Cervico-ocular Reflex Is Increased in People With Nonspecific Neck Pain

Abstract Background Neck pain is a widespread complaint. People experiencing neck pain often present an altered timing in contraction of cervical muscles. This altered afferent information elicits the cervico-ocular reflex (COR), which stabilizes the eye in response to trunk-to-head movements. The vestibulo-ocular reflex (VOR) elicited by the vestibulum is thought to be unaffected by afferent information from the cervical spine. Objective The aim of the study was to measure the COR and VOR in people with nonspecific neck pain. Design This study utilized a cross-sectional design in accordance with the STROBE statement. Methods An infrared eye-tracking device was used to record the COR and the VOR while the participant was sitting on a rotating chair in darkness. Eye velocity was calculated by taking the derivative of the horizontal eye position. Parametric statistics were performed. Results The mean COR gain in the control group (n=30) was 0.26 (SD=0.15) compared with 0.38 (SD=0.16) in the nonspecific neck pain group (n=37). Analyses of covariance were performed to analyze differences in COR and VOR gains, with age and sex as covariates. Analyses of covariance showed a significantly increased COR in participants with neck pain. The VOR between the control group, with a mean VOR of 0.67 (SD=0.17), and the nonspecific neck pain group, with a mean VOR of 0.66 (SD=0.22), was not significantly different. Limitations Measuring eye movements while the participant is sitting on a rotating chair in complete darkness is technically complicated. Conclusions This study suggests that people with nonspecific neck pain have an increased COR. The COR is an objective, nonvoluntary eye reflex and an unaltered VOR. This study shows that an increased COR is not restricted to patients with traumatic neck pain.

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Inaccurate Saccades and Enhanced Vestibulo-Ocular Reflex Suppression during Combined Eye–Head Movements in Patients with Chronic Neck Pain: Possible Implications for Cervical Vertigo

Frontiers in Neurology ◽

10.3389/fneur.2017.00023 ◽

2017 ◽

Vol 8 ◽

Cited By ~ 3

Author(s):

Janine L. Johnston ◽

Pierre M. Daye ◽

Glen T. D. Thomson

Keyword(s):

Neck Pain ◽

Chronic Neck Pain ◽

Head Movements ◽

Ocular Reflex ◽

Cervical Vertigo ◽

Vestibulo Ocular Reflex

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Vestibular adaptation to centrifugation does not transfer across planes of head rotation

Journal of Vestibular Research ◽

10.3233/ves-2008-18103 ◽

2008 ◽

Vol 18 (1) ◽

pp. 25-37

Author(s):

Ian Garrick-Bethell ◽

Thomas Jarchow ◽

Heiko Hecht ◽

Laurence R. Young

Keyword(s):

Sagittal Plane ◽

Head Rotation ◽

Head Movements ◽

Control Group ◽

Illusory Motion ◽

Ocular Reflex ◽

Before And After ◽

Out Of Plane ◽

Vestibulo Ocular Reflex ◽

Axis Rotation

Out-of-plane head movements performed during fast rotation produce non-compensatory nystagmus, sensations of illusory motion, and often motion sickness. Adaptation to this cross-coupled Coriolis stimulus has previously been demonstrated for head turns made in the yaw (transverse) plane of motion, during supine head-on-axis rotation. An open question, however, is if adaptation to head movements in one plane of motion transfers to head movements performed in a new, unpracticed plane of motion. Evidence of transfer would imply the brain builds up a generalized model of the vestibular sensory-motor system, instead of learning a variety of individual input/output relations separately. To investigate, over two days 9 subjects performed pitch head turns (sagittal plane) while rotating, before and after a series of yaw head turns while rotating. A Control Group of 10 subjects performed only the pitch movements. The vestibulo-ocular reflex (VOR) and sensations of illusory motion were recorded in the dark for all movements. Upon comparing the two groups we failed to find any evidence of transfer from the yaw plane to the pitch plane, suggesting that adaptation to cross-coupled stimuli is specific to the particular plane of head movement. The findings have applications for the use of centrifugation as a possible countermeasure for long duration spaceflight. Adapting astronauts to unconstrained head movements while rotating will likely require exposure to head movements in all planes and directions.

