tion) in nystagmus from their vodka subjects,
84 hours after the ingestion of alcohol. A factor
possibly affecting the latter authors’ findings was
their use of some “habituated” subjects; the re-
ported enhancement may conceivably represent
release of the central habituating mechanism in
those subjects due to the alcohol. (Aschan! has
presented data, primarily from fighter pilots,
which indicate that alcohol may eliminate estab-
lished response declines to vestibular stimulation.)
In addition, our subjects made active head move-
ments (involving neck reflexes), while theirs
received passive, whole-body tilts during rotation.

Congeners. Although there were minor differ-
ences between the Bourbon and Vodka groups,
there were no consistent effects which might in-
dicate more severe or longer-lasting influences
on vestibular nystagmus of a congener as op-
posed to a non-congener beverage. Also, the
incidence of headache or hangover as reported
by our subjects was somewhat higher for Vodka
subjects (non-congener) than for Bourbon sub-
jects (congener).

vy. Summary.

1. More spontaneous nystagmus was recorded
from our Controls than might be expected from

16

ee

previous studies. This nystagmus occurred in-
termittently in several subjects and at least once
for each man throughout the trials. Our method
of recording in a dark room from an alert sub-
ject with open eyes and/or the influence of neck
reflexes occasioned by turning the head right or
left may have contributed to this spontaneous
response.

2. The usual PAN I and PAN ITI responses
were obtained. In addition, a positional nys-
tagmus beating in the same direction as PAN I
was recorded during periods 24-32 hours after
the ingestion of alcohol.

3. Alcohol served mainly to depress vestibular
responses in darkness. Decreases in turning sen-
sations and in nystagmic responses to angular
acceleration occurred primarily during the first
hour or two after drinking. In general, alcohol
produced no consistent effects on either the verti-
cal nystagmus or the vertigo produced by Coriolis
stimulation. Coriolis responses 24-30 hours
after the ingestion of alcohol showed a reduction
in both duration and frequency of nystagmus
over pre-drinking response levels.

4, There appeared to be no consistent differ-
ential vestibular effects between congener and
non-congener beverages in our subjects.

a

10.

1.

12.

138.



P
i
} CONTROL GROUP

NYSTAGMUS FREQUENCY (BEATS /SEC)

. 8 7 me a oi a 0 68 re
TIME IN SECONDS

STIMULUS: OW ACCEL St/9ECE FOR 18 SEC

a
*F

Freure 8. Time-course plots of the frequency of nystagmus in 3-second intervals for the Pre, 24-hour, and 30-

hour angular accelerations, Eye-movement frequency was not significantly changed by the repeated trials _ }
Compare with Figure 7. te
i
HOP .
Ze 100 F iH
= ws
ws 90
z
°36
ra
zie sok
on
RZ
ti 70F GROUP: CONTROL o——o
x VODKA ©e—®*
oO o_o
a Z 60+ BOURBON 4& «
Zz 2
© so ACCELERATION: 5*/SEC® FOR 18 SEC ese
Fa .

{4 Fy

PRE | 2 3 4

ures with those obtained 24 and 30 hours post-

ingestion indigoted no nystagmus enhancement
for the alcohol groups.

In general, the statistical analyses provided
no evidence for a significant pattern of change
across sessions (Table 8), and only two of 72

5 6 7 8 24 30
HOURS AFTER DRINKING

Fievre 9. Duration of the turning sensatidn for each session expressed as a percentage of the Pre-drinking level.
A sharp reduction in the sensation time is correlated with peak blood-alcohol levels. Recovery was more
rapid for the Bourbon than for the Vodka group. Control subjects demonstrated little change.

comparisons yielded significant differences among
the three groups (Table 9).

Coriolis Vertigo. The duration and the aver-
age rated intensity of the Coriolis sensations
were relatively similar for both Tilt and Return
movements of the head within each group (see 22 £



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ALCOHOL AND DISORIENTATION-RELATED RESPONSES. V. THE
INFLUENCE OF ALCOHOL ON POSITIONAL, ROTATORY, AND
CORIOLIS VESTIBULAR RESPONSES OVER 32-HOUR PERIODS

I. Problem.

The concern that alcohol ingestion compro-
mises the flying ability of pilots is manifest in
the recent FAA regulation (FAR 91.11) pro-
hibiting the drinking of alcoholic beverages
during the 8-hour period prior to flying. Com-
mercial airline companies have for years imposed
a stricter limitation on their pilots in banning
the use of alcohol for 24 hours preceding flight-
time. However, there are some indications in
the literature that the systems most closely asso-
ciated with disorientation responses—the visual
and vestibular systems—may continue to show
effects of alcohol ingestion for periods in excess
of 24 hours.*? These éffects may be evident both
in static vestibular reactions (e.g., positional
alcohol nystagmus; a patterned eye-movement.
response that occurs when the head is placed in
certain positions after drinking alcohol) and in
dynamic reactions such as those which produce
Coriolis vestibular effects. The present study
sought to clarify some influences of alcohol on
both static and dynamic vestibular responses
over 32-hour post-drinking periods.

Static Effects. Aschan, Bergstedt, Goldberg,
and Laurell? described in detail two types of
positional alcohol nystagmus (PAN): Type I,
that beating in the direction of the lower ear
(when the subject is lying on his side or when
the subject rolls his head to one side while lying
in a supine position), and Type II, beating in

gfrom the Psychology Laboratory, CAMI, and the
Department of Otorhinolaryngology, University of
Oklahoma Medical Wenter. ‘The assistance of Blair
Fennell, Cynthia Cochran, RuthAnn Parvin, and Carlyn
Manley In the conduct of the study and of Dr. Delbert
Lacefield and Mrs. Pat Roberts in the analysis of the
blood samples ts gratefully acknowledged.

the direction opposite the lower ear. They found
PAN I to begin approximately 30 minutes after
the ingestion of alcohol and to persist for several
hours, followed first by a latency period during
which no positional alcohol nystagmus could be
demonstrated, and then by PAN II which began
about 5-6 hours after ingestion, Aschan et al.?
reported PAN II to persist for various periods
of time up to the fourteenth hour after alcohol
ingestion.

Alcohol nystagmus occurring later than 14
hours has rarely been noted in the literature
although Plenkers** and Walter reported direct
observation of the response (subjects wore
Frenzel glasses) through 20 and 16 hours, re-
spectively, following alcohol ingestion. In
Plenker’s study, one patient showed a PAN II
response 20 hours after drinking at which time
measurable concentrations of alcohol were still
in his blood. The 16-hour post-drinking response
(PAN IT) reported by Walter apparently in-
volved subjects who were allowed to continue
drinking for some time after PAN I appeared.
More recently, Ryback and Dowd’? reported
PAN II in six’ subjects 34 hours after the inges-
tion of alcohol, and Oosterveld*® found PAN II
occurring 44-48 hours after the ingestion of 50ce
of whiskey in two subjects exposed to increased
gravitation (2.5g).

Dynamic Effects. Alcohol has been reported
by some to enhance the nystagmic response to
caloric'* #42627 and to simple rotational stim-
ulit® #28 29 80, and by others® 1 "1° to inhibit that
response. With respect to subjective reactions,
Barany* noted a weakened “vertigo” response
following the ingestion of alcohol. Schroeder*’ *
clarified some of these apparent contradictions
by demonstrating that both the “vertigo” and
nystagmus occasioned by caloric irrigations or



i &
urred in-
t least once
ur method
alert sub-
ce of neck
id right or 1
spontaneous
I responses
tional nys- 2,
as PAN T
hours after
3.
B vestibular
rning sen-
to angular 4.
ig the first
ral, alcohol |
the verti-
by Coriolis |
30 hours | 5,
p reduction |
nystagmus |
| 6
ent differ- |
gener and |
|.
|
\
8.
‘9
| 10.
11.
12.
13.

