A brief review of the clinical anatomy of the vestibular-ocular connections—how much do we know?

Bronstein, Adolfo M.; Patel, Mitesh; Arshad, Qadeer

doi:10.1038/eye.2014.262

Cited by 51 publications

(40 citation statements)

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“…There are three motor reflexes directly related to the vestibular peripheral input and central regulation: the vestibulo-ocular reflex (VOR), vestibulo-spinal reflex, and vestibulo-colic reflex. The VOR specifically is useful for evaluation of vestibular function because of more direct innervation of the peripheral vestibular projections into the oculomotor pathway (Bronstein et al, 2015).…”

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Effect of Intensity Level and Speech Stimulus Type on the Vestibulo-Ocular Reflex

et al. 2019

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Accurate vestibulo-ocular reflex (VOR) measurement requires control of extravestibular suppressive factors such as visual fixation. Although visual fixation is the dominant suppressor and has been extensively studied, the mechanisms underlying suppression from nonvisual factors of attention and auditory stimulation are less clear. It has been postulated that the nonvisual suppression of the VOR is the result of one of two mechanisms: (1) activation of auditory reception areas excites efferent pathways to the vestibular nuclei, thus inhibiting the VOR or (2) cortical modulation of the VOR results from directed attention, which implies a nonmodality-specific process.The purpose of this research was to determine if the VOR is affected by the intensity level and/or type of speech stimulus.A repeated measures design was used. The experiment was single-blinded.Participants included 17 adults (14 females, three males) between the ages of 18–34 years who reported normal oculomotor, vestibular, neurological, and musculoskeletal function.Each participant underwent slow harmonic acceleration testing in a rotational chair. VOR gain was assessed at 0.02, 0.08, and 0.32 Hz in quiet (baseline). VOR gain was also assessed at each frequency while a forward running speech stimulus (attentional) or a backward running speech stimulus (nonattentional) was presented binaurally via insert earphones at 42, 62, and 82 dBA. The order of the conditions was randomized across participants. VOR difference gain was calculated as VOR gain in the auditory condition minus baseline VOR gain. To evaluate auditory efferent function, the medial olivocochlear reflex (MOCR) was assayed using transient-evoked otoacoustic emissions (right ear) measured in the presence and absence of broadband noise (left ear). Contralateral acoustic reflex thresholds were also assessed using a broadband noise elicitor. A three-way repeated measures analysis of variance was conducted to evaluate the effect of frequency, intensity level, and speech type on VOR difference gain. Correlations were conducted to determine if difference gain was related to the strength of the MOCR and/or to the acoustic reflex threshold.The analysis of variance indicated that VOR difference gain was not significantly affected by the intensity level or the type of speech stimulus. Correlations indicated VOR difference gain was not significantly related to the strength of the MOCR or the acoustic reflex threshold.The results were in contrast to previous research examining the effect of auditory stimulation on VOR gain as auditory stimulation did not produce VOR suppression or enhancement for most of the participants. Methodological differences between the studies may explain the discrepant results. The removal of an acoustic target from space to attend to may have prevented suppression or enhancement of the VOR. Findings support the hypothesis that VOR gain may be affected by cortical modulation through directed attention rather than due to activation of efferent pathways to the vestibular nuclei.

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“…The VOR functions through a three-neuron arc system with sensory, inter, and motor neurons. The pathway runs via cranial nerves VIII (vestibulocochlear), III (oculomotor), and VI (abducens) (Purves et al, 2001;Bronstein et al, 2015). The vestibular nuclei operate as a pair between ears.…”

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Effect of Intensity Level and Speech Stimulus Type on the Vestibulo-Ocular Reflex

et al. 2019

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“…Для компенсации нарушения ВОР в вестибулярных цен трах центральной нервной системы (ЦНС) генерируется компенсаторная рефиксационная саккада, возвращаю щая глаза к объекту фиксации с некоторой задержкой. Ощущения, возникающие при этом, пациенты называют «головокружением», хотя по своей сути они являются ос циллопсией: нарушением динамической остроты зрения (ДОЗ), когда при движениях головы возникает проскаль зывание изображения по сетчатке и визуальный образ смазывается, становясь нечетким [2].…”

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“…При этом улучшение ДОЗ происходит путем перекалибровки соответствия движе ния глаз и головы и быстрой активации во время поворота других классов движений глаз (плавное слежение, сакка ды, моргание в момент поворота головы и др.) [2,3].…”

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The compensation of the vestibulo-ocular reflex during rehabilitation of the patients presenting with vestibular neuritis

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Baibakova

Nikitkina

et al. 2018

Vestn. otorinolaringol.