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The Vestibulo-ocular Reflex During Active Head Motion in Chiari II Malformation

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100009185 ◽

2008 ◽

Vol 35 (4) ◽

pp. 495-500 ◽

Cited By ~ 8

Author(s):

Michael S. Salman ◽

James A. Sharpe ◽

Linda Lillakas ◽

Maureen Dennis ◽

Martin J. Steinbach

Keyword(s):

High Gain ◽

Head Movements ◽

Head Motion ◽

Control Group ◽

Healthy Children ◽

Eye Tracker ◽

Ocular Reflex ◽

Vestibulo Ocular Reflex ◽

Chiari Ii ◽

Age Range

Background:Chiari type II malformation (CII) is a developmental anomaly of the cerebellum and brainstem, which are important structures for processing the vestibulo-ocular reflex (VOR). We investigated the effects of the deformity of CII on the angular VOR during active head motion.Methods:Eye and head movements were recorded using an infrared eye tracker and magnetic head tracker in 20 participants with CII [11 males, age range 8-19 years, mean (SD) 14.4 (3.2) years]. Thirty-eight age-matched healthy children and adolescents (21 males) constituted the control group. Participants were instructed to ‘look’ in darkness at the position of their thumb, placed 25 cm away, while they made horizontal and vertical sinusoidal head rotations at frequencies of about 0.5 Hz and 2 Hz. Parametric and non-parametric tests were used to compare the two groups.Results:The VOR gains, the ratio of eye to head velocities, were abnormally low in two participants with CII and abnormally high in one participant with CII.Conclusion:The majority of participants with CII had normal VOR performance in this investigation. However, the deformity of CII can impair the active angular VOR in some patients with CII. Low gain is attributed to brainstem damage and high gain to cerebellar dysfunction.

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Viewing Target Distance Influences the Vestibulo-Ocular Reflex Gain when Assessed Using the Video Head Impulse Test

Audiology and Neurotology ◽

10.1159/000493845 ◽

2018 ◽

Vol 23 (5) ◽

pp. 285-289 ◽

Cited By ~ 2

Author(s):

Patricia Castro ◽

Sara Sena Esteves ◽

Florencia Lerchundi ◽

David Buckwell ◽

Michael A. Gresty ◽

...

Keyword(s):

Head Movements ◽

Target Distance ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Gaze Stabilization ◽

Head Impulse ◽

Ocular Reflex ◽

Significant Difference ◽

Vestibulo Ocular Reflex ◽

Reflex Gain

Gaze stabilization during head movements is provided by the vestibulo-ocular reflex (VOR). Clinical assessment of this reflex is performed using the video Head Impulse Test (vHIT). To date, the influence of different fixation distances on VOR gain using the vHIT has not been explored. We assessed the effect of target proximity on the horizontal VOR using the vHIT. Firstly, we assessed the VOR gain in 18 healthy subjects with 5 viewing target distances (150, 40, 30, 20, and 10 cm). The gain increased significantly as the viewing target distance decreased. A second experiment on 10 subjects was performed in darkness whilst the subjects were imagining targets at different distances. There were significant inverse relationships between gain and distance for both the real and the imaginary targets. There was a statistically significant difference between light and dark gains for the 20- and 40-cm distances, but not for the 150-cm distance. Theoretical VOR gains for different target distances were calculated and compared with those found in light and darkness. The increase in gain observed for near targets was lower than predicted by geometrical calculations, implying a physiological ceiling effect on the VOR. The VOR gain in the dark, as assessed with the vHIT, demonstrates an enhancement associated with a reduced target distance.

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Eye-Head Movement Coordination: Vestibulo-Ocular Reflex Suppression with Head-Fixed Target Fixation1

Journal of Vestibular Research ◽

10.3233/ves-1991-1207 ◽

1991 ◽

Vol 1 (2) ◽

pp. 161-170

Author(s):

Jean-Louis Vercher ◽

Gabriel M. Gauthier

Keyword(s):

Eye Movements ◽

Time Course ◽

Mental Arithmetic ◽

Visual Space ◽

Head Movements ◽

Total Darkness ◽

Fixed Target ◽

Ocular Reflex ◽

Optokinetic Reflex ◽

Vestibulo Ocular Reflex

To maintain clear vision, the images on the retina must remain reasonably stable. Head movements are generally dealt with successfully by counter-rotation of the eyes induced by the combined actions of the vestibulo-ocular reflex (VOR) and the optokinetic reflex. A problem of importance relates to the value of the so-called intrinsic gain of the VOR (VORG) in man, and how this gain is modulated to provide appropriate eye movements. We have studied these problems in two situations: 1. fixation of a stationary object of the visual space while the head moves; 2. fixation of an object moving with the head. These two situations were compared to a basic condition in which no visual target was allowed in order to induce “pure” VOR. Eye movements were recorded in seated subjects during stationary sinusoidal and transient rotations around the vertical axis. Subjects were in total darkness (DARK condition) and involved in mental arithmetic. Alternatively, they were provided with a small foveal target, either fixed with respect to earth (earth-fixed target: EFT condition), or moving with them (chair-fixed-target: CFT condition). The stationary rotation experiment was used as baseline for the ensuing experiment and yielded control data in agreement with the literature. In all 3 visual conditions, typical responses to transient rotations were rigorously identical during the first 200 ms. They showed, sequentially, a 16-ms delay of the eye behind the head and a rapid increase in eye velocity during 75 to 80 ms, after which the average VORG was 0.9 ± 0.15. During the following 50 to 100 ms, the gain remained around 0.9 in all three conditions. Beyond 200 ms, the VORG remained around 0.9 in DARK and increased slowly towards 1 or decreased towards zero in the EFT and CFT conditions, respectively. The time-course of the later events suggests that visual tracking mechanisms came into play to reduce retinal slip through smooth pursuit, and position error through saccades. Our data also show that in total darkness VORG is set to 0.9 in man. Lower values reported in the literature essentially reflect predictive properties of the vestibulo-ocular mechanism, particularly evident when the input signal is a sinewave.

