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PubMed1995

Vestibulo-ocular reflex.

Recent animal and clinical studies on the vestibulo-ocular reflex deal with a number of physiological and clinical aspects from which three were chosen for this review: (1) the torsional vestibulo-ocular reflex and its disorders; (2) the otolith contribution to the vestibulo-ocular reflex; and (3) neurotransmitters, neuropharmacological aspects, and medical treatment. Disorders of the vestibulo-ocular reflex can be classified according to the three major planes of action, yaw plane, pitch plane, and roll plane, which equate with horizontal nystagmus, upbeat or downbeat nystagmus, and torsional nystagmus, respectively. The particular interest in the torsional vestibulo-ocular reflex arises from new methods for measuring ocular torsion, especially the three-dimensional eye-movement recordings with scleral coils. These methods make it possible to do three-dimensional analysis of the differential effects of horizontal and vertical semicircular canal function and their individual disorders of the torsional vestibulo-ocular reflex. Otolith and semicircular canal inputs converge at the level of the vestibular nuclei to subserve static graviceptive and dynamic torsional and pitch function. The elaboration of the particular sensorial weight of the input from either the otoliths or the semicircular canal is currently a challenge for both physiologists and neurologists. Disorders of otolith function, still absent from the diagnostic repertoire of most neurologists, are increasingly being reported. The most promising developments in therapeutic measures may come from research on vestibular neurotransmitters, their agonists and antagonists. A number of pharmacological agents are effective suppressants of pathological eye movements. However, systematic prospective studies are needed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2007

The influence of otolith dysfunction on the clinical presentation of people with a peripheral vestibular disorder.

BACKGROUND AND PURPOSE: Traditional vestibular function testing has measured horizontal semicircular canal function only. Otolith function tests have recently been developed, but their clinical significance has not been determined. The purpose of this study was to investigate the influence of otolith dysfunction on the clinical presentation of individuals with a peripheral vestibular disorder. SUBJECTS AND METHODS: Twenty-one subjects with loss of horizontal semicircular canal function only and 37 subjects with combined loss of horizontal semicircular canal and otolith organ function were recruited. All subjects received a comprehensive clinical assessment, including self-report questionnaires and measures of balance performance. RESULTS: No significant differences were identified between subjects with or without otolith dysfunction with respect to symptom severity, self-perceived handicap, functional limitations, or balance performance. DISCUSSION AND CONCLUSION: Otolith dysfunction does not significantly influence the clinical presentation of individuals with a peripheral vestibular disorder. Other factors, including symptom severity, may be more influential.

Activities of Daily Living↗

PubMed1990

Spatial properties of second-order vestibulo-ocular relay neurons in the alert cat.

Second-order vestibular nucleus neurons which were antidromically activated from the region of the oculomotor nucleus (second-order vestibuloocular relay neurons) were studied in alert cats during whole-body rotations in many horizontal and vertical planes. Sinusoidal rotation elicited sinusoidal modulation of firing rates except during rotation in a clearly defined null plane. Response gain (spike/s/deg/s) varied as a cosine function of the orientation of the cat with respect to a horizontal rotation axis, and phases were near that of head velocity, suggesting linear summation of canal inputs. A maximum activation direction (MAD) was calculated for each cell to represent the axis of rotation in three-dimensional space for which the cell responded maximally. Second-order vestibuloocular neurons divided into 3 non-overlapping populations of MADs, indicating primary canal input from either anterior, posterior or horizontal semicircular canal (AC, PC, HC cells). 80/84 neurons received primary canal input from ipsilateral vertical canals. Of these, at least 6 received input from more than one vertical canal, suggested by MAD azimuths which were sufficiently misaligned with their primary canal. In addition, 21/80 received convergent input from a horizontal canal, with about equal number of type I and type II yaw responses. 4/84 neurons were HC cells; all of them received convergent input from at least one vertical canal. Activity of many vertical second-order vestibuloocular neurons was also related to vertical and/or horizontal eye position. All AC and PC cells that had vertical eye position sensitivity had upward and downward on-directions, respectively. A number of PC cells had MADs centered around the MAD of the superior oblique muscle, and 2/3 AC cells recorded in the superior vestibular nucleus had MADs near that of the inferior oblique. Thus, signals with spatial properties appropriate to activate oblique eye muscles are present at the second-order vestibular neuron level. In contrast, none of the second-order vestibuloocular neurons had MADs near those of the superior or inferior rectus muscles. Signals appropriate to activate these eye muscles might be produced by combining signals from ipsilateral and contralateral AC neurons (for superior rectus) or PC neurons (for inferior rectus). Alternatively, less direct pathways such as those involving third or higher order vestibular or interstitial nucleus of Cajal neurons might play a crucial role in the spatial transformations between semicircular canals and vertical rectus eye muscles.

