Off-Vertical Axis Rotational Responses in Patients with Unilateral Peripheral Vestibular Lesions

1993 ◽  
Vol 102 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Joseph M. R. Furman ◽  
Robert H. Schor ◽  
Donald B. Kamerer
Keyword(s):  
Eye Movement ◽  
Semicircular Canal ◽  
Rotational Velocity ◽  
Angular Acceleration ◽  
Population Data ◽  
Vertical Axis ◽  
Normal Subjects ◽  
Otolith Organs ◽  
Rapid Decay ◽  
Axis Rotation

Off-vertical axis rotation (OVAR) stimulates the otolith organs in a manner that is suitable for assessment of the otolith-ocular reflex. To further assess the potential clinical usefulness of OVAR, the eye movement responses of seven patients with surgically confirmed unilateral peripheral vestibular lesions were compared with the eye movement responses of a group of age-matched, healthy, asymptomatic control subjects. Patients and controls were tested with constant velocity rotations that followed a brief period of angular acceleration (velocity trapezoid) using either earth-vertical axis (EVA) rotation or OVAR. Both EVA and OVAR sinusoidal velocity profiles were also performed. Results indicated that each patient had 1) an asymmetric OVAR response, ie, a bias component whose direction was opposite normal when rotating toward the lesioned ear, and 2) a normal modulation component. Population data suggested that patients had 1) a more rapid decay of response than normal subjects during OVAR velocity trapezoids, 2) an increased phase lead as compared to normal subjects during sinusoidal OVAR, and 3) like normal subjects, a less rapid decay of response during OVAR velocity trapezoids than during EVA rotational velocity trapezoids. Taken together, these findings suggest that patients with unilateral peripheral vestibular deficits have abnormal otolith-ocular and semicircular canal—ocular reflexes but that a single labyrinth appears to provide an otolithic signal sufficient for qualitatively normal semicircular canal—otolith interaction.

Visual-vestibular interaction during OVAR in the elderly

2002 ◽  
Vol 11 (6) ◽  
pp. 365-370 ◽  
Author(s):  
Joseph M. Furman ◽  
Mark S. Redfern
Keyword(s):  
Eye Movement ◽  
Visual Target ◽  
Vertical Axis ◽  
The Elderly ◽  
Otolith Organs ◽  
Fixation Target ◽  
Visual Vestibular Interaction ◽  
Older Subjects ◽  
Young Subjects ◽  
Axis Rotation

This study assessed visual-otolith interaction in healthy older humans and compared responses from older subjects to those of younger subjects. Using off-vertical axis rotation (OVAR) to stimulate the otolith organs, eye movement responses, measured using electro-oculography, were recorded during rotation in the dark, rotation with an earth-fixed lighted visual surround, and rotation with a subject-fixed fixation target. Results indicated that older subjects, like young subjects, exhibit a modulation component that was as large during rotation with a lighted earth-fixed visual surround as that seen in the dark and a modulation component during rotation with a subject-fixed visual target that was incompletely suppressed. The modulation component was, in general, larger in the older subjects. This study confirms findings from a previous study of visual-otolith interaction in young subjects and suggests that older subjects, like young subjects, have difficulty visually suppressing the modulation component induced by off-vertical axis rotation.

Effect of Semicircular Canal Stimulation on the Perception of the Visual Vertical

2003 ◽  
Vol 90 (2) ◽  
pp. 622-630 ◽  
Author(s):  
Marousa Pavlou ◽  
Nicole Wijnberg ◽  
Mary E. Faldon ◽  
Adolfo M. Bronstein
Keyword(s):  
Semicircular Canal ◽  
Three Dimensional ◽  
Vertical Axis ◽  
Normal Subjects ◽  
Slow Phase ◽  
Visual Vertical ◽  
Axis Rotation ◽  
Highly Correlated ◽  
Head Positions ◽  
Direction Opposite

