bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing Space Motion Sickness
Authors: Jennings Richard T.
Published: December 2019

Space motion sickness is a well-recognized problem for space flight and affects 73% of crewmembers on the first 2 or 3 days of their initial flight. Illness severity is variable, but over half of cases are categorized as moderate to severe. Management has included elimination of provocative activities and delay of critical performance-related procedures such as extra-vehicular activity (EVA) or Shuttle landing during the first three days of missions. Pharmacological treatment strategies have had variable results, but intramuscular promethazine has been the most effective to date with a 90% initial response rate and important reduction in residual symptoms the next flight day. Oral prophylactic treatment of crewmembers with difficulty on prior flights has had mixed results. In order to accommodate more aggressive pharmacologic management, crew medical officers receive additional training in parenteral administration of medications. Preflight medication testing is accomplished to reduce the risk of unexpected performance decrements or idiosyncratic reactions. When possible, treatment is offered in the presleep period to mask potential treatment-related drowsiness. Another phenomenon noted by crewmembers and physicians as flights have lengthened is readaptation difficulty or motion sickness on return to Earth. These problems have included nausea, vomiting, and difficulty with locomotion or coordination upon early exposure to gravity. Since landing and egress are principal concerns during this portion of the flight, these deficits are of operational concern. Postflight therapy has been directed at nausea and vomiting, and meclizine and promethazine are the principal agents used. There has been no official attempt at prophylactic treatment prior to entry. Since there is considerable individual variation in postflight deficit and since adaptation from prior flights seems to persist, it has been recommended that commanders with prior shuttle landing experience be named to flights of extended duration.
Horizontal Linear and Angular Responses of Neurons in the Medial Vestibular Nucleus of the Decerebrate Cat
Authors: Schor Robert H. , Steinbacher Bernard C. , Yates Bill J.
Published: December 2019

Responses to linear accelerations in the earth-horizontal plane (typically provoked by tilts of the head or body) are characterized by a stimulus direction that produces the maximal excitation. Although changes in cardiovascular, sympathetic, and respiratory outflow are maximized during pitch, no collection of central vestibular neurons had been identified where pitch responses predominate. In the present study, response properties of neurons in the medial vestibular nucleus were examined in decerebrate cats placed on a turntable. Activation of otolith afferents was provided by constant velocity rotation with the turntable axis tilted 5° from the vertical. Responsive neurons exhibited a sinusoidal modulation in their tiring rate; the optimal excitatory stimulus direction was derived from responses to clockwise and counterclockwise rotations. Many of these neurons were also tested for input from horizontal semicircular canals using 0.5 Hz sinusoidal rotation about an earth-vertical axis. Of 22 tilt-sensitive neurons in the medial vestibular nucleus whose optimal stimulus direction was determined, 9 were best stimulated by pitch, 10 by stimuli in one of the two vertical semicircular canal planes, and 3 by roll. Of the 33 neurons in this nucleus tested for possible convergent inputs from the otolith organs and the horizontal semicircular canals, 8 responded to both the constant velocity (otolith) stimulus and to the sinusoidal rotation, 7 appeared to receive otolith, but not horizontal canal, input, while 18 had a canal, but no otolith, response. Thus, besides serving as a relay for horizontal canal signals, the medial vestibular nucleus may also be an important relay for information about orientation within the sagittal (pitch) plane.
Viewing Distance Related Sensory Processing in the Ascending Tract of Deiters Vestibulo-Ocular Reflex Pathway
Authors: Chen-Huang Chiju , McCrea Robert A.
Published: December 2019

1. The firing behavior of seven antidromically identified ascending tract of Deiters (ATD) neurons was recorded in one alert squirrel monkey trained to pursue moving targets and to fixate visual targets at different distances from the head during whole body rotation. 2. ATD cells generated signals related to contralateral horizontal smooth pursuit eye movements and to ipsilateral angular and linear head velocity. Most ATD neurons reversed the direction of their response to head rotation when the vestibulo-ocular reflex was canceled by fixation of a head stationary target. 3. ATD unit gains in respect to linear head velocity increased dramatically (>4×) when a near, earth stationary target (10 cm from the eyes) was fixated, compared to the response recorded during fixation of a far target (130 to 170 cm from the eyes). Since the viewing distance related changes in the responses of ATD neurons closely parallel the changes in the responses of the eyes, the ATD appears to be an important premotor pathway for producing viewing distance related changes in the gain of the vestibulo-ocular reflex.
The Effects of Steroids on Vestibular Compensation and Vestibular Nucleus Neuronal Activity in the Guinea Pig
Authors: Paul C. Alice A.E. , Sansom Andrew J. , Maclennan Karyn , Darlington Cynthia L. , Smith Paul F.
Published: December 2019

