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INTRODUCTION: Astronauts experience a wide variety of sensorimotor disturbances primarily due to microgravity-induced vestibular adaptations during spaceflight. Head Impulse Testing (HIT) will be conducted during the Complement of Integrated Protocols for Human Exploration Research program(CIPHER) Vestibular Health study to examine changes in the horizontal vestibulo-ocular reflex in response to high-velocity head movements to detect changes in peripheral vestibular function [1,2]. However, correct interpretation will require consideration of potential artifacts and the constraints of conducting this test across different phases of the mission. Therefore, the aims of our study were to (1) examine reliability across different test operators, and (2) compare results of active (aHIT) versus passive (pHIT) approaches to evaluate the feasibility of self-administered versus operator-assisted approaches. A comparison of responses with visual viewing of a wall target (default condition) versus vision occluded evaluated the influence of other oculomotor control influence across conditions, and comparison with computer-generated rotator head impulse tests (rHIT) examined the variability associated with the ocular responses independent of the variability in executing the head movements themselves. METHODS: Seventeen non-astronaut volunteers (male n=12, age=22.9 ± 3.0; female n=5, age=27.0 ± 6.0, mean ± std) completed HIT testing using video-oculography (VOG) goggles and a high-torque rotator system. The test order was counterbalanced across conditions: (1) passive head-on-torso (pHIT, default condition for flight study) using two operators (Op1 and Op2), (2) active head-on-torso (aHIT, subject initiated), and (3) passive head and torso using rotary chair (rHIT). Eye and head movement data were processed to obtain gain in each direction. The main outcome measures were average gain and asymmetry [1], as well as the percentage of acceptable trials not excluded due to insufficient head amplitude or recording artifacts. RESULTS: While the pHIT gains were similar with vision (1.032 ± 0.043) and vision occluded (1.029 ± 0.038) conditions, the percentage of acceptable trials was greater with vision (Op1 = 93.0%, Op2 = 93.2%) versus occluded (Op1 = 70.7%, Op2 = 67.6%). The reliability between operators was greater for pHIT gain (Intraclass Correlation, ICC = 0.66, p = 0.001) than for pHIT asymmetry (ICC = 0.57, p = 0.01). The percentage of acceptable trials reduced by ~20% during the self-administered aHITs for both visual conditions and tended to be lower than computer-generated rHITs (76% versus 83%). While the aHIT gains were not significantly different than pHIT gains for vision or vision occluded conditions, these measures were poorly correlated. Both aHIT and pHIT gains were significantly greater than the rHIT gains, presumably due to the reduced velocities from the rotator. The asymmetry measures were poorly correlated across pHIT, aHIT, and rHIT conditions, although none of the subjects had asymmetries greater than 16%. DISCUSSION: Our findings support the feasibility of using the standard pHIT methodology for spaceflight. Similarities between visual conditions reflect that these responses are mediated by the peripheral lateral canals rather than other oculomotor mechanisms. The inter-tester reliability was acceptable despite differences in the tester training. In addition to concerns of non-vestibular mechanisms introduced during self-administered aHITs [2], operator-assisted pHITs resulted in higher percentage of acceptable trials and should result in more efficient and reliable measures during spaceflight.