Semicircular canal functional anatomy in cat, guinea pig and man

Evaluating vestibular contributions to rotation and tilt perception

Vestibular perceptual thresholds provide insights into sensory function and have shown clinical and functional relevance. However, specific sensory contributions to tilt and rotation thresholds have been incompletely characterized. To address this limitation, tilt thresholds (i.e., rotations about earth-horizontal axes) were quantified to assess canal-otolith integration, and rotation thresholds (i.e., rotations about earth-vertical axes) were quantified to assess perception mediated predominantly by the canals. To determine the maximal extent to which non-vestibular sensory cues (e.g., tactile) can contribute to tilt and rotation thresholds, we tested two patients with completely absent vestibular function and compared their data to those obtained from two separate cohorts of young (≤ 40 years), healthy adults. As one primary finding, thresholds for all motions were elevated by approximately 2-35 times in the absence of vestibular function, thus, confirming predominant vestibular contributions to both rotation and tilt self-motion perception. For patients without vestibular function, rotation thresholds showed larger increases relative to healthy adults than tilt thresholds. This suggests that increased extra-vestibular (e.g., tactile or interoceptive) sensory cues may contribute more to the perception of tilt than rotation. In addition, an impact of stimulus frequency was noted, suggesting increased vestibular contributions relative to other sensory systems can be targeted on the basis of stimulus frequency.

A review of the geometrical basis and the principles underlying the use and interpretation of the video head impulse test (vHIT) in clinical vestibular testing

This paper is concerned mainly with the assumptions underpinning the actual testing procedure, measurement, and interpretation of the video head impulse test-vHIT. Other papers have reported in detail the artifacts which can interfere with obtaining accurate eye movement results, but here we focus not on artifacts, but on the basic questions about the assumptions and geometrical considerations by which vHIT works. These matters are crucial in understanding and appropriately interpreting the results obtained, especially as vHIT is now being applied to central disorders. The interpretation of the eye velocity responses relies on thorough knowledge of the factors which can affect the response-for example the orientation of the goggles on the head, the head pitch, and the contribution of vertical canals to the horizontal canal response. We highlight some of these issues and point to future developments and improvements. The paper assumes knowledge of how vHIT testing is conducted.

Three-dimensional visualization of the human membranous labyrinth: The membrana limitans and its role in vestibular form

The inner ear contains the end organs for balance (vestibular labyrinth) and hearing (cochlea). The vestibular labyrinth is comprised of the semicircular canals (detecting angular acceleration) and otolith organs (utricle and saccule, which detect linear acceleration and head tilt relative to gravity). Lying just inferior to the utricle is the membranous membrana limitans (ML). Acting as a keystone to vestibular geometry, the ML provides support for the utricular macula and acts as a structural boundary between the superior (pars superior) and inferior (pars inferior) portions of the vestibular labyrinth. Given its importance in vestibular form, understanding ML morphology is valuable in establishing the spatial organization of other vestibular structures, particularly the utricular macula. Knowledge of the 3D structure and variation of the ML, however, remain elusive. Our study addresses this knowledge gap by visualizing, in 3D, the ML and surrounding structures using micro-CT data. By doing so, we attempt to clarify: (a) the variation of ML shape; (b) the reliability of ML attachment sites; and (c) the spatial relationship of the ML to the stapes footplate using landmark-based Generalized Procrustes, Principal Component and covariance analyses. Results indicate a consistent configuration of three distinct bony ML attachments including an anterolateral, medial, and posterior attachment which all covary with bony structure. Our results set the stage for further understanding into vestibular and more specifically, utricular macula spatial configuration within the human head, offering the potential to aid in clinical and evolutionary studies which rely on a 3D understanding of vestibular spatial configuration.

Enhanced Eye Velocity in Head Impulse Testing-A Possible Indicator of Endolymphatic Hydrops

Introduction: On video head impulse testing (vHIT) of semicircular canal function, some patients reliably show enhanced eye velocity and so VOR gains >1.0. Modeling and imaging indicate this could be due to endolymphatic hydrops. Oral glycerol reduces membranous labyrinth volume and reduces cochlear symptoms of hydrops, so we tested whether oral glycerol reduced the enhanced vHIT eye velocity.

Study Design: Prospective clinical study and retrospective analysis of patient data.

Methods: Patients with enhanced eye velocity during horizontal vHIT were enrolled (n = 9, 17 ears) and given orally 86% glycerol, 1.5 mL/kg of body weight, dissolved 1:1 in physiological saline. Horizontal vHIT testing was performed before glycerol intake (time 0), then at intervals of 1, 2, and 3 h after the oral glycerol intake. Control patients with enhanced eye velocity (n = 4, 6 ears) received water and were tested at the same intervals. To provide an objective index of enhanced eye velocity we used a measure of VOR gain which captures the enhanced eye velocity which is so clear on inspecting the eye velocity records. We call this measure the initial VOR gain and it is defined as: (the ratio of peak eye velocity to the value of head velocity at the time of peak eye velocity). The responses of other patients who showed enhanced eye velocity during routine clinical testing were analyzed to try to identify how the enhancement occurred.

Results: We found that oral glycerol caused, on average, a significant reduction in the enhanced eye velocity response, whereas water caused no systematic change. The enhanced eye velocity during the head impulses is due in some patients to a compensatory saccade-like response during the increasing head velocity.

Conclusion: The significant reduction in enhanced eye velocity during head impulse testing following oral glycerol is consistent with the hypothesis that the enhanced eye velocity in vHIT may be caused by endolymphatic hydrops.

The Anatomical and Physiological Basis of Clinical Tests of Otolith Function. A Tribute to Yoshio Uchino

Otolithic receptors are stimulated by gravitoinertial force (GIF) acting on the otoconia resulting in deflections of the hair bundles of otolithic receptor hair cells. The GIF is the sum of gravitational force and the inertial force due to linear acceleration. The usual clinical and experimental tests of otolith function have used GIFs (roll tilts re gravity or linear accelerations) as test stimuli. However, the opposite polarization of receptors across each otolithic macula is puzzling since a GIF directed across the otolith macula will excite receptors on one side of the line of polarity reversal (LPR at the striola) and simultaneously act to silence receptors on the opposite side of the LPR. It would seem the two neural signals from the one otolith macula should cancel. In fact, Uchino showed that instead of canceling, the simultaneous stimulation of the oppositely polarized hair cells enhances the otolithic response to GIF—both in the saccular macula and the utricular macula. For the utricular system there is also commissural inhibitory interaction between the utricular maculae in each ear. The results are that the one GIF stimulus will cause direct excitation of utricular receptors in the activated sector in one ear as well as indirect excitation resulting from the disfacilitation of utricular receptors in the corresponding sector on the opposite labyrinth. There are effectively two complementary parallel otolithic afferent systems—the sustained system concerned with signaling low frequency GIF stimuli such as roll head tilts and the transient system which is activated by sound and vibration. Clinical tests of the sustained otolith system—such as ocular counterrolling to roll-tilt or tests using linear translation—do not show unilateral otolithic loss reliably, whereas tests of transient otolith function [vestibular evoked myogenic potentials (VEMPs) to brief sound and vibration stimuli] do show unilateral otolithic loss. The opposing sectors of the maculae also explain the results of galvanic vestibular stimulation (GVS) where bilateral mastoid galvanic stimulation causes ocular torsion position similar to the otolithic response to GIF. However, GVS stimulates canal afferents as well as otolithic afferents so the eye movement response is complex.

