Posture, Gait, Quality of Life, and Hearing with a Vestibular Implant

BACKGROUND

Bilateral vestibular hypofunction is associated with chronic disequilibrium, postural instability, and unsteady gait owing to failure of vestibular reflexes that stabilize the eyes, head, and body. A vestibular implant may be effective in alleviating symptoms.

METHODS

Persons who had had ototoxic (7 participants) or idiopathic (1 participant) bilateral vestibular hypofunction for 2 to 23 years underwent unilateral implantation of a prosthesis that electrically stimulates the three semicircular canal branches of the vestibular nerve. Clinical outcomes included the score on the Bruininks-Oseretsky Test of Motor Proficiency balance subtest (range, 0 to 36, with higher scores indicating better balance), time to failure on the modified Romberg test (range, 0 to 30 seconds), score on the Dynamic Gait Index (range, 0 to 24, with higher scores indicating better gait performance), time needed to complete the Timed Up and Go test, gait speed, pure-tone auditory detection thresholds, speech discrimination scores, and quality of life. We compared participants' results at baseline (before implantation) with those at 6 months (8 participants) and at 1 year (6 participants) with the device set in its usual treatment mode (varying stimulus pulse rate and amplitude to represent rotational head motion) and in a placebo mode (holding pulse rate and amplitude constant).

RESULTS

The median scores at baseline and at 6 months on the Bruininks-Oseretsky test were 17.5 and 21.0, respectively (median within-participant difference, 5.5 points; 95% confidence interval [CI], 0 to 10.0); the median times on the modified Romberg test were 3.6 seconds and 8.3 seconds (difference, 5.1; 95% CI, 1.5 to 27.6); the median scores on the Dynamic Gait Index were 12.5 and 22.5 (difference, 10.5 points; 95% CI, 1.5 to 12.0); the median times on the Timed Up and Go test were 11.0 seconds and 8.7 seconds (difference, 2.3; 95% CI, -1.7 to 5.0); and the median speeds on the gait-speed test were 1.03 m per second and 1.10 m per second (difference, 0.13; 95% CI, -0.25 to 0.30). Placebo-mode testing confirmed that improvements were due to treatment-mode stimulation. Among the 6 participants who were also assessed at 1 year, the median within-participant changes from baseline to 1 year were generally consistent with results at 6 months. Implantation caused ipsilateral hearing loss, with the air-conducted pure-tone average detection threshold at 6 months increasing by 3 to 16 dB in 5 participants and by 74 to 104 dB in 3 participants. Changes in participant-reported disability and quality of life paralleled changes in posture and gait.

CONCLUSIONS

Six months and 1 year after unilateral implantation of a vestibular prosthesis for bilateral vestibular hypofunction, measures of posture, gait, and quality of life were generally in the direction of improvement from baseline, but hearing was reduced in the ear with the implant in all but 1 participant. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT02725463.).

Eye Movements in Response to Electric Stimulation of the Human Posterior Ampullary Nerve

Objectives:

The concept of a vestibular implant to restore balance, similar to that of a cochlear implant to restore hearing in deaf patients, has been investigated in animal models. It remains to be shown, however, that electric stimulation of the human end organ or its vestibular nerve branches is capable of eliciting a nystagmic eye movement response.

Methods:

Three subjects were given electric stimulation of their posterior ampullary nerve, which was surgically exposed under local anesthesia, by a procedure developed by Gacek. The stimulus was a multiphasic, charge-balanced train of electric pulses.

Results:

In all subjects, a pulse repetition rate of 200 pulses per second produced a robust vertical nystagmus without any apparent change in the slow component velocity of the preexisting horizontal nystagmus.

Conclusions:

We have been able to replicate in humans a finding somewhat similar to that of Suzuki and Cohen in monkeys for electric stimulation of the posterior semicircular canal. The similarity is an eye movement with a large, predominant vertical component. The difference is that we saw no horizontal response component, and were not able to measure a torsional response, because we used 2-dimensional video methods. In addition, we found a robust nystagmus with slow component velocities that are large enough to compensate for vertical head movements. This is an essential step in demonstrating the feasibility of a vestibular prosthesis using electric stimulation.

Histopathologic Changes of the Inner ear in Rhesus Monkeys After Intratympanic Gentamicin Injection and Vestibular Prosthesis Electrode Array Implantation

Bilateral vestibular deficiency (BVD) due to gentamicin ototoxicity can significantly impact quality of life and result in large socioeconomic burdens. Restoring sensation of head rotation using an implantable multichannel vestibular prosthesis (MVP) is a promising treatment approach that has been tested in animals and humans. However, uncertainty remains regarding the histopathologic effects of gentamicin ototoxicity alone or in combination with electrode implantation. Understanding these histological changes is important because selective MVP-driven stimulation of semicircular canals (SCCs) depends on persistence of primary afferent innervation in each SCC crista despite both the primary cause of BVD (e.g., ototoxic injury) and surgical trauma associated with MVP implantation. Retraction of primary afferents out of the cristae and back toward Scarpa's ganglion would render spatially selective stimulation difficult to achieve and could limit utility of an MVP that relies on electrodes implanted in the lumen of each ampulla. We investigated histopathologic changes of the inner ear associated with intratympanic gentamicin (ITG) injection and/or MVP electrode array implantation in 11 temporal bones from six rhesus macaque monkeys. Hematoxylin and eosin-stained 10-μm temporal bone sections were examined under light microscopy for four treatment groups: normal (three ears), ITG-only (two ears), MVP-only (two ears), and ITG + MVP (four ears). We estimated vestibular hair cell (HC) surface densities for each sensory neuroepithelium and compared findings across end organs and treatment groups. In ITG-only, MVP-only, and ITG + MVP ears, we observed decreased but persistent ampullary nerve fibers of SCC cristae despite ITG treatment and/or MVP electrode implantation. ITG-only and ITG + MVP ears exhibited neuroepithelial thinning and loss of type I HCs in the cristae but little effect on the maculae. MVP-only and ITG + MVP ears exhibited no signs of trauma to the cochlea or otolith end organs except in a single case of saccular injury due to over-insertion of the posterior SCC electrode. While implanted electrodes reached to within 50-760 μm of the target cristae and were usually ensheathed in a thin fibrotic capsule, dense fibrotic reaction and osteoneogenesis were each observed in only one of six electrode tracts examined. Consistent with physiologic studies that have demonstrated directionally appropriate vestibulo-ocular reflex responses to MVP electrical stimulation years after implantation in these animals, histologic findings in the present study indicate that although intralabyrinthine MVP implantation causes some inner ear trauma, it can be accomplished without destroying the distal afferent fibers an MVP is designed to excite.

Cat primary canal neurons: relation of conduction velocity to resting and dynamic firing characteristics

Spontaneous discharge patterns of first-order canal afferents were analyzed in cats anethetized with pentobarbital sodium with particular emphasis on the relationship of regularity of resting discharge, sensitivity to angular acceleration and adaptation to the time delay between electrical labyrinthine stimulation and recording from afferents near Scarpa's ganglion. Regular units were found to have a high resting rate, low sensitivity to angular acceleration, were mostly nonadapting during prolonged acceleration and showed relatively long latency to electrical stimulation. Irregular units tended to have a low resting rate, high sensitivity, frequently showed adaptation and had short latencies. Intermediate neurons had mixed characteristics of regular and irregular units. In medulated nerve fibers, a direct relation exists between conduction velocity and fiber diameter. As latency is due primarily to conduction in the first-order axon, we may speculate that regular neurons have thin fibers which innervate the slope of the crista, irregular neurons have thick fibers which innervate the summit, and intermediate units have medium caliber fibers which innervate both the slope and summit of the crista ampullaris.