Animals↗

PubMed2002

Inferior vestibular neuritis.

Sudden, spontaneous, unilateral loss of vestibular function without simultaneous hearing loss or brain stem signs is generally attributed to a viral infection involving the vestibular nerve and is called acute vestibular neuritis. The clinical hallmarks of acute vestibular neuritis are vertigo, spontaneous nystagmus, and unilateral loss of lateral semicircular function as shown by impulsive and caloric testing. In some patients with vestibular neuritis the process appears to involve only anterior and lateral semicircular function, and these patients are considered to have selective superior vestibular neuritis. Here we report on two patients with acute vertigo, normal lateral semicircular canal function as shown by both impulsive and caloric testing, but selective loss of posterior semicircular canal function as shown by impulsive testing and of saccular function as shown by vestibular evoked myogenic potential testing. We suggest that these patients had selective inferior vestibular neuritis and that contrary to conventional teaching, in a patient with acute spontaneous vertigo, unilateral loss of lateral semicircular canal function is not essential for a diagnosis of acute vestibular neuritis.

Adult↗

PubMed2003

Aging attenuates the vestibulorespiratory reflex in humans.

Activation of the vestibular system changes ventilation in humans. The purpose of the present study was to investigate whether aging alters the vestibulorespiratory reflex in humans. Because aging attenuates the vestibulosympathetic reflex, it was hypothesized that aging would attenuate the vestibulorespiratory reflex. Changes in ventilation during engagement of the semicircular canals and/or the otolith organs were measured in fourteen young (26 +/- 1 years) and twelve older subjects (66 +/- 1 years). In young subjects, natural engagement of the semicircular canals and the otolith organs by head rotation increased breathing frequency during dynamic upright pitch at 0.25 Hz (15 cycles min-1) and 0.5 Hz (30 cycles min-1) (delta2 +/- 1 and delta4 +/- 1 breaths min-1, respectively; P < 0.05) and during dynamic upright roll (delta2 +/- 1 and delta4 +/- 1, respectively; P < 0.05). In older subjects, the only significant changes in breathing frequency occurred during dynamic pitch and roll at 0.5 Hz (delta2 +/- 1 and delta2 +/- 1 for pitch and roll, respectively). Stimulation of the horizontal semicircular canals by yaw rotation increased minute ventilation in young but not older subjects. Selective engagement of the otolith organs during static head-down rotation did not alter breathing frequency in either the young or older subjects. The results of this study indicate that the vestibulorespiratory reflex is attenuated in older humans, with greater vestibular stimulation needed to activate the reflex.

Adult↗

PubMedDate not supplied

The number of procedures required to eliminate positioning nystagmus in benign paroxysmal positional vertigo.

AIM: To evaluate the number of weekly canalith repositioning procedures needed to eliminate positioning nystagmus in patients with benign paroxysmal positional vertigo and to verify influences of canalithiasis or cupulolithiasis and/or semicircular canal involvement. STUDY DESIGN: clinical prospective with transversal cohort. MATERIAL AND METHOD: Sixty patients with benign paroxysmal positional vertigo were consecutively selected according to each combination of canalithiasis or cupulolithiasis with semicircular canal involvement. Patients were treated by means of canalith repositioning procedures repeated weekly until the elimination of the positioning nystagmus. Analysis of Variance was used to verify differences between the variables. RESULTS: An average of 2.13 procedures (from 1 to 8) was needed to eliminate the positioning nystagmus. Canalithiasis required an average of 1.53 procedures, while cupulolithiasis needed 2.92 procedures (p=0.0002). An average of two procedures was needed to eliminate the positioning nystagmus in cases with posterior canal involvement, 2.39 procedures in cases with anterior canal involvement and 2.07 procedures in cases with lateral canal involvement (p=0.5213). CONCLUSIONS: From one to eight weekly canalith repositioning procedures were needed, with an average of two, to eliminate positioning nystagmus in benign paroxysmal positional vertigo. Cupulolithiasis requires a greater number of procedures than canalithiasis to eliminate positioning nystagmus. Semicircular canal involvement didn't influence the number of therapeutic maneuvers.