. Coats, A. C.:

. Coats, A. C.: The diagnostic si

REFERENCES

. Aschan, G.: Habituation to repeated rotatory stimuli

(cupulometry) and the effect of antinausea drugs
and alcohol on the results, ACTA OTO-LARYN-
GOLOGICA, 64 :95-106, 1967.

. Aschan, G., M. Bergstedt, L. Goldberg, and L.

Laurell: Positional nystagmus in man during and
after alcohol intoxication, QUARTERLY JOURNAL
OF STUDIES OF ALCOHOL, 17:381-405, 1956.
Barany, R.: Experimentelle alkoholintoxication,
MONATSCHRIFT FUR OHRENKEILKUNDE UND
LARYNGO-RHINOLOGIE, 45:959-961, 1911.
Bergstedt, M.: Disturbances of the balance system
in man during alcoholic hangover. In Hannisdahl,
B, and C. Sem-Jacobsen (Eds.): Aviation and
Space Medicine, Proceedings of the XVII Interna-
tional Congress on Aviation and Space Medicine,
Norway: Oslo Universitetsforlaget, 286-294, 1969.

. Bergstedt, M.: Studies of positional nystagmus in

the human centrifuge, ACTA OTO-LARYNGOLO-
GICA, Supplement 165, 1961.

. Bochenek, Z, and F. ©. Ormerod: The inhibitory

action of certain substances on the response to
vestibular stimulation, JOURNAL OF LARYNGOL-
OGY AND OTOLOGY, 76:39-44, 1962.

Bochenek, 2, L. Gromowa, and R. Maciejewicz :
Comparative studies of positional nystagmus in
healthy subjects and in cases with impaired hearing
or equilibrium, POLISH MEDICAL JOURNAL,
6 11382-1337, 1967,

Directional preponderance and spon-
taneous nystagmus, ANNALS OF OTOLOGY, RHIN-
OLOGY AND LARYNGOLOGY, 75 :1135-1159, 1966.

icance of spon-
taneous nystagmus as observed in, the electro-
nystagmographic examination, ACTA OTOLARYN-
GOLOGICA, 67 :83-42, 1969.

Collins, W. E.: Effect of mental set upon vestibular
nystagmus, JOURNAL OF EXPERIMENTAL PSY-
CHOLOGY, 63:191-197, 1962. ’

DiGiunta, B., and D. Raso: Rilievi nistagmografici
post-rotatorii in corso di intossicazione alcoolica
acuta, CLINICA OTO-RINO-LARINGOIATRICA
(Roma), 20 :88-105, 1968,

Dow, P, J.: Factors affecting vestibular nystagmus
in coriolis stimulatiog, ACTA OTO-LARYNGOLO-
GICA, 61:228-236, 1966.

Dowd, P. J., M. E, Wing, and R. L. Cramer: Effects
of high acceleration on vestibulo-ocular responses.
SAM-TR-67-93, Brooks AFB, Texas, 1967.

14,

15.

16.

1%.

18.

19,

21.

24,

25.

26.

Forster, B.: Electronystagmographische untersuch-
ungen uber den grehbeschlemgunge nystagmus mach
alkoholgaben, DEUTSCHE ZEITSCHRIFT FUR
DIE GESAMTE GERICHTLICHE MEDIZIN,
47 :282-288, 1958,

Manz, R.: Der einfluss geringer alkoholgaben aut
teilfunktionen von auge und ohr, DEUTSCHE
ZEITSCHRIFT FUR DIE GESAMTE GERICHT-
LICHE MEDIZIN, 32:301-812, 1940.

Mizoi, Y., T. Ishido, and N. Ohga: Studies on post-
rotatory nystagmus in alcohol intoxication, JAPA-
NESE JOURNAL OF LEGAL MEDICINE, 16:247-
260, 1962.

Money, K. E., W. H. Johnson, and B. M. A, Corlett:
Role of semicircular canals in positional alcohol
nystagmus, AMERICAN JOURNAL OF PHYSIOL-
OGY, 208 :1065-1070, 1965.

Nito, Y., W. H. Johnson, K. E. Money, and P. EL
Ireland: The non-auditory labyrinth and positional
alcohol nystagmus, ACTA OTO-LARYNGOLOGICA,
58 :65-67, 1964.

Oosterveld, W. J.: Effects of gravity on positional
alcohol nystagmus (PAN), AEROSPACE MEDI-
CINE, 41:557-560, 1970.

Plenkers, J.: Uber lagnystagmus wahrend akuter
alkohol-intoxication beim mensechen, ARCHIV FUR
OHREN-, NASEN- UND KEHLKOPFHEILKUNDE,
152 :197-206, 1943.

Rauschke, J.: Alkohol-nystagmus und leistungschadi-
gung, MEDIZINISCHE, 12 :460-465, 1958.

» Ryback, R. S. and P. J. Dowd: Aftereffects of

various alcoholic beverages, AEROSPACE MEDI-
CINE, 41 :429-435, 4970.

Schroeder, D, J.: Influence of alcohol on vestibular
responses to angular acceleration, AEROSPACE
MEDICIND, 42 :959-974, 1971.

Schroeder, D. J.; Some effects of alcohol on nys-
tagmus and “vertigo” during calorie and optokinetic
stimulatior, ANNALS OF OTOLOGY, RHINOLOGY,
AND LARYNGOLOGY, 1972 (in press).

Schulte, K., and H. Roth: Drehnystagmus un blut-
alkohol-konzentration, ZENTRABLATT FUER VER-
KEHRS-MEDIZIN, VERTEHS-PSYCHOLOGIB
UND AUGRENZENDE GEBIETE (Alfred/Leino,
Germany), 3:141-144, 1957,

Schwab, W., and W. Ey: Experimentelle unter-
suchungen an hor-und gleichgewichtsapparat unter
alkohol, ARCHIV FUR OHREN-NASEN UND
KEHLKOPFHEIKUNDE, 164 :519-528, 1954.



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;NOILVINGIXOSIG GNV 'TOHOOTVY ‘emoysi¥o
AND BUIOYRTYO “OINIYSUT [BoypaUlOISY TaD “oMpOIpSTT
uoTelAy JO ayO ‘uoNeaIs: HV uoBay [erepeT

ZEIT-
‘HRICHTLICHE
IZIN, 43 :232-241,

TSCHE



VODKA SUBJECT :

BEFORE DRINKING

PRE
AFTER ORINKING

4 HOURS

24 HOURS

BOURBON SUBJECT:

BEFORE DRINKING

PRE
AFTER DRINKING

8 HOURS

30 HOURS

CORIOLIS (VERTICAL)

Figure 12,

BF

2 SEC

AP

A pel earn re FL

ner nnnn, Ra

ee

kh

NYSTAGMUS

Coriolis (vertical) nystagmus recorded from the Head Tilts of a Bourbon and a Vodka subject

during several sessions,

hour responses they reported, and the character
of these responses cannot, therefore, be compared
with our results. Difference in experimental
design, types of subjects, and the differing sleep
periods may account for many of the differences
between the two studies, e.g., dur subjects drank
over a 30-minute period and the testing was be-
gun one hour later, whereas Ryback and Dowd’s
subjects drank over a 114 hour evening period,
and were tested the next morning. It,can be
concluded that our study confirms the regular
appearance of PAN J and PAN II during the
first ten hours after alcohol ingestion as reported
most earlier authors, and that some subjects
lemonstrated a “PAN-I-type” response from
24-82 hours afterTMlcohol ingestion.
The genesis of these nystagmic reactions is not
clear. However, evidence from studies of ani-
mals" ** indicates that the semicircular canals of

the vestibular system are necessary for PAN.
Money, Johnson, and Corlett have concluded that
PAN is initiated by the action of gravity on
semicircular canal receptors although the site
and “mechanism of the action of alcohol remain
to be elucidated.” **