Efferent innervation of turtle semicircular canal cristae: comparisons with bird and mouse

In the vestibular periphery of nearly every vertebrate, cholinergic vestibular efferent neurons give rise to numerous presynaptic varicosities that target hair cells and afferent processes in the sensory neuroepithelium. Although pharmacological studies have described the postsynaptic actions of vestibular efferent stimulation in several species, characterization of efferent innervation patterns and the relative distribution of efferent varicosities among hair cells and afferents are also integral to understanding how efferent synapses operate. Vestibular efferent markers, however, have not been well characterized in the turtle, one of the animal models used by our laboratory. Here we sought to identify reliable efferent neuronal markers in the vestibular periphery of turtle, to use these markers to understand how efferent synapses are organized, and to compare efferent neuronal labeling patterns in turtle with two other amniotes using some of the same markers. Efferent fibers and varicosities were visualized in the semicircular canal of red-eared turtles (Trachemys scripta elegans), zebra finches (Taeniopygia guttata), and mice (Mus musculus) utilizing fluorescent immunohistochemistry with antibodies against choline acetyltransferase (ChAT). Vestibular hair cells and afferents were counterstained using antibodies to myosin VIIa and calretinin. In all species, ChAT labeled a population of small diameter fibers giving rise to numerous spherical varicosities abutting type II hair cells and afferent processes. That these ChAT-positive varicosities represent presynaptic release sites were demonstrated by colabeling with antibodies against the synaptic vesicle proteins synapsin I, SV2, or syntaxin and the neuropeptide calcitonin gene-related peptide. Comparisons of efferent innervation patterns among the three species are discussed.

Input-output functions of vestibular afferent responses to air-conducted clicks in rats

Sound-evoked vestibular myogenic potentials recorded from the sternocleidomastoid muscles (the cervical vestibular-evoked myogenic potential or cVEMP) and the extraocular muscles (the ocular VEMP or oVEMP) have proven useful in clinical assessment of vestibular function. VEMPs are commonly interpreted as a test of saccular function, based on neurophysiological evidence showing activation of saccular afferents by intense acoustic click stimuli. However, recent neurophysiological studies suggest that the clicks used in clinical VEMP tests activate vestibular end organs other than the saccule. To provide the neural basis for interpreting clinical VEMP testing results, the present study examined the extent to which air-conducted clicks differentially activate the various vestibular end organs at several intensities and durations in Sprague-Dawley rats. Single unit recordings were made from 562 vestibular afferents that innervated the otoliths [inferior branch otolith (IO) and superior branch otolith (SO)], the anterior canal (AC), the horizontal canal (HC), and the posterior canal (PC). Clicks higher than 60 dB SL (re-auditory brainstem response threshold) activated both semicircular canal and otolith organ afferents. Clicks at or below 60 dB SL, however, activated only otolith organ afferents. Longer duration clicks evoked larger responses in AC, HC, and SO afferents, but not in IO afferents. Intra-axonal recording and labeling confirmed that sound sensitive vestibular afferents innervated the horizontal and anterior canal cristae as well as the saccular and utricular maculae. Interestingly, all sound sensitive afferents are calyx-bearing fibers. These results demonstrate stimulus-dependent acoustic activation of both semicircular canals and otolith organs, and suggest that sound activation of vestibular end organs other than the saccule should not be ruled out when designing and interpreting clinical VEMP tests.

Adaptation of vestibular tone studied with electrical stimulation of semicircular canal afferents

Damage to one vestibular labyrinth or nerve causes a central tone imbalance, reflected by prominent spontaneous nystagmus. Central adaptive mechanisms eliminate the nystagmus over several days, and the mechanisms underlying this process have received extensive study. The characteristics of vestibular compensation when the tone imbalance is presented gradually or repeatedly have never been studied. We used high-frequency electrical stimulation of semicircular canal afferents to generate a vestibular tone imbalance and recorded the nystagmus produced when the stimulation was started abruptly or gradually and when it was repeatedly cycled on and off. In the acute-onset protocol, brisk nystagmus occurred when stimulation started, gradually resolved within 1 day, and reversed direction when the stimulation was stopped after 1 week. Repeated stimulation cycles resulted in progressively smaller nystagmus responses. In the slow-onset protocol, minimal nystagmus occurred while the stimulation ramped-up to its maximum rate over 12 h, but a reversal still occurred when the stimulation was stopped after 1 week, and repeated stimulation cycles did not affect this pattern. The absence of nystagmus during the 12 h ramp of stimulation demonstrates that central vestibular tone can rebalance relatively quickly, and the reduction in the stimulation-off nystagmus with repeated cycles of the acute-onset but not the slow-onset stimulation suggests that dual-state adaptation may have occurred with the former paradigm but not the latter.

Changes in the cupula after disruption of the membranous labyrinth

CONCLUSION

Various changes were observed in the cupula, including shrinkage and enlarged volume, following the disruption of the membranous labyrinth. Cupular change after membranous labyrinth disruption may be a pathology of vestibular disorders.

OBJECTIVES

To observe the morphological changes of the cupula after disruption of the membranous labyrinth and to compare the cupular changes with changes in the compound action potential (CAP) of the ampullary nerve.

METHODS

A labyrinthine injury model was created by puncturing the membranous labyrinth of bullfrogs. The cupula was observed from 3 to 17 days after the membrane puncture. The CAP in response to mechanical endolymphatic flow was recorded from the ampullary nerve. The correlation between cupular change and CAP positivity was evaluated using the authors' scale.

RESULTS

Various kinds of cupular changes including shrinkage were observed. Cupular change was more severe after a longer survival period. Large or elongated volume of the cupula was also observed, which was not observed in our previous study using gentamicin. The CAP could be recorded even when the cupular change was severe.

Variation in response dynamics of regular and irregular vestibular-nerve afferents during sinusoidal head rotations and currents in the chinchilla

In mammals, vestibular-nerve afferents that innervate only type I hair cells (calyx-only afferents) respond nearly in phase with head acceleration for high-frequency motion, whereas afferents that innervate both type I and type II (dimorphic) or only type II (bouton-only) hair cells respond more in phase with head velocity. Afferents that exhibit irregular background discharge rates have a larger phase lead re-head velocity than those that fire more regularly. The goal of this study was to investigate the cause of the variation in phase lead between regular and irregular afferents at high-frequency head rotations. Under the assumption that externally applied galvanic currents act directly on the nerve, we derived a transfer function describing the dynamics of a semicircular canal and its hair cells through comparison of responses to sinusoidally modulated head velocity and currents. Responses of all afferents were fit well with a transfer function with one zero (lead term). Best-fit lead terms describing responses to current for each group of afferents were similar to the lead term describing responses to head velocity for regular afferents (0.006 s + 1). This finding indicated that the pre-synaptic and synaptic inputs to regular afferents were likely to be pure velocity transducers. However, the variation in phase lead between regular and irregular afferents could not be explained solely by the ratio of type I to II hair cells (Baird et al 1988), suggesting that the variation was caused by a combination of pre- (type of hair cell) and post-synaptic properties.

Effect of cupula shrinkage on the semicircular canal activity

CONCLUSION

With half-sized cupula, the semicircular canal nerve potentials decreased under slow stimulus, thus potentially leading to reduced caloric response. This also suggests that shrunken cupula may cause dizziness because of its hypermobility.

OBJECTIVES

To examine the physiological effect of half-sized cupula on the semicircular canal nerve potential.

METHODS

The isolated cupula of the bullfrog was sectioned in half with fine scissors and was replaced on the crista. Mechanical endolymphatic flow and slow and fast stimuli were delivered and the evoked action potentials were recorded.

RESULTS

The cupula was successfully sectioned in half and was replaced on the crista. With the half-sized cupula, the action potentials became smaller under slow stimulus than under fast stimulus.