Adolescent↗

PubMed1998

[Mechanism of benign, peripheral, paroxysmal positional vertigo (BPPV)].

BACKGROUND: Positioning nystagmus of the peripheral benign type (BPPV) has long been considered to be due to cupulolithiasis-i.e. attachment of inorganic material to the cupula-of the posterior vertical semicircular canal. Meanwhile it has generally been recognized that not all characteristics of this type of nystagmus/vertigo can be explained by assuming a gravity-dependent reaction of the posterior canal. Canalolithiasis-i.e. floating material within the canal, heavier than endolymphe-of the posterior semicircular canal is now widely regarded as the cause of BPPV. Again, however, this is a concept far too simple to explain most of the properties of BPPV. METHODS: Clearly defined, carefully performed positioning and positional maneuvers were carried out on 79 patients suffering from typical BPPV in order to reveal those positioning movements and positions necessary to elicit BPPV. RESULTS: Detailed analysis of those positioning maneuvers necessary to elicit BPPV clearly reveals that canalolithiasis cannot be the cause of BBPV. CONCLUSIONS: BPPV is a combination of positioning, and positional-dependent reactions in which the otolithic organs, and particularly the sacculus, seem to be involved.

Adult↗

PubMed1992

Filtering properties of hair cells.

Three questions were asked about filtering properties of hair cells. First, it was asked if hair cells in different receptors showed different filtering properties to match the receptor response to the particular characteristics of the stimulus? It seems that the answer is yes, since for example, the resonant frequencies of pigeon semicircular hair cells at membrane potentials around the RMP are in a range (12-280 Hz) that could match angular head frequencies. Since critical frequency tuning of one frequency probably is not necessary for the semicircular canals it is quite reasonable that the largest quality factor (Qe) of resonance in pigeon semicircular canal hair cells for membrane potentials around the RMP is 4 times lower than the largest Qe in bullfrog saccular hair cells and 10 times lower than Qe in the turtle basilar papilla. Second, it was asked if hair cells of the same morphological type but in different regions of the neuroepithelium have different filtering properties. It seems that this question needs more careful study since most available data on hair cells that show different filtering properties depending on their location in the neuroepithelium show subtle morphological differences and therefore the hair cells could be classified as different types. Finally, it was asked if different hair cell types (based on morphology and innervation) have different filtering properties. The currents in pigeon and guinea pig type I and type II semicircular canal hair cells, guinea pig inner and outer cochlear hair cells, goldfish short and tall saccule hair cells and chick short and tall cochlea hair cells suggest that the answer to this question is yes. The challenge is to continue to precisely specify the filtering properties of different types of hair cells in different places on the neuroepithelium of different receptors.

Animals↗

PubMed2002

A new classification for cochleovestibular malformations.