Control Subjects. A second static effect dem-
onstrated by this study was the intermittent
appearance of apparent positional nystagmus in
the majority of our Control subjects. There was
a predominance of left-beating nystagmus
throughout the trials. Coats*® and Bochenek,
et al.,” have demonstrated the appearance of po-
sitional nystagmus in 25% and 32% of healthy
normal subjects. The latter authors found that,

by increasing the gain on the recording amplifier,
they could demonstrate nystagmus in subjects
who had previously not exhibited any. It is felt
that the presence of weak, spontaneous positional

RATED INTENSITY OF CORIOLIS SENSATION (%)
3
8

50

Ficure
each
arin
thre

respont
jects r
which
nystag.
obtaine
a tota
factor
numbe
obtain
ing thi
neck r
that, u
may b
subject

Ang
cline :
celerat
alcoho
respon
after (
three
group:
the fir
ures (
were |



VOOKA SUBJECT: @F

ap SR

a

8 hours !
cee er ie

a ane

snons" nN
be

a vours nt
‘

seme

sevoune nN

Ficure 8. Positional nystagmus recorded from a subject in the Vodka group upon rolling his head to the rignv
(R) and to the left (L) prior to drinking and during several post-drinking test sessions, PAN I and PAN II
responses are vigorous. The positional nystagmus obtained during the second day is relatively typical, in terms
of intensity and frequency, of that exhibited by the several subjects who showed such responses after a night

of rest. ,
amu 3
Postetonal Reapooses: As noted earlier, not all of the apparent posi-
The sumber of subjects who showed left-beating or right-beating systesmus tor tional responses were very strong. Some repre-
the various haad positions during static pre-and post-driaking sensions. sentative tracings appear in Figures 1-3,
Heed Posie Dynamic Tests
Direction Control Bourbon Vega
funn metus ou od ok oy ok 8 6g a 8 © Angular Acceleration
Wee ‘ Se Nystagmus. Responses to rotation by the
Lehout L s 6 8 3 ww 0 8 we Control Group showed no regular change across
® poe eos,’ 2 8 sessions for the frequency and duration measures
2hour ‘ foe ££ § ! 8 2 8 8 of nystagmus (although the 4-hour duration
dehour L > 6 8s 4 8 on toe ot score was shorter than the Pre-test score, p<.05) ;
. oe Re et EF? however, a relatively steady decline in slow phase
fnew H {1 502 2 8 8 6 $3 6 displacement occurred from session-to-session,
S-hour L Bp gf 2 2 3 & such that the 30-hour response level was reduced
vo-tour , ok. ewe lke significantly (p<.05) by approximately 30 per
x vw oo i 0 6 0 1 6 cent from the Pre-test level (see Figure 4 and
2h-hour 1 5s 6 # fo S$ oO 2 F 3 Tables 4 and 5). Both alcohol groups had a
x o 2 4 ft tos 1 2 8 :
abe L tec Se ae 2a marked suppression of all three measures of
x mo 2 5 to 6 nystagmus during the 1-hour and 2-hour sessions
so-howr H R$ $b bg ob ts (p<.05—.001) with substantial recovery evident
da-nour L em ee ee during the 4-hour session; slow-phase displace-
* mmm yg eet ment showed the most. prolonged reduction (see
er tres Table 5). There was somewhat less mean decline

Measuee

Slow Phase
nystagmus

(Degrees)

Nunber of
Nystagaic Beats

if

Duration of

Duration of
Sensation
(Seconds)

‘Sentat ton
Seconds)

i

it


tally dark-
assumed a
le, with his
so that the
roximately

with the

was given
tain alert-
re drinking
hours after

tudies were
rer rotat-
the subject
as fixed in

total dark-
to keep his
sted so that
tilts of 30°
subject. was
°/sec? to a
his time he
ler approxi-
tation, the
ead to the
Each head
with a rest

following
and return
erated to a

nystagmus

were taped
record hori-

A second
Hy about the
yebrow and

i —

picked up changes in corneo-retinal potential
and relayed them through a terminal board to
an Offner Type T electroencephalograph. These
signals were then amplified, using a three-second
time constant, and recorded. Eye-movement
calibrations were obtained prior to positional
and rotational testing.

Subjective reactions were also recorded. Each
subject signalled the start and end of his turning
sensation to acceleration stimuli and the begin-
ning and end of his sensations of apparent
“climb” or “dive” occasioned by his head move-
ments during constant velocity; he also rated the
intensity of the sensations arising from the head
movements. The stronger of the initial two head
movements (a tilt and a return) was rated as
100% ; all subsequent effects were rated by each
subject with reference to his 100% “standard.”

Blood Samples. Prior to the drinking period,
a venous blood sample was drawn from all sub-
jects. Other venous samples were obtained from
the two alcohol groups at 1, 2, 4, 8, and 24 hours
after the drinking period; a 6-hour sample was
also drawn from most subjects. Only pre-
drinking and 24-hour blood samples were ob-
tained from the control group. Gas chroma-
tography was used to determine the blood alcohol
levels. ‘

Scoring. Nystagmic responses to the accelera-
tions were scored for duration, frequency of eye
movements, and slow-phase displacement. The
slow-phase eye movement was scored by meas-
uring in millimeters the amplitude of each
nystagmic beat from the peak to baseline; these
values were summed for three-second intervals
and converted to degrees by using the calibration
constant obtained prior to each trial.

Vertical components of nystagmic responses to
Coriolis stimulation were scored for duration and
frequency. Since these vertical responses are
frequently of low amplitude, and since blocking
of the recording pens and superimposition of
blink reflexes are not unusual effects obtainéd in
recording Coriolis nystagmus, slow-phase dis-
placement measurements were not made.

Positional responses were rated independently
by 4he authors on a 0 (no nystagmus) to 4
(vigorous nystagmif&) scale. A rating of “0”
was given when no positional nystagmus was
seen; “1” represented the occurrence of only a
few beats of low-amplitude nystagmus; a rating

of “2” was assigned when regular-beating nys-
tagmus with a relatively low slow-phase velocity
was observed; “3” denoted a high frequency,
regular nystagmus; and “4” represented a vig-
orous response of regular frequency and of high
slow-phase velocity. In practice, half-step rat-
ings (eg., “1.5”) were frequently made. An
average rating for each head position was ob-
tained for each subject.

III, Results,

Mean blood alcohol levels and their standard
deviations were computed by sessions for each
group (see Table 1). No measurable ethanol
content was obtained from any subject during
the Pre-tests or 24 hours after alcohol ingestion.
In general, the Bourbon Group showed slightly
higher mean blood-alcohol levels than did the
Vodka Group, but the differences in no case
reached statistical significance at the .05 level.

TABLE 1
Means and standard deviations in per cent for blood alcohol
levels derived for the three groups. (N=10 for all

calculations unless otherwise indicated.)

Session

Group Rm Lei &hr Ee Sie Tiche
Mean 0 No Samples "Drawn 0
controt Ye ° 3
Mean 0 +104 097.067.036.002,
Bourbon sp) ° 1027 fol2o1t L009. :003 oo
Vodka Mean 092.088.065.032 0050
sD 0 cols 017, ‘019, L020 10080

* Samples dravn only from four subjects.