Static and dynamic discharge properties of vestibular-nerve afferents in the mouse are affected by core body temperature

The goal of this study was to determine the effect of changes in core body temperature on the resting discharge rate and sensitivity of vestibular-nerve afferents. Extracellular recordings were made from vestibular-nerve afferents innervating the semicircular canals in anesthetized C57BL/6 mice maintained at a core body temperature of either 30-32 degrees C (T (31)) or 35-37 degrees C (T (36)). The resting rates of regular (CV* < 0.1) and irregular afferents (CV* > 0.1) were lower at T (31) than at T (36). Sensitivity and phase were compared for rotations ranging from 0.1 to 12 Hz by calculating coefficients of a transfer function, g . t(c)S . (t(z)S +1)/(t(c)S + 1), for each afferent. The sensitivity (g) increased with CV* and with higher core body temperature. The value of the coefficient representing the low-frequency dynamics (t (c)) varied inversely with CV* but did not change with core body temperature. The high-frequency dynamics represented by t (z) increased with CV* and decreased with higher core body temperature. These findings indicate that changes in temperature have effects on the static and dynamic properties of vestibular-nerve afferents.

Vestibular evoked myogenic potentials in patients with benign paroxysmal positional vertigo involving each semicircular canal

PURPOSE

We have investigated vestibular evoked myogenic potentials (VEMPs) as a function of age and the involvement of each of the 3 semicircular canals in patients with benign paroxysmal positional vertigo (BPPV).

MATERIALS AND METHODS

We performed prospective assessment from January 2005 to September 2006. Vestibular evoked myogenic potential was measured in 53 patients with BPPV and 84 healthy subjects, with the latter subdivided by patient age.

RESULTS

The subgroup of healthy subjects older than 60 years showed significantly more prolonged p13 and n23 latencies and lower amplitude than the other 2 subgroups. Of the 53 patients with BPPV, 13 (24.5%) showed abnormal VEMP responses on the affected side when compared with their age-related control subgroup. There was no correlation between VEMP findings and the affected semicircular canal.

CONCLUSION

Patients with BPPV may show abnormal VEMP findings, irrespective of the involved semicircular canal, and age was associated with VEMP results suggesting degeneration of the maculae of the saccule.

Relationship of semicircular canal size to vestibular-nerve afferent sensitivity in mammals

The relationship between semicircular canal radius of curvature and afferent sensitivity has not been experimentally determined. We characterized mouse semicircular canal afferent responses to sinusoidal head rotations to facilitate interspecies and intraspecies comparisons of canal size to sensitivity. The interspecies experiment compared the horizontal canal afferent responses among animals ranging in size from mouse to rhesus monkey. The intraspecies experiment compared afferent responses from the larger anterior canal to those from the smaller horizontal canal of mice. The responses of mouse vestibular-nerve afferents showed a low- and high-frequency phase lead and high-frequency gain enhancement. Regular horizontal-canal afferents showed a sensitivity to 0.5-Hz sinusoidal rotations of 0.10 +/- 0.03 (SD) spike . s(-1)/deg . s(-1) and high-gain irregular afferents showed a sensitivity of 0.25 +/- 0.11 spike . s(-1)/deg . s(-1). The interspecies comparison showed that the sensitivity of regular afferents was related to the radius of curvature R according to the formula G(r) = 0.23R - 0.09 (r(2) = 0.86) and the sensitivity of irregular afferents was related to radius according to the formula G(i) = 0.32R + 0.01 (r(2) = 0.67). The intraspecies comparison showed that regularly firing anterior canal afferents were significantly more sensitive than those from the relatively smaller horizontal canal, with G(r) = 0.25R. This suggests that canal radius of curvature is closely related to afferent sensitivity both among and within species. If the relationship in humans is similar to that demonstrated here, the sensitivity of their regular vestibular-nerve afferents to 0.5-Hz rotations is likely to be about 0.67 spike . s(-1)/deg . s(-1) and of their high-gain irregular afferents about 1.06 spikes . s(-1)/deg . s(-1).

Purkinje cells in posterior cerebellar vermis encode motion in an inertial reference frame

The ability to orient and navigate through the terrestrial environment represents a computational challenge common to all vertebrates. It arises because motion sensors in the inner ear, the otolith organs, and the semicircular canals transduce self-motion in an egocentric reference frame. As a result, vestibular afferent information reaching the brain is inappropriate for coding our own motion and orientation relative to the outside world. Here we show that cerebellar cortical neuron activity in vermal lobules 9 and 10 reflects the critical computations of transforming head-centered vestibular afferent information into earth-referenced self-motion and spatial orientation signals. Unlike vestibular and deep cerebellar nuclei neurons, where a mixture of responses was observed, Purkinje cells represent a homogeneous population that encodes inertial motion. They carry the earth-horizontal component of a spatially transformed and temporally integrated rotation signal from the semicircular canals, which is critical for computing head attitude, thus isolating inertial linear accelerations during navigation.

The role of defensins in the excitability of the peripheral vestibular system in the frog: Evidence for the presence of communication between the immune and nervous systems

Defensins are one of the major groups of endogenous peptides that are considered to be important antibiotic-like effectors of host innate and adaptive antimicrobial immunity. The current study investigated the electrophysiological effects of externally applied human and rabbit defensins (HNP-1 and RNP-1, correspondingly) on afferent neurotransmission in the frog semicircular canals (SCC). Application of HNP-1 and RNP-1 induces a concentration-dependent decrease in resting activity. Threshold concentrations for both substances were of the order of 0.0001 nM. The firing evoked by L-glutamate (L-Glu) and its agonists alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA), kainate and N-methyl-D-aspartate (NMDA) and (1S, 3R)-1-aminocyclopentane-trans-1,3-dicarboxilic acid (ACPD) could be inhibited by HNP-1, suggesting that defensins exert inhibitory control over both ionotropic and metabotropic glutamate receptors. HNP-1 considerably inhibited the L-glutamate/high Mg2+ -induced increase in frequency, thus, demonstrating its postsynaptic site of action. Acetylcholine (ACh) responses under HNP-1 did not differ from the frequency increase induced by ACh alone, and the ACh antagonist atropine left the response to HNP-1 intact. The specific opioid receptor antagonist naloxone (Nal) antagonized the inhibitory response evoked by HNP-1. The results obtained support the evidence for the recruitment of defensins in communication between the immune and nervous systems, and on the potential of sensory receptors to participate in the inflammatory response.

Chronic vestibulo-ocular reflexes evoked by a vestibular prosthesis

We are developing prosthetics for patients suffering from peripheral vestibular dysfunction. We tested a sensory-replacement prosthesis that stimulates neurons innervating the vestibular system by providing chronic pulsatile stimulation to electrodes placed in monkeys' lateral semicircular canals, which were plugged bilaterally, and used head angular velocity to modulate the current pulse rate. As an encouraging finding, we observed vestibulo-ocular reflexes that continued to be evoked by the motion-modulated stimulation months after the nystagmus evoked by the constant-rate baseline stimulation had dissipated. This suggests that long-term functional replacement of absent vestibular function is feasible.

