Human optokinetic afternystagmus. Effects of repeated stimulation

Coding of Velocity Storage in the Vestibular Nuclei

Semicircular canal afferents sense angular acceleration and output angular velocity with a short time constant of ≈4.5 s. This output is prolonged by a central integrative network, velocity storage that lengthens the time constants of eye velocity. This mechanism utilizes canal, otolith, and visual (optokinetic) information to align the axis of eye velocity toward the spatial vertical when head orientation is off-vertical axis. Previous studies indicated that vestibular-only (VO) and vestibular-pause-saccade (VPS) neurons located in the medial and superior vestibular nucleus could code all aspects of velocity storage. A recently developed technique enabled prolonged recording while animals were rotated and received optokinetic stimulation about a spatial vertical axis while upright, side-down, prone, and supine. Firing rates of 33 VO and 8 VPS neurons were studied in alert cynomolgus monkeys. Majority VO neurons were closely correlated with the horizontal component of velocity storage in head coordinates, regardless of head orientation in space. Approximately, half of all tested neurons (46%) code horizontal component of velocity in head coordinates, while the other half (54%) changed their firing rates as the head was oriented relative to the spatial vertical, coding the horizontal component of eye velocity in spatial coordinates. Some VO neurons only coded the cross-coupled pitch or roll components that move the axis of eye rotation toward the spatial vertical. Sixty-five percent of these VO and VPS neurons were more sensitive to rotation in one direction (predominantly contralateral), providing directional orientation for the subset of VO neurons on either side of the brainstem. This indicates that the three-dimensional velocity storage integrator is composed of directional subsets of neurons that are likely to be the bases for the spatial characteristics of velocity storage. Most VPS neurons ceased firing during drowsiness, but the firing rates of VO neurons were unaffected by states of alertness and declined with the time constant of velocity storage. Thus, the VO neurons are the prime components of the mechanism of coding for velocity storage, whereas the VPS neurons are likely to provide the path from the vestibular to the oculomotor system for the VO neurons.

Epistaxis: some aspects of laterality in 326 patients

Lateralization of primary epistaxis was prospectively studied in 326 patients at Radebeul Elblandklinikum. The male-female-ratio was 1.3:1. A slight dominance of the right side (45% right vs. 39% left) was found in all patients. Further analyzed were the relationship to the localization of bleeding (anterior or posterior), the age and possible causes or risk factors. Nose bleeding from the posterior nasal portion appears to be statistically significantly higher than on both sides of anterior epistaxis. No statistically significant age dependence of laterality of epistaxis was observed in the age groups which we selected. However, nosebleed appears more frequently in women under the age of 50 years in both nostrils. With identified risk factors, idiopathic epistaxis occurs more frequently on the right side than does nosebleed. Mechanical trauma (intranasal sprays or nose picking) is a possible factor explaining the dominance of epistaxis on the right side, especially in idiopathic cases.

Eye movements and motion perception induced by off-vertical axis rotation (OVAR) at small angles of tilt after spaceflight

The nystagmus and motion perception of two astronauts were recorded during Earth-vertical axis rotation and during off-vertical axis rotation (OVAR) before and after 7 days of spaceflight. Postflight, the peak velocity and duration of per- and postrotatory nystagmus during velocity steps about the Earth-vertical axis were the same as preflight values. During OVAR at constant velocity (45/s, tilt angles successively 5, 10, and 15 degrees), the mean horizontal slow-phase eye velocity (bias), produced by the 'velocity storage mechanism' in the vestibular system, and the peak-to-peak amplitude (modulation) in horizontal eye velocity and position, generated from the output of otolith afferents, were also the same before as after flight. There were, however, changes in the vertical eve position and in the perceived body motion during OVAR. The angle of the perceived body path described as a cone was larger in both astronauts postflight. One astronaut experienced either a large cone angle with its axis upright, or a smaller cone angle with its axis tilted backwards, accompanied by an upward vertical eye drift. These results suggest an increase in the sensitivity of the otolithic system after spaceflight and a longer period of readaptation to Earth's gravity for otolith-induced responses than for canal-induced responses. Our data support the hypothesis that just after spaceflight the CNS generally interprets changes in the otolith signals to be due to translation rather than to tilt.

Effect of transdermally administered scopolamine on the vestibular system in humans

In order to elucidate the effect of scopolamine on the vestibular system in humans, various experimentally-induced forms of nystagmus, i.e. caloric nystagmus, rotational nystagmus, optokinetic nystagmus, visual-vestibular interaction and optokinetic after nystagmus, were evaluated before and after the administration of two pieces of Scopoderm-TTS or placebo patches retro-auricularly. Scopolamine reduced the responses of both the caloric and optokinetic after nystagmus compared with the placebo. The possible action site of this drug is discussed.