Improvement of Asymmetric Vestibulo-Ocular Reflex Responses Following Onset of Vestibular Neuritis Is Similar Across Canal Planes

Background: We examined whether, after onset of acute unilateral vestibular neuritis (aUVN), initial disease effects, subsequent peripheral recovery and central compensation cause similar changes in vestibular ocular reflex (VOR) gains in all 3 semi-circular canal planes. Methods: 20 patients, mean age 56.5 years, with pathological lateral canal video head impulse test (vHIT) VOR gains due to aUVN, were subsequently examined with vHIT in all 3 canal planes on average 4.3 and 36.7 days ("5 weeks") after aUVN onset. Results: Lateral and anterior deficit side (DS) average gains equaled 0.41 at aUVN onset. Non-deficit, normal, side (NS) gains were 0.88 and 0.81, respectively. Mean posterior DS gain was similar at onset, 0.43, provided only gains lower than 0.6 (lower limit of healthy controls) were considered. NS posterior mean gain at onset (0.68) was less (p ≤ 0.0006) than lateral and anterior NS gains. After 5 weeks, DS lateral, anterior and posterior canal gains increased (p ≤ 0.05), on average, to 0.65, 0.59, and 0.58, respectively. NS gains increased to 0.91, 0.87, and 0.76 (p = 0.007), respectively. At 5 weeks deficit-lateral/normal-lateral canal plane gain asymmetries were significantly (p < 0.0008) reduced from 36.9 to 19.4%, deficit-anterior/normal-posterior asymmetry decreased from 28.6 to 18.1%, while deficit-posterior/normal-anterior asymmetry changed from 29.7 to 21.4%, all to circa 20%. Roll plane asymmetries decreased slightly over 5 weeks (28.6-18.1%) but pitch plane asymmetries remained significantly less (p = 0.001), not different from 0% regardless of initial DS posterior canal vHIT gain. Yaw plane asymmetry changes are identical to those of the lateral canals (36.7-19.4%). Conclusions: These results indicate that, at onset, aUVN of the superior vestibular nerve has a similar effect on lateral and anterior deficit DS VOR gains, and on posterior DS canal VOR gains if the inferior nerve was also affected at onset. The significant improvements to equal 5 week levels of DS gains and slightly greater posterior NS gain improvements, compared to lateral and anterior NS gains, yielding a common canal plane gain asymmetry of 20% at 5 weeks, suggest similar neural compensation mechanisms were active along VOR pathways. Unexpectantly, canal plane improvement was not replicated in pitch plane asymmetries.

Semicircular Canal Influences on the Developmental Tuning of the Translational Vestibulo-Ocular Reflex

Vestibulo-ocular reflexes (VORs) rely on neuronal computations that transform vestibular sensory signals into spatio-temporally appropriate extraocular motor commands. The motoneuronal discharge for contractions of the superior oblique eye muscle during linear translation derives from a utricular epithelial sector that is spatially aligned with the pulling direction of this muscle. In Xenopus laevis, the alignment is gradually achieved during larval development and requires motion-related semicircular canal afferent activity. Here, we studied the origin of semicircular canal and utricular signals responsible for the establishment and maturation of the extraocular motor response vector. Experiments were conducted on semi-intact preparations of Xenopus tadpoles before and after unilateral transection of the VIIIth nerve and in preparations of animals in which semicircular canal formation was prevented on one side by the injection of hyaluronidase into the otic capsule prior to the establishment of the tubular structures. Unilateral VIIIth nerve sections revealed that the excitation underlying the contraction of the superior oblique eye muscle during horizontal linear acceleration and clockwise/counter-clockwise roll motion derives exclusively from the utricle and the posterior semicircular canal on the ipsilateral side. In contrast, the developmental constriction of the otolith response vector depends on signals from the posterior semicircular canal on the contralateral side. These latter signals suppress directionally incorrect components that derive from the utricular sector perpendicular to the superior oblique eye muscle. This directional tuning complies with a stabilization of spatially correct utricular inputs that are aligned with the extraocular motor target muscle. In addition, misaligned signals are concurrently suppressed by semicircular canal-related commissural pathways from the contralateral side and through local interneuronal inhibitory circuits within the ipsilateral vestibular nuclei.

Recent advances in head impulse test findings in central vestibular disorders

The head impulse test (HIT) is used to evaluate the vestibulo-ocular reflex (VOR) during a high-velocity head rotation. Corrective catch-up saccades that occur during or after the HITs usually indicate peripheral vestibular hypofunction, whereas in acute vestibular syndrome, normal clinical (bedside) HITs should prompt a search for a central lesion. However, recent quantitative studies that evaluated HITs using magnetic search coils or video-based techniques have demonstrated that specific patterns of HIT abnormalities are associated with central vestibular disorders. While normal clinical HITs are typical of central lesions, discrepancies have been observed between clinical and quantitative HITs. The horizontal head impulse VOR gains can be significantly reduced unilaterally or bilaterally (positive HITs) in lesions involving the vestibular nucleus, nucleus prepositus hypoglossi, or flocculus. In diffuse cerebellar lesions, the VOR gain during horizontal head impulses may increase (hyperactive) with corrective saccades directed the opposite way. The presence of cross-coupled vertical corrective saccades during horizontal HITs is also suggestive of diffuse cerebellar lesions. Lesions involving the vestibular nucleus, medial longitudinal fasciculus, and cerebellum may show decreased or increased gains of the VOR during vertical HITs. Defining the differences in patterns observed during abnormal HITs may help practitioners localize the responsible lesions in both central and peripheral vestibulopathy.

The Video Head Impulse Test

In 1988, we introduced impulsive testing of semicircular canal (SCC) function measured with scleral search coils and showed that it could accurately and reliably detect impaired function even of a single lateral canal. Later we showed that it was also possible to test individual vertical canal function in peripheral and also in central vestibular disorders and proposed a physiological mechanism for why this might be so. For the next 20 years, between 1988 and 2008, impulsive testing of individual SCC function could only be accurately done by a few aficionados with the time and money to support scleral search-coil systems—an expensive, complicated and cumbersome, semi-invasive technique that never made the transition from the research lab to the dizzy clinic. Then, in 2009 and 2013, we introduced a video method of testing function of each of the six canals individually. Since 2009, the method has been taken up by most dizzy clinics around the world, with now close to 100 refereed articles in PubMed. In many dizzy clinics around the world, video Head Impulse Testing has supplanted caloric testing as the initial and in some cases the final test of choice in patients with suspected vestibular disorders. Here, we consider seven current, interesting, and controversial aspects of video Head Impulse Testing: (1) introduction to the test; (2) the progress from the head impulse protocol (HIMPs) to the new variant—suppression head impulse protocol (SHIMPs); (3) the physiological basis for head impulse testing; (4) practical aspects and potential pitfalls of video head impulse testing; (5) problems of vestibulo-ocular reflex gain calculations; (6) head impulse testing in central vestibular disorders; and (7) to stay right up-to-date—new clinical disease patterns emerging from video head impulse testing. With thanks and appreciation we dedicate this article to our friend, colleague, and mentor, Dr Bernard Cohen of Mount Sinai Medical School, New York, who since his first article 55 years ago on compensatory eye movements induced by vertical SCC stimulation has become one of the giants of the vestibular world.

Head movement during walking in the cat

Knowledge of how the head moves during locomotion is essential for understanding how locomotion is controlled by sensory systems of the head. We have analyzed head movements of the cat walking along a straight flat pathway in the darkness and light. We found that cats' head left-right translations, and roll and yaw rotations oscillated once per stride, while fore-aft and vertical translations, and pitch rotations oscillated twice. The head reached its highest vertical positions during second half of each forelimb swing, following maxima of the shoulder/trunk by 20–90°. Nose-up rotation followed head upward translation by another 40–90° delay. The peak-to-peak amplitude of vertical translation was ~1.5 cm and amplitude of pitch rotation was ~3°. Amplitudes of lateral translation and roll rotation were ~1 cm and 1.5–3°, respectively. Overall, cats' heads were neutral in roll and 10–30° nose-down, maintaining horizontal semicircular canals and utriculi within 10° of the earth horizontal. The head longitudinal velocity was 0.5–1 m/s, maximal upward and downward linear velocities were ~0.05 and ~0.1 m/s, respectively, and maximal lateral velocity was ~0.05 m/s. Maximal velocities of head pitch rotation were 20–50 °/s. During walking in light, cats stood 0.3–0.5 cm taller and held their head 0.5–2 cm higher than in darkness. Forward acceleration was 25–100% higher and peak-to-peak amplitude of head pitch oscillations was ~20 °/s larger. We concluded that, during walking, the head of the cat is held actively. Reflexes appear to play only a partial role in determining head movement, and vision might further diminish their role.

Head position and increased head velocity to optimize video head impulse test sensitivity

This study investigated the effects of head position on gain values during video head impulse tests (vHITs). Different head positions were used for vHIT of the horizontal semicircular canals of 20 healthy controls and 18 patients with unilateral vestibular loss (UVL), with head velocities ranging from 150°/s to 200°/s. Differences in vestibulo-ocular reflex gain in the control and patient groups according to head position (0° and 30° downward pitch) were analyzed. In the unaffected control group, the 30° pitched-down position resulted in a mean gain increase of up to 1.0 in both ears (right ear: 0.85 ± 0.26 for head-up and 1.05 ± 0.12 for head-down, p = 0.004; left ear: 0.75 ± 0.18 for head-up and 0.98 ± 0.16 for head-down, p < 0.001). In patients with UVL, the mean gains on the diseased side were 0.92 ± 0.16 in the head-up position and 0.82 ± 0.2 in the head-down position, at similar head velocities (p = 0.046). The pitched-down position also increased the asymmetry between ears in patients with UVL, at the same head velocity. A 30° head-down position can increase vHIT sensitivity, which resulted in increased mean gain in unaffected people and decreased mean gain in most of the patients with UVL in this study. This method may more effectively stimulate the horizontal semicircular canal. This vHIT modification may be helpful for more precisely evaluating vestibular function, thus reducing false-negative findings.