Recent studies have suggested that steroids such as dexamethasone and methylprednisolone might be useful in the treatment of vestibular disorders, irrespective of whether inflammatory processes are involved. The aim of this study was to investigate the effects of systemic administration of dexamethasone on vestibular compensation of spontaneous nystagmus (SN) in guinea pig, and the effects of dexamethasone and methylprednisolone on extracellularly recorded spontaneous activity of medial vestibular nucleus (MVN) neurons in brainstem slices in vitro. In the behavioral study, none of the 3 doses of dexamethasone (5, 10, or 40 mg/kg ip, delivered at 0, 12, 24, and 36 h following a unilateral surgical labyrinthectomy (UL)) resulted in a significant change in the frequency or compensation of SN, relative to the vehicle control group. In the in vitro study, only a minority of MVN neurons showed any response to 1μM dexamethasone (lout of 9 neurons), or 10 nM (3 out of 13), or 0.1μM methylprednisolone (3 out of 7). These results suggest, contrary to previous evidence, that dexamethasone may not accelerate compensation of SN following surgical UL and that dexamethasone and methylprednisolone may have a direct action only on a minority of MVN neurons.
Immunocytochemical Localization of Calmodulin in the Vestibular End-Organs of the Gerbil
Authors: Ogata Yoichi , Slepecky Norma B.
Published: December 2019

This study demonstrates the presence of calmodulin in the vestibular end-organs of the gerbil by use of immunocytochemistry. Using fluorescence microscopy, calmodulin was localized to the cytoplasm, cuticular plate, and stereocilia of both type I and type II hair cells in the sensory epithelia of the utricle and cristae ampullaris; no label was found in the supporting cells, the dark cells, or the nerve fibers. There was no immunoreactive distinction between the labeling of type I and type II hair cells in the striolar or extrastriolar regions. Thus, immunocytochemical labeling for calmodulin provides a good marker for hair cells in gerbil vestibular epithelium. The presence of calmodulin in the stereocilia was confirmed by immunoelectron microscopy using secondary antibodies coupled to colloidal gold.
The Effect of Space Missions on Gravity-Responsive Torsional Eye Movements
Authors: Diamond Shirley G. , Markham Charles H.
Published: December 2019

Three astronauts underwent preflight, inflight, and postflight testing of spontaneous ocular torsion and of ocular counterrolling (OCR), reflexes governed by the gravity-responsive otolith organs in the inner ear. One astronaut, A, had a 30-day space mission on Euromir '94 and was examined monocularly with SeusoMotoric Instruments video-oculography (VOG). The other two astronauts, B and C, were studied with a binocular VOG and flew an ISO-day mission on Euromir '95. In space, spontaneous eye torsion in the upright position was found to be substantially offset from baseline Earth-based recordings in all three subjects for the duration of the flights. In addition, the binocular studies showed a marked torsional disconjugacy. On return to Earth, offset and torsional disconjugacy persisted for many days. OCR in response to 30° right and left tilt was examined preflight and postflight. Compared to preflight, Astronaut A showed reduced OCR immediately postflight, which increased over the next few days. Both Astronauts Band C had increased OCR postflight, which gradually approached but did not achieve the preflight values over 13 days postflight. The adaptation of ocular torsion in space in one astronaut and not in the other two, and slow adaptation postflight, may reflect the lack of visual feedback and the open loop nature of the otolith-ocular torsion reflex.
Post-Rotatory Nystagmus and Turning Sensations After Active and Passive Turning
Authors: Howard Ian P. , Zacher James E. , Allison Robert S.
Published: December 2019

We measured post-rotatory nystagmus and sensations of body rotation in standing subjects brought to rest in the dark after 3 minutes of each of the following conditions: 1) passive turning about the mid-body axis, involving only vestibular stimulation, 2) active turning about the mid-body axis, involving both vestibular stimulation and motor-proprioceptive activity in the legs, and 3) stepping round while remaining facing in the same direction on the center of a rotating platform with the head held in a stationary holder (apparent turning), involving only motor-proprioceptive activity. The same acceleration-velocity profile was used in all conditions. Post-rotatory nystagmus (slow phase) occurred in the same direction to passive body turning and was reduced in velocity after active body turning. After apparent turning, nystagmus was in the opposite direction as attempted body turning. Our theoretical analysis suggests that nystagmus after active turning should conform to the mean of the responses after passive and apparent turning rather than to their sum. The results conform more closely to the mean than to the sum, but with greater weight given to vestibular inputs than to motor-proprioceptive inputs. Post-rotatory sensations of self-rotation were in the expected opposite direction after passive turning and were lower in magnitude after active turning. After apparent turning, sensations of self-rotation were in the same direction as those after attempted turning-an effect known as the antisomatogyral illusion.
Spectral Analysis of Low-Frequency, Active-Head Vestibulo-Ocular Reflex Responses
Authors: O'Leary Dennis P. , Davis Linda L.
Published: December 2019