A multichannel semicircular canal neural prosthesis using electrical stimulation to restore 3-d vestibular sensation

Bilateral loss of vestibular sensation can be disabling. Those afflicted suffer illusory visual field movement during head movements, chronic disequilibrium and postural instability due to failure of vestibulo-ocular and vestibulo-spinal reflexes. A neural prosthesis that emulates the normal transduction of head rotation by semicircular canals could significantly improve quality of life for these patients. Like the three semicircular canals in a normal ear, such a device should at least transduce three orthogonal (or linearly separable) components of head rotation into activity on corresponding ampullary branches of the vestibular nerve. We describe the design, circuit performance and in vivo application of a head-mounted, semi-implantable multichannel vestibular prosthesis that encodes head movement in three dimensions as pulse-frequency-modulated electrical stimulation of three or more ampullary nerves. In chinchillas treated with intratympanic gentamicin to ablate vestibular sensation bilaterally, prosthetic stimuli elicited a partly compensatory angular vestibulo-ocular reflex in multiple planes. Minimizing misalignment between the axis of eye and head rotation, apparently caused by current spread beyond each electrode's targeted nerve branch, emerged as a key challenge. Increasing stimulation selectivity via improvements in electrode design, surgical technique and stimulus protocol will likely be required to restore AVOR function over the full range of normal behavior.

Spatial symmetry groups as sensorimotor guidelines

While some aspects of neuroanatomical organization are related to packing and access rather than to function, other aspects of anatomical/physiological organization are directly related to function. The mathematics of symmetry groups can be used to determine logical structure in projections and to relate it to function. This paper reviews two studies of the symmetry groups of vestibular projections that are related to the spatial functions of the vestibular complex, including gaze, posture, and movement. These logical structures have been determined by finding symmetry groups of two vestibular projections directly from physiological and anatomical data. Logical structures in vestibular projections are distinct from mapping properties such as the ability to maintain two- and three-dimensional coordinate systems; rather, they provide anatomical/physiological foundations for these mapping properties. The symmetry group of the direct projection from the semicircular canal primary afferents to neck motor neurons is that of the cube (O, the octahedral group), which can serve as a discrete skeleton for coordinate systems in three-dimensional space. The symmetry group of the canal projection from the secondary vestibular afferents to the inferior olive and thence to the cerebellar uvula-nodulus is that of the square (D8), which can support coordinates for the horizontal plane. While the mathematical relationship between these symmetry groups and functions of the vestibular complex are clear, these studies open a larger question: what is the causal logic by which neural centers and their intrinsic organization affect each other and behavior? The relationship of vestibular projection symmetry groups to spatial function make them ideal projections for investigating this causal logic. The symmetry group results are discussed in relationship to possible ways they communicate spatial structure to other neural centers and format spatial functions such as body movements. These two projection symmetry groups suggest that all vestibular projections may have symmetry groups significantly related to function, perhaps all to spatial function.

Response of vestibular-nerve afferents to active and passive rotations under normal conditions and after unilateral labyrinthectomy

We investigated the possible contribution of signals carried by vestibular-nerve afferents to long-term processes of vestibular compensation after unilateral labyrinthectomy. Semicircular canal afferents were recorded from the contralesional nerve in three macaque monkeys before [horizontal (HC) = 67, anterior (AC) = 66, posterior (PC) = 50] and 1-12 mo after (HC = 192, AC = 86, PC = 57) lesion. Vestibular responses were evaluated using passive sinusoidal rotations with frequencies of 0.5-15 Hz (20-80 degrees /s) and fast whole-body rotations reaching velocities of 500 degrees /s. Sensitivities to nonvestibular inputs were tested by: 1) comparing responses during active and passive head movements, 2) rotating the body with the head held stationary to activate neck proprioceptors, and 3) encouraging head-restrained animals to attempt to make head movements that resulted in the production of neck torques of < or =2 Nm. Mean resting discharge rate before and after the lesion did not differ for the regular, D (dimorphic)-irregular, or C (calyx)-irregular afferents. In response to passive rotations, afferents showed no change in sensitivity and phase, inhibitory cutoff, and excitatory saturation after unilateral labyrinthectomy. Moreover, head sensitivities were similar during voluntary and passive head rotations and responses were not altered by neck proprioceptive or efference copy signals before or after the lesion. The only significant change was an increase in the proportion of C-irregular units postlesion, accompanied by a decrease in the proportion of regular afferents. Taken together, our findings show that changes in response properties of the vestibular afferent population are not likely to play a major role in the long-term changes associated with compensation after unilateral labyrinthectomy.

Resolving head rotation for human bipedalism

Alignment of the body to the gravitational vertical is considered to be the key to human bipedalism. However, changes to the semicircular canals during human evolution suggest that the sense of head rotation that they provide is important for modern human bipedal locomotion. When walking, the canals signal a mix of head rotations associated with path turns, balance perturbations, and other body movements. It is uncertain how the brain uses this information. Here, we show dual roles for the semicircular canals in balance control and navigation control. We electrically evoke a head-fixed virtual rotation signal from semicircular canal nerves as subjects walk in the dark with their head held in different orientations. Depending on head orientation, we can either steer walking by "remote control" or produce balance disturbances. This shows that the brain resolves the canal signal according to head posture into Earth-referenced orthogonal components and uses rotations in vertical planes to control balance and rotations in the horizontal plane to navigate. Because the semicircular canals are concerned with movement rather than detecting vertical alignment, this result shows the importance of movement control and agility rather than precise vertical alignment of the body for human bipedalism.

Afferent innervation patterns of the pigeon horizontal crista ampullaris

The vestibular semicircular canals are responsible for detection of rotational head motion although the precise mechanisms underlying the transduction and encoding of movement information are still under study. In the present investigation, we utilized neural tracers and immunohistochemistry to quantitatively examine the topology and afferent innervation patterns of the horizontal semicircular canal crista (HCC) in pigeons (Columba livia). Two hundred and eighty-six afferents from five horizontal canal organs were identified of which 92 units were sufficiently labeled and isolated to perform anatomical reconstructions. In addition, a three-dimensional contour map of the crista was constructed. Bouton afferents were located only in the peripheral regions of the receptor epithelium. Bouton afferents had the most complex innervation patterns with significantly longer and more numerous branches as well as a higher branch order than any other fiber type. Bouton fibers also contained significantly more bouton terminals than did dimorph afferents. Calyx afferents were located only in the apex and central planar regions. Calyx fibers had the largest axonal diameters yet the smallest fiber lengths and innervation areas, the fewest number of branches, the lowest branch order, and the fewest total number of terminals of all fiber types. Dimorph afferents were located throughout the central crista with afferent terminations that were larger and more complex than calyx fibers but less so than bouton fibers. Overall, the pigeon HCC morphology and innervation shares many common features with those of other animal classes.

Semicircular canal geometry, afferent sensitivity, and animal behavior

The geometry of the semicircular canals has been used in evolutionary studies to predict the behaviors of extinct animals. These predictions have relied on an assumption that the responses of the canals can be determined from their dimensions, and that an organism's behavior can be determined from these responses. However, the relationship between a canal's sensitivity and its size is not well known. An intraspecies comparison among canal responses in each of three species (cat, squirrel monkey, and pigeon) was undertaken to evaluate various models of canal function and determine how their dimensions may be related to afferent physiology. All models predicted the responses of the cat afferents, but the models performed less well for squirrel monkey and pigeon. Possible causes for this discrepancy include incorrectly assuming that afferent responses accurately represent canal function or errors in current biophysical models of the canals. These findings leave open the question as to how reliably canal anatomy can be used to estimate afferent responses and how closely afferent responses are related to behavior. Other labyrinthine features, such as orientation of the horizontal canal, which is reliably held near earth-horizontal across many species, may be better to use when extrapolating the posture and related behavior of extinct animals from labyrinthine morphology.