The subjective visual vertical (SVV) is usually considered a measure of otolith function. Herewith we investigate the influence of semicircular canal (SCC) stimulation on the SVV by rotating normal subjects in yaw about an earth-vertical axis, with velocity steps of ± 90°/s, for 60 s. SVV was assessed by setting an illuminated line to perceived earth vertical in darkness, during a per- and postrotary period. Four head positions were tested: upright, 30° backward (chin up) or forward, and ∼40° forward from upright. During head upright/backward conditions, a significant SVV tilt ( P < 0.01) in the direction opposite to rotation was found that reversed during postrotary responses. The rotationally induced SVV tilt had a time constant of decay of ∼30 s. Rotation with the head 30° forward did not affect SVV, whereas the 40° forward tilt caused a direction reversal of SVV responses compared with head upright/backward. Spearman correlation values (Rho) between individual SCC efficiencies in different head positions and mean SVV tilts were 0.79 for posterior, 0.34 for anterior, and – 0.80 for horizontal SCCs. Three-dimensional video-oculography showed that SVV and torsional eye position measurements were highly correlated (0.83) and in the direction opposite to the slow phase torsional vestibuloocular reflex. In conclusion: 1) during yaw axis rotation without reorientation of the head with respect to gravity, the SVV is influenced by SCC stimulation; 2) this effect is mediated by the vertical SCCs, particularly the posterior SCCs; 3) rotationally induced SVV changes are due to torsional ocular tilt; 4) SVV and ocular tilts occur in the “anticompensatory,” fast phase direction of the torsional nystagmus; and 5) clinically, abnormal SVV tilts cannot be considered a specific indication of otolith system dysfunction.

Vestibulo-ocular function in anxiety disorders

2007 ◽  
Vol 16 (4-5) ◽  
pp. 209-215
Author(s):  
Joseph M. Furman ◽  
Mark S. Redfern ◽  
Rolf G. Jacob
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Semicircular Canal ◽  
Constant Velocity ◽  
Vertical Axis ◽  
Velocity Storage ◽  
Movement Response ◽  
Ocular Reflex ◽  
Axis Rotation ◽  
High Degree

Previous studies of vestibulo-ocular function in patients with anxiety disorders have suggested a higher prevalence of peripheral vestibular dysfunction compared to control populations, especially in panic disorder with agoraphobia. Also, our recent companion studies have indicated abnormalities in postural control in patients with anxiety disorders who report a high degree of space and motion discomfort. The aim of the present study was to assess the VOR, including the semicircular canal-ocular reflex, the otolith-ocular reflex, and semicircular canal-otolith interaction, in a well-defined group of patients with anxiety disorders. The study included 72 patients with anxiety disorders (age 30.6 +/− 10.6 yrs; 60 (83.3% F) and 29 psychiatrically normal controls (age 35.0 +/minus; 11.6 yrs; 24 (82.8% F). 25 patients had panic disorder; 47 patients had non-panic anxiety. Patients were further categorized based on the presence (45 of 72) or absence (27 of 72) of height phobia and the presence (27 of 72) or absence (45 of 72) of excessive space and motion discomfort (SMD). Sinusoidal and constant velocity earth-vertical axis rotation (EVAR) was used to assess the semicircular canal-ocular reflex. Constant velocity off-vertical axis rotation (OVAR) was used to assess both the otolith-ocular reflex and static semicircular canal-otolith interaction. Sinusoidal OVAR was used to assess dynamic semicircular canal-otolith interaction. The eye movement response to rotation was measured using bitemporal electro-oculography. Results showed a significantly higher VOR gain and a significantly shorter VOR time constant in anxiety patients. The effect of anxiety on VOR gain was significantly greater in patients without SMD as compared to those with SMD. Anxiety patients without height phobia had a larger OVAR modulation. We postulate that in patients with anxiety, there is increased vestibular sensitivity and impaired velocity storage. Excessive SMD and height phobia seem to have a mitigating effect on abnormal vestibular sensitivity, possibly via a down-weighting of central vestibular pathways.

scholarly journals Relation Between Perception of Vertical Axis Rotation and Vestibulo-Ocular Reflex Symmetry

1992 ◽  
Vol 2 (1) ◽  
pp. 59-69
Author(s):  
Robert J. Peterka ◽  
Martha S. Benolken
Keyword(s):  
Measurement Errors ◽  
Rotational Velocity ◽  
Vestibular Function ◽  
Vertical Axis ◽  
Perceptual Bias ◽  
Common Source ◽  
Ocular Reflex ◽  
Small Constant ◽  
Vestibulo Ocular Reflex ◽  
Axis Rotation