Translational otolith-ocular reflex during off-vertical axis rotation in humans

Two characteristics of otolith-ocular responses - linear vestibulo-ocular reflex and vergence - were examined during constant velocity off-vertical axis rotation (OVAR) in the dark. Sixteen subjects were rotated about their longitudinal axis when tilted 30° relative to the direction of gravity. Rotational velocities were 36 and 288/s corresponding to frequencies of 0.1 and 0.8Hz, respectively. Subjects were asked to imagine stationary targets located at 0.5m, 1m, and 2m in the straight-ahead direction. Binocular eye movements were recorded in the dark using infrared videography. The modulation of horizontal slow phase velocity during OVAR was larger at 0.8Hz than at 0.1Hz, and the modulation at the high frequency was larger for the near target than for the mid and far targets. These characteristics confirm that the horizontal slow phase velocity during yaw OVAR represents a translational otolith-ocular reflex in response to acceleration along the inter-aural axis that is dependent on imagined fixation distance.

Prolonged asymmetric vestibular stimulation induces opposite, long-term effects on self-motion perception and ocular responses

Self-motion perception and the vestibulo-ocular reflex (VOR) were investigated in healthy subjects during asymmetric whole body yaw plane oscillations while standing on a platform in the dark. Platform oscillation consisted of two half-sinusoidal cycles of the same amplitude (40°) but different duration, featuring a fast (FHC) and a slow half-cycle (SHC). Rotation consisted of four or 20 consecutive cycles to probe adaptation further with the longer duration protocol. Self-motion perception was estimated by subjects tracking with a pointer the remembered position of an earth-fixed visual target. VOR was measured by electro-oculography. The asymmetric stimulation pattern consistently induced a progressive increase of asymmetry in motion perception, whereby the gain of the tracking response gradually increased during FHCs and decreased during SHCs. The effect was observed already during the first few cycles and further increased during 20 cycles, leading to a totally distorted location of the initial straight-ahead. In contrast, after some initial interindividual variability, the gain of the slow phase VOR became symmetric, decreasing for FHCs and increasing for SHCs. These oppositely directed adaptive effects in motion perception and VOR persisted for nearly an hour. Control conditions using prolonged but symmetrical stimuli produced no adaptive effects on either motion perception or VOR. These findings show that prolonged asymmetric activation of the vestibular system leads to opposite patterns of adaptation of self-motion perception and VOR. The results provide strong evidence that semicircular canal inputs are processed centrally by independent mechanisms for perception of body motion and eye movement control. These divergent adaptation mechanisms enhance awareness of movement toward the faster body rotation, while improving the eye stabilizing properties of the VOR.

Is vestibular self-motion perception controlled by the velocity storage? Insights from patients with chronic degeneration of the vestibulo-cerebellum

Background

The rotational vestibulo-ocular reflex (rVOR) generates compensatory eye movements in response to rotational head accelerations. The velocity-storage mechanism (VSM), which is controlled by the vestibulo-cerebellar nodulus and uvula, determines the rVOR time constant. In healthy subjects, it has been suggested that self-motion perception in response to earth-vertical axis rotations depends on the VSM in a similar way as reflexive eye movements. We aimed at further investigating this hypothesis and speculated that if the rVOR and rotational self-motion perception share a common VSM, alteration in the latter, such as those occurring after a loss of the regulatory control by vestibulo-cerebellar structures, would result in similar reflexive and perceptual response changes. We therefore set out to explore both responses in patients with vestibulo-cerebellar degeneration.

Methodology/Principal Findings

Reflexive eye movements and perceived rotational velocity were simultaneously recorded in 14 patients with chronic vestibulo-cerebellar degeneration (28–81yrs) and 12 age-matched healthy subjects (30–72yrs) after the sudden deceleration (90°/s2) from constant-velocity (90°/s) rotations about the earth-vertical yaw and pitch axes. rVOR and perceived rotational velocity data were analyzed using a two-exponential model with a direct pathway, representing semicircular canal activity, and an indirect pathway, implementing the VSM. We found that VSM time constants of rVOR and perceived rotational velocity co-varied in cerebellar patients and in healthy controls (Pearson correlation coefficient for yaw 0.95; for pitch 0.93, p<0.01). When constraining model parameters to use the same VSM time constant for rVOR and perceived rotational velocity, moreover, no significant deterioration of the quality of fit was found for both populations (variance-accounted-for >0.8).

Conclusions/Significance

Our results confirm that self-motion perception in response to rotational velocity-steps may be controlled by the same velocity storage network that controls reflexive eye movements and that no additional, e.g. cortical, mechanisms are required to explain perceptual dynamics.

Spatial orientation of the angular vestibulo-ocular reflex (aVOR) after semicircular canal plugging and canal nerve section

We investigated spatial responses of the aVOR to small and large accelerations in six canal-plugged and lateral canal nerve-sectioned monkeys. The aim was to determine whether there was spatial adaptation after partial and complete loss of all inputs in a canal plane. Impulses of torques generated head thrusts of ≈ 3,000°/s². Smaller accelerations of ≈ 300°/s² initiated the steps of velocity (60°/s). Animals were rotated about a spatial vertical axis while upright (0°) or statically tilted fore-aft up to ± 90°. Temporal aVOR yaw and roll gains were computed at every head orientation and were fit with a sinusoid to obtain the spatial gains and phases. Spatial gains peaked at ≈ 0° for yaw and ≈ 90° for roll in normal animals. After bilateral lateral canal nerve section, the spatial yaw and roll gains peaked when animals were tilted back ≈ 50°, to bring the intact vertical canals in the plane of rotation. Yaw and roll gains were identical in the lateral canal nerve-sectioned monkeys tested with both low- and high-acceleration stimuli. The responses were close to normal for high-acceleration thrusts in canal-plugged animals, but were significantly reduced when these animals were given step stimuli. Thus, high accelerations adequately activated the plugged canals, whereas yaw and roll spatial aVOR gains were produced only by the intact vertical canals after total loss of lateral canal input. We conclude that there is no spatial adaptation of the aVOR even after complete loss of specific semicircular canal input.

Adaptation of vestibular signals for self-motion perception

A fundamental concern of the brain is to establish the spatial relationship between self and the world to allow purposeful action. Response adaptation to unvarying sensory stimuli is a common feature of neural processing, both peripherally and centrally. For the semicircular canals, peripheral adaptation of the canal-cupula system to constant angular-velocity stimuli dominates the picture and masks central adaptation. Here we ask whether galvanic vestibular stimulation circumvents peripheral adaptation and, if so, does it reveal central adaptive processes. Transmastoidal bipolar galvanic stimulation and platform rotation (20 deg s−1) were applied separately and held constant for 2 min while perceived rotation was measured by verbal report. During real rotation, the perception of turn decayed from the onset of constant velocity with a mean time constant of 15.8 s. During galvanic-evoked virtual rotation, the perception of rotation initially rose but then declined towards zero over a period of ∼100 s. For both stimuli, oppositely directed perceptions of similar amplitude were reported when stimulation ceased indicating signal adaptation at some level. From these data the time constants of three independent processes were estimated: (i) the peripheral canal-cupula adaptation with time constant 7.3 s, (ii) the central ‘velocity-storage' process that extends the afferent signal with time constant 7.7 s, and (iii) a long-term adaptation with time constant 75.9 s. The first two agree with previous data based on constant-velocity stimuli. The third component decayed with the profile of a real constant angular acceleration stimulus, showing that the galvanic stimulus signal bypasses the peripheral transformation so that the brainstem sees the galvanic signal as angular acceleration. An adaptive process involving both peripheral and central processes is indicated. Signals evoked by most natural movements will decay peripherally before adaptation can exert an appreciable effect, making a specific vestibular behavioural role unlikely. This adaptation appears to be a general property of the internal coding of self-motion that receives information from multiple sensory sources and filters out the unvarying components regardless of their origin. In this instance of a pure vestibular sensation, it defines the afferent signal that represents the stationary or zero-rotation state.

Analysis of intraindividual and intraspecific variation in semicircular canal dimensions using high-resolution x-ray computed tomography

The semicircular canal system tracks head rotation and provides sensory input for the reflexive stabilization of gaze and posture. The purpose of this study was to investigate the intraspecific and intraindividual variation in the size of the three semicircular canals. The right and left temporal bones were extracted from 31 individuals of the short-tailed shrew (Blarina brevicauda) and scanned on a high-resolution x-ray computed tomography system. The radius of curvature was calculated for each of the three semicircular canals for each side. Paired t-tests and independent sample t-tests indicated no significant differences in canal size between the right and left canals of the same individuals or between those of males and females of the same species. Pearson product moment correlation analyses demonstrated that there was no significant correlation between canal size and body mass in this sample.