Static Tests

Mean ratings ‘of the positional responses ap-
pear in Table 2 according to direction of nys-
tagmus and head position. A tabulation of
subjects who showed apparent nystagmus in the
various head positions is in Table 3.

The data in Tables 2 and 3 provide several
points of interest. First, among all three groups,
a considerable number of subjects showed some
apparent positional responses during the Pre-
tests. Second, although nystagmus frequently
was not very strong, the number of Control
subjects who showed some apparent. positional
responses varied considerably across the 11 test
sessions. For example, rolling the head to the

left produced some apparent nystagmus to the



angular accelerations are reduced in darkness as
a consequence of alcohol; on the other hand, the
ability to inhibit nystagmus and “vertigo” by
visual fixation in the light is impaired by drink-
ing. However, Ryback and Dowd” have reported
an increase in both nystagmus and the sensations
occasioned by Coriolis vestibular stimulation
(apparently in darkness) after the ingestion of
alcohol; the authors reported that bourbon pro-
duced more pronounced effects in this regard
than did vodka.

The present study was designed to evaluate
the prolonged effects of two types of alcohol on
the vestibular apparatus as evidenced by changes
in electronystagmographic recordings and in
subjective responses to positional, rotational, and
Coriolis stimulation.

Il. Method.

Subjects. Thirty male college students, rang-
ing from 21 to 27 years of age, and screened as
being either non-drinkers or “light to moderate”
drinkers, were randomly assigned to one of three
groups of ten subjects each. One group received
100-proof Smirnoff vodka as the test beverage,
the second group received 101-proof Wild Turkey
bourbon, and the third (control group) was
given a non-alcoholic beverage. The beverages
were imbibed over a 30-minute period following
the administration of preliminary vestibular
tests. With the exception of one subject who
weighed 124 kg, each alcohol subject was given
2.5 ml/kg of liquor added to orange juice to a
total volume of 1100 cc; the heavy subject was
given an amount of alcohol equal to that of the
heaviest other subject (102 kg). The control
subjects imbibed 1100 cc of orange juice, to which
a few drops of rum extract were added to give a
distinct rum odor and some flavor.

Procedure. The subjects reported at 8:00 a.m.
of the first test day after a light breakfast (at
about 7:00 a.m.), usually toast or roll and coffee.
A blood sample was drawn and electrade place-
ment, instructions, and a practice rotation trial
followed. The earliest time that alcohol was
administered was 9:30 am. The subjects had

#previously been asked to refrain from drinking
alcoholic bevergges during the 24 hours prior to
testing. All ¥ the subjects denied the use of
drugs. The subjects had meals with the research
personnel and remained at the Institute overnight
for the second day of testing.

Positional testing was done in a totally dark-
ened examination room. The subject assumed a
supine position on an examining table, with his
eyes open, and his head elevated 30° so that the
plane of the horizontal canals was approximately
aligned with gravity; testing began with the
head in this position (ie., nose pointed up) for
one minute. At signals from the experimenter,
the subject turned his head to the left for one
minute, rolled it back to upright for another
minute, turned it to the right for one minute,
and then rolled it upright for a final minute.
Throughout the trial, the subject was given
mental arithmetic problems to maintain alert-
ness, Positional testing was done before drinking
and 1, 2, 4, 6, 8, 10, 24, 27, 30, and 32 hours after
drinking.

Rotational and Coriolis vestibular studies were
accomplished in a modified Stille-Werner rotat-
ing chair (the rotating structure and the subject
were totally enclosed). The head was fixed in
a head-holder and a bite-block was used to posi-
tion the horizontal canals approximately in the
plane of rotation. The room was in total dark-
ness and the subject was requested to keep his
eyes open. The head-holder was adjusted so that
the subject could make uniform head tilts of 30°
to the left and to the right. The subject was
accelerated at an angular rate of 5°/sec? to a
constant velocity of 90°/sec; during this time he
signalled his turning sensations. After approxi-
mately three minutes of constant rotation, the
subject was instructed to tilt his head to the
right and, later, to return to upright. Each head
tilt was made in about one second with a rest
period of at least one minute allowed following
the end of the response to each tilt and return
movement. ‘The chair was then decelerated to a
stop at 5°/sec? with the subject’s head upright.
First CCW (practice) then CW rotations were
performed during the pre-alcohol testing. At
1, 2, 4, 8, 24, and 30 hours following alcohol
ingestion, CW rotations were used. Throughout
each trial, recordings were made of nystagmus
and subjective signals.

Recordings. Silver disc electrodes were taped
by the outer canthus of each eye to record hori-
zontal components of eye movements. A second
pair of electrodes was placed vertically about the
left eye, one electrode above the eyebrow and
one on the malar area, directly above and below
the pupil in straight-ahead gaze. The electrodes

pi
an
an
si
ti
ca
ar

su

ni
Ke

BEBES

su

tiv

sh
ur
ny
va
ar
co

by
(v

set

fe


alcohol remain

tic effect. dem-
e intermittent
nystagmus in
ts. There was
g nystagmus
nd Bochenek,
earance of po-
% of healthy

a Vodka subject

ary for PAN.
concluded that
of gravity on
ough the site

‘©

=

3

” . et
z ~

3 Su ee
ae =
z 50

5

°

& 1

2 1p

8

se

:

re

2

s

Zr

Q

Be nove: conreo. oo

PEt 20306<4~«<SCUGlUOU 24 30
HOURS AFTER DRINKING

Figure 13. Rated intensity of Coriolis sensations for
each session expressed as a percentage of the Pre-
drinking level. A general decline is evident for all
three groups.

responses in such a large percentage of our sub-
jects may reflect, in part, our test procedure
which we consider optimal for the detection of
nystagmus, ?1% ie, an electronystagmogram
obtained from an alert subject with eyes open in
a totally-dark room. However, an additional
factor which may have contributed to the large
number of weak positional responses which we
obtained might have been our procedure of hay-
ing the subject turn his head, thereby activating
neck reflexes. At any rate, our results suggest
that, under some conditions, positional nystagmus
may be present in a greater number of “normal”
subjects than previously reported. +

Dynamic Effects

Angular Acceleration. Our finding of a de-
cline in the nystagmic response to angular ac-
celeration in darkness after the ingestion of
alcohol confirms the work of Schroeder.*® This
response suppression during the first two hours
aftge drinking was statistically significant for all
three measures of nystagmus for both alcohol
groups. In general,’the response recovered after
the first two post-ingestion hours, but some meas-
ures (e.g., slow-phase nystagmus for both groups)
were still significantly below pre-drinking levels

eight or more hours post-ingestion. Authors re-
porting an enhancement of nystagmus from
caloric irrigations or from rotatory stimuli con-
ducted their tests in lighted rooms and were most
likely demonstrating a depressant effect of alcohol
on the ability of the subject to inhibit nystagmus
by fixating his eyes.*** The duration of the
turning sensation from the alcohol subjects was
shortened during the first hour after drinking,
but exhibited recovery during subsequent tests.
Coriolis Stimulation. Our alcohol subjects
demonstrated no statistically significant change
from pre-drinking levels in number of beats or
duration of nystagmus to Coriolis stimulation
either during the period of intoxication or the
next day. Similarly, there was little effect of
alcohol on either the rated intensity or the dura-
tion of vertigo, In fact, the 24- and 30-hour
post-ingestion responses to Coriolis stimulation
were decreased from pre-drinking levels (al-
though not significantly) in both of the alcohol
groups. This finding is in contrast to the report
by Ryback and Dowd* of increased subjective
tumbling in both their alcohol groups, an en-
hancement in duration and frequency of nys-
tagmus from their bourbon subjects, and an
increase in frequency (with a decrease in dura-