Useful medical diagnostic information has been reported from low-frequency rotational testing of the horizontal vestibulo-ocular reflex (VOR) of patients with vestibular disorders. Servocontrolled rotating systems have been used as the only practical method to generate stimuli over lower VOR frequency response ranges, the decade from 0.01 to 0.1 Hz. Active head movements have been used for testing the human VOR at higher frequencies, exceeding 0.5 Hz. We examined whether active head movements could be used also to test the VORs of subjects over lower frequency ranges, extending to 0.02 Hz. We used a swept-frequency, active head movement protocol to generate a broad-band stimulus. Eye position was recorded with electro-oculography. Head velocity was recorded with a rotational sensor attached to a head band. Six individual test epochs from human subjects were concatenated to form complex, periodic waveforms of head and eye velocity, 75 seconds in duration. Broad-band crossspectral signal processing methods were used to compute horizontal VOR system characteristics from these waveforms extending from 0.02 to 2 Hz. The low-frequency VOR data appeared to originate from amplitude modulation of high-frequency active movements, acting as carrier signals. Control experiments and processing of simulated data from a known system excluded the possibility of signal processing artifacts. Results from six healthy subjects showed low-frequency gains and phase values in ranges similar to those from published rotational chair studies of normal subjects. We conclude that it is feasible to test the human VOR over extended low-frequency ranges using active head movements because of amplitude modulation of the head and eye signals.
Why Do Benign Paroxysmal Positional Vertigo Episodes Recover Spontaneously?
Authors: Zucca Gianpiero , Valli Stefano , Valli Paolo , Perin Paola , Mira Eugenio
Published: December 2019

It is well known that most episodes of benign paroxysmal positional vertigo (BPPV), even in untreated, recover spontaneously in 2 to 6 weeks. In the present study, we put forward the hypothesis that this is mainly due to the fact that endolymph, owing to its low calcium content (20μM) is able to dissolve otoconia. To support this, the fate of frog saccular otoconia immersed in normal endolymph (Ca2+ content 20μM) and in Ca2+-rich endolymphatic fluids (up to 500μM) was studied by observing the crystals at regular intervals for 3 weeks. The results demonstrated that normal endolymph can dissolve otoconia very rapidly (in about 20 hours). When the endolymphatic Ca2+ content was increased (50 to 200μM) otoconia dissolution time was slowed down (about 100 to 130 hours, respectively) and completely stopped when the endolymphatic Ca2+ content was of 500μM. The present results therefore suggest that the major process involved in the spontaneous recovery of BPPV episodes is the capability of the endolymph to dissolve dislodged otoconia.
Adaptation of the VOR in Patients with Low VOR Gains
Authors: Viirre Erik , Draper Mark , Gailey Clark , Miller David , Furness Thomas
Published: December 2019

Six subjects with histories of vertigo and with vestibulo-ocular reflex (VOR) gains less than 0.5 were tested in an adaptation protocol. After initial VOR testing in the dark, the subjects had a computer-driven visual display system placed on their heads. The system had the capability for variation of visual image magnification. The magnification was set to be 5% greater than the subject's average VOR gain. Subjects then performed active head movements as they carried out a visual searching task looking for objects in a panoramic scene. After 6 minutes with each image, the magnification was increased by 3 to 5%. The process was repeated for a total of 5 images, for a total increase in magnification of approximately 20% over 30 minutes. The VOR gain was measured again. In 17 of 18 conditions tested, the VOR gain increased. The average increase was 16%. Significant increases in VOR gain occurred at 0.32 and 0.64 Hz. The VOR gain increase in these patients occurred in a visual environment that lowered VOR gain in normal subjects. These results suggest that the VOR has an adaptation mechanism tuned to correct for small changes in required gain. Further research is necessary to determine if this method can result in persistent VOR gain improvements and reduction in symptoms and disability in patients with vestibular disorders.
Head-Only Rotational Testing in the Elderly
Authors: Furman Joseph M. , Durrant John D.
Published: December 2019

Head-only rotational testing (HORT) is a noninvasive technique to assess the vestibulo-ocular reflex (VOR) that can be performed in a nonlaboratory environment with inexpensive, portable equipment. Little data are available regarding the applicability of this technique to the elderly in whom limitations of cervical range of motion might reduce the usefulness of the technique. This study was designed to apply HORT to a small group of normal elderly subjects to determine whether the technique could be used successfully in this population. Also, the VOR parameters derived from HORT were compared with the results obtained from a group of healthy young control subjects. HORT was performed both with and without visual fixation of an earth-fixed target, using both active head movement and passive head movement. Results indicated that the responses of the elderly were indistinguishable from those of the young except for a slightly higher gain at 1 Hz in the young subjects. Other findings, consistent across young and elderly, were that visual fixation increased gain and decreased phase lead at lower frequencies and that VOR parameters were unaffected by volition, that is, active and passive head rotation produced similar responses. These findings suggest that HORT can be applied to the elderly without difficulty. Future studies will assess the usefulness of HORT in elderly patients with VOR disorders.
A Versatile Stereoscopic Visual Display System for Vestibular and Oculomotor Research
Authors: Kramer Phillip D. , Roberts Dale C. , Shelhamer Mark , Zee David S.
Published: December 2019