OBJECTIVE: The report proposes a new classification system for inner ear malformations, based on radiological features of inner ear malformations reviewed in 23 patients. STUDY DESIGN: The investigation took the form of a retrospective review of computerized tomography findings relating to the temporal bone in 23 patients (13 male and 10 female patients) with inner ear malformations. The subjects were patients with profound bilateral sensorineural hearing loss who had all had high-resolution computed tomography (CT) with contiguous 1-mm-thick images obtained through the petrous bone in axial sections. METHODS: The CT results were reviewed for malformations of bony otic capsule under the following subgroups: cochlear, vestibular, semicircular canal, internal auditory canal (IAC), and vestibular and cochlear aqueduct malformations. Cochlear malformations were classified as Michel deformity, common cavity deformity, cochlear aplasia, hypoplastic cochlea, incomplete partition types I (IP-I) and II (IP-II) (Mondini deformity). Incomplete partition type I (cystic cochleovestibular malformation) is defined as a malformation in which the cochlea lacks the entire modiolus and cribriform area, resulting in a cystic appearance, and there is an accompanying large cystic vestibule. In IP-II (the Mondini deformity), there is a cochlea consisting of 1.5 turns (in which the middle and apical turns coalesce to form a cystic apex) accompanied by a dilated vestibule and enlarged vestibular aqueduct. RESULTS: Four patients demonstrated anomalies involving only one inner ear component. All the remaining patients had diseases or conditions affecting more than one inner ear component. Eight ears had IP-I, and 10 patients had IP-II. Ears with IP-I had large cystic vestibules, whereas the amount of dilation was minimal in patients with IP-II. The majority of the semicircular canals (67%) were normal. Semicircular canal aplasia accompanied cases of Michel deformity, cochlear hypoplasia, and common cavity. In 14 ears, the IAC had a defective fundus at the lateral end. In two ears the IAC was absent. In all seven cases of common cavity malformations, there was a bony defect at the lateral end of the IAC. In five of them the IAC was enlarged, whereas in two the IAC was narrow. All patients with IP-I had an enlarged IAC, whereas in patients with type II disease, four had a normal IAC and 10 had an enlarged IAC. All cases of IP-II had an enlarged vestibular aqueduct, whereas this finding was not present in any of the cases of IP-I. In all cases, the vestibular aqueduct findings were symmetrical on both sides (simultaneously normal or enlarged). No patient demonstrated enlargement or any other abnormalities involving the cochlear aqueduct. CONCLUSIONS: Radiological findings of congenital malformations in the present study suggested two different types of incomplete partition. Cystic cochleovestibular malformation (IP-I) and the classic Mondini deformity (IP-II). The type I malformation is less differentiated than the type II malformation. Classic Mondini deformity has three components (a cystic apex, dilated vestibule, and large vestibular aqueduct), whereas type I malformation has an empty, cystic cochlea and vestibule without an enlarged vestibular aqueduct. Mondini deformity represents a later malformation, so the amount of dysplasia is much less than in type II. Therefore, it is more accurate and useful for clinical purposes to classify these malformations (in descending order of severity) as follows: Michel deformity, cochlear aplasia, common cavity, IP-I (cystic cochleovestibular malformation), cochlear hypoplasia, and IP-II (Mondini deformity). Only in this way can these complex malformations be grouped precisely and the results of cochlear implantation compared.

Child↗

PubMed1993

Effect of changes in blood pressure on per-rotational nystagmus in guinea pigs with obliterated endolymphatic sac.

The effect of blood pressure (BP) changes on per-rotational nystagmus (PRN) was compared between normal guinea pigs and guinea pigs with unilaterally obliterated endolymphatic sac. Eye movements were recorded 3 months postoperatively. When the animal was rotated sinusoidally, asymmetry of PRN was minimal in the control animals. In the operated guinea pigs, however, nystagmus oscillating toward the operated side was largely suppressed when BP was decreased (30-40 mmHg). Thus, directional preponderance of PRN toward the nonoperated side was established. Oxygen tension (pO2) was measured in the perilymphatic space of the lateral semicircular canal to investigate the mechanisms underlying the PRN asymmetry. When BP was reduced below normal, pO2 on the operated side decreased much more than that on the intact side. It is suggested that obliteration of the endolymphatic sac results in an autoregulatory dysfunction in the semicircular canal. Asymmetry of the vestibulo-oculomotor reflex at low BP may be the result of decreased blood flow to the semicircular canal.

Animals↗

PubMed1992

Anatomical organization of the brainstem octavolateralis area of the oyster toadfish, Opsanus tau.