HEAD TILT

DURATION OF CORIOLIS SENSATION (%)

60 GROUP: CONTROL o——o
VODKA e——«
30 BOURBON a--—a
PRE} 2038 64 U5 UU 24 30

HOURS AFTER DRINKING

Fiaure 14, Duration of Corlolis sensations for each
session expressed as a percentage of the Pre-drink-
ing level. All groups show a decline.


lear PAN I
g the inges-
ugh-10-hour
consistently
jour sessions,
I were again
leak,

darkness
ions,
lodka
L &
10 13
le 20
23 .00
00 3.08
83 .00
00 2.68
57 03
03 58
00 1.15
98 00
+00 1.60
222 00
00 1.07
7 00
63 13
2 .23
50 105
00 35
50 07
05 125
55 17
00 33

CONTROL SUBJECT: KS

AFTER ORI
®
2 WouRs rp
L TN
®
8 wours >
L ;
f
24 HouRS a
t —
®
27 Hours im
t
R
sowours rm
— 1
Fn
32 HOURS

L

Ficurr 1, Positional nystagmus recorded from a control subject upon rolling his head to the right (R) and to
the left (L) prior to drinking (non-alcoholic beverage) and during several post-drinking test sessions, Note
differences in the response from session to session.

BOURBON SUBJECT: RJ

StFORE ORM aot
R
Pre A
L ea —
ASTER ORDNING

RRA SAS SARS RN
BHOURS e  eeee ty eee eeteeen *

8 Hours

24 HOURS &

a7 ours fn

30 HOURS

Ce I

s sevens" f

bo -

Figure 2. Positionanystagmus recorded from a subject in the Bourbon group upon rolling his head to the right
(R) and to the left (L) prior to drinking and during several post-drinking test sessions. This subject shows
typical PAN I and PAN II responses and, on the second day, gave the strongest positional nystagmus (in the
same direction as PAN I) of all alcohol subjects. He is also the only subject, not accounted for by Pre-drink-
ing tests, to show “PAN-II-type” responses on the sezond day (during the 27-hour test only).

5





8
=
z
é
6
g
z
w
a
€
z
=
z
&
3
a

pre] 2S 24 30

gs

FREQUENCY OF NYSTAGMUS (%)

gI0

g sof

3 90

2

2 2

&

Zr Nae GROUP: CONTROL o—o
. vooka

B wot BOURBON

& cL accerenarion stimnus. s17sectro# 18 se¢

§ :

%

ro

8

Bo “be 1 e@ 8 4 5 6 7 8  * 30

HOURS AFTER DRINKING

Figure 4. Plots of the nystagmic response measures to
angular acceleration during several post-drinking
test sessions expressed as percentages of the Pre-
drinking levels, There is a marked decline tn
frequency, slow phase displacement, and duration
of nystagmus during the first two hours after
alcohol ingestion in the Bourbon and Vodka sub-
jects. At no time was any response enhancement
evident after alcohol ingestion.

session and some recovery during the 8-hour
session for both alcohol groups; Control subjects
produced no significant changes. These effects
of alcohol on angular-acceleration responses con-
firm the work of Schroeder.** Additional time-
course comparisons of nystagmus output appear
in Figures 7 and 8 for the Pre, the 24-hour, and
the 30-hour sessions. For all three groups of
subjects, there was no marked change in fre-
quency measures, gut slow phase nystagmus was
reduced from the Pre-test levels as a function
of repeated stimulation.

Turning Sensation. Plots of the duration of
the turning sensation occasioned by the angular

accelerations were similar to nystagmus plots,
ie., both alcohol groups showed a drop from the
pre-drinking level to the 1-hour post-ingestion
session (p<.01) and recovery thereafter (Figure
9). The Control Group had no marked change
in mean duration across the test sessions (Table
5). There was a slight but general tendency for
longer durations (recovery) of the sensation
after a night of rest (ie. during the 24-hour
session). Group comparisons yielded only one
significant difference: The Bourbon Group re-
ported shorter durations (p<.05) than Control
subjects one hour after drinking (Table 6).

Coriolis Stimulation

Nystagmus. The duration and the frequency
measures of vertical nystagmus yielded fairly
consistent group patterns across sessions for the
Head Tilts and for the Return-To-Upright head
movements considered independently, but appar-
ently different patterns for the two head move-
ments (Figures 10 and 11). Thus, for the
Control Group, both measures of nystagmus
during Head Tilts increased from Pre levels
during the 1- and 2-hour sessions and then de-
clined steadily; the alcohol groups showed a
lesser increase or none at all during the 1- and
2-hour post-drinking sessions, and somewhat
variable values across the other sessions (Table
7). However, tracings for the alcohol groups
were not always readily scorable, especially dur-
ing the 1- and 2-hour post-ingestion sessions.
For example, as indicated in Table 7, only five
Vodka subjects provided scorable records for
Head Tilts during the first post-drinking test.
In some cases, blocking of the recording pens
prevented scoring, in others positional nystagmus
became superinrposed on the Coriolis response
and confounded measurement. In general, good
tracings were obtained from all groups during
the Pre, 8-, 24-, and 30-hour sessions (see Figure
12). Since the 8-hour session showed duration
and frequency scores that ranged from 93-110
per cent of Pre-values, no “recovery” was evident
during the 24-hour session.

For Return-To-Upright head movements, how-
ever, declines for both measures were greater
during the first day for both alcohol groups, and
all three groups produced a response during the
24-hour session that was elevated from that of
the 8-hour session (i.e., some recovery may have
occurred). Comparison of Pre-drinking meas-

SLOW PHASE NYSTAGMUS (DEG/SEC)

Fiaure |

NYSTAGMUS FREQUENCY (BEATS /SEC)

Figure
ang
Sh

SLOW PHASE NYSTAGMUS (DEG/SEC)

FIGURE
ang


to the rignt
and PAN II
ical, in terms
after a night

duration

re, P<.05) ;
slow phase

our sessions
ery evident
se displace-
luction (see
ean decline

TABLE 6
Angular Aceelorations
Means and standard deviations by session (or total slow phase dteplacenent,
frequency, and duration of horizontal nystagmus and for the duration of
the turning sensation produced by the angular acceleestions of

3° fsec? for 18 seconds.

Session
Group Li Em er ee
control ME® 489.6 436.8 421.2 408.4 AH0.8 389.8

so 244 tao'7 tela 1731820810 90.9

Moan 603.4 342.1 455.8 Gta.7 469.6
sb

EF sesnon

ea? 11203 O3le ters font
SF egny Mean 625.2 42.0 480.9 400.8 siz
So" sels aaa's ise Tels elk

2 contro. MA 70.6 70.8 71.9 68.3 no 2.8

H so st oo ton dele
Stourton Man 88 57 SLB
3H Pv so aaa? doe le SD
ae fen 87.4 68.5 70.3 aL 3 1
2 ‘edka sp 0 16.0176 2156

ean 52.3 50.3 48.6 48.
contro: +

fom BY ORD EL 8g dome oe
vote EM G2 Ge Bee aa
Epp oe Geo ne mM mE pa we
BS me gp mp ap me nr ay ay
nus

Angular Accalerat ions
Senule of sratistical evaluations (e ests for correlated data)

of the significance of the éttt

cet between Pre-dr inking

leresures and those obtained after drinking.

