spatial representation tasks compared with UVL and NC subjects (p < 0.05 and p < 0.05, respectively). All subject groups performed similarly on tasks assessing nonvisuospatial cognitive domains, such as auditory short-term and working memory, executive function, and attention. PROMs did not seem to correlate with performance on neuropsychological tasks.ConclusionPatients with vestibular loss exhibit impairments in tasks requiring visuospatial representation but perform similarly to NC subjects in tasks of auditory working memory, executive function, or attention. Currently available questionnaires may be insufficient to screen patients for cognitive deficits.