Proprioception in extraocular muscles

Another Look at Fatigued Individuals with and without Chronic Ankle Instability: Posturography and Proprioception

Fatigue can impair function of the three sensory systems (vestibular, visual, and somatosensory) that control postural balance. Yet impairment may be greater among individuals with than those without chronic ankle instability (CAI). The present study used posturography assessment to extend previous findings demonstrating reduced function of the three systems in CAI participants following fatigue. Our aim in this study was to examine the influence of anaerobic and aerobic protocols on the function of these three sensory systems in individuals with and without CAI. We assessed 60 healthy physical education students (Mage = 24.3, SD = 3.4) by a Tetrax® Posturography device for Stability-Index and Fourier-frequencies [low sway (F1) visual input, medium-low sway (F2-F4) vestibular input, medium-high sway (F5-F6) somatosensory input] and by the Active Movement Extent Discrimination Assessment (AMEDA) for active ankle somatosensory ability, before and after performing anaerobic or aerobic protocols. Among participants, 45% were identified with CAI. We found significant Time effect (pre-post), CAI effect, and CAI X Time interactions for Fourier frequencies, Stability-Index, and AMEDA scores, indicating greater pre-post deterioration for those with CAI compared to those without CAI (p < .05). CI (95%) showed that, although there was a Time effect for F1, F2-F4, and F5-F6, only F5-F6 frequencies (i.e., somatosensory input) showed the CAI effect and the Time X CAI interaction. Thus, participants with and without CAI showed reduced visual, vestibular, and somatosensory ability following fatigue. While we found greater deterioration in both passive and active somatosensory ability (F5-6 and AMEDA) among individuals with CAI compared with those with no-CAI, we recommend intervention programs for improving vestibular abilities following fatigue in both those with and without CAI.

The Function of the Proprioceptive, Vestibular and Visual Systems Following Fatigue in Individuals With and Without Chronic Ankle Instability

To maintain postural balance, the proprioceptive, vestibular, and visual systems continuously provide body position and movement data to the central nervous system. In this study, our main aim was to examine, for the first time, the influence of anaerobically or aerobically induced fatigue on these separate functions in persons with and without chronic ankle instability (CAI). We obtained assessments pre- and post-fatigue protocols from 60 physical education students (Mage = 24.3, SD = 3.4) Twenty-seven students had CAI, and 33 students did not have CAI). To measure proprioception, we used the AMEDA device; for vision, we used near point of convergence (NPC); and, for vestibular function, we used subjective visual vertical (SVV). We found a pre-post proprioception (AMEDA) effect in the aerobic group (p < .001), and a visual (NPC) effect in both anaerobic and aerobic participant groups (both p < .001). There were no visual system (NPC) fatigue effect differences among aerobic or anerobic participants who had or did not have CAI (p = .047); there was a significant aerobic fatigue effect on proprioception (AMEDA) (p = .010) that favored participants without CAI. There was a significant interaction effect between time of testing and CAI for visual (NPC) (p = .003) in the aerobic group only. In both the anaerobic and aerobic groups, post-fatigue vestibular function (AMEDA) was significantly lower for those with than those without CAI (anaerobic: p = .030; and aerobic: p =.016). Thus, post-fatigue, participants with CAI showed worse proprioceptive, visual, and vestibular function than those without CAI. Future investigators should further examine each movement sense system in individuals with CAI.

Do rectus muscle parameters vary between emmetropes and myopes?

PURPOSE

This study investigated the thickness, area, and insertion site of the medial (MR) and lateral (LR) rectus muscles in individuals with emmetropia and different degrees of myopia.

METHODS

Swept-source optical coherence tomography images of the MR and LR muscles in 80 participants including emmetropes (spherical equivalent refractive error [SER] ±0.50 D, N = 14) and myopes (≤ -0.75 D, N = 66), were analysed. Custom-designed, semi-automated software was used to measure parameters such as insertion distance from limbus, muscle thickness at every 1 mm interval to 3 mm periphery and muscle area from insertion site to 3 mm.