£ for Pre-Drinking Seuston vs,

Post-Orisking Seveions

Manure Group chew Zchowr Gchour —ahour —échoyt 20-hour

faq cmmol asso nena
EPP souvon aso tse are aSe tse
ERE vos 2am aston Gasman gene
tg Comet 0.05.2 -0.98 0.08 ae oat
Ff a ne ne
EET see ee aime ok .ak aie os
Byg omen ease aaa
a
gee Vodka 443et 8 SeeeE 1.03 2.80% 2.66" 2a
Teg comet sete wots an

Bourbon 3.69" 1950.81 Lar wont 0.99)

45H 1.59 0.70.60.

ane 6
Angular AeceLerat tons
Results of stattutical evaluations (¢ cent) of the significance of the
‘si€ferences between groups. Compartaone were made of the percentage
of change betveen Pre-drinking meseuren and chose chtained efter

‘trloking for Concros (€), Bourbon (B), and Vodka (¥) subjects

13t o.et tae
18a 0s to.
oat 0.26 Lo
146 1.68 tat
Lease oat
0.62 0,0 0.36
219 0.88 ve
0.28 ost oes
Liz oso.
O16 0.28 0.80
0.9 023.
0. 0a.

and somewhat more rapid recovery for the Vodka
as compared with the Bourbon Group, but these
comparative trends were not statistically signifi-
cant at the .05 level (Table 6). There was no
significant “recovery” during the 24-hour session
(after a night of rest) probably due to the rela-
tively small changes evident in a comparison of
the Pre-session output with that of the 8-hour
session.

In comparing the groups, only the 1-hour and
2-hour sessions yielded any significant differences
in nystagmus measures. During both of those
sessions, the two alcohol groups produced shorter
durations and fewer beats of nystagmus than did
the Control Group. In addition, the Bourbon
Group had less slow-phase nystagmus and shorter
durations of their turning sensations than did
the Control Group during the 1-hour post-
drinking session. No other difference among the
groups was statistically reliable, and in no case
did any of these four measures of responses to
angular acceleration yield any significant differ-
ences between the Bourbon and the Vodka groups
(Table 6).

Time-course comparisons of nystagmus ob-
tained during the Pre-test and at the 2- and
8-hour post-drinking sessions indicated a clear
depression of both slow phase and frequency
measures (Figures 5 and 6) during the 2-hour

y


left in 5-6 Controls and to the right in 1-3 sub-
jects, depending upon the test session (see Table
3). Similarly, rolling the head to the right re-
sulted in apparent left-beating responses in 3-6
Control subjects and right-beating responses in
0-5 Controls, again depending upon the test ses-
sion. As a third point of interest, both groups

of alcohol subjects demonstrated clear PAN I
during the first four hours following the inges-
tion of alcohol. During the 6-through-10-hour
sessions, PAN II responses were consistently
evident. For the 24-through-32-hour sessions,
responses in the direction of PAN I were again
predominant, although relatively weak.

TABLE 2

Positional Respmses:

Mean ratings (0-4 scale) and direction of nystagmus from positional tracings obtained in darkness

for upright, left, and right positions of the head during pre- and post-drinking sessions.

Head Position

Direction Control Bourbon Vodka
of
Session Nystagmus u L g u L R u L R
Pre L 37 47 25 107 27 227 +10 10 13
R 07 208 225 +13 +13 -00 +03 sie 220
1-hour L 230 72 225 +10 3.15 .00 +00 3.23 -00
R 03 10 00 +00 +00 3.08 13 -00 3.08
2-hour L 35 63 +35 37 2.90 +00 10 2.83 .00
R .07 +10 27 +00 00 2.85 13 +00 2.68
4-hour L -40 58 227 05 1.08 10 +02 57 +03
R 00 -10 113 +00 200 87 .07 103 58
6-hour L 18 45 37 13 +10 .78 203 -00 1.15
R 02 AS 17 03 72 +00 -00 98 +00
8-hour L 225 38 42 222 226 1,03 .08 +00 1.60
R 00 -10 202 -00 +92 13 07 1,22 00
10-hour L +28, AT a ly 07 +00 78 -20 +00 1.07
R .07 +00 -02 +00 265 +00 +05 77 -00
24-hour L 227 67 +15 :03 +23 +00 08 +63 +13
R 00 10 +22 .07 03 .27 02 12 223
27-hour L 33,4 438 yy .07 233 +10 05 +50 205
R +00 200) 00 105 230 .08 +00 35
30-hour L -30 +52 ¥ 40 107 45 -00 103 -50 .07
R .03 +20 +00 +03 =00 45 +08 +05 225
32-hour L « LByeee + 38yne «LSet 03 37 02 03 +55 7
R 202 +08 .07 -07 +00 +22 +08 +00 33
aN = 8 =
, we = 7
»

Figur

di

Fietri
(E
ty
sa
in


27. Schwab, W., and W. Ey: Das hor-und gleichgweichts-
organ beim menschen under akuter alkoholeinwirk-
ung; klinisch experimentelle ergebnisse und moglich-
keiten der praktischen auswertung, MUNCHENER
MEDIZINISCHE WOCHENSCHRIPFT, 97 :658-662,
1955.

28. Schweitzer, H.: Graphologische, klinische und psy-

chologische untersuchungen unter alkoholwirkung,

OFFENTLICHE GESUNDHEITSDIENST  (Stutt-

gart), 16 :361-872, 1955.
|
i

.
‘
i
| ‘’
.

81.

18

. Taschen, H.:

. Taschen, B.:

Fine einfache nystagmusprobe zur
festselling der alkoholbeeinflussung, MEDIZIN-
ISCHE MONATSSHRIFT, 9:25-27, 1955.
Nystagmusprufungen zur verstellung
der alkoholbeeinflussung, DEUTSCHE  ZEIT-
SCHRIFT FUR DIE GESAMTE GERICHTLICHE
MEDIZIN, 44 :436-437, 1955-1956.

Walter, H. W.: Alkoholmissbrauch und alkohollagen-
nystagmus, DEUTSCHE ZEITSCHRIFT FUR DIE
GESAMTE GERICHTLICHE MEDIZIN, 43 :232-241,
1954.



a

TECHNICAL REPORT STANDARD TITLE PAGE

T. Report No. 2. Government Accession No. 3. Recipient's Catalog No.
FAA-AM-71-39
4. Title and Subtitle 3, Report Date
ALCOHOL AND DISORIENTATION-RELATED RESPONSES: V. October 1971

THE INFLUENCE OF ALCOHOL ON POSITIONAL, ROTATORY,
AND CORIOLIS VESTIBULAR RESPONSES OVER 32-HOUR PERIOD!

7, Author's) Ronald J, Hill, M.D. 8. Performing Organization Report No.
William E. Collins, Ph.D.
David J. Schroeder, Ph.D.

9. Performing Organization Nome and Address 10. Work Unit No.
FAA Civil Aeromedical Institute

P. 0. Box 25082
Oklahoma City, Oklahoma 73125

6. Performing Organization Code

11. Contract or Grant No.

13. Type of Report and Period Covered

12. Sponsoring Agency Name and Address

Office of Aviation Medicine OAM Report
Federal Aviation Administration
800 Independence Avenue, S.W. 14. Sponsoring Agency Code

Washington, D.C. 20590
15. Supplementary Notes

This research was performed under Task AM-A-71-PSY-27.