Inferior olive and oculomotor system

Three subnuclei within the inferior olive are implicated in the control of eye movement; the dorsal cap (DC), the beta-nucleus and the dorsomedial cell column (DMCC). Each of these subnuclei can be further divided into clusters of cells that encode specific parameters of optokinetic and vestibular stimulation. DC neurons respond to optokinetic stimulation in one of three planes, corresponding to the anatomical planes of the semicircular canals. Neurons in the beta-nucleus and DMCC respond to vestibular stimulation in the planes of the vertical semicircular canals and otoliths. Each these olivary nuclei receives excitatory and inhibitory signals from pre-olivary structures. The DC receives excitatory signals from the ipsilateral nucleus of the optic tract (NOT) and inhibitory signals from the contralateral nucleus prepositus hypoglossi (NPH). The beta-nucleus and DMCC receive inhibitory signals from the ipsilateral nucleus parasolitarius (Psol) and excitatory signals from the contralateral dorsal Y group. Consequently, the olivary projection to the cerebellum, although totally crossed, still represents bilateral sensory stimulation. Inputs to the inferior olive from the NOT, NPH, Psol or Y-group discharge at frequencies of 10-100 imp/s. CFRs discharge at 1-5 imp/s; a frequency reduction of an order of magnitude. Inferior olivary projections to the contralateral cerebellum are sagittally arrayed onto multiple cerebellar folia. These arrays establish coordinate systems in the flocculus and nodulus, representing head-body movement. These climbing fiber-defined spatial coordinate systems align Purkinje cell discharge onto subjacent cerebellar and vestibular nuclei. In the oculomotor system, olivo-cerebellar circuitry enhances and modifies eye movements based on movement of the head-body in space.

Anterior canal neurons in cat vestibular nuclei have large phase leads during low frequency vertical axis pitch

Vestibulo-ocular and second-order neurons in medial and superior vestibular nuclei of alert cats were identified by antidromic and orthodromic electrical stimulation, and their responses to whole body rotations were recorded in the dark. Neurons that had spatial sensitivity most closely aligned with the anterior canal (anterior canal neurons) were compared with neurons that had spatial sensitivity most closely aligned with the posterior canal (posterior canal neurons). Responses were recorded during low frequency earth-horizontal axis pitch rotations in the normal upright posture, and during earth-vertical axis pitch with the head and body lying on the left side. During upright pitch, response phases of anterior canal neurons slightly lagged those of posterior canal neurons or primary vestibular afferents, as previously reported. During on-side pitch, anterior canal neurons showed far greater phase leads with respect to head velocity than posterior canal neurons, primary vestibular afferents, or previously reported vestibulo-ocular reflex eye movements. These results provide challenges for vestibulo-ocular reflex models to incorporate central mechanisms for phase leads among the inputs to anterior canal neurons and to explain how the anterior canal neuron signals reported here combine with other signals to produce observed vestibulo-ocular reflex behavior.

The anatomy of the vestibular nuclei

The vestibular portion of the eighth cranial nerve informs the brain about the linear and angular movements of the head in space and the position of the head with respect to gravity. The termination sites of these eighth nerve afferents define the territory of the vestibular nuclei in the brainstem. (There is also a subset of afferents that project directly to the cerebellum.) This chapter reviews the anatomical organization of the vestibular nuclei, and the anatomy of the pathways from the nuclei to various target areas in the brain. The cytoarchitectonics of the vestibular brainstem are discussed, since these features have been used to distinguish the individual nuclei. The neurochemical phenotype of vestibular neurons and pathways are also summarized because the chemical anatomy of the system contributes to its signal-processing capabilities. Similarly, the morphologic features of short-axon local circuit neurons and long-axon cells with extrinsic projections are described in detail, since these structural attributes of the neurons are critical to their functional potential. Finally, the composition and hodology of the afferent and efferent pathways of the vestibular nuclei are discussed. In sum, this chapter reviews the morphology, chemoanatomy, connectivity, and synaptology of the vestibular nuclei.

Contribution of Endolymphatic Fluid Shift to Caloric Response in Plugged Semicircular Canals

The purpose of this study was to clarify the role of endolymphatic fluid shift in caloric response, using frog posterior semicircular canals (PSCs). PSCs were sutured using 10-0 nylon thread and were used as a model of canal plugging. Compound action potentials (CAPs) of the PSC nerve evoked by a cooling stimulus were recorded. The CAPs after suturing the PSCs were found to be greater than those before suturing. This indicates that the fluid shift effect increases after canal suturing. Additionally, we present a clinical case in which caloric nystagmus was observed after lateral canal plugging. In this case MRI revealed the fluid space from the plugged portion toward the ampulla to be intact. There was another case with lateral canal plugging that showed the same findings on MRI. The above findings support the hypothesis that fluid shift is responsible for the caloric response without the convective flow of endolymph in the plugged canal.

Histamine (H3) receptors modulate the excitatory amino acid receptor response of the vestibular afferents

Although the effectiveness of histamine-related drugs in the treatment of peripheral and central vestibular disorders may be explained by their action on the vestibular nuclei, it has also been shown that antivertigo effects can take place at the peripheral level. In this work, we examined the actions of H3 histaminergic agonists and antagonists on the afferent neuron electrical discharge in the isolated inner ear of the axolotl. Our results indicate that H3 antagonists such as thioperamide, clobenpropit, and betahistine (BH) decreased the electrical discharge of afferent neurons by interfering with the postsynaptic response to excitatory amino acid agonists. These results lend further support to the idea that the antivertigo action of histamine-related drugs may be caused, at least in part, by a decrease in the sensory input from the vestibular endorgans. The present data show that the inhibitory action of the afferent neurons discharge previously described for BH is not restricted to this molecule but is also shared by other H3 antagonists.

Immunocytochemical and pharmacological characterization of metabotropic glutamate receptors of the vestibular end organs in the frog

Using immunocytochemistry and multiunit recording of afferent activity of the whole vestibular nerve, we investigated the role of metabotropic glutamate receptors (mGluR) in the afferent neurotransmission in the frog semicircular canals (SCC). Group I (mGluR1alpha) and group II (mGluR2/3) mGluR immunoreactivities were distributed to the vestibular ganglion neurons, and this can be attributed to a postsynaptic locus of metabotropic regulation of rapid excitatory transmission. The effects of group I/II mGluR agonist (1S,3R)-1-aminocyclopentane-trans-1,3-dicarboxylic acid (ACPD) and antagonist (R,S)-alpha-methyl-4-carboxyphenylglycine (MCPG) on resting and chemically induced afferent activity were studied. ACPD (10-100 microM) enhanced the resting discharge frequency. MCPG (5-100 microM) led to a concentration-dependent decrease of both resting activity and ACPD-induced responses. If the discharge frequency had previously been restored by L-glutamate (L-Glu) in high-Mg2+ solution, ACPD elicited a transient increase in the firing rate in the afferent nerve suggesting that ACPD acts on postsynaptic receptors. The L-Glu agonists, alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) and N-methyl-D-aspartate (NMDA), were tested during application of ACPD. AMPA- and NMDA-induced responses were higher in the presence than absence of ACPD, implicating mGluR in the modulation of ionotropic glutamate receptors. These results indicate that activation of mGluR potentiates AMPA and NMDA responses through a postsynaptic interaction. We conclude that ACPD may exert modulating postsynaptic effects on vestibular afferents and that this process is activity-dependent.

Otolith and canal reflexes in human standing

We used galvanic vestibular stimulation (GVS) to identify human balance reflexes of the semicircular canals and otolith organs. The experiment used a model of vestibular signals arising from GVS modulation of the net signal from vestibular afferents. With the head upright, the model predicts that the GVS-evoked canal signal indicates lateral head rotation while the otolith signal indicates lateral tilt or acceleration. Both signify body sway transverse to the head. With the head bent forward, the model predicts that the canal signal indicates body spin about a vertical axis but the otolith signal still signifies lateral body motion. Thus, we compared electromyograms (EMG) in the leg muscles and body sway evoked by GVS when subjects stood with the head upright or bent forward. With the head upright, GVS evoked a large sway in the direction of the anodal electrode. This response was abolished with the head bent forward leaving only small, oppositely directed, transient responses at the start and end of the stimulus. With the head upright, GVS evoked short-latency (60-70 ms), followed by medium-latency (120 ms) EMG responses, of opposite polarity. Bending the head forward abolished the medium-latency but preserved the short-latency response. This is compatible with GVS evoking separate otolithic and canal reflexes, indicating that balance is controlled by independent canal and otolith reflexes, probably through different pathways. We propose that the short-latency reflex and small transient sway are driven by the otolith organs and the medium-latency response and the large sway are driven by the semicircular canals.

