Representation of three-dimensional space in the vestibular, oculomotor, and visual systems. Concluding remarks

A review on screening tests for vestibular disorders

Although many studies have reported on tests of the vestibular system a valid and reliable, evidence-based screening battery for easy clinical use remains elusive. Many screening tests attempt to assess the vestibulo-ocular reflex. Therefore, head shaking, the Dix-Hallpike maneuver, the supine roll test, and head impulse tests are discussed. Other tests address the spatial orientation functions of the vestibular system, such as the Bucket Test and the Fukuda Stepping test. Still, other tests are based on the known correlates with balance skills, both static and dynamic, such as tandem walking and the modern variation of the Romberg test, the modified Clinical Test of Sensory Interaction and Balance. This review provides a critical overview of the literature on some of these tests and their value for clinical use and in epidemiological studies.

The efference cascade, consciousness, and its self: naturalizing the first person pivot of action control

The 20 billion neurons of the neocortex have a mere hundred thousand motor neurons by which to express cortical contents in overt behavior. Implemented through a staggered cortical "efference cascade" originating in the descending axons of layer five pyramidal cells throughout the neocortical expanse, this steep convergence accomplishes final integration for action of cortical information through a system of interconnected subcortical way stations. Coherent and effective action control requires the inclusion of a continually updated joint "global best estimate" of current sensory, motivational, and motor circumstances in this process. I have previously proposed that this running best estimate is extracted from cortical probabilistic preliminaries by a subcortical neural "reality model" implementing our conscious sensory phenomenology. As such it must exhibit first person perspectival organization, suggested to derive from formating requirements of the brain's subsystem for gaze control, with the superior colliculus at its base. Gaze movements provide the leading edge of behavior by capturing targets of engagement prior to contact. The rotation-based geometry of directional gaze movements places their implicit origin inside the head, a location recoverable by cortical probabilistic source reconstruction from the rampant primary sensory variance generated by the incessant play of collicularly triggered gaze movements. At the interface between cortex and colliculus lies the dorsal pulvinar. Its unique long-range inhibitory circuitry may precipitate the brain's global best estimate of its momentary circumstances through multiple constraint satisfaction across its afferents from numerous cortical areas and colliculus. As phenomenal content of our sensory awareness, such a global best estimate would exhibit perspectival organization centered on a purely implicit first person origin, inherently incapable of appearing as a phenomenal content of the sensory space it serves.

Motion perception during selfmotion: The direct versus inferential controversy revisited

According to the traditional inferential theory of perception, percepts of object motion or stationarity stem from an evaluation of afferent retinal signals (which encode image motion) with the help of extraretinal signals (which encode eye movements). According to direct perception theory, on the other hand, the percepts derive from retinally conveyed information only. Neither view is compatible with a perceptual phenomenon that occurs during visually induced sensations of ego motion (vection). A modified version of inferential theory yields a model in which the concept of extraretinal signals is replaced by that of reference signals, which do not encode how the eyes move in their orbits but how they move in space. Hence reference signals are produced not only during eye movements but also during ego motion (i.e., in response to vestibular stimulation and to retinal image flow, which may induce vection). The present theory describes the interface between self-motion and object-motion percepts. An experimental paradigm that allows quantitative measurement of the magnitude and gain of reference signals and the size of the just noticeable difference (JND) between retinal and reference signals reveals that the distinction between direct and inferential theories largely depends on: (1) a mistaken belief that perceptual veridicality is evidence that extraretinal information is not involved, and (2) a failure to distinguish between (the perception of) absolute object motion in space and relative motion of objects with respect to each other. The model corrects these errors, and provides a new, unified framework for interpreting many phenomena in the field of motion perception.

The role of 3-canal biomechanics in angular motion transduction by the human vestibular labyrinth

The present work examines the role of the complex geometry of the human vestibular membranous labyrinth in the process of angular motion transduction by the semicircular canals. A morphologically descriptive mathematical model was constructed to address the biomechanical origins of temporal signal processing and directional coding in determining the inputs to the brain. The geometrical model was developed based on shrinkage-corrected temporal bone sections using a segmentation/data-fitting procedure. Endolymph fluid dynamics within the 3-canal labyrinth was modeled using an asymptotic form of the Navier-Stokes equations and solved to estimate endolymph and cupulae volume displacements. The geometrical model was manipulated to study the role of major morphological features on directional and temporal coding. Anatomical results show that the bony osseous canals provide reasonable estimates of the orientation of the delicate membranous canals--the two differed by only 3.48 +/- 1.89 degrees . Biomechanical results show that the maximal response directions are distinct from the anatomical canal planes, but can be closely approximated by fitting a flat plane to the centerline of the canal of interest and weighting each location along the centerline with the inverse of the cross-sectional area squared. Vector cross-products of these maximal response directions, in turn, determine the null planes and prime directions that transmit the direction of angular motion to the brain as three independent directional channels associated with the nerve bundles. Finally, parameter studies indicate that changes in canal cross-sectional area and shape only moderately affect canal temporal and directional coding, while three-canal orientation is critical to directional coding.