Anatomical studies were undertaken to analyze the brainstem organization of the auditory, vestibular, and lateral line nuclei in a teleost, the oyster toadfish, Opsanus tau. Neuronal cytoarchitectonics and horseradish peroxidase label of cranial nerves were utilized to delineate the borders of the five octavus and two lateralis brainstem nuclei. Each of the eight octavolateralis nerves were labeled individually to compare and contrast their central projections. Projections of the three semicircular canals were found to be largely overlapping. Terminal fields were observed within the eminentia granularis and in each of the octavus nuclei. The nucleus anterior octavus was reciprocally innervated by the semicircular canals and the saccule. The canals terminated heavily in the ventral portions of the anterior octavus, whereas the saccule terminated extensively in the dorsal nuclear portions. The saccule also distributed terminals throughout the octavus cell column, including a light terminal field within the dorsal, medial, and anterior portions of the descending octavus nucleus, a region densely innervated by this end-organ in other species. These results suggest that the anterior octavus nucleus may have a dual function. The dorsal portions may be an auditory relay nucleus, whereas the ventral portions may subserve vestibular function. Utriclar and lagenar afferents also terminated throughout the octavus cell column. Afferents of the anterior and posterior lateral lines ended within the eminentia granularis and the lateral line nuclei. Semicircular canal afferents and lateral line afferents appeared completely segregated within the eminentia. The above results are useful as an aid in the understanding of an ongoing, comprehensive functional analysis of auditory and vestibular mechanisms in toadfish and complement previous work on the efferent vestibular and sound-producing motor systems. Examination of toadfish contributes to a more general and complete overview of the octavolateralis area of teleosts and the eventual identification of primitive and derived patterns of octaval organization. Additionally, this work may permit the further demonstration of species-typical characters that may indicate adaptations to particular behavioral repertoires.

Animals↗

PubMedDate not supplied

Horizontal linear and angular responses of neurons in the medial vestibular nucleus of the decerebrate cat.

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 degrees from the vertical. Responsive neurons exhibited a sinusoidal modulation in their firing 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.

Acceleration↗

PubMed1993

Responses of neurons in the rostral ventrolateral medulla of the cat to natural vestibular stimulation.

To investigate the neural substrate of vestibulo-sympathetic reflexes, we studied the responses of neurons in the rostral ventrolateral medulla (RVLM) of decerebrate cats to natural stimulation of the labyrinth in vertical and horizontal planes. The RVLM is a major source of excitatory inputs to sympathetic preganglionic neurons. The animals used in these studies were baroreceptor-denervated and vagotomized and had a cervical spinal transection so that inputs from tilt-sensitive receptors outside of the labyrinth did not influence the units we recorded. Of the 38 neurons whose type of vertical vestibular inputs could be classified, the majority (27) received signals mainly from otolith organs. Only 4 of the neurons received inputs predominantly from vertical semicircular canals, and 7 were classified as having convergent inputs from otoliths and canals that were spatially aligned (2 cells) or misaligned (5 cells). In addition, only 2 of 68 neurons tested responded to sinusoidal horizontal rotations in a manner typical of brainstem neurons that receive inputs from the horizontal semicircular canals. Thus, the vestibular inputs to the RVLM appear to come mainly from otolith receptors. In labyrinthectomized cats, we were unable to locate neurons with responses to tilt similar to those of cells recorded in labyrinth-intact cats, confirming that the responses attributed to vertical vestibular inputs were produced by signals from the labyrinth. In animals whose semicircular canals had been rendered dysfunctional by plugging, we only recorded responses similar to those of neurons classified as having mainly otolith inputs in canal-intact animals, indicating that the dynamic behavior of these cells does not depend upon canal inputs. The presence of otolith inputs to the RVLM is consistent with the hypothesis that this region mediates vestibulo-sympathetic reflexes involved in correcting posturally-related changes in blood pressure.

Animals↗

PubMed1992

Immunohistochemical findings of IgG recognized in the planum semilunatum of the guinea pig.