Acoustic Responses of Vestibular Afferents in a Model of Superior Canal Dehiscence

HYPOTHESIS

Afferents innervating the superior semicircular canal are rendered especially sensitive to acoustic stimulation when there is a dehiscence of the superior canal. Other vestibular end organs are also more sensitive to acoustic stimulation.

BACKGROUND

Dehiscence of the superior semicircular canal is associated with vertigo and nystagmus caused by loud sounds (Tullio phenomenon) or changes in middle ear or intracranial pressures. The mechanisms by which acoustic stimuli act on the vestibular end organs are unclear. The nystagmus caused by acoustic stimuli generally aligns with the affected superior canal.

METHODS

Responses to acoustic stimuli in the superior vestibular nerves of anesthetized chinchillas were recorded before and after fenestration of the superior canal.

RESULTS

Two acoustic response patterns were seen: rapid phase locking and slow tonic changes in firing rate. Phasic responses principally occurred in irregular afferents and tonic responses in regular afferents. Afferents from all of the vestibular end organs encountered could respond to acoustic stimuli, even before fenestration. However, fenestration lowered the thresholds for acoustic stimulation in superior canal afferents with phasic responses and increased the magnitude of tonic responses.

CONCLUSIONS

Superior canal dehiscence may render the irregular afferents innervating the superior canal particularly sensitive to loud sounds. Rapid phase-locking responses may explain the short latency of nystagmus seen in patients with superior canal dehiscence syndrome. The mechanisms by which acoustic stimuli activate the vestibular end organs may differ from the damped endolymph motion associated with head acceleration.

Properties of horizontal semicircular canal nerve-activated vestibulospinal neurons in cats

Axonal pathways, projection levels, and locations of horizontal semicircular canal (HC) nerve-activated vestibulospinal neurons were studied. The HC nerve was selectively stimulated. Vestibulospinal neurons were activated antidromically with four stimulating electrodes, inserted bilaterally into the lateral vestibulospinal tracts (LVST) and medial vestibulospinal tracts (MVST) at the C1/C2 junction. Stimulating electrodes were also positioned in the C3, T1, and L3 segments and in the oculomotor nuclei. Most HC nerve-activated vestibulospinal neurons were located in the ventral portion of the medial, lateral, and the descending nuclei. Among the 157 HC nerve-activated vestibular neurons, 83 were antidromically activated by stimulation at the C1/C2 junction. Of these 83 neurons, axonal pathways of 56 HC nerve-activated vestibulospinal neurons were determined. Most (48/56) of these had axons that descended through the MVST, with the remainder (8 neurons) having axons that descended through the ipsilateral (i-) LVST. Laterality of the axons' trajectories through the MVST was investigated. The majority of vestibulospinal neurons (24/28) with axons descending through the contralateral MVST were also antidromically activated from the oculomotor nucleus, whereas almost all vestibulospinal neurons (19/20) with axons descending through the i-MVST were not. Most HC nerve-activated vestibulospinal neurons were activated antidromically only from the C1/C2 or C3 segments. Only one neuron that was antidromically activated from the T1 segment had an axon that descended through the i-LVST. None of the HC nerve-activated vestibulospinal neurons were antidromically activated from the L3 segment. It is likely that the majority of HC nerve-activated vestibulospinal neurons terminate in the cervical cord and have strong connections with neck motoneurons.

Central distribution of vestibular afferents that innervate the anterior or lateral semicircular canal in the mongolian gerbil

The central distribution of afferents that innervate the crista ampullaris of the anterior or lateral semicircular canals was determined in gerbils following the direct injection of tracers into one sensory neuroepithelia. Labeled somata were scattered throughout the superior ganglion. The central distribution of fibers demonstrated extensive overlap. The central branch of afferents innervating either canal was located in the rostral part of the nerve. Nerve fibers divided into ascending and descending branches. Ascending branch ramifications terminated in the superior vestibular nucleus, the magnocellular and parvicellular medial vestibular nuclei, and the cerebellum. Cerebellar terminal areas include the flocculus, nodulus and uvula. Descending branch ramifications terminated in the caudal medial, parvicellular medial and descending vestibular nuclei, and the nucleus prepositus hypoglossi. Lateral canal afferents terminated sparsely in nucleus cuneatus. The anterior canal had sparse innervation in the paratrigeminal and gigantocellular reticular formation. This study has shown many similarities in the central distribution of fibers that innervate the anterior and lateral canals and a few areas of segregated input. Projections outside the vestibular nuclei are more extensive than previously determined, including afferents to prepositus hypoglossi, cochlear nuclei, and reticular formation. Projections to the flocculus appear as numerous as those to the vermis.

Octavolateral projections and organization in the medulla of a teleost fish, the sleeper goby (Dormitator latifrons)

This study is the first to employ simultaneous labeling with different colored fluorescent dyes and confocal microscopy to investigate the central projections of the octavolateral nerves in any fish. Three-dimensional reconstructions of the hindbrain octavolateral nuclei were made and overlap of octavolateral projections was assessed in a teleost, the sleeper goby (Dormitator latifrons). The octavolateral nerves, which innervate the otolithic organs, semicircular canals, and lateral lines, project to seven hindbrain nuclei in diverse, complex patterns. The medulla is generally organized with auditory regions dorsal to vestibular regions. The intermediate subdivision of the descending octaval nucleus (DON) receives interdigitating projections from the otolithic organs, and the dorsomedial DON likely integrates multiple auditory inputs. Afferents from the three otolithic organs (the utricle, saccule, and lagena) project to the intermediate DON in approximately equal proportion, supporting physiological evidence that suggests auditory roles for all three otolithic organs in the sleeper goby. The anterior octaval nucleus receives partially segregated inputs from the octavolateral organs. The dorsal division of the magnocellular octaval nucleus (MgON) receives highly overlapping otolithic organ and semicircular canal input, and we propose that this region is a major octaval integration center. Regions in the ventral medulla (the tangential octaval nucleus, ventral DON, and ventral MgON) receive mainly utricular and semicircular canal inputs, suggesting vestibular roles. Each semicircular canal nerve projects to distinct regions of the hindbrain, with little overlap in most octaval nuclei. Efferent neurons receive bilateral input and project unilaterally to the octavolateral organs.

Ultrastructural observations of efferent terminals in the crista Ampullaris of the toadfish, opsanus tau

The present study was conducted to visualize the ultrastructural features of vestibular efferent boutons in the oyster toadfish, Opsanus tau. The crista ampullaris of the horizontal semicircular canal was processed for and examined by routine transmission electron microscopy. The results demonstrate that such boutons vary in size and shape, and contain a heterogeneous population of lucent vesicles with scattered dense core vesicles. Efferent contacts with hair cells are characterized by local vesicle accumulations in the presynaptic terminal and a subsynaptic cistern in the postsynaptic region of the hair cell. Serial efferent to hair cell to afferent synaptic arrangements are common, particularly in the central portion of the crista. However, direct contacts between efferent terminals and afferent neurites were not observed in our specimens. The existence of serial synaptic contacts, often with a row of vesicles in the efferent boutons lining the efferent-afferent membrane apposition, suggests that the efferent influence on the crista may involve both synaptic and nonsynaptic, secretory mechanisms. Further, it is suggested that differences in more subtle aspects of synaptic architecture and/or transmitter and receptor localization and interaction may render the efferent innervation of the peripheral crista less effective in influencing sensory processing.

