Vestibulo-ocular reflex

Overview. Neurologists are frequently called upon to evaluate patients with vertigo and dizziness and, in some cases, to make sense of abnormal vestibular tests. Consequently, it is useful to have some familiarity with the methods used to test vestibular function. The vestibulo-ocular reflex (VOR) is a reflex that acts at short latency to generate eye movements that compensate for head

Vestibulo-Ocular Reflex (VOR) abnormalities in cerebellar ataxias are a matter of renewed interest. We have previously reported vestibular areflexia in a group of Yemenite-Jews with Spinocerebellar Ataxia Type 3 (SCA3) who had clear bilateral pathological horizontal Head Impulse Test (HIT). The objective of this study was to evaluate the VOR of ten SCA3 patients who have variable bedside HIT responses by recording their eye movements using magnetic search coils and to correlate these results with their clinical and genetic data. Eight out of the ten patients have abnormal horizontal HIT detected by both clinical bedside examination and laboratory tests. Results of bedside HIT testing were significantly correlated with the VOR gain recorded using magnetic search coils. No significant correlations were found between VOR gain and other clinical or genetic data. Our study confirms the presence of defective VOR in SCA3 patients and corroborates the useful of the HIT as a reliable bedside test for diagnosis of VOR deficits.

Vestibular reflexes act to stabilize the head and eyes in space during locomotion. Head stability is essential for postural control, whereas retinal image stability enhances visual acuity and may be essential for an animal to distinguish self-motion from that of an object in the environment. Guinea pig eye and head movements were measured during passive whole-body rotation in order to assess the efficacy of vestibular reflexes. The vestibulo-ocular reflex (VOR) produced compensatory eye movements with a latency of ~7 ms that compensated for 46% of head movement in the dark and only slightly more in the light (54%). Head movements, in response to abrupt body rotations, also contributed to retinal stability (21% in the dark; 25% in the light) but exhibited significant variability. Although compensatory eye velocity produced by the VOR was well correlated with head-in-space velocity, compensatory head-on-body speed and direction were variable and poorly correlated with body speed. The compensatory head movements appeared to be determined by passive biomechanical (e.g., inertial effects, initial tonus) and active mechanisms (the vestibulo-collic reflex or VCR). Chemically induced, bilateral lesions of the peripheral vestibular system abolished both compensatory head and eye movement responses.

The vestibulo-ocular reflex was studied at high frequencies of active head rotation (2 to 6 Hz) in twenty-three patients with benign positional vertigo (BPPV). Gain and phase measurements were obtained in the vertical and horizontal planes, and the results were compared to those of a control group consisting of 19 asymptomatic age-matched subjects. In the horizontal plane, the phase lead was significantly smaller in patients with BPPV as compared to controls (p < 0.01 at all frequencies). Vertical results did not differ from normals. These findings challenge "cupulolithiasis" as an explanation of the mechanism of BPPV's symptoms.

Abstruct- We present a comlbined head-eye tracking system suitable for use with free head imovement during natural activ- ities. This system provides an integrated head and eye position measurement while allowing for a large range of head movement (approx 1.8 m of head translation is tolerated). Six degrees of freedom of head motion and two degrees of freedom of eye

The contribution of neck proprioceptive signals to signal processing in the vestibular nucleus was studied by recording responses of secondary horizontal canal-related neurons to neck rotation in the squirrel monkey. Responses evoked by passive neck rotation while the head was held stationary in space were compared with responses evoked by passive whole body rotation and by forced rotation of the head on the trunk. Most neurons (76%; 45/59) were sensitive to neck rotation. The nature and strength of neck proprioceptive inputs varied and usually combined linearly with vestibular inputs. In most cases (94%), the direction of the neck proprioceptive input was "antagonistic" or "reciprocal" with respect to vestibular sensitivity and, consequently, reduced the vestibular response during head-on-trunk rotation. Different types of vestibular neurons received different types of proprioceptive input. Neurons whose firing behavior was related to eye position (position-vestibular-pause neurons and position-vestibular neurons) were often sensitive to the position of the head with respect to the trunk. The sensitivity to head position was usually in the same direction as the neuron's eye position sensitivity. Non-eye-movement related neurons and eye-head-velocity neurons exhibited the strongest sensitivity to passive neck rotation and had signals that were best related to neck velocity. The results suggest that neck proprioceptive inputs play an important role in shaping the output of the primate vestibular nucleus and its contribution to posture, gaze and perception.

Background and Aim: Several studies have shown the anatomical associations between the vestibular system and cognitive processes, especially spatial memory. One of the first problems that occur in Alzheimer's disease (AD) is spatial memory deficits. The preclinical stage of AD is mild cognitive impairment (MCI). Amnestic type of MCI (aMCI) is more likely to progress to AD. Previous studies have demonstrated high incidence of vestibular disorders in AD patients; however, the balance system of aMCI patients has not been investigated. Therefore, the present study aimed to investigate vestibulo-ocular reflex (VOR) impairments in aMCI patients compared with control group. Methods: In this cross-sectional study VOR gain and catch-up saccades in six semicircular canals were measured in 12 aMCI patients and 12 normal controls using video head impulse test. Results: Vestibulo-ocular reflex gains in direction of all vertical semicircular canals were lower in aMCI-compared with normal-group (right anterior canal 0.74±0.17 vs 0.87±0.12; right

It is well known that vergence movements are important for distance appreciation, depth vision and stereopsis. Moreover, vergence movements are very probably used by the CNS during head and body motion to adjust the gain of the vestibulo-ocular reflex (VOR) according to the viewing distance. A recent clinical study of Anoh-Tanon et al. suggested that vertigo in children with normal vestibular function could be associated with abnormal vergence clinically assessed. The purpose of this study was to test this hypothesis with objective vergence eye movement recordings. We examined the latency of vergence, saccades and combined movements in twelve children with the complaint of vertigo but without vestibular abnormality. Convergence and saccades combined with convergence or with divergence had abnormally long latencies (relative to normal children of matched age). In contrast, divergence and isolated saccades showed only mild latency increase relative to normals. Lengthening of latency could be due to impaired cortical control. Orthoptic vergence training reduced all latencies; however, even the reduced latency of vergence and of combined movements was still abnormal. The improvement after orthoptic vergence training could be due to increased visual attention, although such mechanism cannot eliminate completely the initiation deficit of vergence movements. Objective eye movement recordings are thus useful for a diagnosis and treatment of children with vertigo.