Tilt and translation motion perception during off-vertical axis rotation

The effect of stimulus frequency on tilt and translation motion perception was studied during constant velocity off-vertical axis rotation (OVAR), and compared to the effect of stimulus frequency on eye movements. Fourteen healthy subjects were rotated in darkness about their longitudinal axis 10 degrees and 20 degrees off-vertical at 45 degrees /s (0.125 Hz) and 20 degrees off-vertical at 180 degrees /s (0.5 Hz). Perceived motion was evaluated using verbal reports and a joystick capable of recording tilt and translation in both sagittal and lateral planes. Eye movements were also recorded using videography. At the lower frequency, subjects reported the perception of progressing along the edge of a cone, whereas at the higher frequency they had the sensation of progressing along the edge of an upright cylinder. Tilt perception and ocular torsion significantly increased as the tilt angle increased from 10 degrees to 20 degrees at the lower frequency, and then decreased at the higher frequency. The phase lag of ocular torsion increased as a function of frequency, while the phase lag of tilt perception did not change. Horizontal eye movements were small at the lower frequency and showed a phase lead relative to the linear acceleration stimulus. While the phase lead of horizontal eye movements decreased at 0.5 Hz, the phase of translation perception did not vary with stimulus frequency and was similar to the phase of tilt perception during all conditions. A second data set was obtained in 12 subjects to compare motion perception phase when using a simple push-button to indicate nose-up orientation, continuous setting of pitch tilt alone, or continuous setting of tilt and translation in both pitch and roll planes as in the first data set. This set of measurements indicated that in the frequency range studied subjects tend to lead the stimulus when using a push-button task while lagging the stimulus when using a continuous setting of tilt with a joystick. Both amplitude and phase of tilt perception using the joystick were not different whether concentrating on pitch tilt alone or attempting a more complex reporting of tilt and translation in both sagittal and lateral planes. During dynamic linear stimuli in the absence of canal and visual input, a change in stimulus frequency alone elicits similar changes in the amplitude of both self-motion perception and eye movements. However, in contrast to the eye movements, the phase of both perceived tilt and translation motion is not altered by stimulus frequency over this limited range. These results are consistent with the hypothesis that neural processing to distinguish tilt and translation stimuli differs between eye movements and motion perception.

A new approach to visualizing the membranous structures of the inner ear - high resolution X-ray micro-tomography

CONCLUSION

Through the application of high resolution X-ray micro-tomography and a method of contrast enhancement based on en bloc staining in osmium tetroxide (OsO4), we report an approach that facilitates accurate three-dimensional (3D) reconstruction to reveal the fine structure of the inner ear.

OBJECTIVES

To overcome the problems of artefacts, including tissue distortion and loss of 3D context that are inherent in existing methods that rely on manual dissection and/or histological sectioning.

MATERIALS AND METHODS

A staining protocol was developed that involved the en bloc application of the OsO4 solution (2% w/v) for an extended period of time. The samples were then scanned using an X-ray micro-tomography platform and subsequent 3D visualizations were constructed.

RESULTS

The digital nature of the data allowed a complete 3D contextual visualization to be constructed whereby the individual sensory structures could be seen in relation to other inner ear structures. This included a detailed anatomy of the membranous labyrinth and nerve supply including the spatial configuration of the utricular and saccular maculae. This is a new way of undertaking temporal bone histology.

Bone conducted vibration selectively activates irregular primary otolithic vestibular neurons in the guinea pig

The main objective of this study was to determine whether bone-conducted vibration (BCV) is equally effective in activating both semicircular canal and otolith afferents in the guinea pig or whether there is preferential activation of one of these classes of vestibular afferents. To answer this question a large number (346) of single primary vestibular neurons were recorded extracellularly in anesthetized guinea pigs and were identified by their location in the vestibular nerve and classed as regular or irregular on the basis of the variability of their spontaneous discharge. If a neuron responded to angular acceleration it was classed as a semicircular canal neuron, if it responded to maintained roll or pitch tilts it was classified as an otolith neuron. Each neuron was then tested by BCV stimuli-either clicks, continuous pure tones (200-1,500 Hz) or short tone bursts (500 Hz lasting 7 ms)-delivered by a B-71 clinical bone-conduction oscillator cemented to the guinea pig's skull. All stimulus intensities were referred to that animal's own auditory brainstem response (ABR) threshold to BCV clicks, and the maximum intensity used was within the animal's physiological range and was usually around 70 dB above BCV threshold. In addition two sensitive single axis linear accelerometers cemented to the skull gave absolute values of the stimulus acceleration in the rostro-caudal direction. The criterion for a neuron being classed as activated was an audible, stimulus-locked increase in firing rate (a 10% change was easily detectable) in response to the BCV stimulus. At the stimulus levels used in this study, semicircular canal neurons, both regular and irregular, were insensitive to BCV stimuli and very few responded: only nine of 189 semicircular canal neurons tested (4.7%) showed a detectable increase in firing in response to BCV stimuli up to the maximum 2 V peak-to-peak level we delivered to the B-71 oscillator (which produced a peak-to-peak skull acceleration of around 6-8 g and was usually around 60-70 dB above the animal's own ABR threshold for BCV clicks). Regular otolithic afferents likewise had a poor response; only 14 of 99 tested (14.1%) showed any increase in firing rate up to the maximum BCV stimulus level. However, most irregular otolithic afferents (82.8%) showed a clear increase in firing rate in response to BCV stimuli: of the 58 irregular otolith neurons tested, 48 were activated, with some being activated at very low intensities (only about 10 dB above the animal's ABR threshold to BCV clicks). Most of the activated otolith afferents were in the superior division of the vestibular nerve and were probably utricular afferents. That was confirmed by evidence using juxtacellular injection of neurobiotin near BCV activated neurons to trace their site of origin to the utricular macula. We conclude there is a very clear preference for irregular otolith afferents to be activated selectively by BCV stimuli at low stimulus levels and that BCV stimuli activate some utricular irregular afferent neurons. The BCV generates compressional and shear waves, which travel through the skull and constitute head accelerations, which are sufficient to stimulate the most sensitive otolithic receptor cells.

Orientation of human semicircular canals measured by three-dimensional multiplanar CT reconstruction

Analysis of vestibulo-ocular reflex experiments requires knowledge of the absolute orientations (with respect to skull landmarks) of semicircular canals (SCC). Data relating SCC orientations to accessible skull landmarks in humans are sparse, apart from a classic study of 10 skulls, which concluded that the horizontal and anterior SCC are not mutually orthogonal (111 +/- 7.6 degrees). Multiple studies of isolated labyrinths have shown the inter-SCC angles are close to 90 degrees. We hypothesized that a larger sample would yield mean absolute SCC orientations closer to the mutual orthogonality demonstrated for isolated labyrinths. We measured canal orientations with respect to accessible skull landmarks using 3-D multiplanar reconstructions of computerized tomography scans of the temporal bones of 22 human subjects. Images were acquired with 0.5-mm thickness and reconstructed with in-plane resolution of 234 microm. There was no significant difference between the left and a mirror image of the right (p > 0.57 on multiway ANOVA of orientation vector coefficients), so data were pooled for the 44 labyrinths. The angle between the anterior and posterior SCC was 94.0 +/- 4.0 degrees (mean +/- SD). The angle between the anterior and horizontal SCC was 90.6 +/- 6.2 degrees. The angle between the horizontal and posterior SCC was 90.4 +/- 4.9 degrees. The direction angles between a vector normal to the left horizontal SCC and the positive Reid's stereotaxic X (+nasal), Y (+left), and Z (+superior) axes were 108.7 +/- 7.5 degrees, 92.2 +/- 5.7 degrees, and 19.9 +/- 7.0 degrees, respectively. The angles between a vector normal to the left anterior SCC and the positive Reid's stereotaxic X, Y, and Z axes were 125.9 +/- 5.2 degrees, 38.4 +/- 5.1 degrees, and 100.1 +/- 6.2 degrees, respectively. The angles between a vector normal to the left posterior SCC and the positive Reid's stereotaxic X, Y, and Z axes were 133.6 +/- 5.3 degrees, 131.5 +/- 5.1 degrees, and 105.6 +/- 6.6 degrees, respectively. The mean anterior SCC-contralateral posterior SCC angle was 15.3 +/- 7.2 degrees. The absolute orientations of human SCC are more nearly orthogonal than previously reported.