Testing of the vestibular system requires a vestibular stimulus (motion) and/or a visual stimulus. We have developed a versatile, low cost, stereoscopic visual display system, using “virtual reality” (VR) technology. The display system can produce images for each eye that correspond to targets at any virtual distance relative to the subject, and so require the appropriate ocular vergence. We elicited smooth pursuit, “stare” optokinetic nystagmus (OKN) and after-nystagmus (OKAN), vergence for targets at various distances, and short-term adaptation of the vestibulo-ocular reflex (VOR), using both conventional methods and the stereoscopic display. Pursuit, OKN, and OKAN were comparable with both methods. When used with a vestibular stimulus, VR induced appropriate adaptive changes of the phase and gain of the angular VOR. In addition, using the VR display system and a human linear acceleration sled, we adapted the phase of the linear VOR. The VR-based stimulus system not only offers an alternative to more cumbersome means of stimulating the visual system in vestibular experiments, it also can produce visual stimuli that would otherwise be impractical or impossible. Our techniques provide images without the latencies encountered in most VR systems. Its inherent versatility allows it to be useful in several different types of experiments, and because it is software driven it can be quickly adapted to provide a new stimulus. These two factors allow VR to provide considerable savings in time and money, as well as flexibility in developing experimental paradigms.
The diagnostic value of earlier and later components of Vestibular Evoked Myogenic Potentials (VEMP) in Multiple Sclerosis
Authors: Eleftheriadou A. , Deftereos S.N. , Zarikas V. , Panagopoulos G. , Sfetsos S. , Karageorgiou C.L. , Ferekidou E. , Kandiloros D. , Korres S.
Published: December 2019

Aim of the study: To evaluate the ability of VEMP to disclose spatial dissemination of Multiple Sclerosis. Materials and methods: Forty-six MS patients with auditory and /or vestibular symptoms were studied. Patients were divided in two groups. Group 1 included 24 patients with brainstem MRI findings, and Group 2 included 22 patients without MRI findings. VEMP and BAEP have been recorded and assessed. Results: Abnormal p13n23 wave was observed in 50%, while unilateral absence or bilateral delay of the n34p44 in 43% of the patients. The overall diagnostic value considering abnormal cases suggested by both first and second VEMP waves was increased to 71%. Statistically significant differences revealed between patients and controls for p13 latency (p=0.018). The p13n23 was abnormal in 7 patients, although MRI scanning did not reveal brainstem lesions. In 9 out of 18 MS patients suffering from unilateral hearing loss, n34p44 was present in the unaffected ears and absent in the affected side, although p13n23 was normal. Conclusion: Abnormal VEMP imply the presence of lesions undetected by MRI neuroimaging, which verifies the diagnostic value of the method. Unilateral absence of n34p44 complex was related with sensorineural hearing loss, supporting the hypothesis that n34p44 is of cochlear origin.
The relative effectiveness of different stimulus waveforms in evoking VEMPs: Significance of stimulus energy and frequency
Authors: Rosengren Sally M. , Govender Sendhil , Colebatch James G.
Published: December 2019

We compared the effectiveness of a series of different sound stimulus waveforms in evoking VEMPs in normal volunteers. The waveforms were clicks (0.1âĂŞ0.8 ms), biphasic clicks (0.8 ms) and sine waves (1250 Hz, 0.8 ms and 500 Hz, 2 ms) with different peak intensity and duration but similar root mean square area. VEMP amplitudes varied widely (corrected values 0.35 to 1.06), but when the amplitudes were plotted against the physical energy content and A-weighted intensity (L A e q : a measure of acoustic energy) of the waveforms, the relationship was found to be highly linear. However, when the stimuli were matched for their A-weighted energy, a 500 Hz 2 ms sine wave was the most effective waveform, suggesting that frequency tuning in the vestibular system is also an important factor. VEMP amplitude is thus determined by three stimulus-related factors: physical energy, transmission through the middle ear and vestibular frequency tuning. Use of a 500 Hz stimulus will maximise the prevalence and amplitude of the VEMP for a given sound exposure level.
Presynaptic and postsynaptic ion channel expression in vestibular nuclei neurons after unilateral vestibular deafferentation
Authors: Shao Mei , Popratiloff Anastas , Hirsch June C. , Peusner Kenna D.
Published: December 2019