16, Abstract

There are some indications that the systems most closely associated with disorien-
fation responses--the visual and vestibular systems--may continue to show effects
of alcohol ingestion for periods in excess of 24 hours. These effects may be
evident both in static vestibular reactions and in dynamic reactions such as those
which produce Coriolis vestibular effects, The present study sought to clarify
some influences of alcohol on both static and dynamic vestibular responses over
32-hour post-drinking periods. Thirty male subjects were divided into three groups
of ten each: Control (no alcohol), Bourbon, and Vodka. Each group underwent
eye-movement monitoring for responses to positional, rotational, and Coriolis
stimulation. The subjects were tested immediately prior to ingestion of the test
or the control beverage and for regular intervals up to 32 hours thereafter. Blood
alcohol levels were determined by gas chromatography, The usual PAN I and PAN II
nystagmic responses were noted and, additionally, a direction-changing, positional
nystagmus was obtained 24-32 hours after the ingestion of alcohol. More spon-
taneous nystagmus was noted among control subjects than might be expected from
previous studies. Responses were generally depressed to angular accelerations and
to Coriolis stimulation, ‘There was no differential vestibular effect between con-
gener and non-congener beverages. Implications of the results are discussed with
emphasis on long-term vestibular effects of alcohol.

* .

17. Key Words 18. Distribution Statement
Alcohol Availability is unlimited. Document may
Vestibular be released to the National Technical
#yy stagmus Information Service, Springfield, Virginia
Coriolis Effgsts 22151, for sale to the public,
19. Security Classif. (of this report) 20. Security Classif. (of this page) BH. No. of Pages | 22, Price
Unclassified Unclassified 18 $3.00

Form DOT F 1700.7 (e-69)



7anc® FOR Im SEC

rE oe
24 HOUR O~
30 HOUR oa

hour, and 380-
peated trials,

sensations
id Return

Ane 7
Cortette (verescel) nyatagons:

Meana and standard devises

by seseton for the frequency aad duration
of vertical nystegms produced by 30° head eilts and retura-tor

Upright head movements during rotation at 15 rp0.

Sopsion

russ
conteot Mean 1.9 20.0 6.9 15.4
3 8 uy M3 oss 52S
af
% roo MEMS 18.6, 20.3, 19.6, 17.2, 18.7, 16.3, 18.6,
Te eS
Bo tote so ott Ge 2 See SES
Mew Wl 165185,
' Gomerol sp 5836 82st Sa SF
Men 12.9, 1209, Ua, Lo, 2, 12.0, 124,
ges feo 12.8, 193, 9.6, IL, 9s
a aS SO CO
‘RETURN HEAD wovmENTS
Men 15.9 13.9 134 Oa
go fmert sa Teo Tee Sue TEE
a Mean 13.6, 9.6, 10.7, LA, to, 13.6, 17,
By tourboa 5s Sie Sle ke Hite Ufa
2 vot MHD 98th
ba ac ee
E
control g3 0s
278s
F339 73 9 8,
ERE tourbon ue glee 358
$33 70 ion 946,
BRo vote tr We ais
wore. 6 otherwise indicated; “Wea; bbs
ante &
Coriolis (Wertteal) Nyotagsee
Resoles of stactetical evaluations (e teats for correlated data) of
che siamificance of the differences between Pre-dr lating nossures
of nystagmus ond thoee obtaiaed after drtakton
foc Pee-Driniing Session Vs
Post-Drinking Sessions
Mss Group chow shows shou Behour—achour
POvEste
Se
FEE romeo ou ors 0 on Fin °
ae Vodka: 0.08 0.15 0.90 0.6 0.6 0.40
TE corel 1) sto 0.08032
TE Bourbon 0.01 1.03.24 0.6558.
ae Vodka -0.34 186 0.62 ts 2.03 142
erinn HEAD rovmeeers
: Contsol 1.07 0.980.960.9700
EEE ourton 3.tse 0.79 a7 toe 1.66
Ip Py a I oS
a ,
EE weorton ages ae as ane
BE voden 138 iz b.2aem O12 Las
te <0 (WORE: The W used for the various couperteons can
mp lot be dacermined fron Table 6.)

TABLE 9
Corfolts (Vert teat) Mystagms
Results of seatiatical evaluations (¢ teste) of 80 elgatfseance of the

atfferences between groupe. Comparizone were mide of the pet

wre and tnose obtained after

of change betveen Pre-drinktag med

Setnking for Contre! (€), Bourben (B), aad Vodka (V) ubjecta.

Heteure Comparison shou 2showr shout ehourdashoue — MOshove
wap sur
se Cs
yBE cum 0.06 07st? wth
a3
35 vb 0.69 0.58 0.90083
35 Cu y 066 1050 haw
22 Cub 050 1S Owes hat
ae ves B 0.07 060.608
senna asap sou
ve Fwy 04) 0.080.982 UL
EP cet cup ou oss oan teas
22 Vive 8 0.28 0.03 0.2 t0s 20a
3s Cu 0.08 Oh OKO 08
ay Cvs 180.080.2810
ge Vue La? 008008 oss
tp 6.08 (WORE: The W used for the various comparisons can be

deterwlaed fron Table 7.)

Figures 13 and 14). There was a general decline
in both measures across sessions during the first
day and no striking changes during the following
day. There were some apparent differences
among the groups, however. For Head Tilts,
both the Control and Bourbon subjects showed
some declines across sessions for both intensity
and duration measures; many of these declines
were significantly below Pre levels (see Tables
10 and 11). Only one of the 12 statistical com-
parisons yielded a significant decline in these
same measures for the Vodka group, For Head
Returns, there werd few statistically significant
declines for the two measures of Coriolis sensa-
tions, but all of these (four in intensity and one
in duration) occurred for the Vodka group.
However, in comparing the groups, no statistic-
ally significant differences were obtained at any
session for the intensity measure and only one
of 36 group comparisons yielded a significant
difference for the duration measure (Table 12).

FV. Discussion.

Static Effects

Alcohol Subjects. The demonstration of the
regular appearance of PAN I and then PAN IT
during the first ten hours of testing after alechol



d prolongation
of the drinking
and Aschan et

post-ingestion

to last from
was completed,

one additional
ime limits that
is the “PAN-I-
of our subjects,
ion, Although
owed apparent
ie same time

GROUP: CONTROL o—~o
VooKA  #—e
BOURBON a---4

py yt
@ 24 30

tical) nystagmus
ercentage of the
for the 1- and
not plotted for
cords were ob-
In general, the
ion of nystagmus

Weane and standard deviations by wension for the rated Intensity and the

Mesure

Rated Tatenetey
(Per cent)

uration of
Vertigo
(Seconds)

y

er

Rated Tacenstty

Duration of
Vereige
Geconds)

(rer tent)

‘enue 19 ann

Cortolie Somations Cortolts Sensations:

Resules of etactseical evaluattoas (t teste) of the significance of the
duration of the Cortolte sensations (vertigo) produced by 30° head