Cerebellar Disease Alters the Axis of the High-Acceleration Vestibuloocular Reflex

L. W. Schultheis and D. A. Robinson showed that the axis of the rotational vestibuloocular reflex (RVOR) cannot be altered by visual-vestibular mismatch (“cross-axis adaptation”) when the vestibulocerebellum is lesioned. This suggests that the cerebellum may calibrate the axis of eye velocity of the RVOR under natural conditions. Thus we asked whether patients with cerebellar disease have alterations in the RVOR axis and, if so, what might be the mechanism. We used three-axis scleral coils to record head and eye movements during yaw, pitch, and roll head impulses in 18 patients with cerebellar disease and in a comparison group of eight subjects without neurologic disease. We found distinct shifts of the eye-velocity axis in patients. The characteristic finding was a disconjugate upward eye velocity during yaw. Measured at 70 ms after the onset of head rotation, the median upward gaze velocity was 15% of yaw head velocity for patients and <1% for normal subjects ( P < 0.001). Upward eye velocity was greater in the contralateral (abducting) eye during yaw and in the ipsilateral eye during roll. Patients had a higher gain (eye speed/head speed) for downward than for upward pitch (median ratio of downward to upward gain: 1.3). In patients, upward gaze velocities during both yaw and roll correlated with the difference in anterior (AC) and posterior canal excitations, scaled by the respective pitch gains. Our findings support the hypothesis that upward eye velocity during yaw results from AC excitation, which must normally be suppressed by the intact cerebellum.

Patient and normal three-dimensional eye-movement responses to maintained (DC) surface galvanic vestibular stimulation

HYPOTHESIS

That disease or dysfunction of vestibular end organs in human patients will reduce or eliminate the contribution of the affected end organs to the total eye-movement response to DC surface galvanic vestibular stimulation (GVS).

BACKGROUND

It was assumed that DC GVS (at current of 5 mA) stimulates all vestibular end organs, an assumption that is strongly supported by physiological evidence, including the activation of primary vestibular afferent neurons by galvanic stimulation. Previous studies also have described the oculomotor responses to vestibular activation. Stimulation of individual semicircular canals results in eye movements parallel to the plane of the stimulated canal, and stimulation of the utricular macula produces changes in ocular torsional position. It was also assumed that the total three-dimensional eye-movement response to GVS is the sum of the contributions of the oculomotor drive of all the vestibular end organs. If a particular vestibular end organ were to be diseased or dysfunctional, it was reasoned that its contribution to the GVS-induced oculomotor response would be reduced or absent and that patients thus affected would have a systematic difference in their GVS-induced oculomotor response compared with the response of normal healthy individuals.

METHODS

Three-dimensional video eye-movement recording was carried out in complete darkness on normal healthy subjects and patients with various types of vestibular dysfunction, as diagnosed by independent vestibular clinical tests. The eye-movement response to long-duration bilateral and unilateral surface GVS was measured.

RESULTS

The pattern of horizontal, vertical, and torsional eye velocity and eye position during GVS of patients independently diagnosed with bilateral vestibular dysfunction, unilateral vestibular dysfunction, CHARGE syndrome (semicircular canal hypoplasia), semicircular canal occlusion, or inferior vestibular neuritis differed systematically from the responses of normal healthy subjects in ways that corresponded to the expectations from the conceptual approach of the study.

CONCLUSION

The study reports the first data on the differences between the normal response to GVS and those of patients with a number of clinical vestibular conditions including unilateral vestibular loss, canal block, and vestibular neuritis. The GVS-induced eye-movement patterns of patients with vestibular dysfunction are consistent with the reduction or absence of oculomotor contribution from the end organs implicated in their particular disease condition.

Spatial properties of central vestibular neurons of monkeys after bilateral lateral canal nerve section

Thirty-seven neurons were recorded in the superior vestibular nucleus (SVN) of two cynomolgus monkeys 1-2 yr after bilateral lateral canal nerve section to test whether the central neurons had spatially adapted for the loss of lateral canal input. The absence of lateral canal function was verified with eye movement recordings. The relation of unit activity to the vertical canals was determined by oscillating the animals about a horizontal axis with the head in various orientations relative to the axis of rotation. Animals were also oscillated about a vertical axis while upright or tilted in pitch. In the second test, the vertical canals are maximally activated when the animals are tilted back about -50 degrees from the spatial upright and the lateral canals when the animals are tilted forward about 30 degrees . We reasoned that if central compensation occurred, the head orientation at which the response of the vertical canal-related neurons was maximal should be shifted toward the plane of the lateral canals. No lateral canal-related units were found after nerve section, and vertical canal-related units were found only in SVN not in the rostral medial vestibular nucleus. SVN canal-related units were maximally activated when the head was tilted back at -47 +/- 17 and -50 +/- 12 degrees (means +/- SD) in the two animals, close to the predicted orientation of the vertical canals. This indicated that spatial adaptation of vertical canal-related vestibular neurons had not occurred. There were substantial neck and/or otolith-related inputs activating the vertical canal-related neurons in the nerve-sectioned animals, which could have contributed to oculomotor compensation after nerve section.

Otolith organ or semicircular canal stimulation induces c-fos expression in unipolar brush cells and granule cells of cat and squirrel monkey

Immediate early gene expression in the cerebellar vermis of cats and squirrel monkeys was stimulated by prolonged whole body rotations. Continuous, earth-horizontal axis rotations that excited only otoliths or high velocity vertical axis rotations that excited only semicircular canals resulted in c-fos immunoreactive nuclei concentrated in the granular layer of lobules X and ventral IX (the nodulus and ventral uvula), which represent the medial parts of the vestibulo-cerebellum. Large clusters of labeled nuclei consisting mainly of granule cells and calretinin-positive unipolar brush cells were present in the granular layer, whereas Purkinje cell nuclei were unlabeled, and labeled basket and stellate cell nuclei were scattered in the molecular layer. In other vermal lobules there was a significant but less dense label than in the nodulus and ventral uvula. Generally, the extent of c-fos labeling of molecular layer interneurons was in relation to nuclear labeling of granular layer neurons: labeling of both basket and stellate cells accompanied nuclear labeling of neurons throughout the depth of the granular layer, whereas only stellate cells were labeled when nuclear labeling was restricted to the superficial granular layer. Yaw horizontal or roll vertical rotations each stimulated c-fos expression in the cat medial vestibulo-cerebellum to approximately the same extent. Low-velocity rotations resulted in much less c-fos expression. Similar, albeit less intense, patterns of c-fos activation were observed in monkeys. Concentrated c-fos expression in the medial vestibulo-cerebellum after exposure to a strong head velocity signal that could originate from either otolith or canal excitation suggests that granule and unipolar brush cells participate in a neuronal network for estimating head velocity, irrespective of the signal source.

Origin of Orientation-Dependent Asymmetries in Vestibulo-Ocular Reflexes Evoked by Caloric Stimulation

A caloric stimulus evokes primarily a horizontal vestibulo-ocular reflex (VOR) when subjects are in a supine or prone orientation with the horizontal semicircular canal plane oriented vertically. In both monkeys and humans, the magnitude of VOR eye movements is greater in the supine than in the prone orientation, indicating that some factor or factors, other than the conventionally accepted convective stimulation of the horizontal canals, contributes to the generation of the VOR. We used long-duration caloric irrigations and mathematical models of canal-otolith interactions to investigate factors contributing to the prone/supine asymmetry. Binaural caloric irrigations were applied for 7.5 or 9.5 min with subjects in a null orientation with horizontal canals in the earth-horizontal plane (control trial), or with the subject's pitch orientation periodically changing between null, supine, and prone positions with each orientation held for 30 s (caloric step trial). The control trial responses identified a small response attributable to a direct thermal effect on vestibular afferent activity that accounted for only 15% of the observed prone/supine asymmetry. We show that the gravito-inertial force resolution hypothesis for sensory integration of canal and otolith information predicts that the central processing of canal and otolith information produces an internal estimate of motion that includes both a rotational motion component and a linear acceleration component. These components evoke a horizontal angular VOR and linear VOR, which combine additively in the supine orientation, but subtract in the prone orientation, thus accounting for the majority of the observed prone/supine asymmetry.

A new rotational test for vertical semicircular canal function

OBJECTIVE

We developed a new rotating chair in order to assess the function of the vertical semicircular canal (VSCC) by analyzing VSCC-induced post-rotatory nystagmus (PRN).

METHODS

We examined 14 healthy subjects, wearing goggles equipped with an infrared CCD camera, and sitting on a chair which was designed to stimulate a pair of the VSCCs by tilting the head 60 degrees backward with a 45 degrees rotation to the left or right side from the sagital plane. The time constant (TC) or maximal slow phase eye velocity (MSPEV) of the vertical component of four kinds of PRN were analyzed in four corresponding rotatory conditions, and used as functional index of the corresponding VSCC.