Perspectives for the comprehensive examination of semicircular canal and otolith function

A review is presented on the three-dimensional aspects of the vestibulo-oculomotor system and the current functional tests for unilateral examination of the individual receptors in the vestibular labyrinth. In the presentation, attention is directed towards the recently developed vestibular tests, which promise a more comprehensive examination of labyrinth function. More explicitly, unilateral tests for the utricle, saccule and the individual semicircular canals are discussed. Caloric irrigation and rotatory testing are widely used as tests for the integrity of the (horizontal) semicircular canals. Little useful diagnosis is made however on the vertical canals, not to mention the otolith organs. A promising approach to the examination of individual semicircular canal function has been described. This involves the perception of self-rotation in each of the planes of the semicircular canals. The patient/subject is rotated by an arbitrary amount on a standard Barany chair and then required to return the chair to its original position, by joystick control of the chair velocity. In order to test the vertical canals, the head of the subject/patient is positioned so that the plane of each canal lies in the plane of rotation. A promising unilateral test of saccular function involves the use of vestibular evoked myogenic potentials. Here it has been demonstrated that the saccules can be activated using brief, high-intensity acoustic clicks. The myogenic potential is measured using surface electrodes over the sternocleidomastoid muscles. Initial data from patients has indicated that the test is specific for unilateral saccule disorders. The unilateral test of utricle function is based on the eccentric displacement profile. Thus, eccentric displacement of the head to 3.5 cm during constant velocity rotation about the earth-vertical axis generates an adequate unilateral stimulation of the otolith organ, without involving the semicircular canals. This paradigm has also proved efficient in localizing peripheral otolith dysfunction by means of SVV estimation. This represents a novel test of otolith function that can be easily integrated into routine clinical testing. In contrast to the otolith-ocular response, the subjective visual vertical also reflects the processing of otolithic information in the higher brain centres (thalamus, vestibular cortex). Exploitation of the two complementary approaches therefore provides useful information for both experimental and clinical scientists. Of direct interest is the finding that testing with the subject rotating on-centre is sufficient to localize peripheral otolith dysfunction by means of SVV estimation. This represents a novel test of otolith function that can be easily integrated into routine clinical testing. In addition to caloric testing, which has remained the classical unilateral test of vestibular function, the newly developed tests should improve the differential diagnosis of vestibular disorders.

Vestibulo-oculomotor research and measurement technology for the space station era

Recent improvements in measurement techniques and mathematical representations for eye, head and body movement have enhanced our appreciation of the complexity of spatial orientation and locomotion in three-dimensional space. The shortcomings of present measurement techniques, and their solution with emerging technologies are described. The prolonged microgravity conditions on the space station provide a unique opportunity to investigate these three-dimensional aspects of the vestibular and oculomotor systems, and in particular, the role of the otolith afferences. While the canal-ocular responses and their central pathways are reasonably well understood, the community has only recently become aware of the variety of functions fulfilled by otolith-mediated information, i.e., translational otolith-ocular reflex, inertial processing, gravitational reference, vergence control. Recent results, largely from experiments performed on the Mir Station, where the emphasis was on the otolith contribution to the vestibulo-ocular response mechanisms, are reviewed.

Thalamic connections of the vestibular cortical fields in the squirrel monkey (Saimiri sciureus)

The afferent thalamic connections to cortical fields important for control of head movement in space were analysed by intracortical retrograde tracer injections. The proprioceptive/vestibular area 3aV, the neck-trunk region of area 3a, receives two thirds of its thalamic projections from the oral and superior ventroposterior nucleus (VPO/VPS), which is considered as the proprioceptive relay of the ventroposterior complex (Kaas et al., J. Comp. Neurol. 226:211-240, 1984). The parieto-insular vestibular cortex (PIVC, area retroinsularis, Ri) receives its main thalamic input from posterior parts of the ventroposterior complex and from the medial pulvinar. Anatomical evidence is presented that the posterior region of the ventroposterior complex is a special compartment within this principal somatosensory relay complex. The parietotemporal association area T3, mainly involved in visual-optokinetic signal processing, receives a substantial input from the medial, the lateral, and the inferior pulvinar. Dual tracer experiments revealed that about 5% of the thalamic neurons projecting to 3aV were spatially intermingled with neurons projecting to areas PIVC or T3. This spatial intermingling was distributed over small but numerous, circumscribed thalamic regions, called "common patches," which were found mainly in the intralaminar nuclei, the posterior group of thalamic nuclei, and the caudal parts of the ventroposterior complex. The "common patches" may indicate a functional coupling of area 3aV with the PIVC or area T3 on the thalamic level. In control experiments thalamic projections to the granular insula Ig and the anterior part of area 7, two cerebral structures connected with the vestibular cortical areas, were studied. Some overlap in the thalamic relay structures projecting to these areas with those projecting to the vestibular cortices was found. A quantitative evaluation of thalamic regions projecting to different cortical structures was performed by constructing so-called "thalamograms." A scheme was developed that describes the afferent thalamic connections by which vestibular, visual-optokinetic, and proprioceptive signals reach the vestibular cortical areas PIVC and 3aV.