RESULTS

The median (Q1, Q3) SER error and axial length were -6.00 D (-13.25, -2.12) and 25.78 mm (23.78, 28.61), respectively. The MR was significantly thinner (mean ± SE: 137.7 ± 8.9 vs. 159.7 ± 8.9 µm, p < 0.01) and occupied less area than the LR (0.35 ± 0.01 vs. 0.42 ± 0.01 mm² , respectively, p < 0.01). The thickness of the MR gradually increased from the insertion site to a 3 mm peripheral eccentric location (106.5 3.8 µm at 1 mm, 135.5 ± 4.5 µm at 2 mm and 156.1 ± 5.9 µm at 3 mm, p < 0.01). The overall median thickness of the MR was significantly less in myopes (129 µm [111.5, 152.2]) than emmetropes (158.1 [134.3, 167.7] µm, p = 0.03). However, no such trend was seen in the LR muscle. Muscle area and insertion distance were not different between emmetropes and myopes in both horizontal rectus muscles.

CONCLUSION

Unlike the LR, the parameters of the MR (thin and occupying less area) show significant association with myopia. While the key finding of this study indicates the possible association of MR parameters with myopia, the clinical relevance of this finding and its role in myopiogenesis/progression needs to be investigated further.

Visual Binocular Disorders and Their Relationship with Baropodometric Parameters: A Cross-Association Study

The aim of this study was to establish a relationship between nonstrabismic binocular dysfunction and baropodometric parameters. A total of 106 participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges, and vergence facility. Posturography was measured using the FreeMED baropodometric platform. Among the variables that the software calculates are foot surface, foot load, and foot pressure. Our results showed that in the participants with positive fusional vergence (PFV) (near) blur and recovery values outside the norm, there are statistically significant differences between the total foot area (p < 0.05), forefoot area (p < 0.05), forefoot load (p < 0.05), and rearfoot load (p < 0.05), in all of the cases of left foot vs. right foot. In the group of subjects who did not meet Sheard's criterion (distance), that is, those with unstable binocular vision, there was a statistically significant difference (p < 0.01) between maximum left and right foot pressure. In conclusion, our results establish a relationship between nonstrabismic binocular dysfunctions and some baropodometric parameters.

Children with Dyslexia Have Altered Cross-Modal Processing Linked to Binocular Fusion. A Pilot Study

Introduction

The cause of dyslexia, a reading disability characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities, is unknown. A considerable body of evidence shows that dyslexics have phonological disorders. Other studies support a theory of altered cross-modal processing with the existence of a pan-sensory temporal processing deficit associated with dyslexia. Learning to read ultimately relies on the formation of automatic multisensory representations of sounds and their written representation while eyes fix a word or move along a text. We therefore studied the effect of brief sounds on vision with a modification of binocular fusion at the same time (using the Maddox Rod test).

Methods

To check if the effect of sound on vision is specific, we first tested with sounds and then replaced them with proprioceptive stimulation on 8 muscular sites. We tested two groups of children composed respectively of 14 dyslexic children and 10 controls.

Results

The results show transient visual scotoma (VS) produced by sensory stimulations associated with the manipulation of oculomotor balance, the effect being drastically higher in the dyslexic group. The spatial distribution of the VS is stochastic. The effect is not specific for sounds but exists also with proprioceptive stimulations.

Discussion

Although there was a very significant difference between the two groups, we were not able to correlate the (VS) occurrence with the dyslexic’s reading performance. One possibility to confirm the link between VS and reading impairment would be to find a specific treatment reducing the occurrence of the VS and to check its effect on dyslexia.

Neuroanatomical Structures in Human Extraocular Muscles and Their Potential Implication in the Development of Oculomotor Disorders

The potential role of sensory feedback from human extraocular muscles has been subjected to considerable speculation in the ophthalmic literature. Extraocular muscles pull against a fairly even load and do not initiate a stretch reflex, even when the eyes are directed toward the boundaries of their respective field of action. These unique working conditions and physiological properties have led to the notion that the sensory signal arising from receptors in extraocular muscles differs from the conventional proprioceptive signal arising from their somatic counterparts. The interest in the receptors at the myotendinous junction of human extraocular muscles has been renewed due to their alleged role in the development of binocular vision and their potential implication in the etiology of binocular vision anomalies. The idea that extraocular muscles provide knowledge of eye position and whether this function can be affected by surgical intervention has initiated several clinical and neuroanatomical studies. Many of these studies support this concept and suggest that surgical procedures that impose only minimal interference with the proprioceptive signal will give a better postoperative result. However, other studies contradict this view because the afferent capacity of the receptors can be questioned and some uncertainties remain. The purpose of this study was to review the related literature and discuss the possible role of ocular proprioceptors in relation to binocular vision and the development of eye motility disorders. [J Pediatr Ophthalmol Strabismus. 2018;55(1):14-22.].