Vestibular compensation refers to the recovery of function occurring after unilateral vestibular deafferentation, but some patients remain uncompensated. Similarly, more than half of the operated chickens compensate three days after unilateral vestibular ganglionectomy (UVG), but the rest remain uncompensated. This review focuses on the studies performed on the principal cells of the chick tangential nucleus after UVG. The tangential nucleus is a major avian vestibular nucleus whose principal cells are all second-order, vestibular reflex projection neurons participating in the vestibuloocular and vestibulocollic reflexes controlling posture, balance, and eye movements. Using whole-cell patch-clamp approach in brain slice preparations, spontaneous spike firing, ionic conductances, and spontaneous excitatory postsynaptic currents (sEPSCs) are recorded in principal cells from controls and operated chickens three days after UVG. In compensated chickens, the proportion of spontaneous spike firing principal cells and their spike discharge rate are symmetric on the lesion and intact sides, with the rates increased over controls. However, in the uncompensated chickens, the spike discharge rate increases on the lesion side, but not on the intact side, where only silent principal cells are recorded. In all the experimental groups, including controls, silent principal cells are distinguished from spontaneous spiking cells by smaller persistent sodium conductances and higher activation thresholds for the fast sodium channel. In addition, silent principal cells on the intact side of uncompensated chickens have larger dendrotoxin-sensitive potassium conductances, with a higher ratio of immunolabeling for surface/cytoplasmic expression of a dendrotoxin-sensitive, potassium channel subunit, Kv1.1. Finally, in compensated chickens, sEPSC frequency is symmetric bilaterally, but in uncompensated chickens sEPSC frequency increased only on the lesion side, where the expression of Kv1.2 decreased in synaptotagmin-labeled terminal profiles on the principal cell bodies. Altogether, the specific sodium and potassium channels important for the development of spike firing pattern and/or presynaptic glutamate release on vestibular reflex projection neurons may be critically involved in changing postsynaptic neuron excitability after vestibular deafferentation.
Tonic and phasic contributions to the pathways mediating compensation and adaptation of the vestibulo-ocular reflex
Authors: Minor Lloyd B. , Lasker David M.
Published: December 2019

Processes of vestibular compensation mediate recovery of many aspects of vestibular dysfunction following unilateral vestibular injury. The VOR in response to high-frequency, high-acceleration head movements, however, retains an enduring asymmetry. Head movements that are inhibitory with respect to semicircular canals on the intact side lead to a diminished VOR whereas head movements that are excitatory for semicircular canals on the intact side lead to a VOR that returns close to normal. We review our work directed toward understanding the processes of VOR compensation to high-frequency, high-acceleration head movements and the related topic of adaptation to changes in the visual requirements for a compensatory VOR. Our work has shown that the processes of both compensation and adaptation to these stimuli can be described by a mathematical model with inputs from tonic and phasic components. We have further shown that the dynamics of regular afferents have close resemblance to the tonic pathway whereas the dynamics of irregular afferents match those of the phasic pathway.
Neural substrates underlying vestibular compensation: Contribution of peripheral versus central processing
Authors: Cullen Kathleen E. , Minor Lloyd B. , Beraneck Mathieu , Sadeghi Soroush G.
Published: December 2019

The vestibulo-ocular reflex (VOR), which functions to stabilize gaze and ensure clear vision during everyday activities, shows impressive adaptation in response to environmental requirements. In particular, the VOR exhibits remarkable recovery following the loss of unilateral labyrinthine input as a result of injury or disease. The relative simplicity of the pathways that mediate the VOR, make it an excellent model system for understanding the changes (learning) that occur in the brain following peripheral vestibular loss to yield adaptive changes. This mini review considers the findings of behavioral, single unit recording and lesion studies of VOR compensation. Recent experiments have provided evidence that the brain makes use of multiple plasticity mechanisms (i.e., changes in peripheral as well as central processing) during the course of vestibular compensation to accomplish the sensory-motor transformations required to accurately guide behavior.
Stochastic galvanic vestibular stimulation produces a small reduction in sway in Parkinson's disease
Authors: Pal Sudipto , Rosengren Sally M. , Colebatch James G.
Published: December 2019

We investigated the effects of bicathodal stochastic galvanic vestibular stimulation (GVS) on body sway in normal subjects and in Parkinson's Disease (PD) patients. Twenty normal subjects and five PD patients were stimulated with four stimulus intensities between 0 and 0.5 mA and sway was measured in two stance conditions (on a compliant surface with either eyes open (EOCS) or closed (ECCS)). Subjects stood facing forward with their feet together on a force platform. Centre of pressure (CoP) displacement over 26 seconds was measured in the anteroposterior (AP) and mediolateral (ML) planes. GVS had no significant overall effect on sway in the normal subjects. In the patients a small (4.5%) significant decrease in sway was seen in the ECCS condition with low intensity (0.1 mA) stimulation (P=0.02). Similar changes were seen in the normal subjects. This work indicates that low intensities of stochastic GVS can reduce sway levels in PD patients for certain stance conditions.
Potential solutions to several vestibular challenges facing clinicians
Authors: Merfeld Daniel M. , Priesol Adrian , Lee Daniel , Lewis Richard F.
Published: December 2019