RESULTS

The mean values of MSPEV in both anterior semicircular canal (ASCC) and posterior semicircular canal (PSCC)-induced PRN tended to be lower (P<0.10) than those induced by the lateral semicircular canal (LSCC). The result suggests that the threshold to the angular velocity in the VSCC is lower than that in the LSCC. The mean values of TC in both ASCC and PSCC-induced PRN were significantly lower (P<0.05) than those induced by the LSCC.

CONCLUSION

The significant reduction of TC in VSCC-induced PRN compared with LSCC-induced PRN indicates that VSCC function is less affected by velocity storage mechanisms than LSCC function. The rotational test with respect to the VSCC can be used as a tool for assessing vertical canal function.

Timing of low frequency responses of anterior and posterior canal vestibulo-ocular neurons in alert cats

The pitch vertical vestibulo-ocular reflex (VOR) is accurate and symmetrical when tested in the normal upright posture, where otolith organ and central velocity storage signals supplement the basic VOR mediated by the semicircular canals. However, when the animal and rotation axis are together repositioned by rolling 90 degrees to one side, head forward pitch rotations that excite the anterior semicircular canals elicit a more accurately timed VOR than do oppositely directed rotations that excite the posterior canals. This suggests that velocity storage of posterior canal signals is lost when the head is placed on its side. We recorded from 47 VOR relay neurons, second-order vestibulo-ocular neurons, of alert cats to test whether asymmetries are evident in the responses of neurons in the medial and superior vestibular nuclei during earth-horizontal axis rotations in the normal upright posture. Neurons were identified by antidromic responses to oculomotor nucleus stimulation and orthodromic responses to labyrinth stimulation, and were classified as having primarily anterior, posterior, or horizontal canal input based on response directionality. Neuronal response gains and phases were recorded during 0.5 Hz and 0.05 Hz sinusoidal oscillations in darkness. During 0.5 Hz rotations, anterior canal second-order vestibulo-ocular neurons responded approximately in phase with head velocity (mean phase re head position, +/- SE, 80 degrees +/- 3 degrees, n=18), as did posterior canal second-order vestibulo-ocular neurons (mean phase 81 degrees +/- 1 degree, n=25). Lowering the rotation frequency to 0.05 Hz resulted in only slight advances in response phases of individual anterior canal second-order vestibulo-ocular neurons (mean phase 86 degrees +/- 6 degrees, mean advance 7 degrees +/- 5 degrees, n=12). In contrast, posterior canal second-order vestibulo-ocular neurons behaved more like semicircular canal afferents, with responses markedly phase-advanced (mean advance 28 degrees +/- 5 degrees, n=14) by lowering rotation frequency to 0.05 Hz (mean phase 111 degrees +/- 5 degrees, n=14). In summary, low frequency responses of anterior and posterior canal second-order vestibulo-ocular neurons recorded during horizontal axis pitch correspond to the VOR they excite during vertical axis pitch. These results show that velocity storage is evident at anterior but not posterior canal second-order vestibulo-ocular neurons. We conclude that responses of posterior canal second-order vestibulo-ocular neurons are insufficient to explain the accurate low frequency VOR phase observed during backward head pitch in the upright posture, and that velocity storage or otolith signals required for VOR accuracy are carried by other neurons.

Neural processing of gravitoinertial cues in humans. III. Modeling tilt and translation responses

All linear accelerometers measure gravitoinertial force, which is the sum of gravitational force (tilt) and inertial force due to linear acceleration (translation). Neural strategies must exist to elicit tilt and translation responses from this ambiguous cue. To investigate these neural processes, we developed a model of human responses and simulated a number of motion paradigms used to investigate this tilt/translation ambiguity. In this model, the separation of GIF into neural estimates of gravity and linear acceleration is accomplished via an internal model made up of three principal components: 1) the influence of rotational cues (e.g., semicircular canals) on the neural representation of gravity, 2) the resolution of gravitoinertial force into neural representations of gravity and linear acceleration, and 3) the neural representation of the dynamics of the semicircular canals. By combining these simple hypotheses within the internal model framework, the model mimics human responses to a number of different paradigms, ranging from simple paradigms, like roll tilt, to complex paradigms, like postrotational tilt and centrifugation. It is important to note that the exact same mechanisms can explain responses induced by simple movements as well as by more complex paradigms; no additional elements or hypotheses are needed to match the data obtained during more complex paradigms. Therefore these modeled response characteristics are consistent with available data and with the hypothesis that the nervous system uses internal models to estimate tilt and translation in the presence of ambiguous sensory cues.

Mechanics of Coriolis stimulus and inducing factors of motion sickness

To specify inducing factors of motion sickness comprised in Coriolis stimulus, or cross-coupled rotation, the sensation of rotation derived from the semicircular canal system during and after Coriolis stimulus under a variety of stimulus conditions, was estimated by an approach from mechanics with giving minimal hypotheses and simplifications on the semicircular canal system and the sensory nervous system. By solving an equation of motion of the endolymph during Coriolis stimulus, rotating angle of the endolymph was obtained, and the sensation of rotation derived from each semicircular canal was estimated. Then the sensation derived from the whole semicircular canal system was particularly considered in two cases of a single Coriolis stimulus and cyclic Coriolis stimuli. The magnitude and the direction of sensation of rotation were shown to depend on an angular velocity of body rotation and a rotating angle of head movement (amplitude of head oscillation when cyclic Coriolis stimuli) irrespective of initial angle (center angle) of the head relative to the vertical axis. The present mechanical analysis of Coriolis stimulus led a suggestion that the severity of nausea evoked by Coriolis stimulus is proportional to the effective value of the sensation of rotation caused by the Coriolis stimulus.

Changes in the vestibulo-ocular reflex after plugging of the semicircular canals

The gain of the angular vestibulo-ocular reflex (aVOR) was determined in monkeys by rotation about a spatial vertical axis while upright or statically tilted forward and backward. Horizontal, vertical, and roll gains were determined at each head orientation and plotted as a function of head tilt. Before canal plugging, animals had maximal (spatial) horizontal gains when upright (spatial phase 0 degrees) and maximal roll gains when tilted forward or backward 90 degrees. Plugging caused striking changes in the characteristics of the aVOR gains at low frequencies. After plugging of the vertical canals, maximal horizontal and roll gains both occurred at head tilts of approximately 30 degrees forward. When the lateral canals were plugged, maximal horizontal and roll responses occurred when the head was tilted back approximately 50 degrees. The aVOR gains of the canal-plugged animals were also affected by stimulus frequency. In every instance, as stimulus frequency increased, the spatial phases shifted toward the normal response, that is, the response before plugging. This normalization effect was observed even in the animals with all six semicircular canals plugged, indicating that normalization was not due to spatial adaptation. A three-dimensional dynamic and kinematic model of the aVOR was able to account for all types of canal plugging by a simple change in the dominant time constant of the plugged canals from 3 s to 5 s to approximately 0.07 s. The model accurately predicted responses of the normal and canal-plugged animals at all frequencies. These data show that the central vestibular system does not spatially adapt to losses resulting from canal plugging.

Tullio phenomenon with dehiscence of the superior semicircular canal

HYPOTHESIS

The goal of the investigation was to determine if vector analysis of nystagmus in a patient with the Tullio phenomenon could determine the source of the nystagmus.

BACKGROUND

The Tullio phenomenon consists of the combination of vertigo and abnormal eye and/or head movements provoked by sound. Dehiscence of the superior semicircular canal can be found in certain patients with the Tullio phenomenon.

METHODS

The patient was tested with pure tones ranging from 250 to 3,000 Hz at 95dB HL. The time course of the three-dimensional vector of eye movement, including torsion and vertical and horizontal displacement angles was determined by individual stop-frame analysis of digitized video.

RESULTS

Torsion amplitude varied from 1 to 7 degrees; vertical amplitude varied from 1 to 5 degrees; and horizontal amplitude varied less than 1.5 degrees. The maximal response occurred on stimulation of the right ear with a 1,250-Hz 95-dB HL tone. This elicited a reliable counterclockwise torsional and down-beating fast phase nystagmus as seen from the examiner's point of view. Comparison of the nystagmus with known canal vectors identified the right superior semicircular canal as the source of stimulation. High-resolution computed tomography scan of the temporal bone showed a definite right superior canal dehiscence.

CONCLUSION

The origin of nystagmus from the Tullio phenomenon can be identified by calculating the three-dimensional vector of the observed nystagmus. We show that vector analysis of the observed eye movement can be used to infer the source of nystagmus in these patients. The development of real-time, three-dimensional vector analysis of nystagmus is desirable.