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The study has demonstrated that the course of vestibular rehabilitation of the patients presenting with vestibular neuritis resulted in a significant decrease in the scores of dizziness estimated based on the dizziness handicap inventory and an improvement of dynamic visual acuity in the case of the complete gain recovery as well as in the case of persisting impairment of the gain and the development of sufficient 'covert' saccade. Vestibular rehabilitation was unsuccessful in the patients with persistereduced gain and simultaneous development of 'covert' and 'overt' saccades.

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“…Aynı taraf labirentinin vestibüler çekirdeğinden gönderilen uyarı karşı taraf okülomotor çekirdeğine uyarıcı, aynı taraf beyinsapındaki antagonist kas çekirdeklerine inhibitör etki yapar. [3] [3] Vestibüler sinirin bipolar ganglion hücreleri scarpa ganglionunda yer alır. Buradan süperior ve inferior vestibüler sinir olmak üzere iki ana demet halinde çıkar.…”

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A new and objective test to evaluate functions of the semicircular canals: A review of video head impulse test

Kökten¹

2017

Kulak Burun Bogaz Ihtis Derg

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ÖZVertigo, kulak burun boğaz pratiğinde sıklıkla karşılaşılan ve hastanın kendisinin veya çevresinin döndüğü şeklinde algıladığı bir hareket ilizyonudur. Birçok periferik veya santral kaynaklı hastalık vertigo ile ortaya çıkabildiğinden, ayırıcı tanının yapılması ve objektif bir testle hastanın hızlıca değerlendirilmesi önemlidir. Denge reseptörleri her iki kulakta üçer adet semisirküler kanal ampullasında ve otolit organlar olarak da adlandırılan utrikulus ve sakkulus makülasında yerleşiktir. Semisürküler kanallar açısal, otolit organlar ise statik eğilme ve dinamik doğrusal hızlanmalara karşı duyarlıdır. Vestibülooküler refleks kafa hareketleri esnasında kafanın hareketine eşit hızda karşı tarafa göz hareketi sağlayarak görüntünün gözde sabit kalmasını sağlar. Doğal uyarı kullanımı, kolay ve hızlı bir şekilde uygulanabilmesi, hastanın uyumu ve vestibüler lezyonları göstermedeki yüksek duyarlılığı sayesinde video baş savurma testi son yıllarda vertigolu hastaların değerlendirmesinde popüler hale gelmiştir. Bu derlemede video baş savurma testinin uygulama alanları ve şekli ile yorumlanışı irdelendi.Anahtar Sözcükler: Tanı; vertigo; video baş savurma testi. ABSTRACTVertigo is an illusion of motion that is frequently encountered in the practice of otolaryngology and which the patient perceives as either a self-rotation or the rotation of the surroundings. Due to the fact that numerous peripheral-or central-based diseases may emerge with vertigo, it is important to establish a definitive diagnosis and evaluate the patient promptly with a reliable test. Balance receptors are located in the ampulla of each of the three semicircular canals in both ears and in the macula of the utricle and saccule, also named as the otolith organs. Semicircular canals are sensitive to angular acceleration whereas otolith organs are sensitive to static tilt and dynamic linear accelerations. Vestibuloocular reflex ensures the stabilization of vision in the eye during head movements by stimulating eye movement at equal velocity in the opposite direction of the head movement. On account of its natural stimulus usage, easy and prompt administration, patient adaptation, and high sensitivity in showing the vestibular lesions, video head impulse test has become popular in recent years in the evaluation of patients with vertigo. In this review, we studied the fields and manner of application as well as the interpretation of the video head impulse test.

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A brief review of the clinical anatomy of the vestibular-ocular connections—how much do we know?

Cited by 51 publications

References 28 publications

Effect of Intensity Level and Speech Stimulus Type on the Vestibulo-Ocular Reflex

Effect of Intensity Level and Speech Stimulus Type on the Vestibulo-Ocular Reflex

The compensation of the vestibulo-ocular reflex during rehabilitation of the patients presenting with vestibular neuritis

A new and objective test to evaluate functions of the semicircular canals: A review of video head impulse test

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