Among other problems, patients with vestibular problems suffer imbalance, spatial disorientation, and blurred vision. These problems lead to varying degrees of disability and can be debilitating. Unfortunately, a large number of patients with vestibular complaints cannot be diagnosed with the clinical tests available today. Nor do we have treatments for all patients that we can diagnose. These clinical problems provide challenges to and opportunities for the field of vestibular research. In this paper, we discuss some new diagnostic and treatment options that could become available for tomorrow's patients. As a new diagnostic, we have begun measuring patient's perceptual direction-detection thresholds. Preliminary results appear encouraging; patients diagnosed with bilateral loss have yaw rotation thresholds almost ten times greater than normals, while patients diagnosed with migraine associated vertigo have roll tilt thresholds well below normal at 0.1 Hz. As a new treatment, we have performed animal studies looking at responses evoked by electrical stimulation provided by a vestibular prosthesis. Results measuring the VOR demonstrate promise and preliminary studies of balance and perception are also encouraging. While electrical stimulation is a standard means of stimulation, optical stimulation is also being investigated as a way to improve prosthetic stimulation specificity.
Neurovestibular effects of bed rest and centrifugation
Authors: Jarchow T. , Young L.R.
Published: December 2019

Subjective body position, as influenced by 21-day 6Âř-head-down bed rest and intermittent supine centrifugation, was investigated in two experimental groups. Treatment subjects were exposed to a daily dose of 1-hour of horizontal centrifugation, whereas control subjects were also put on the centrifuge, but were not spun. During the centrifuge runs subjects were exposed to a constant gradient with 1-G z at the heart and 2.5-G z at the feet. Subjects reported their subjective postural position (SPP) before, during and after each 1-hour centrifuge exposure. We find that subjects shift their frame of reference over the first week of bed rest and perceive the 6Âř-head-down position as horizontal. Spinning shifts the SPP by about 30Âř towards an upright position, consistent with the angle of the gravito-inertial vector positioned close to the vestibular system. The SPP estimates for the upper and lower body failed to reflect the massive gravity gradient between head and feet, and subjects generally reported a single tilt for the whole body.
Auditory-pupillary responses in deaf subjects
Authors: Kitajima Naoharu , Otsuka Koji , Ogawa Yasuo , Shimizu Shigetaka , Hayashi Mami , Ichimura Akihide , Suzuki Mamoru
Published: December 2019

Pupillary dilation in response to sound stimuli is well established and is generally considered to represent a startle reflex to sound. We believe that the auditory-pupillary response represents not only a simple startle reflex to sound stimuli but also represents a reaction to stimulation of other sense organs, such as otolith organs. Eight young healthy volunteers without a history of hearing and equilibrium problems and 12 subjects with bilateral deafness participated in this study. Computer pupillography was used to analyze the auditory-pupillary responses of both eyes in all subjects. We found that auditory-pupillary responses occurred even in subjects with bilateral deafness and that this response was comparable to those of normal subjects. We propose that the auditory-pupillary response also relates to vestibular function. Thus, assessing the auditory-pupillary response may be useful for evaluating the vestibulo-autonomic response in patients with peripheral disequilibrium.
Test-retest reliability of vibration-induced nystagmus in peripheral dizzy patients
Authors: Park HongJu , Lee YeoJin , Park MunSu , Kim JaeMyung , Shin JungEun
Published: December 2019

The purpose of this study was to analyze test-retest reliability of vibration-induced nystagmus (VIN) in dizzy patients. Fifty-two consecutive patients with positive eye movements induced by vibration at all four different stimulation sites were enrolled. Evaluation of VIN was repeated in 2 separate sessions, 30 minutes apart. Maximum slow-phase eye velocities at different sites from the first and second sessions were assessed via the intraclass correlation coefficient (ICC) and the Pearson correlation coefficient. The incidence of directional changing of evoked nystagmus and the abnormal rates were also evaluated. Excellent reliability with ICC values ranging from 0.89–0.98 and substantial-to-excellent correlation was obtained for the maximum slow-phase eye velocities at different sites. The incidence of directional changes of evoked nystagmus was 0%–4% at each stimulation site. Forty-three patients (83%) had abnormal results in the first session and 41 patients (79%) had abnormal results in the second session. Overall, the direction and maximum slow-phase eye velocities of VIN for different stimulation sites had excellent test-retest reliability. The VIN test is a reliable test for detecting vestibular imbalance in evaluating a dizzy patient.
A re-investigation of the role of utricular asymmetries in Space Motion Sickness
Authors: Nooij S.A.E. , Vanspauwen R. , Bos J.E. , Wuyts F.L.
Published: December 2019