Simultaneous recordings of ocular microtremor and microsaccades with a piezoelectric sensor and a video-oculography system

Our eyes are in continuous motion. Even when we attempt to fix our gaze, we produce so called "fixational eye movements", which include microsaccades, drift, and ocular microtremor (OMT). Microsaccades, the largest and fastest type of fixational eye movement, shift the retinal image from several dozen to several hundred photoreceptors and have equivalent physical characteristics to saccades, only on a smaller scale (Martinez-Conde, Otero-Millan & Macknik, 2013). OMT occurs simultaneously with drift and is the smallest of the fixational eye movements (∼1 photoreceptor width, >0.5 arcmin), with dominant frequencies ranging from 70 Hz to 103 Hz (Martinez-Conde, Macknik & Hubel, 2004). Due to OMT's small amplitude and high frequency, the most accurate and stringent way to record it is the piezoelectric transduction method. Thus, OMT studies are far rarer than those focusing on microsaccades or drift. Here we conducted simultaneous recordings of OMT and microsaccades with a piezoelectric device and a commercial infrared video tracking system. We set out to determine whether OMT could help to restore perceptually faded targets during attempted fixation, and we also wondered whether the piezoelectric sensor could affect the characteristics of microsaccades. Our results showed that microsaccades, but not OMT, counteracted perceptual fading. We moreover found that the piezoelectric sensor affected microsaccades in a complex way, and that the oculomotor system adjusted to the stress brought on by the sensor by adjusting the magnitudes of microsaccades.

Extraocular muscle afferent signals modulate visual attention

PURPOSE

Extraocular muscle afferent signals contribute to oculomotor control and visual localization. Prompted by the close links between the oculomotor and attention systems, it was investigated whether these proprioceptive signals also modulated the allocation of attention in space.

METHODS

A suction sclera contact lens was used to impose an eye rotation on the nonviewing, dominant eye. With their viewing, nondominant eye, participants (n = 4) fixated centrally and detected targets presented at 5° in the left or right visual hemifield. The position of the viewing eye was monitored throughout the experiment. As a control, visual localization was tested using finger pointing without visual feedback of the hand, whereas the nonviewing eye remained deviated.

RESULTS

The sustained passive rotation of the occluded, dominant eye, while the other eye maintained central fixation, resulted in a lateralized change in the detectability of visual targets. In all participants, the advantage in speed and accuracy for detecting right versus left hemifield targets that occurred during a sustained rightward eye rotation of the dominant eye was reduced or reversed by a leftward eye rotation. The control experiment confirmed that the eye deviation procedure caused pointing errors consistent with an approximately 2° shift in perceived eye position, in the direction of rotation of the nonviewing eye.

CONCLUSIONS

With the caveat of the small number of participants, these results suggest that extraocular muscle afferent signals modulate the deployment of attention in visual space.

Sensory adaptation in exophoria and exotropia

INTRODUCTION AND PURPOSE

To investigate the effect of exodeviation in spatial visual attention using the illusory line motion paradigm.

METHODS

The perception of visual illusion (i.e., illusory line motion) in the dominant and nondominant eyes was examined in 12 control subjects (under 5(Δ)), 12 exophoria patients (over 10(Δ)), and 12 exotropia patients. This paradigm presents two cues followed by an instantaneously presented horizontal bar, which the subjects perceive as bars that emanate from the two priming cues. These bars appear to grow toward the center of the visual field and continue to move inward until they collide with each other. In these experiments, the priming cues were asynchronously and simultaneously presented.

RESULTS

In the dominant eye, there was no correlation between the collision point shift and the ocular deviation, regardless of the stimulus patterns. However, a correlation was noted between the collision point shift and the ocular deviation in the nondominant eye when the second cue was presented in the nasal hemi-retina (P < 0.01). The shift of the collision point in exophoria and exotropia was greater than that seen in the control subjects (P < 0.01). When there was simultaneous presentation of the two cues in the nasal and temporal hemi-retina, there was a difference in the shift of the collision point in the exotropia patients, as compared to both the control subjects and exophoria patients (P < 0.05).

CONCLUSIONS

Current findings strongly suggest that sensory adaptation in the nondominant eye compensates for visual stress with ocular deviation.