Cortico-cortical connections and cytoarchitectonics of the primate vestibular cortex: a study in squirrel monkeys (Saimiri sciureus)

The cortical connections of two vestibular fields [parieto-insular vestibular cortex (PIVC) and area 3aV] were studied in the squirrel monkey (Saimiri sciureus) by means of retrograde tracer techniques. Small iontophoretic or pressure injections of horseradish peroxidase (HRP), wheat-germ-HRP, Nuclear Yellow, and Fast Blue were administered to the cytoarchitectonic areas Ri (PIVC), 3aV, the parieto-temporal association area T3, the granular insula (Ig), and the rostral part of area 7 (7ant). The injection sites were physiologically characterized by means of microelectrode recordings and vestibular, optokinetic, or somatosensory stimulation: Area Ri is the region of the parieto-insular vestibular cortex (PIVC) as defined in macaques. The neck-trunk region of area 3a (area 3aV) also contains many neurons responding to stimulation of semicircular canal receptors. Some neurons of area T3 bordering on the PIVC also receive vestibular signals, but most neurons in area T3 responded preferentially to large-field optokinetic stimulation and not to vestibular stimulation. In none of the areas mentioned were responses to otolith stimulation found. The PIVC receives inputs from frontal and parietal cortical areas, especially areas 8a, 6, 3a, 3aV, 2, and 7ant. Area T3 receives signals from the insular and retroinsular cortex, various parts of area 7, visual areas of the parieto-occipital and parieto-temporal regions (area 19) and from a sector of the upper bank of the temporal sulcus (STS-area). The cortical afferents to area 3aV stem from areas 24, 4, 6, 7ant, from other parts of the primary somatosensory cortex, the secondary somatosensory cortex (SII), the retroinsular cortex (Ri), and the granular insula (Ig). In the border region of the areas 2 and 7ant, labelled neurons appeared after injections into both the PIVC and the area 3aV. This region is presumably the homologue to the vestibular area 2v of the macaque brain. In all regions cells within the contralateral cortex were less frequently labelled than cells in the homologous structures of the ipsilateral hemisphere. The cortical system for processing vestibular information about head-in-space movement consists mainly of the reciprocally interconnected areas PIVC and 3aV, and most likely of border regions of area 2 and 7ant. This "inner cortical vestibular circuit" also receives signals from two other cortical sensory systems, the somatosensory-proprioceptive system mediated by the primary somatosensory cortex and the visual movement system (optokinetic or visual flow signals). These visual movement signals reach PIVC via area 19 and area T3.(ABSTRACT TRUNCATED AT 400 WORDS)

Wallenberg's syndrome: lateropulsion, cyclorotation, and subjective visual vertical in thirty-six patients

We measured the subjective visual vertical, cyclorotation of the eyes, and head and body lateropulsion in 36 patients with Wallenberg's syndrome. All patients exhibited significant tilts of the internal representation of the gravity vector, as indicated by deviation of subjective visual vertical ipsiversive to the lesion. Most patients (82%) had ipsiversive cyclorotation of one or both eyes, especially excyclotropia of the eye ipsilateral to the brainstem lesion. Twelve of 36 patients (33%), those with the most severe body lateropulsion, had a complete ocular tilt reaction consisting of head tilt, skew deviation, and cyclorotation in the roll plane. We hypothesize that deviation of subjective visual vertical, lateropulsion of the body, and cyclorotation of the eyes are the perceptual, the ocular motor, and the postural consequences of a common lesion of central vestibular pathways that subserve the vestibuloocular reflex in the roll plane. Lateropulsion in patients with Wallenberg's syndrome is interpreted as a postural consequence of an abnormal tilt of the internal representation of orientation in space.

A compact equipment package for vestibular experiments during spaceflight

A compact measurement and stimulus equipment package for vestibular testing is described. The package is designed on a modular concept so that a customised version can be assembled for each experimental situation. Although primarily conceived for space-related research, the equipment has also been introduced successfully into the clinical diagnostic procedure. An essential function of the equipment is the recording and evaluation of eye movements. This is performed by a video-based measurement system which permits evaluation of horizontal, vertical and torsional components of eye movement. Objective testing of the vestibulo-ocular reflex in all three orthogonal planes is therefore possible. Furthermore evaluation of the otolithic function in weightlessness is made feasible by the possibility of measuring dynamic ocular counterrolling. Some applications of the equipment are described.