Subjects seated in a vertical axis rotation chair controlled their rotational velocity by adjusting a potentiometer. Their goal was to null out pseudorandom rotational perturbations in order to remain perceptually stationary. Most subjects showed a slow linear drift of velocity (a constant acceleration) to one side when they were deprived of an earth-fixed visual reference. The amplitude and direction of this drift can be considered a measure of a static bias in a subject’s perception of rotation. The presence of a perceptual bias is consistent with a small, constant imbalance of vestibular function that could be of either central or peripheral origin. Deviations from perfect vestibulo-ocular reflex (VOR) symmetry are also assumed to be related to imbalances in either peripheral or central vestibular function. We looked for correlations between perceptual bias and various measures of vestibular reflex symmetry that might suggest a common source for both reflexive and perceptual imbalances. No correlations were found. Measurement errors could not account for these results since repeated tests in the same subjects of both perceptual bias and VOR symmetry were well correlated.

Contribution of Vestibular Commissural Pathways to Spatial Orientation of the Angular Vestibuloocular Reflex

1997 ◽  
Vol 78 (2) ◽  
pp. 1193-1197 ◽  
Author(s):  
Susan Wearne ◽  
Theodore Raphan ◽  
Bernard Cohen
Keyword(s):  
Spatial Orientation ◽  
Semicircular Canal ◽  
Vertical Axis ◽  
Vestibular Stimulation ◽  
Velocity Storage ◽  
Vestibuloocular Reflex ◽  
Time Constants ◽  
Commissural Pathways ◽  
Before And After ◽  
Axis Rotation

Wearne, Susan, Theodore Raphan, and Bernard Cohen. Contribution of vestibular commissural pathways to spatial orientation of the angular vestibuloocular reflex. J. Neurophysiol. 78: 1193–1197, 1997. During nystagmus induced by the angular vestibuloocular reflex (aVOR), the axis of eye velocity tends to align with the direction of gravitoinertial acceleration (GIA), a process we term “spatial orientation of the aVOR.” We studied spatial orientation of the aVOR in rhesus and cynomolgus monkeys before and after midline section of the rostral medulla abolished all oculomotor functions related to velocity storage, leaving the direct optokinetic and vestibular pathways intact. Optokinetic afternystagmus and the bias component of off-vertical-axis rotation were lost, and the aVOR time constant was reduced to a value commensurate with the time constants of primary semicircular canal afferents. Spatial orientation of the aVOR, induced either during optokinetic or vestibular stimulation, was also lost. Vertical and roll aVOR time constants could no longer be lengthened in side-down or supine/prone positions, and static and dynamic tilts of the GIA no longer produced cross-coupling from the yaw to pitch and yaw to roll axes. Consequently, the induced nystagmus remained entirely in head coordinates after the lesion, regardless of the direction of the resultant GIA vector. Gains of the aVOR and of optokinetic nystagmus to steps of velocity were unaffected or slightly increased. These results are consistent with a model in which the direct aVOR pathways are organized in semicircular canal coordinates and spatial orientation is restricted to the indirect (velocity storage) pathways.

Effect of aging on the otolith-ocular reflex

2001 ◽  
Vol 11 (2) ◽  
pp. 91-103
Author(s):  
Joseph M. Furman ◽  
Mark S. Redfern
Keyword(s):  
Semicircular Canal ◽  
Head Tilt ◽  
Vestibular Function ◽  
Vertical Axis ◽  
Ocular Reflex ◽  
Age Related ◽  
Vestibulo Ocular Reflex ◽  
Older Subjects ◽  
Axis Rotation ◽  
Reflex Time

We assessed the influence of age on the otolith-ocular reflex and semicircular canal-otolith interaction. Healthy young (n=30) and healthy older (n=60) subjects were rotated about an earth vertical axis, and about a 30 degree off-vertical axis. Eye movements during and following rotation were recorded using electro-oculography. Results indicated that there were statistically significant changes in the otolith-ocular reflex and semicircular canal-otolith interaction as a function of age. The modulation component during off-vertical axis rotation (OVAR) was greater in the older group compard to the young adults, whereas the bias component was smaller with advanced age. The foreshortening of the vestibulo-ocular reflex time constant induced by post-rotatory head tilt following cessation of rotation was less prominent in the older group. There were no consistent changes in the semicircular canal-ocular reflex. Overall, response parameters showed more variability in the older subjects. We conclude that age related changes in the otolith-ocular reflex and semicircular canal-otolith interaction are a result primarily of a degradation of central vestibular processing of otolith signals rather than a decline of peripheral vestibular function.