Gtfterences between groups. Comparisons vere made of the per

£lte and returnetocupright head movements during of change between Fra-drinting meaworas and thove obtatnad after
rotation at 13 cpm. drinking for Controt (6), Bourton (8), and Youka (V) subjects.
Sessio0
iro Pry i 2 cy 2 cy x =
wo mus Wessure  Gomgeetson L-howr —Ashour  Gehout chou lchour—0chour
e , Mae 95.0 76.5 71.0 57.0 7.0 58.0 58.0 ‘MeAD TILT
esol gp” 179 We 168 terse Cuy 0.95 106 Loss te
pourton So toe oe 3 Me HS Cun p 0.79 Ong 9.07 0g 04
can 68. Vom an Las tm ea
vote 55" $83 dee to, SBE GS
a
cotenr MI ORE BE 2 220 $8 ge Cue out 202 oko tah
mn 29 2 ete en ge Vern 0st 028 1.07850 tot
reurnon 3p” 7a 6s Sees 8
RETURN EAD WOVEARNETS
Man 86 73 79 68 66S 69
Vodka Ey ba 22 S.2 35 3 29 32 23 Cu v 1.20 O97 0.76 1.26 an 1.39
‘RETUR usAD wovEMTS 38 cvs. 8 0.33 0.3086 0.38 oa 0.64
coucos Mam $7 91.0 so ans ms mes to TEE vn 0.580 ows war
enerol $027.9 16:2, 9012.92 210 23:3 58.8
pourvon Mem 97.0 7.2 A293. 8TH i
sp BS wr Ra Be 0 et ee
voana Meum $60 BSL 77.8 D6 Lt ee ee ee ee ee)
coneeot BB ine 6S GS te eas
rowton So oe 82 SR Se eS period, their responses were direction-fixed. The
Vota MAS AB 25 76 683 nystagmus seen in our alcohol subjects was
st a er) rae : . . .
direction-changing (ie., right-beating when the
+ head was to the right and left-beating when the
head was to the left), with the exception of
aniz UL {a) one or two alcohol subjects (depending on
Cortotie Sensation: the session) who exhibited the same direction-
esulte of statiseienl evelustions (¢ tests for correlated date) of fixed nystagmus which they exhibited during
the significance of the dtfferences between Pre-drinking Pre-trial positional testing, and (b) one subject
otsurer and thote obtained atcar drinking. (RJ; see Figure 2) who showed a “PAN-II-
for Pre-Drinking Sosston vt, type” positional response during the 27-hour
Fost-Drinking Sessions session (but not during the 24-, 30-, or 32-hour
Group shower chowt shout chur Meher Beene geggions),
SeAD TES sie sume yan Ryback and Dowd” reported PAN II in sey-
Control 3.10" 2,798 3,880 er a v
eral of their subjects 34 hours after alcohol
oorbon 2.988 Atm name a9 ata

vais se one 2s zor su—_=ingestion and hypothesized a “recycling” of PAN
I and PAN II in spite of the irregular appear-

comrot 0.78 agers 2aer he hot 22" ‘ance of these responses in their subjects. It may
Bourton 2.06 LAS aT toe ¢ .

be that our subjects were demonstrating one
vohe Lol 0.70 2k 2g LR

phase of this “recycling” and Ryback and Dowd’s
(EMEA paves subjects showed the following PAN II phase
Genero (since they were tested two hours later than our
subjects). However, discrepancies between the

Bourton 0.56 BLT L870 148

w Ce ee ee ee i
approach and results of our and other studies

Gontrot wae tes bge kay Gar "and that of Ryback and Dowd? make it difficult,
ee ae “ “oe or Gf not impossible, to explain differences in find-
ings. Furthermore, the latter authors showed

et no electronystagmographic tracings of the 34-



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mus plots,
p from the
st-ingestion.
ter (Figure
‘ked change
ions (Table

the 24-hour
d only one
Group re-

e frequency
Ided fairly
ions for the
pright head
|, but appar-
head move-
lus, for the
nystagmus
Pre levels
nd then de-
is showed a
the 1- and
somewhat

7, only five
records for
‘inking test.

lis response
neral, good
‘oups during
(see Figure
ed duration
from 93-110
was evident

ments, how-
were greater
groups, and

during the
rom that of
y may have
Inking meas-

srmycus: cw ACCEL S*7sEC FOR 18 SEC

‘SLOW PHASE NYSTAGMUS (DEG/SEC)

. ee OM oe
TIME IN SECONDS

Ficuse 5. Time-course plots of slow phase nystagmus in 3-second intervals for the Pre, 2-hour, and 8-hour ang-
ular accelerations. Alcohol depresses nystagmus in darkness.

STIMULUS: EW accEL 9*/ SEC? FoR 19 SEC
SESSION PRE oe

NYSTAGMUS FREQUENCY (BEATS /SEC)

oe aT a8 oe ase
TIME IN: SECONDS

Ficure 6. Time-course plots of the frequency of nystagmus in 3-second intervals for the Pre, 2-hour, and 8-hour
angular accelerations. The alcohol-depressed responses during the 2-hour session show some recovery in the
S-hour session. Compare with Figure 5.

STIMULUS: Cw ACCEL 5*/SEC? FOR 10 SEC
26 HOUR
30 HOUR

onrnot. orove voona crows

t

rr re er er ee)
TIME IN SECONDS

SLOW PHASE NYSTAGMUS (DEG/SEC)

Fiovre 7. Time-course plots of slow phase nystagmus in 3-second intervals for the Pre, 24-hour, and 30-hour
angular accelerations, All groups show reduced slow-phase activity as a result of repeated stimulation.

9



HEAD TILT
rob
veoh
He
z
eo
Zz
&
i oof
3
3 ool
2 0
& rob
g
3 cof
3B GROUP: CONTROL o—o
z vooka =e
8 sof @ouRBON a---0
Q ome 1 es «8 6 7 em a
ro
g HEAO RETURN
5 wok
2
z
goof
Bool
Fd
3 eof
Fd
E10
«0
s0

PRE 1 20304068 6 le ze” 30
HOURS AFTER DRINKING

Figure 10. Frequency of Coriolis (vertical) nystagmus
for each session expressed as a percentage of the
Pre-drinking level. Scores for the 1- and 2-hour
post-drinking sessions were not plotted for the
Vodka group since scorable records were obtained
from only a few subjects. In no case did alcohol
produce an enhancement of response.

is consistent with the findings of most previous
authors.24°** Qur finding of the regular con-
version of PAN I to PAN II between the fourth
and sixth post-ingestion hour is,in general agree-
ment with the findings of Walter,*? Aschan et
al? and Plenkers.?? Contrary to the findings of
the regular appearance of PAN I and PAN II,
Ryback and Dowd’? reported the irregular ap-
pearance of PAN I and PAN II 7-15 houys after
alcohol ingestion. The latter authors reported
PAN I responses from some subjects 7-10 hours
after drinking; from the earlier literature, one
ypould expect a PAN II response at this time.
Other authors gyho have extended the testing
period have found PAN II to persist until the
16th to the 20th hour. Plenker’s subject,?? who
had PAN II 20 hours after he began drinking,
had drunk four liters of beer and eight whiskeys

12

a

and his blood alcohol was 0.92 mg% at the time
of testing. Walter had reported prolongation
of PAN II with the prolongation of the drinking
period; however, both Walter and Aschan et
al found no influence on the post-ingestion
duration of PAN I with extension of the drink-
ing period, ie. PAN I appeared to last from
two to five hours after drinking was completed,
regardless of whether the drinking period was
of 30 minutes or of two hours duration.

Our results suggest at least one additional
phase of PAN well beyond the time limits that
might be expected. That phase is the “PAN-I-
type” response, observed in some of our subjects,
24-32 hours after alcohol ingestion. Although
some of the Control subjects showed apparent
positional nystagmus during the same time

HEAD TILT

8 8

T

cot GROUP: CONTROL o—o.
VODKA #—#

sof BOURBON 4---4
PRE) 203 UT 24 30

DURATION OF NYSTAGMUS TO CORIOLIS STIMULATION (%)
ee 8 = 6
8 $$ § 8 8

8

8

PRE | 2 3 4 58 6 7 @ 24 x»
HOURS AFTER DRINKING

Fievure 11. Duration of Coriolis (vertical) nystagmus
for each session expressed as a percentage of the
Pre-drinking response level. Scores for the 1- and
2-hour post-drinking sessions were not plotted for
the Vodka group since scorable records were ob-
tained from only a few subjects. In general, the
alcohol groups showed some depression of nystagmus
during post-drinking sessions.

Means 1

dor

Rated Intensity
(Ber Cent)

PS,
u
Bo
i
aU
Fo.
e
Boe
ahh TM
Be ..

Raced
Intenetty
(Pee Cent)

Vertigo
(Seconds)

E
a