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Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2846-z ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 9

Author(s):

Ravi Shankar Reddy ◽

Jaya Shanker Tedla ◽

Snehil Dixit ◽

Mohammed Abohashrh

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Cervical Spondylosis ◽

Target Position ◽

Absolute Error ◽

Healthy Control Group ◽

Control Group ◽

Cross Sectional ◽

Control Subjects ◽

Healthy Control

Abstract Background Cervical proprioception is critical in the maintenance of posture and movements, so its assessment in different cervical conditions has gained importance in recent clinical practice. Studies reporting this assessment in subjects with cervical spondylosis (CS) have not previously been investigated. The goals of the study are (1) comparison of joint position error (JPE) in subjects with CS to healthy control group. (2) Correlation of neck pain intensity to cervical proprioception in patients with CS. Methods In a Cross-sectional study, 132 subjects with CS and 132 healthy age-matched control subjects were evaluated for cervical JPE with the cervical range of motion device. The subjects were blindfolded and repositioned their heads to a target position, which was determined by the examiner previously and their repositioning accuracy (absolute error in degrees) was measured in the frontal (flexion and extension) and transverse planes (left rotation and right rotation). The CS subjects resting neck pain intensity was assessed using visual analog scale (VAS). Results CS subjects showed statistically significantly larger JPEs compared to healthy control subjects in all the directions tested (flexion - 95% CI = 2.38–3.55, p < 0.001, extension - 95% CI =3.26–4.33, p < 0.001, left rotation - 95% CI = 2.64 - 3.83, p < 0.001, right rotation − 95% CI = 3.77–4.76, p < 0.001). The mean JPE errors in the CS group ranged from 6.27° to 8.28° and in the control group ranged from 2.36° to 4.48°. Pearson’s correlation coefficient showed a significant and positive relationship between neck pain intensity and cervical proprioception (p ≤ 0.001). Conclusions Proprioception is impaired in subjects with CS when compared to healthy control group. Higher pain intensity was associated with greater cervical JPE in patients with CS.

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Analysis of Vestibulo-Ocular Reflex Using Sweep Frequency Active Head Movements

Neurophysiology of the Vestibular System - Advances in Oto-Rhino-Laryngology ◽

10.1159/000416053 ◽

2015 ◽

pp. 179-183 ◽

Cited By ~ 5

Author(s):

Dennis P. O�Leary ◽

Linda L. Davis ◽

Geli-Ann Kitsigianis

Keyword(s):

Head Movements ◽

Sweep Frequency ◽

Ocular Reflex ◽

Vestibulo Ocular Reflex

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Occupation and Visual/Vestibular Interaction in Vestibular Rehabilitation

Otolaryngology ◽

10.1177/019459989511200404 ◽

1995 ◽

Vol 112 (4) ◽

pp. 526-532 ◽

Cited By ~ 1

Author(s):

Helen Cohen ◽

Maureen Kane-Wineland ◽

Laura V. Miller ◽

Catherine L. Hatfield

Keyword(s):

Motor Skills ◽

Therapy Group ◽

Exercise Program ◽

Head Movements ◽

Vestibular Disorders ◽

Essential Factor ◽

Gross Motor Skills ◽

Ocular Reflex ◽

Before And After ◽

Vestibulo Ocular Reflex

Otolaryngologists often prescribe head movement exercise programs for patients with vestibular disorders, although the effectiveness of these programs and the critical features of the exercises are poorly understood. Because many patients who dislike exercising do not follow through with their exercises, alternatives to the traditional repetitive exercises would be useful. Subjects diagnosed with vestibular disorders were treated for 6 weeks with either an outpatient exercise program that incorporated interesting, purposeful activities or a simple home program of head movements, comparable with the exercises otolaryngologists often give their patients when they do not refer to rehabilitation. Both treatments incorporated repetitive head movements in all planes in space, graduated in size and speed. Subjects were all tested before and after treatment with standard measures of vestibulo-ocular reflex and balance, level of vertigo, gross motor skills, and self-care independence. Subjects in both groups improved significantly on the functional measures, with slightly greater improvements in the occupational therapy group. The results were maintained 3 months after the cessation of intervention. These data suggest that graded purposeful activities are a useful alternative for treating this patient population and that the essential factor in any exercise program is the use of repetitive head movements.

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