During the first days of spaceflight, about 50–70% of the astronauts experience symptoms of Space Motion Sickness (SMS). It has been proposed that an asymmetry between the left and right otolith organs contributes to an astronaut's individual susceptibility. A recently developed test to measure unilateral utricular function enabled us to re-investigate this so-called otolith asymmetry hypothesis, while using the paradigm of sustained centrifugation as a ground based model for SMS. This latter paradigm has been shown to elicit symptoms similar to those of SMS and is referred to as Sickness Induced by Centrifugation (SIC). In 15 healthy subjects unilateral utricular function was assessed by recording ocular counter rolling during a unilateral centrifugation paradigm. In addition, saccular function was assessed by recording Vestibular Evoked Myogenic Potentials (VEMPs), and horizontal semicircular canal function was assessed using bithermal caloric stimulation. SIC-susceptible subjects showed a marginally higher degree of utricular asymmetry, utricular sensitivity and semicircular canal sensitivity (p < 0.1) than the non-susceptible group. Interestingly, a logistic regression model using both utricular and semicircular canal parameters led to a correct classification of 91% of the subjects. As such, these results suggest that otolith asymmetry is at most one factor – and not present in all susceptible subjects – in defining susceptibility to SMS and SIC. Both the utricular and the canal system might be involved as well.
Differences between perception and eye movements during complex motions
Authors: Holly Jan E. , Davis Saralin M. , Sullivan Kelly E.
Published: December 2019

During passive whole-body motion in the dark, the motion perceived by subjects may or may not be veridical. Either way, reflexive eye movements are typically compensatory for the perceived motion. However, studies are discovering that for certain motions, the perceived motion and eye movements are incompatible. The incompatibility has not been explained by basic differences in gain or time constants of decay. This paper uses three-dimensional modeling to investigate gondola centrifugation (with a tilting carriage) and off-vertical axis rotation. The first goal was to determine whether known differences between perceived motions and eye movements are true differences when all three-dimensional combinations of angular and linear components are considered. The second goal was to identify the likely areas of processing in which perceived motions match or differ from eye movements, whether in angular components, linear components and/or dynamics. The results were that perceived motions are more compatible with eye movements in three dimensions than the one-dimensional components indicate, and that they differ more in their linear than their angular components. In addition, while eye movements are consistent with linear filtering processes, perceived motion has dynamics that cannot be explained by basic differences in time constants, filtering, or standard GIF-resolution processes.
Motion sickness: A cholinomimetic agent hypothesis
Authors: Sheehan Scott E. , Oman Charles M. , Duda Kevin R.
Published: December 2019

Motion sickness has been defined as a set of physiological signs and symptoms produced as a result of prolonged sensory conflict in central nervous system vestibular centers. It has long been noted that the particular pattern of motion sickness signs and symptoms does not fit the conventional "fight or flight vs. rest and digest" autonomic synergy. We argue that most of the progression of symptoms is consistent with a new etiologic hypothesis: that an as-yet-unidentified ganglionic cholinomimetic agent is slowly released in proportion to sensory conflict. The agent accumulates systemically and stimulates the peripheral sympathetic and parasympathetic ganglia, the adrenal medulla, and potentiates the response of central cholinergic emetic pathways to the same conflict stimulus. The predominant effects of ganglionic stimulation on each autonomic organ, determined by resting tone, are selectively enhanced or inhibited by adrenal catecholamine release, producing the atypical pattern of autonomic changes seen in motion sickness. The adrenergic response may eventually also counter the central emetic drive. The hypothesis could be experimentally pursued via human and animal experiments employing a nicotinic antagonist that has both central and peripheral ganglionic actions such as mecamylamine.
Optokinetic response in patients with vestibular areflexia
Authors: Huygen Patrick L.M. , Verhagen Wim I.M.
Published: December 2019

Optokinetic nystagmus (OKN) responses (stimuli 40°/s and 60°/s) were evaluated in 121 patients with vestibular areflexia (VA) and were compared with a control group of 99 control subjects matched by age. The mean response levels were significantly higher in the VA group than in the control group: 1.7°/s at 40°/s stimulation, and 4.4°/s at 60°/s. The VA group showed a significantly wider scattering and greater variances and, as a group, they exhibited higher OKN gains than the control subjects. We suggest that the higher gain of OKN responses in VA patients can be attributed to an increased efficiency in signal processing by the cortical optokinetic system. This enhancement may be similar to the enhancement which, in healthy subjects, is produced by "optokinetic training".
Changes of amino acid concentrations in the rat vestibular nuclei after midline lesions
Authors: Sun Yizhe , Godfrey Donald A. , Godfrey Matthew A. , Hong Steven , Jin Yong-Ming , Rubin Allan M.
Published: December 2019