Role of muscle pulleys in producing eye position-dependence in the angular vestibuloocular reflex: a model-based study

It is well established that the head and eye velocity axes do not always align during compensatory vestibular slow phases. It has been shown that the eye velocity axis systematically tilts away from the head velocity axis in a manner that is dependent on eye-in-head position. The mechanisms responsible for producing these axis tilts are unclear. In this model-based study, we aimed to determine whether muscle pulleys could be involved in bringing about these phenomena. The model presented incorporates semicircular canals, central vestibular pathways, and an ocular motor plant with pulleys. The pulleys were modeled so that they brought about a rotation of the torque axes of the extraocular muscles that was a fraction of the angle of eye deviation from primary position. The degree to which the pulleys rotated the torque axes was altered by means of a pulley coefficient. Model input was head velocity and initial eye position data from passive and active yaw head impulses with fixation at 0 degrees, 20 degrees up and 20 degrees down, obtained from a previous experiment. The optimal pulley coefficient required to fit the data was determined by calculating the mean square error between data and model predictions of torsional eye velocity. For active head impulses, the optimal pulley coefficient varied considerably between subjects. The median optimal pulley coefficient was found to be 0.5, the pulley coefficient required for producing saccades that perfectly obey Listing's law when using a two-dimensional saccadic pulse signal. The model predicted the direction of the axis tilts observed in response to passive head impulses from 50 ms after onset. During passive head impulses, the median optimal pulley coefficient was found to be 0.21, when roll gain was fixed at 0.7. The model did not accurately predict the alignment of the eye and head velocity axes that was observed early in the response to passive head impulses. We found that this alignment could be well predicted if the roll gain of the angular vestibuloocular reflex was modified during the initial period of the response, while pulley coefficient was maintained at 0.5. Hence a roll gain modification allows stabilization of the retinal image without requiring a change in the pulley effect. Our results therefore indicate that the eye position-dependent velocity axis tilts could arise due to the effects of the pulleys and that a roll gain modification in the central vestibular structures may be responsible for countering the pulley effect.

Directional abnormalities of vestibular and optokinetic responses in cerebellar disease

Directional abnormalities of vestibular and optokinetic responses in patients with cerebellar degeneration are reported. Three-axis magnetic search-coil recordings of the eye and head were performed in eight cerebellar patients. Among these patients, examples of directional cross-coupling were found during (1) high-frequency, high-acceleration head thrusts; (2) constant-velocity chair rotations with the head fixed; (3) constant-velocity optokinetic stimulation; and (4) following repetitive head shaking. Cross-coupling during horizontal head thrusts consisted of an inappropriate upward eye-velocity component. In some patients, sustained constant-velocity yaw-axis chair rotations produced a mixed horizontal-torsional nystagmus and/or an increase in the baseline vertical slow-phase velocity. Following horizontal head shaking, some patients showed an increase in the slow-phase velocity of their downbeat nystagmus. These various forms of cross-coupling did not necessarily occur to the same degree in a given patient; this suggests that different mechanisms may be responsible. It is suggested that cross-coupling during head thrusts may reflect a loss of calibration of brainstem connections involved in the direct vestibular pathways, perhaps due to dysfunction of the flocculus. Cross-coupling during constant-velocity rotations and following head shaking may result from a misorientation of the angular eye-velocity vector in the velocity-storage system. Finally, responses to horizontal optokinetic stimulation included an inappropriate torsional component in some patients. This suggests that the underlying organization of horizontal optokinetic tracking is in labyrinthine coordinates. The findings are also consistent with prior animal-lesion studies that have shown a role for the vestibulocerebellum in the control of the direction of the VOR.

Dynamics and kinematics of the angular vestibulo-ocular reflex in monkey: effects of canal plugging

Dynamics and kinematics of the angular vestibulo-ocular reflex in monkey: effects of canal plugging. J. Neurophysiol. 80: 3077-3099, 1998. Horizontal and roll components of the angular vestibulo-ocular reflex (aVOR) were elicited by sinusoidal rotation at frequencies from 0.2 Hz (60 degrees/s) to 4.0 Hz ( approximately 6 degrees/s) in cynomolgus monkeys. Animals had both lateral canals plugged (VC, vertical canals intact), both lateral canals and one pair of the vertical canals plugged (RALP, right anterior and left posterior canals intact; LARP, left anterior and right posterior canal intact), or all six semicircular canal plugged (NC, no canals). In normal animals, horizontal and roll eye velocity was in phase with head velocity and peak horizontal and roll gains were approximately 0.8 and 0.6 in upright and 90 degrees pitch, respectively. NC animals had small aVOR gains at 0.2 Hz, and the temporal phases were shifted approximately 90 degrees toward acceleration. As the frequency increased to 4 Hz, aVOR temporal gains and phases tended to normalize. Findings were similar for the LARP, RALP, and VC animals when they were rotated in the planes of the plugged canals. That is, they tended to normalize at higher frequencies. A model was developed incorporating the geometric organization of the canals and first order canal-endolymph dynamics. Canal plugging was modeled as an alteration in the low frequency 3-db roll-off and corresponding dominant time constant. The shift in the low-frequency 3-dB roll-off was seen in the temporal responses as a phase lead of the aVOR toward acceleration at higher frequencies. The phase shifted toward stimulus velocity as the frequency increased toward 4.0 Hz. By incorporating a dynamic model of the canals into the three-dimensional canal system, the spatial responses were predicted at all frequencies. Animals were also stimulated with steps of velocity in planes parallel to the plugged lateral canals. This induced a response with a short time constant and low peak velocity in each monkey. Gains were normalized for step rotation with respect to time constant as (steady state eye velocity)/(stimulus acceleration x time constant). Using this procedure, the gains were the same in canal plugged as in normal animals and corresponded to gains obtained in the frequency analysis. The study suggests that canal plugging does not block the afferent response to rotation, it merely shifts the dynamic response to higher frequencies.

The contribution of the vertical semicircular canals to high-velocity horizontal vestibulo-ocular reflex (VOR) in normal subjects and patients with unilateral vestibular nerve section

We have examined to what extent the vertical semicircular canals contribute to the nonlinearity of the horizontal VOR imposed by the driving of primary vestibular afferents into inhibitory cutoff at high velocities of head rotation (Ewald's second law). The gain (eye velocity/head velocity) of the horizontal component of the VOR with the head pitched down 30 degrees and pitched up 30 degrees was examined during constant-velocity rotations in normal subjects and patients following unilateral vestibular nerve section. In normal subjects, VOR gain decreases as chair velocity increases from 60-300 degrees/s when the head is pitched up, but VOR gain remains constant when the head is pitched down. This finding implies that the mechanism by which the gain of the horizontal VOR gain remains constant at all velocities of rotation depends upon the pattern of labyrinthine stimulation. Following unilateral nerve section, we found that the directional preponderance (DP) in horizontal VOR depends upon whether the head is pitched up 30 (mean asymmetry = 5%) or pitched down 30 degrees (mean asymmetry = 20%). This is what is expected based on the degree to which the lateral and vertical semicircular canals sense horizontal head acceleration with the head in different degrees of pitch. Hence, following unilateral vestibular lesions, the DP of horizontal VOR gain is most easily elicited at high velocities of head rotation and with the head pitched down 30 degrees. Evidence for DP at the bedside using the "head-shaking nystagmus" technique may be optimally elicited with the head pitched down 30 degrees.

The shape of self-motion perception--I. Equivalence classification for sustained motions

Two completely different motions of a subject relative to the earth can induce exactly the same stimuli to the vestibular, somatosensory and visual systems. When this happens, the subject may experience disorientation and misperception of self-motion. We have identified large classes of motions that are perceptually equivalent, i.e. indistinguishable by the subject, under three sets of conditions: no vision, with vision and earth-fixed visual surround, and with vision during possible movement of the visual surround. For each of these sets of conditions, we have developed a classification of all sustained motions according to their perceptual equivalences. The result is a complete list of the possible misperceptions of sustained motion due to equivalence of the forces and other direct stimuli to the sensors under the given conditions. This research expands the range of possible experiments by including all components of linear and angular velocity and acceleration. Many of the predictions in this paper can be tested experimentally. In addition, the equivalence classes developed here predict perceptual phenomena in unusual motion environments that are difficult or impossible to investigate in the laboratory.

