When uncertain, does human self-motion decision-making fully utilize complete information?

Intra-individual consistency of vestibular perceptual thresholds

Vestibular perceptual thresholds quantify sensory noise associated with reliable perception of small self-motions. Previous studies have identified substantial variation between even healthy individuals' thresholds. However, it remains unclear if or how an individual's vestibular threshold varies over repeated measures across various time scales (repeated measurements on the same day, across days, weeks, or months). Here, we assessed yaw rotation and roll tilt thresholds in four individuals and compared this intra-individual variability to inter-individual variability of thresholds measured across a large age-matched cohort each measured only once. For analysis, we performed simulations of threshold measurements where there was no underlying variability (or it was manipulated) to compare to that observed empirically. We found remarkable consistency in vestibular thresholds within individuals, for both yaw rotation and roll tilt; this contrasts with substantial inter-individual differences. Thus, we conclude that vestibular perceptual thresholds are an innate characteristic, which validates pooling measures across sessions and potentially serves as a stable clinical diagnostic and/or biomarker.

Noise and vestibular perception of passive self-motion

Noise defined as random disturbances is ubiquitous in both the external environment and the nervous system. Depending on the context, noise can degrade or improve information processing and performance. In all cases, it contributes to neural systems dynamics. We review some effects of various sources of noise on the neural processing of self-motion signals at different stages of the vestibular pathways and the resulting perceptual responses. Hair cells in the inner ear reduce the impact of noise by means of mechanical and neural filtering. Hair cells synapse on regular and irregular afferents. Variability of discharge (noise) is low in regular afferents and high in irregular units. The high variability of irregular units provides information about the envelope of naturalistic head motion stimuli. A subset of neurons in the vestibular nuclei and thalamus are optimally tuned to noisy motion stimuli that reproduce the statistics of naturalistic head movements. In the thalamus, variability of neural discharge increases with increasing motion amplitude but saturates at high amplitudes, accounting for behavioral violation of Weber's law. In general, the precision of individual vestibular neurons in encoding head motion is worse than the perceptual precision measured behaviorally. However, the global precision predicted by neural population codes matches the high behavioral precision. The latter is estimated by means of psychometric functions for detection or discrimination of whole-body displacements. Vestibular motion thresholds (inverse of precision) reflect the contribution of intrinsic and extrinsic noise to perception. Vestibular motion thresholds tend to deteriorate progressively after the age of 40 years, possibly due to oxidative stress resulting from high discharge rates and metabolic loads of vestibular afferents. In the elderly, vestibular thresholds correlate with postural stability: the higher the threshold, the greater is the postural imbalance and risk of falling. Experimental application of optimal levels of either galvanic noise or whole-body oscillations can ameliorate vestibular function with a mechanism reminiscent of stochastic resonance. Assessment of vestibular thresholds is diagnostic in several types of vestibulopathies, and vestibular stimulation might be useful in vestibular rehabilitation.

Vestibular perceptual thresholds for rotation about the yaw, roll, and pitch axes

This effort seeks to further assess human perception of self-motion by quantifying and comparing earth-vertical rotational vestibular perceptual thresholds about the yaw, roll, and pitch axes. Early seminal works (Benson Aviat Space Environ Med 60:205-213, 1989) quantified thresholds for yaw, roll, and pitch rotations, using single-cycle sinusoids in angular acceleration with a frequency of 0.3 Hz (3.33 s motion duration) and found yaw thresholds to be significantly lower than roll and pitch thresholds (1.58-1.20 deg/s vs. 2.07 deg/s and 2.04 deg/s, respectively). Our current effort uses modern methods and definitions to reassess if rotational thresholds differ between these three axes of rotation in ten human subjects at 0.3 Hz and additionally across a range of frequencies: 0.1 Hz, 0.3 Hz, and 0.5 Hz. In contrast to the established findings of Benson et al., no statistically significant differences were found between the three rotational axes at 0.3 Hz. Further, no statistically significant differences were found at any of these frequencies. Instead, a consistent pattern was found for yaw, pitch, and roll of increasing thresholds with decreasing rotational frequency, consistent with the brain employing high-pass filter mechanisms for decision-making. We also fill a gap in the literature by extending the quantification of pitch rotation thresholds to 0.1 Hz. Finally, we assessed inter-individual trends between these three frequencies and across all three axes of rotation. In thoroughly considering methodological and other differences between the current and previous studies, we conclude yaw rotation thresholds do not differ from those in roll or pitch.

Enhancement of Vestibular Motion Discrimination by Small Stochastic Whole-body Perturbations in Young Healthy Humans

Noisy galvanic vestibular stimulation has been shown to improve vestibular perception in healthy subjects. Here, we sought to obtain similar results using more natural stimuli consisting of small-amplitude motion perturbations of the whole body. Thirty participants were asked to report the perceived direction of antero-posterior sinusoidal motion on a MOOG platform. We compared the baseline perceptual thresholds with those obtained by applying small, stochastic perturbations at different power levels along the antero-posterior axis, symmetrically distributed around a zero-mean. At the population level, we found that the thresholds for all but the highest level of noise were significantly lower than the baseline threshold. At the individual level, the threshold was lower with at least one noise level than the threshold without noise in 87% of participants. Thus, small, stochastic oscillations of the whole body can increase the probability of recognizing the direction of motion from low, normally subthreshold vestibular signals, possibly due to stochastic resonance mechanisms. We suggest that, just as the external noise of the present experiments, also the spontaneous random oscillations of the head and body associated with standing posture are beneficial by enhancing vestibular thresholds with a mechanism similar to stochastic resonance.