Human optokinetic after-nystagmus: variability in serial test results

Test-retest variability of values for directional asymmetry in primary and secondary horizontal optokinetic after-nystagmus (OKAN I and OKAN II, respectively) was studied in 16 apparently healthy subjects. OKAN was induced by 60 s of whole-field optokinetic stimulation at speeds of 60 degrees/s and 90 degrees/s in either direction (left and right), each subject being tested on the same respective weekday once a week for 4 consecutive weeks. Values for directional asymmetry were calculated as the relative side-difference between response to drum rotation toward the right and toward the left. The subjects manifested considerable variation in values for directional asymmetry in OKAN I. This suggests prediction of a given individual's true value for directional asymmetry in OKAN I to require several measurements. On the other hand, 15/16 subjects manifested no asymmetry in OKAN II (the 16th subject was a further investigation found to have significant asymmetric caloric responses). As both OKAN I and OKAN II are known to reflect asymmetric vestibular function it is suggested that studying OKAN II may require fewer measurements of directional asymmetry, compared with studying OKAN I, when assessing the course of peripheral vestibular asymmetry.

Cross-coupling between horizontal and vertical eye movements during optokinetic nystagmus and optokinetic afternystagmus elicited in microgravity

The occurrence of horizontal jerks with larger amplitudes than on Earth was observed during vertical optokinetic nystagmus in astronauts tested throughout a 7-day spaceflight. During early exposure to microgravity, a horizontal spontaneous-like nystagmus was recorded in darkness following both vertical and horizontal optokinetic stimulation. In addition, the time constant of vertical OKAN with slow phase up was larger than on the ground. These effects disappeared on flight day 2. Then, the horizontal and vertical OKAN time constants decreased, and gradually returned to the preflight values, as previously observed with the gain of the vestibulo-ocular reflex. The early changes in microgravity are in agreement with those obtained on Earth in monkeys and humans during static tilt relative to gravity. Our findings suggest that the absence of otolithic input in microgravity may have an effect on the optokinetic system which could be mediated by the velocity storage mechanism.

Cross-coupled effects of repeated vestibular and optokinetic stimulations on the dynamics of the vestibulo-ocular and optokinetic reflexes in the cat

Cats were submitted to repeated step stimulations either vestibular or optokinetic. Regardless of which of the two stimuli was used, dynamic modifications were observed in both vestibulo-ocular response and optokinetic after-nystagmus (OKAN). The progressive changes in post-rotational nystagmus and OKAN were quantified by measuring the duration of their primary phase. A parallel evolution of these two parameters was found. When repeated unidirectional vestibular stimulations were used, the same asymmetry was induced in both vestibuloocular responses and OKAN. These results support the hypothesis that the vestibulo-ocular and the optokinetic reflex share a common velocity storage mechanism, although alternative hypotheses cannot be excluded.

Eye movements induced by off-vertical axis rotation (OVAR) at small angles of tilt

Off-vertical rotation (OVAR) in darkness induced continuous horizontal nystagmus in humans at small tilts of the rotation axis (5 to 30 degrees). The horizontal slow eye velocity had two components: a mean velocity in the direction opposite to head rotation and a sinusoidal modulation around the mean. Mean velocity generally did not exceed 10 deg/s, and was less than or equal to the maximum velocity of optokinetic after-nystagmus (OKAN). Both the mean and modulation components of horizontal nystagmus increased with tilt angle and rotational velocity. Vertical slow eye velocity was also modulated sinusoidally, generally around zero. The amplitude of the vertical modulation increased with tilt angle, but not with rotational velocity. In addition to modulations in eye velocity, there were also modulations in horizontal and vertical eye positions. These would partially compensate for head position changes in the yaw and pitch planes during each cycle of OVAR. Modulations in vertical eye position were regular, increased with increases in tilt angle and were separated from eye velocity by 90 deg. These results are compatible with the interpretation that, during OVAR, mean slow velocity of horizontal nystagmus is produced by the velocity storage mechanism in the vestibular system. In addition, they indicate that the otolith organs induce compensatory eye position changes with regard to gravity for tilts in the pitch, yaw and probably also the roll planes. Such compensatory changes could be utilized to study the function of the otolith organs. A functional interpretation of these results is that nystagmus attempts to stabilize the image on the retina of one point of the surrounding world. Mean horizontal velocity would then be opposite to the estimate of head rotational velocity provided by the output of the velocity storage mechanism, as charged by an otolithic input during OVAR. In spite of the lack of actual translation, an estimate of head translational velocity could, in this condition, be constructed from the otolithic signal. The modulation in horizontal eye position would then be compensatory for the perceived head translation. Modulation of vertical eye velocity would compensate for actual changes in head orientation with respect to gravity.

Human optokinetic afternystagmus. Charging characteristics and stimulus exposure time dependence in the two-component model

The dependence of human optokinetic afternystagmus (OKAN) velocity storage (charging) and optokinetic nystagmus (OKN) characteristics on optokinetic (OK) stimulus exposure time was investigated, using the two-component double exponential model for OKAN decay. Results are compatible with our previously proposed concept of two velocity storage integrators, one responsible for the short time constant decay (pursuit-mediated) and the other for the long time constant decay (OK system-mediated). The dependence of the long time constant integrator of OKAN on stimulus exposure time was clearly demonstrated. The short time constant integrator appeared to be independent of stimulus exposure time within the range studied. We conclude that the charging time-course of each component is distinct from that of the other. The time constants of each component decay were found to be invariant. A left-right asymmetry observed in both OKN and OKAN responses suggests that the integrators are direction sensitive.