Semicircular canal contributions to the three-dimensional vestibuloocular reflex: a model-based approach

1. We studied the contribution of the individual semicircular canals to the generation of horizontal and torsional eye movements in cynomolgus monkeys. Eye movements were elicited by sinusoidal rotation about a vertical (gravitational) axis at 0.2 Hz with the animals tilted in various attitudes of static forward or backward pitch. The gains of the horizontal and torsional components of the vestibuloocular reflex (VOR) were measured for each tilt position. The gains as a function of tilt position were fit with sinusoidal functions, and spatial gains and phases were determined. After control responses were recorded, the semicircular canals were plugged, animals were allowed to adapt, and the test procedure was repeated. Animals were prepared with only the anterior and posterior canals intact [vertical canal (VC) animals], with only the lateral canals intact [lateral canal (LC) animal], and with only one anterior and the contralateral posterior canals intact [right anterior and left posterior canal (RALP) animals; left anterior and right posterior canal (LARP) animals]. 2. In normal animals, the gain of the horizontal (yaw axis) velocity of the compensatory eye movements decreased as they were pitched forward or backward, and a torsional velocity appeared, reversing phase at the peak of the horizontal gain. After the anterior and posterior canals were plugged (LC animal), the horizontal component was reduced when the animal was tilted backward; the gain was zero with about -60 degrees of backward tilt. The spatial phase of the torsional component had the same characteristics. This is consistent with the fact that both responses were produced by the lateral canals, which from our results are tilted between 28 and 39 degrees above the horizontal stereotaxic plane. 3. After both lateral canals were plugged (VC animals), horizontal velocity was reduced in the upright position but increased as the animals were pitched backward relative to the axis of rotation. Torsional velocities, which were zero in the upright position in the normal animal, were now 180 degrees out of phase with the horizontal velocity. The peak values of the horizontal and torsional components were significantly shifted from the normal data and were closely aligned with each other, reaching peak values at approximately -56 degrees pitched back (-53 degrees horizontal, -58 degrees torsional). The same was true for the LARP and RALP animals; the peak values were at -59 degrees pitched back (-55 degrees horizontal, -62 degrees torsional). Likewise, in the LC animal the peak yaw and roll gains occurred at about the same angle of forward tilt, 35 degrees (30 degrees horizontal, 39 degrees torsional). Thus, in each case, the canal plugging had transformed the VOR from a compensatory to a direction-fixed response with regard to the head. Therefore there was no adaptation of the response planes of the individual canals after plugging. 4. The data were compared with eye velocity predictions of a model based on the geometric organization of the canals and their relation to a head coordinate frame. The model used the normal to the canal planes to form a nonorthogonal coordinate basis for representing eye velocity. An analysis of variance was used to define the goodness of fit of model predictions to the data. Model predictions and experimental data agreed closely for both normal animals and for the animals with canal lesions. Moreover, if horizontal and roll components from the LC and VC animals were combined, the summation overlay the response of the normal monkeys and the predictions of the model. In addition, a combination of the RALP and LARP animals predicted the response of the lateral-canal-plugged (VC) animals. 5. When operated animals were tested in light, the gains, peak values, and spatial phases of horizontal and roll eye velocity returned to the preoperative values, regardless of the type of surgery performed. This indicates that vision compensated for the lack o

The human ocular torsion position response during yaw angular acceleration

Recent results by Wearne [(1993) Ph.D. thesis] using the scleral search-coil method of measuring eye position indicate that changes in ocular torsion position (OTP) occur during yaw angular acceleration about an earth vertical axis. The present set of experiments, using an image processing method of eye movement measurement free from the possible confound of search coil slippage, demonstrates the generality and repeatability of this phenomenon and examines its possible causes. The change in torsion position is not a linear vestibulo-ocular reflex (LVOR) response to interaural linear acceleration stimulation of the otoliths, but rather the effect is dependent on the characteristics of the angular acceleration stimulus, commencing at the onset and decaying at the offset of the angular acceleration. In the experiments reported here, the magnitude of the angular acceleration stimulus was varied and the torsion position response showed corresponding variations. We consider that the change in torsion position observed during angular acceleration is most likely to be due to activity of the semicircular canals.

Sensitivity to full-field visual movement compatible with head rotation: variations among axes of rotation

Movement detection thresholds for full-field visual motion about various axes were measured in three subjects using a two-alternative forced-choice staircase method. Thresholds for 1-s exposures to rotation about different rotation axes varied significantly over the range 0.139 +/- 0.05 deg/s to 0.463 +/- 0.166 deg/s. The highest thresholds were found in response to rotation about axes closely aligned to the line of sight. Variations among the thresholds for different axes could not be explained by different movement patterns in the fovea or variations in motion sensitivity with eccentricity. The variations can be well simulated by a three-channel model for coding the axis and velocity of full-field visual motion. A three-channel visual coding system would be well suited for extracting information about self-rotation from a complex pattern of retinal image motion containing components due to both rotation and translation. A three-channel visual motion system would also be readily compatible with vestibular information concerning self-rotation arising from the semicircular canals.

Excitation of the extraocular muscles in decerebrate cats during the vestibulo-ocular reflex in three-dimensional space

(1) Vestibulo-ocular reflex excitation of the six extraocular muscles was studied by recording their electromyographic activity in decerebrate cats during oscillations about horizontal and vertical axes, at frequencies from 0.07 to 4 Hz. Animals were oriented in many different positions and rotated about axes that lay in the horizontal, frontal, or sagittal planes defined by our coordinate system. (2) The strengths of modulation (gains) of the responses of all extraocular muscles were a sinusoidal function of the orientation of the rotation axis within a coordinate plane, and this function was nearly independent of rotation frequency. (3) The responses were used to determine an axis of maximal excitation for each of the extraocular muscles by the vestibulo-ocular reflex. Antagonistic muscle pairs were found to have best axes in nearly opposite directions, confirming their operation as pairs. (4) Excitation of the medial and lateral rectus could be explained by input from the paired horizontal semicircular canals, with essentially no convergent input from vertical canals. (5) Excitation of the vertical rectus and oblique muscles could be explained by convergent inputs from the vertical canals with little or no horizontal canal input.

Electrovestibulogram: first results in the guinea pig

This paper describes a method of investigation of the peripheral vestibular system. Electrical stimulations (ES) are applied on the round window of chronically implanted guinea pigs, with and without vestibular stimulation (either per or post rotational accelerations). The whole nerve action potential recorded at the output of the internal auditory meatus, the difference between the two conditions, reveals the change in electrical excitability and thus presumably in discharge rate of vestibular fibres determined by rotational stimuli. This electrical vestibular action potential (EVAP) presents as a mainly monophasic potential with a peak latency to ES of about 0.3 ms. Right and left accelerations versus rest are shown to give responses with opposite polarity, reflecting the inhibitory and excitatory influences of these opposite accelerations, whereas the transfer function of EVAP versus acceleration amplitude appears roughly linear. These observations appear altogether coherent with published mechano-physiological data about individual discharge rates of canal fibres. Also relative amplitudes of acoustical and vestibular responses are in agreement with related number of fibres in the two systems. This EVAP could be the basis of a quantitative evaluation method for the vestibular system, the electrovestibulogram (EVG).

Motor output to lateral rectus in cats during the vestibulo-ocular reflex in three-dimensional space

The motor output to the lateral rectus eye muscle was studied in decerebrate cats with electromyographic recordings and in alert cats with multi-unit and single neuron recordings from abducens nucleus. The axis of rotation that produced maximal excitation of the lateral rectus was calculated from responses to rotations in many different stimulus orientations, and was found to lie near the axis of the horizontal semicircular canals, but pitched slightly nose down from the canal axis (4.6 degrees). The results from decerebrate and alert cats were in agreement. The dynamics of lateral rectus activation were quite similar in all planes. Responses at high frequencies were in phase with rotation velocity and responses lagged toward position phase as frequency and velocity were decreased. Differences in decerebrate cat low frequency responses to rotations with and without a sinusoidal gravitational stimulus implicated an otolith input to lateral rectus.

Vestibular contribution to the orientation of cervico-ocular reflex in rabbit

In the rabbit the cervico-ocular reflex (COR) helps to maintain the gaze stability during passive head displacements, by increasing the gain and decreasing the phase lead of low frequency vestibular responses and by diminishing in amplitude the anticompensatory vestibular fast phases. These cervical influences appear only for horizontal stimulations, while they are scarce or absent in the vertical and sagittal planes. Ocular responses to horizontal body displacements are oriented in the horizontal plane and remain in the same plane when the head is statically pitched at various degrees, in spite of the directional changes in the extraocular muscle (EOM) lines of force with respect to space. Tension recordings from the EOMs show that the oculomotor system is differently activated depending upon the degree of head inclination. This change in the EOM activation is not observed when the body, instead of the head, is pitched. Furthermore, after bilateral labyrinthectomy (BL) the cervico-ocular responses lose their appropriate directionality. It is concluded that the information for determining the plane of the eye movements during cervical stimulations does not originate from the neck proprioception but is provided by the otolithic receptors.