Chlorpheniramine and ephedrine in combination for motion sickness

2008 ◽  
Vol 17 (5-6) ◽  
pp. 301-311
Author(s):  
Jay C. Buckey ◽  
Donna L. Alvarenga ◽  
Todd A. MacKenzie
Keyword(s):  
Motion Sickness ◽  
Vertical Axis ◽  
Normal Subjects ◽  
Cognitive Testing ◽  
Double Blind ◽  
Performance Effects ◽  
Objective Tests ◽  
Axis Rotation ◽  
And Performance ◽  
C 50

Background: Chlorpheniramine is effective against motion sickness, but produces sedation. To reduce chlorpheniramine's sedating effect and increase its effectiveness, ephedrine was combined with chlorpheniramine to prevent motion sickness. Methods: Chlorpheniramine (C) and chlorpheniramine plus ephedrine (Chlorphedra) were studied in a randomized, double blind, crossover trial. Eighteen normal subjects were randomized to six different orderings of placebo, C (12 mg) or Chlorphedra (12 mg C + 50 mg ephedrine). They ingested the medication 3.25 hours before off vertical axis rotation in a rotating chair. Cognitive testing with both objective and subjective tests was performed before drug ingestion, at peak drug effect and following rotation. Results: Both C and Chlorphedra significantly increased chair time compared to placebo [6.6 to 10.3 minutes (C), 10.2 minutes (Chlorphedra), p < 0.01]. Subjects reported significantly more sleepiness on the Karolinska sleepiness scale after taking C (3.3 placebo, 4.9 C (p < 0.005)) but not with Chlorphedra (3.3 placebo, 3.1 Chlorphedra). Chlorphedra resulted in significantly higher reported alertness, clearheadedness and attentiveness compared to C. Deficits seen on objective tests with C were corrected with Chlorphedra. Subjects noted more side effects with Chlorphedra. Conclusion: Ephedrine does not increase the effectiveness of chlorpheniramine against motion sickness, but counteracts sedative and performance effects successfully.

Unilateral Peripheral Semicircular Canal Lesion and Off-Vertical Axis Rotation

1996 ◽  
Vol 116 (3) ◽  
pp. 361-367 ◽  
Author(s):  
P. Denise ◽  
C. Darlot ◽  
P. Ignatiew-Charles ◽  
M. Toupet
Keyword(s):  
Semicircular Canal ◽  
Vertical Axis ◽  
Axis Rotation

Human ocular counter-rolling and roll tilt perception during off-vertical axis rotation after spaceflight

2008 ◽  
Vol 17 (5-6) ◽  
pp. 209-215
Author(s):  
Gilles Clément ◽  
Pierre Denise ◽  
Millard F. Reschke ◽  
Scott J. Wood
Keyword(s):  
Head Tilt ◽  
Internal Representation ◽  
Vertical Axis ◽  
Body Tilt ◽  
Whole Body ◽  
Otolith Organs ◽  
Otolith Function ◽  
Significant Difference ◽  
Axis Rotation ◽  
Roll Tilt

Ocular counter-rolling (OCR) induced by whole body tilt in roll has been explored after spaceflight as an indicator of the adaptation of the otolith function to microgravity. It has been claimed that the overall pattern of OCR responses during static body tilt after spaceflight is indicative of a decreased role of the otolith function, but the results of these studies have not been consistent, mostly due to large variations in the OCR within and across individuals. By contrast with static head tilt, off-vertical axis rotation (OVAR) presents the advantage of generating a sinusoidal modulation of OCR, allowing averaged measurements over several cycles, thus improving measurement accuracy. Accordingly, OCR and the sense of roll tilt were evaluated in seven astronauts before and after spaceflight during OVAR at 45°/s in darkness at two angles of tilt (10° and 20°). There was no significant difference in OCR during OVAR immediately after landing compared to preflight. However, the amplitude of the perceived roll tilt during OVAR was significantly larger immediately postflight, and then returned to control values in the following days. Since the OCR response is predominantly attributed to the shearing force exerted on the utricular macula, the absence of change in OCR postflight suggests that the peripheral otolith organs function normally after short-term spaceflight. However, the increased sense of roll tilt indicates an adaptation in the central processing of gravitational input, presumably related to a re-weighting of the internal representation of gravitational vertical as a result of adaptation to microgravity.

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