Changes in concentrations of amino acids, especially GABA, glutamate, and aspartate, occur in vestibular nuclei after removal of cerebellar and labyrinth inputs. Here, we examined the effects of transecting midline-crossing connections between the two vestibular nuclear complexes, which especially include commissural connections. Three rats were euthanized at each of 2, 7, and 30 days after a midline cut at the level of the vestibular nuclei. Two sham-lesioned rats were prepared for surgery but no cut made. Samples of superior (SuVN), dorsal and ventral lateral (LVNd and LVNv), dorsal and ventral medial (MVNd and MVNv), and spinal vestibular nuclei (SpVN) were microdissected from freeze-dried coronal sections and assayed for amino acid concentrations. Reductions of GABA concentration occurred by 2 days and continued through 30 days after surgery in most regions. Glutamate and aspartate concentrations decreased by 2 days in LVN and MVN, then glutamate showed some recovery by 30 days. Glutamine and taurine concentrations increased in almost all regions. Glycine concentration decreased in MVN and LVNv. Our results support association of GABA, glutamate, aspartate, and to some extent glycine, with vestibular crossed connections. Comparisons to our previous studies suggest some complex lesion effects, especially in LVNd.
Epidemiological evidence for a link between vertigo and migraine
Authors: von Brevern Michael , Neuhauser Hannelore
Published: December 2019

Both migraine and dizziness/vertigo rank among the most common complaints in the general population. Worldwide, the lifetime prevalence of migraine is about 14%. Approximately 20% to 30% of the general population are affected by dizziness and vertigo. Given the high prevalence of vertigo and migraine in the general population it is not surprising that many patients suffer from both symptoms. Nonetheless, in the last decade epidemiological arguments have progressively accumulated to strengthen the hypothesis that vertigo is linked to migraine beyond a mere chance concurrence. Several studies with selected patient groups have shown that the prevalence of vertigo is increased in patients with migraine. Vice versa, patients presenting to a dizziness clinic have a history of migraine more often than would be expected by chance. The epidemiological link between vertigo and migraine has recently been confirmed on the population level. The relation between vertigo and migraine is intricate. In vestibular migraine, vertigo is conceptualized as a vestibular symptom caused by migraine. Vestibular migraine is the most common cause for recurrent spontaneous vertigo with a lifetime-prevalence in the general population of about 1%. Other vestibular disorders that display an increased prevalence of migraine are benign paroxysmal positional vertigo and Menière's disease. Furthermore, migraine is associated with motion sickness, rare ataxia disorders and psychiatric syndromes that can also manifest with vertigo and dizziness.
Experimental parameter estimation of a visuo-vestibular interaction model in humans
Authors: Laurens Jean , Valko Yulia , Straumann Dominik
Published: December 2019

Visuo-vestibular interactions in monkeys can be accurately modelled using the classical Raphan and Cohen's model. This model is composed of direct vestibular and visual contributions to the vestibulo-ocular reflex (VOR) and of a velocity storage. We applied this model to humans and estimated its parameters in a series of experiments: yaw rotations at moderate (60°/s) and high velocities (240°/s), suppression of the VOR by a head-fixed wide-field visual stimulus, and optokinetic stimulation with measurements of optokinetic nystagmus (OKN) and optokinetic afternystagmus (OKAN). We found the velocity storage time constant to be 13 s, which decreased to 8 s during visual suppression. OKAN initial velocity was 12% of the OKN stimulus velocity. The gain of the direct visual pathway was 0.75 during both visual suppression and OKN; however, the visual input to the velocity storage was higher during visual suppression than during OKN. We could not estimate the time constant of the semicircular canals accurately. Finally, we inferred from high-velocity rotations that the velocity storage saturates around 20–30°/s. Our results indicate that the dynamics of visuo-vestibular interactions in humans is similar as in monkeys. The central integration of visual cues, however, is weaker in humans.
Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall
Authors: Honaker Julie A. , Shepard Neil T.
Published: December 2019

Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58–78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of > 0.25.
Are evolutionary hypotheses for motion sickness "just-so" stories?1
Authors: Oman Charles M.
Published: December 2019

Vertebrates have evolved rapidly conditionable nausea and vomiting reflexes mediated by gut and brainstem receptors, clearly as a defense against neurotoxin ingestion. In 1977 Treisman proposed that sensory orientation linkages to emetic centers evolved for the same reason, and that motion sickness was an accidental byproduct. It was an “adaptationist” explanation for motion sickness, since it assumed that evolution has shaped all phenotypic traits for survival advantage. Treisman's “poison” theory is plausible, and frequently cited as the accepted scientific explanation for motion sickness. However, alternative explanations have been proposed. The creation of hypotheses is an essential part of science – provided they are testable. This paper reviews the evidence for the Poison theory and several other adaptationist explanations. These hypotheses are certainly not “just-so stories”, but supporting evidence is equivocal, and contradictory evidence exists Parsimony suggests an alternative “pluralistic” view: The vertebrate reticular formation maintains oxygenated blood flow to the brain, discriminates unexpected sensory stimuli- including postural disturbances, and detects and expels ingested neurotoxins. The three systems share neuroarchitectural elements but normally function independently. Brainstem sensory conflict neurons normally discriminate brief postural disturbances, but can be abnormally stimulated during prolonged passive transport (e.g. by boat, beginning about 150–200 generations ago). Sensory conflict signals cross couple into the neurotoxin expulsion and avoidance system, producing an arguably maladaptive emetic phenotype.