Vestibular Precision at the Level of Perception, Eye Movements, Posture, and Neurons

Precision and accuracy are two fundamental properties of any system, including the nervous system. Reduced precision (i.e., imprecision) results from the presence of neural noise at each level of sensory, motor, and perceptual processing. This review has three objectives: (1) to show the importance of studying vestibular precision, and specifically that studying accuracy without studying precision ignores fundamental aspects of the vestibular system; (2) to synthesize key hypotheses about precision in vestibular perception, the vestibulo-ocular reflex, posture, and neurons; and (3) to show that groups of studies that are thoughts to be distinct (e.g., perceptual thresholds, subjective visual vertical variability, neuronal variability) are actually "two sides of the same coin" - because the methods used allow results to be related to the standard deviation of a Gaussian distribution describing the underlying neural noise. Vestibular precision varies with age, stimulus amplitude, stimulus frequency, body orientation, motion direction, pathology, medication, and electrical/mechanical vestibular stimulation, but does not vary with sex. The brain optimizes precision during integration of vestibular cues with visual, auditory, and/or somatosensory cues. Since a common concern with precision metrics is time required for testing, we describe approaches to optimize data collection and provide evidence that fatigue and session effects are minimal. Finally, we summarize how precision is an individual trait that is correlated with clinical outcomes in patients as well as with performance in functional tasks like balance. These findings highlight the importance of studying vestibular precision and accuracy, and that knowledge gaps remain.

The medical decision-making process in the time of the coronavirus pandemic

The disease pandemic caused by the novel coronavirus has triggered significant changes in the medical decision-making process relating to critically ill patients. Admissions to intensive care units have suddenly increased, but many of these patients do not present with clinical manifestations related to the viral infection but rather exacerbation of preexisting diseases. In this context, we must prevent intuitive decision-making and insecurity from leading us to exhaust the available critical-care beds before they are truly necessary, while still recognizing the importance of rapid decision-making in emergency situations. One of the best ways to achieve this goal may be by practicing metacognition and establishing ways for regular feedback to be provided to professionals engaged in inherently rapid decision-making processes.

The Do's and Don'ts of Psychophysical Methods for Interpretability of Psychometric Functions and Their Descriptors

Many areas of research require measuring psychometric functions or their descriptors (thresholds, slopes, etc.). Data for this purpose are collected with psychophysical methods of various types and justification for the interpretation of results arises from a model of performance grounded in signal detection theory. Decades of research have shown that psychophysical data display features that are incompatible with such framework, questioning the validity of interpretations obtained under it and revealing that psychophysical performance is more complex than this framework entertains. This paper describes the assumptions and formulation of the conventional framework for the two major classes of psychophysical methods (single- and dual-presentation methods) and presents various lines of empirical evidence that the framework is inconsistent with. An alternative framework is then described and shown to account for all the characteristics that the conventional framework regards as anomalies. This alternative process model explicitly separates the sensory, decisional, and response components of performance and represents them via parameters whose estimation characterizes the corresponding processes. Retrospective and prospective evidence of the validity of the alternative framework is also presented. A formal analysis also reveals that some psychophysical methods and response formats are unsuitable for separation of the three components of observed performance. Recommendations are thus given regarding practices that should be avoided and those that should be followed to ensure interpretability of the psychometric function, or descriptors (detection threshold, difference limen, point of subjective equality, etc.) obtained with shortcut methods that do not require estimation of psychometric functions.

Self-Motion Versus Environmental-Motion Perception Following Rotational Vestibular Stimulation and Factors Modifying Them

Motion perception following rotational vestibular stimulation is described either as a self-motion or as an environmental-motion. The purpose of the present study was to establish frequency of occurrence of both sensations in healthy humans; what other sensations they experience and how factors insinuation and visual cues modify them. Twenty-four healthy subjects were rotated with constant velocity of 80°/s in four combinations of opened and closed eyes during the rotation and after a sudden stop. After the cessation of the rotation they reported their spontaneous or insinuated illusory motion. During spontaneous perception after sudden cessation of rotation and with the subject's eyes open, the illusory sensations of self- and environmental-motion were almost equally presented. There was no simultaneous illusory perception of self-motion and environmental-motion. Insinuation modified the perception of motion; presence or absence of visual cues prior to the cessation of the rotation and the presence or absence of visual cues immediately after the cessation of the rotation changed the motion sensation. There is a gender effect in motion perception. This finding might be of benefit in further exploring the gender difference in the susceptibility to motion sickness.