[Absence of the effect of opioid peptides on muscarine receptors in the frog vestibular apparatus]

We studied the effects of opioid peptide leu-enkephaline, a specific antagonist of acetylcholine receptors atropine, and non-selective opiate antagonist naloxone on synaptic transmission and responses evoked by acetylcholine in semicircular organs of the frog. A decrease in frequency of acetylcholine (0.1-5.0 microM) responses under leu-enkephaline (10 nM) id not differ from the frequency decline induced by leu-enkephaline alone. Atropine (1 microM) left the response to leu-enkephaline intact while blocking the excitatory effect of acetylcholine. No modification of the acetylcholine response under leu-enkephaline was observed in the presence of naloxone (1 microM). The findings suggest that no interaction exists between the acetylcholine-mediated excitatory action on resting activity in the isolated semicircular canal preparation and the suppressive action of leu-enkephaline.

Vestibular convergence patterns in vestibular nuclei neurons of alert primates

Sensory signal convergence is a fundamental and important aspect of brain function. Such convergence may often involve complex multidimensional interactions as those proposed for the processing of otolith and semicircular canal (SCC) information for the detection of translational head movements and the effective discrimination from physically congruent gravity signals. In the present study, we have examined the responses of primate rostral vestibular nuclei (VN) neurons that do not exhibit any eye movement-related activity using 0.5-Hz translational and three-dimensional (3D) rotational motion. Three distinct neural populations were identified. Approximately one-fourth of the cells exclusively encoded rotational movements (canal-only neurons) and were unresponsive to translation. The canal-only central neurons encoded head rotation in SCC coordinates, exhibited little orthogonal canal convergence, and were characterized with significantly higher sensitivities to rotation as compared to primary SCC afferents. Another fourth of the neurons modulated their firing rates during translation (otolith-only cells). During rotations, these neurons only responded when the axis of rotation was earth-horizontal and the head was changing orientation relative to gravity. The remaining one-half of VN neurons were sensitive to both rotations and translations (otolith + canal neurons). Unlike primary otolith afferents, however, central neurons often exhibited significant spatiotemporal (noncosine) tuning properties and a wide variety of response dynamics to translation. To characterize the pattern of SCC inputs to otolith + canal neurons, their rotational maximum sensitivity vectors were computed using exclusively responses during earth-vertical axis rotations (EVA). Maximum sensitivity vectors were distributed throughout the 3D space, suggesting strong convergence from multiple SCCs. These neurons were also tested with earth-horizontal axis rotations (EHA), which would activate both vertical canals and otolith organs. However, the recorded responses could not be predicted from a linear combination of EVA rotational and translational responses. In contrast, one-third of the neurons responded similarly during EVA and EHA rotations, although a significant response modulation was present during translation. Thus this subpopulation of otolith + canal cells, which included neurons with either high- or low-pass dynamics to translation, appear to selectively ignore the component of otolith-selective activation that is due to changes in the orientation of the head relative to gravity. Thus contrary to primary otolith afferents and otolith-only central neurons that respond equivalently to tilts relative to gravity and translational movements, approximately one-third of the otolith + canal cells seem to encode a true estimate of the translational component of the imposed passive head and body movement.

Convergence of the anterior semicircular canal and otolith afferents on cat single vestibular neurons

The convergence between the anterior semicircular canal (AC) and utricular (UT) inputs, as well as the convergence between the AC and saccular (SAC) inputs in single vestibular neurons of decerebrated cats were investigated. Postsynaptic potentials were recorded intracellularly after selective stimulation of each pair of vestibular nerves AC/UT or AC/SAC. Neurons were recorded from the central parts of the vestibular nuclei, where the otolith afferents mainly terminate. Of a total of 105 neurons that were activated after stimulation of the AC and UT nerves, 42 received convergent inputs. Thirty-eight of these neurons received excitatory inputs from both afferents. Convergent neurons were further classified into vestibulospinal (n=28) and vestibulooculospinal (n=6) neurons by antidromic activation from the border between the C1 and C2 spinal cord and the oculomotor or trochlear nucleus. Eight neurons that were not antidromically activated from either site were classified as vestibular neurons. Forty three percent of the convergent vestibulospinal neurons and most of the convergent vestibulooculospinal neurons projected to the spinal cord through the medial vestibulospinal tract. The remaining vestibulospinal and vestibulooculospinal neurons descended through the ipsilateral lateral vestibulospinal tract. Of a total of 118 neurons that were activated after stimulation of the AC and/or SAC nerves, 51 received convergent inputs (27 vestibulospinal, 4 vestibulooculospinal, 5 vestibuloocular and 15 vestibular neurons). Forty-two of the convergent neurons received excitatory inputs from both afferents. Thirty seven percent of the convergent vestibulospinal neurons and all of the convergent vestibulooculospinal neurons projected to the spinal cord through the medial vestibulospinal tract. The remaining vestibulospinal and vestibulooculospinal neurons descended through the ipsilateral lateral vestibulospinal tract.

Results of singular neurectomy in the posterior ampullary recess

OBJECTIVE

To determine the effect on hearing and balance symptoms following singular neurectomy (SN) for benign paroxysmal positional vertigo (BPPV) in the ampullary recess of the posterior semicircular canal.

RESEARCH DESIGN

The charts of 242 patients with chronic disabling BPPV who were treated with SN over a 29-year period (1972-2001) were reviewed. The results on relief of BPPV and hearing function were recorded. A subset of 16 patients where the posterior ampullary recess was entered to expose the SN is described in detail with regard to an effect on hearing and balance.

RESULTS

A total of 252 SN were performed in 242 patients. Ten patients underwent bilateral SN sequentially; the remaining 232 patients had unilateral SN. The ages of the patients ranged from 21 to 86 years, with a mean at 57 years. The female:male ratio was 174:68. Complete relief of BPPV was achieved in 244 patients (96.8%), incomplete relief in 3 (1%), and no relief in 5 (2%). Sensorineural hearing loss (SNHL) occurred in 9 patients (3.7%). A subset of 16 patients in whom the ampullary recess was opened during SN ranged in age from 21 to 79 years, with a mean at 56 years. The female:male ratio was 12:4, with right and left sides divided almost equally. Relief of BPPV was achieved in all 16 patients with no loss of hearing function. Five patients complained of a fistula response postoperatively (31%). The fistula response resolved by 6 months postoperatively in all 5 patients.

CONCLUSIONS

SN is effective in relief of BPPV with little risk of SNHL (3.7%). The risk of SNHL is not increased when the posterior ampullary recess must be entered in order to transect the singular nerve. A positive fistula response may be present temporarily in almost one third of these patients.

Fiber diameter distributions in the chinchilla's ampullary nerves

A morphometric study of the chinchilla's ampullary nerves was conducted to produce an unbiased accounting of the diameter distribution of their constituent fibers. Diameter analyses were determined from 1 microm plastic-embedded nerve sections taken at a plane immediately proximal to the sensory epithelium. We found these nerves to be composed of 2094+/-573 fibers, having diameters that ranged from 0.5 to 8 microm. The distributions of diameters were positively skewed, where approximately 75% of the fibers were found to have diameters less than 3.5 microm. An analysis of the spatial distribution of diameters within the nerve section revealed that the lateralmost areas of the nerve contained larger fractions of fibers within the smallest diameter quintiles, and the central area harbored greater proportions of the larger diameter quintiles. However, significant fractions of all quintiles were found in all areas. These data were integrated with available data of Fernandez et al. (1998) to produce diameter estimates of calyx, dimorphic, and bouton morphology subpopulations. In view of a general relationship between diameter, innervation locus, and an afferent's physiologic characteristics, these data provide the basis for developing a perspective for the in situ distribution of afferent response dynamics.