The planum semilunatum is located on the lateral side of the crista ampullaris of the semicircular canal. With regard to the functions of the planum semilunatum, some researchers assume the existence of secretory activity based on the microstructural features observed in isotopic experiments. In the present study, in order to confirm the existence of an immunological mechanism in the ampulla of the semicircular canal, the distribution of immunoglobulins in the semi-circular canal of guinea pigs was investigated immunohistochemically. Positivity of IgG was observed in the constituent cells of the planum semilunatum or beneath the basement membrane of the cells. It is concluded that ample IgG, which is an important constituent of the body fluids, is collected within this region. The planum semilunatum containing such ample amounts of IgG might be involved in the immunological mechanism operating in the ampullar of the semicircular canal.

Animals↗

PubMed1999

Three-dimensional extraocular motoneuron innervation in the rhesus monkey. I: Muscle rotation axes and on-directions during fixation.

The rotation axis for each of the six extraocular muscles was determined in four eyes from three perfused rhesus monkeys. Measurements of the locations of muscle insertions and origins were made in the stereotaxic reference frame with the x-y plane horizontal and the x-z plane sagittal. The computed rotation axes of the horizontal recti were close to being in the x-z plane at an angle of about 15 degrees to the z axis. The rotation axes of the vertical recti and the obliques were close to being in the x-y plane at an angle of about 30 degrees to the y axis. In five alert rhesus monkeys, we simultaneously recorded extraocular motoneuron activity and eye position in three dimensions (3D). The activity of 51 motoneuron axons was obtained from the oculomotor (n=34), trochlear (n=11), and abducens nerve (n=6) during spontaneous eye movements. To extend the torsional range of eye position, the animals were also put in different static roll positions, which induced ocular counterroll without dynamic vestibular stimulation. Periods of 100 ms during fixation or slow eye movements (<10 degrees/s) were chosen for analysis. For each motoneuron, a multiple linear regression was performed between firing frequency and 3D eye position, expressed as a rotation vector, in both stereotaxic and Listing's reference frame. The direction with the highest correlation coefficient (average R=0.94+/-0.07 SD) was taken as the on-direction. Each unit's activity could be unequivocally attributed to one particular muscle. On-directions for each motoneuron were confined to a well-defined cone in 3D. Average on-directions of motoneurons differed significantly from the corresponding anatomically determined muscle rotation axes expressed in the stereotaxic reference frame (range of deviations: 11.9 degrees to 29.0 degrees). This difference was most pronounced for the vertical recti and oblique muscles. The muscle rotation axes of the vertical rectus pair and the oblique muscle pair form an angle of 58.3 degrees, whereas the corresponding angle for paired motoneuron on-directions was 105.6 degrees. On-directions of motoneurons were better aligned with the on-directions of semicircular canal afferents (range of deviation: 9.4-18.9 degrees) or with the anatomically determined sensitivity vectors of the semicircular canals (range of deviation: 3.9-15.9 degrees) than with the anatomically determined muscle rotation axes, but significant differences remain to be explained. The on-directions of motoneurons were arranged symmetrically to Listing's plane, in the sense that the torsional components for antagonistically paired muscles were almost equal, but of opposite sign. Thus, the torsional components of motoneuron on-directions cancel when eye movements are confined to Listing's plane. This arrangement simplifies the neuronal transformations for conjugate head-fixed voluntary eye movements, while the approximate alignment with the semicircular canal reference frame is optimal for generating compensatory eye movements.

Animals↗

PubMed2005

Search-coil head-thrust and caloric tests in Ménière's disease.

