Functional coupling of the stabilizing gaze reflexes during vertical linear motion in the alert cat

Effects of microvascular decompression surgery on posture control: A case report in an elderly patient

AIMS OF THE STUDY

We report the case of an 84-year-old woman with neurovascular conflict of the left cochleovestibular nerve. Prior to surgery, the patient complained of positional vertigo and dizziness for the past two years, and marked instability. Hearing loss and tinnitus were reported on the left side. The aim of this study was to investigate the effects of microvascular decompression of the cochleovestibular nerve on posture control.

MATERIALS AND METHODS

Evaluation of cochleovestibular function and posture control was performed before and after surgery. Postural performance was analyzed in static and dynamic conditions, with and without vision, and with optokinetic stimulation. Perception of the static visual vertical (SVV) was recorded in darkness.

RESULTS

Positional vertigo and tinnitus disappeared immediately after the decompression. The SVV remained unchanged one week after the surgery. Speech intelligibility of the left ear was improved (30 dB), and the vestibular deficit on this side was also significantly reduced (54% versus 18%). However, the more spectacular result was the effect on postural control. This elderly patient improved her postural balance in both static and dynamic conditions, and became able to maintain her equilibrium in the more challenging dynamic conditions, with and without vision, as early as one week after the surgery, a postural performance that she had been unable to do preoperatively.

CONCLUSION

This work is the first to show that the postural deficits resulting from neurovascular conflict of the cochleovestibular nerve are strongly improved after microvascular decompression.

Current approaches and future directions to understanding control of head movement

This chapter reviews four key issues that must be addressed to advance our knowledge of control of head movement by the central nervous system (CNS). (1) Researchers must consider how the CNS utilizes the multiple muscle patterns that can produce the same head movement in carrying out tasks in an optimal way. (2) More attention must be paid to the dynamics of neck muscle activation that are required to implement head movements and show they are produced by CNS circuits. (3) Research is required to determine how the multiple pathways that impinge upon neck motor centers are utilized in a variety of tasks including eye-head gaze shifts, smooth head tracking, head stabilization and manipulating objects with the head. These pathways include corticospinal, vestibulospinal, reticulospinal (three subdivisions), fastigiospinal, tectospinal and interstitiospinal tracts. (4) Further analysis is needed to understand how vestibular signals are modulated during each of the above-mentioned tasks. This ambitious agenda is justified by the fact that the head-neck motor system is an ideal model for understanding issues of complex motor control.

Eye–neck coupling during optokinetic responses in head-fixed pigeons (Columba livia): influence of the flying behaviour

The effects of the behavioural context on the properties of slow and fast phases of the horizontal optokinetic nystagmus (OKN) and on the electromyographic neck response (EMG) were investigated in head-fixed pigeons. Responses in two situations were compared: (i) animals were hung in a harness ('resting' condition); (ii) animals in harness were subjected to a frontal airflow that provoked a flight posture ('flying' condition). During optokinetic stimuli the neck muscles responded in synchrony and in synergy with the eye nystagmus in both the 'resting' and the 'flying' conditions. In the 'resting' condition the neck activity was essentially correlated to the slow phase velocity of the eyes (eye SPV) whereas in the 'flying' condition, the neck response was also correlated to the eye position. The neck response was independent of the retinal slip velocity during the OKN. The velocity of the slow and fast phases of the OKN was not modified by flight. However, the 'flying' condition provoked an increase of the neck response by augmenting both its velocity gain (neck EMG/eye SPV) and its position gain (neck EMG/eye position). These results show that although an optokinetic stimulation results in synchronised eye and head motor commands in head-fixed pigeons, only the head motor command is modified by the behavioural context ('flying' vs. 'resting'). This strategy could help pigeons in reorienting their gaze during the flight.