Convergence of ipsilateral semicircular canal inputs onto single vestibular nucleus neurons in cats

Convergent inputs from the ipsilateral semicircular canal nerves onto single vestibular nucleus neurons were investigated in decerebrate cats using intracellular recording after selective stimulation of each ampullar nerve. One hundred and seventy-four neurons were activated by stimulating the anterior semicircular (AC) and/or posterior semicircular canal (PC) nerves. These neurons were also antidromically stimulated and classified according to the pattern of their collateral projections to the oculomotor complex and the spinal cord. Four types were found: vestibulo-ocular (VO), vestibulospinal (VS), vestibulo-oculospinal (VOS), and vestibular (V) neurons, the latter of which were not activated by stimulation of either the oculomotor complex or the spinal cord. Of 174 AC- and/or PC-activated vestibular nucleus neurons, 32 (18%) received convergent inputs from both nerves. These convergent neurons included 11 VS, 6 VOS, and 15 V neurons. We found no VO neurons with convergent input. The vast majority (82%) of AC/PC-activated VS and VOS convergent neurons received excitatory inputs from both nerves, 12% received reciprocal inputs (i.e., excitatory from one and inhibitory from the other), and the remaining neurons received inhibitory inputs from both nerves. By stimulating the horizontal semicircular (HC) and/or PC nerves, 183 neurons were activated. Of these, 44 (24%) received convergent inputs from both nerves. These convergent neurons included 19 VS, 5 VOS, 2 VO, and 18 V neurons. Approximately one-half (46%) of HC/PC-activated VS and VOS convergent neurons received excitatory inputs from both nerves and 42% received reciprocal inputs, and the remaining neurons received inhibitory inputs from both nerves. In both nerve pairs, the percentage of VS neurons was higher (AC/PC, 34%; HC/PC, 43%) than that of VOS or VO neurons. Approximately half of these convergent neurons were located in the lateral nucleus. These results suggest that, during mixed angular head accelerations, the vestibulocollic reflex may be partly accomplished by VS and VOS convergent neurons.

Functional recovery of anterior semicircular canal afferents following hair cell regeneration in birds

Streptomycin sulfate (1.2 g/kg i.m.) was administered for 5 consecutive days to 5-7-day-old white Leghorn chicks; this causes damage to semicircular canal hair cells that ultimately regenerate to reform the sensory epithelium. During the recovery period, electrophysiological recordings were taken sequentially from anterior semicircular canal primary afferents using an indentation stimulus of the canal that has been shown to mimic rotational stimulation. Chicks were assigned to an early (14-18 days; n = 8), intermediate (28-34 days; n = 5), and late (38-58 days; n = 4) period based on days after treatment. Seven untreated chicks, 15-67 days old, provided control data. An absence of background and indent-induced discharge was the prominent feature of afferents in the early period: only "silent" afferents were encountered in 5/8 experiments. In several of these chicks, fascicles of afferent fibers were seen extending up to the epithelium that was void of hair cells, and intra- and extracellular biocytin labeling revealed afferent processes penetrating into the supporting cell layer of the crista. In 3/8 chicks 74 afferents could be characterized, and they significantly differed from controls (n = 130) by having a lower discharge rate and a negligible response to canal stimulation. In the intermediate period there was considerable variability in discharge properties of 121 afferents, but as a whole the number of "silent" fibers in the canal nerve diminished, the background rate increased, and a response to canal stimulation detected. Individually biocytin-labeled afferents had normal-appearing terminal specializations in the sensory epithelium by 28 days poststreptomycin. In the late period, afferents (n = 58) remained significantly different from controls in background discharge properties and response gain. The evidence suggests that a considerable amount of variability exists between chicks in the return of vestibular afferent function following ototoxic injury and that the secretory function of regenerating hair cells might become functional before their transducer function.

Neural representations of the axis of acoustic particle motion in nucleus centralis of the torus semicircularis of the goldfish, Carassius auratus

Experiments examined differential coding of acoustic particle motion axis in the auditory midbrain of goldfish. Animals were exposed to vibratory stimuli varying in axis orientation as action potentials were recorded from single units in the central neuropil of nucleus centralis in the torus semicircularis. Response magnitudes as a function of stimulation axis were visualized in three dimensional plots called directional response profiles. These are generally comparable to directional responses observed among primary saccular afferents in having substantially vertical orientations. Distortions in shape from the peripheral patterns indicate neural information processing. A three-dimensional model was used to evaluate the hypothesis that responses in the auditory midbrain reflect the convergence of excitatory and inhibitory primary afferent-like responses. Model afferent inputs were generated and combined arithmetically. This analysis gives insight into the mechanisms of information processing that appear to occur in brainstem nuclei. The lack of diversity in best axis directions suggests that this mechanism alone cannot account for directional hearing abilities in this species. The roles that this directional representation and processing may play in directional hearing and sound source localization are not yet clear. Implications of these data on current models of fish directional hearing are discussed.

Relationship between inner-ear fluid pressure and semicircular canal afferent nerve discharge

The present study was designed to determine (1) the transcupular fluid pressure (deltaP) generated across the semicircular canal cupula in response to sinusoidal head rotation, (2) the translabyrinthine dilational pressure (P0) generated across the membranous labyrinth in response to an increase in endolymph fluid volume (hydrops), (3) afferent nerve discharge patterns generated by these distinct pressure stimuli and, (4) threshold values of deltaP and P0 required to elicit afferent neural responses. The experimental model was the oyster toadfish, Opsanus tau. Micromechanical indentation of the horizontal canal (HC) duct and utricular vestibule was used to simulate sinusoidal head rotation and fluid volume injection. Single-unit neural spike trains and endolymph pressure within the ampulla, on both sides of the cupula, were recorded simultaneously. deltaP averaged 0.013 Pa per 1 degrees/s of sinusoidal angular head velocity and P0 averaged 0.2 Pa per 1 nL of endolymph volume injection. The most responsive afferents had a threshold sensitivity to deltaP of 10(-3) Pa and to P0 of 5 x 10(-2) Pa based on a discharge modulation criterion of 1 impulse/s per cycle for 2 Hz pressure stimuli. Neural sensitivity to AP was expected on the basis of transverse cupular and hair bundle deflections. Analysis of mechanics of the end organ, neuronal projections into the crista, and individual neural firing patterns indicates that P0 sensitivity resulted from pressure-induced distension of the ampulla that led to a nonuniform cupular deformation pattern and hair bundle deflections. This explanation is consistent with predictions of a finite element model of the end organ. Results have implications regarding the role of deltaP in angular motion transduction and the role of P0 under transient hydropic conditions.

Functional physiology of the semicircular canal ampulla

Physiology of the semicircular canal (sc) was studied by applying different manipulations to the isolated frog sc. Function of the cupula was investigated by mapping out the mechanical sensitivity on the cupular surface and by removing and replacing the cupula. The cupula was found to be most essential for effective activation of sc receptors. Responses of sc receptors to direct temperature change were studied. The sc nerve discharge increased and decreased due to cool and warm temperature change respectively. This suggests a possibility of direct temperature effect as one of the mechanisms of caloric response.

A model of cerebellar computations for dynamical state estimation

The cerebellum is a neural structure that is essential for agility in vertebrate movements. Its contribution to motor control appears to be due to a fundamental role in dynamical state estimation, which also underlies its role in various non-motor tasks. Single spikes in vestibular sensory neurons carry information about head state. We show how computations for optimal dynamical state estimation may be accomplished when signals are encoded in spikes. This provides a novel way to design dynamical state estimators, and a novel way to interpret the structure and function of the cerebellum.