CONCLUSIONS: Our findings suggest that canal function is substantially preserved in subjects with active vertigo attacks as a result of Ménière's disease (MD). In these subjects, the head-thrust test (HTT) may not be as sensitive to canal dysfunction as traditional caloric testing. MD may differentially affect the low-frequency sensitivity of the canals. OBJECTIVE: Caloric tests have traditionally been used to characterize semicircular canal function in vestibular disorders, including MD. The quantitative HTT provides an objective measurement of semicircular canal function in the frequency and velocity ranges of normal head movements. The aim of this study was to compare the findings of caloric and HTTs in subjects with unilateral MD. MATERIAL AND METHODS: The study population consisted of 38 candidates for gentamicin treatment due to a high frequency of vertiginous attacks (25 males, 13 females; mean age 52.9 years; range 30-70 years). The duration of symptoms was 1-30 years (mean 5.3 years). Horizontal canal function was characterized with bithermal aqueous caloric tests and recordings of the angular vestibulo-ocular reflexes (aVORs) using the scleral search-coil technique during HTTs. The main outcomes were unilateral weakness (UW) on caloric testing and aVOR gain asymmetry (GA) during HTTs. A caloric response asymmetry of >20% was considered to be indicative of pathologic UW. A difference in GA during HTTs of >5.8% was considered significant. RESULTS: Twenty subjects (52.6%) showed abnormal results on one or both tests. Pathologic UW was present in 16 subjects (42.1%). During HTTs, 11 subjects (28.9%) showed pathologic GA. Seven subjects (18.4%) showed abnormal results on both tests. A significant correlation was found between UW and GA. However, pathologic GA during HTTs in subjects with unilateral MD was less frequent and the values smaller than those published for vestibular neuritis patients. Two subjects with unilateral MD had 100% UW, but none had >30% asymmetry on HTTs.

Adult↗

PubMed1999

Computation of inertial motion: neural strategies to resolve ambiguous otolith information.

According to Einstein's equivalence principle, inertial accelerations during translational motion are physically indistinguishable from gravitational accelerations experienced during tilting movements. Nevertheless, despite ambiguous sensory representation of motion in primary otolith afferents, primate oculomotor responses are appropriately compensatory for the correct translational component of the head movement. The neural computational strategies used by the brain to discriminate the two and to reliably detect translational motion were investigated in the primate vestibulo-ocular system. The experimental protocols consisted of either lateral translations, roll tilts, or combined translation-tilt paradigms. Results using both steady-state sinusoidal and transient motion profiles in darkness or near target viewing demonstrated that semicircular canal signals are necessary sensory cues for the discrimination between different sources of linear acceleration. When the semicircular canals were inactivated, horizontal eye movements (appropriate for translational motion) could no longer be correlated with head translation. Instead, translational eye movements totally reflected the erroneous primary otolith afferent signals and were correlated with the resultant acceleration, regardless of whether it resulted from translation or tilt. Therefore, at least for frequencies in which the vestibulo-ocular reflex is important for gaze stabilization (>0.1 Hz), the oculomotor system discriminates between head translation and tilt primarily by sensory integration mechanisms rather than frequency segregation of otolith afferent information. Nonlinear neural computational schemes are proposed in which not only linear acceleration information from the otolith receptors but also angular velocity signals from the semicircular canals are simultaneously used by the brain to correctly estimate the source of linear acceleration and to elicit appropriate oculomotor responses.

Animals↗

PubMed1998

The differential sensitivities of inner ear structures to retinoic acid during development.

In order to examine the mechanisms that underlie development of the inner ear, the normal processes were perturbed using all-trans-retinoic acid (RA). By implanting a resin exchange bead saturated with RA into stage 16 (Hamburger and Hamilton, 1951, J. Morphol. 88, 49-92) embryonic day 2.5 chick ears, it was possible to analyze its in vivo effects on inner ear development. There is a temporal window during which the developing chick inner ear is particularly susceptible to the effects of RA (stages 16-19). This RA period of sensitivity precedes evidence of gross morphologic or histologic differentiation by at least 24 h, suggesting that mechanisms controlling formation of key inner ear structures are already in progress. There is a dose dependence on RA, with increasing doses of RA generating increasingly severe phenotypic abnormalities. Data indicate that these effects are due to differential sensitivities of the various inner ear structures to RA during their formation. In general, the vestibular structures were more susceptible to RA effects than the cochlear duct. Furthermore, nonsensory structures such as semicircular canals seemed to display a greater susceptibility to RA than their associated sensory structures (i.e., cristae). Among the three semicircular canals, the superior canal was the most susceptible to RA treatment, whereas the common crus was particularly resistant, suggesting that the molecular mechanisms for each structure's formation are different. The defect in semicircular canal formation is due to problems in the initial outgrowth of the canal plate which in turn is related to a down-regulation of early otocyst cell proliferation. This perturbation model provides valuable insight into the processes involved in producing the intricate patterning of the inner ear.

Animals↗