The influence of cervical movement on eye stabilization reflexes: a randomized trial

Abstract

To investigate the influence of the amount of cervical movement on the cervico-ocular reflex (COR) and vestibulo-ocular reflex (VOR) in healthy individuals. Eye stabilization reflexes, especially the COR, are changed in neck pain patients. In healthy humans, the strength of the VOR and the COR are inversely related. In a cross-over trial the amplitude of the COR and VOR (measured with a rotational chair with eye tracking device) and the active cervical range of motion (CROM) was measured in 20 healthy participants (mean age 24.7). The parameters were tested before and after two different interventions (hyperkinesia: 20 min of extensive active neck movement; and hypokinesia: 60 min of wearing a stiff neck collar). In an additional replication experiment the effect of prolonged (120 min) hypokinesia on the eye reflexes were tested in 11 individuals. The COR did not change after 60 min of hypokinesia, but did increase after prolonged hypokinesia (median change 0.220; IQR 0.168, p = 0.017). The VOR increased after 60 min of hypokinesia (median change 0.155, IQR 0.26, p = 0.003), but this increase was gone after 120 min of hypokinesia. Both reflexes were unaffected by cervical hyperkinesia. Diminished neck movements influences both the COR and VOR, although on a different time scale. However, increased neck movements do not affect the reflexes. These findings suggest that diminished neck movements could cause the increased COR in patients with neck complaints.

Peer Review #2 of "Patient-reported outcomes measured with and without dizziness associated with non-specific chronic neck pain: implications for primary care (v0.2)"

“…This issue may be explained by the presence of dizziness could be mediated by an amplified central sensitization process (Holle et al, 2015) Recently, the cervico-ocular reflex was shown to be increased in both patients with chronic nontraumatic neck pain without dizziness and patients with chronic traumatic neck pain due to whiplash with associated dizziness. The role of reflexes should be compared in patients who suffer from NSCNP with or without associated dizziness for future studies (Ischebeck et al, 2018). In addition, a very relevant aspect in cervical dizziness which was not measured in the Manuscript to be reviewed present study is the cervical movement.…”

Modification of Eye–Head Coordination With High Frequency Random Noise Stimulation

“…The vestibular receptors of the inner ear are known to accurately detect movements of the head (Chin, 2018). The VOR receives input from the vestibular receptors, responding to movements of the head (Ischebeck et al, 2018). Electrical stimulation is a well-known procedure used to stimulate the vestibular system (Fitzpatrick and Day, 2004;Kim and Curthoys, 2004;Uchino and Kushiro, 2011;Yang et al, 2015;Fujimoto et al, 2016;Wuehr et al, 2016;Inukai et al, 2018).…”

“…In previous studies, the participant's head was passively turned approximately 5-15 • at 0.1-33 s for VOR assessment (Halmagyi et al, 2017;Ischebeck et al, 2017Ischebeck et al, , 2018. However, in daily living, when people actively turn their heads faster and wider and gaze at the fixation target, their eye movement can compensate for the head turn to maintain their gaze on FIGURE 1 | Experimental design for the eye-head coordination task.…”

“…The vestibula, including three semicircular canals and otolith organs (utricle and saccule), can perceive angular velocity and the acceleration of the head (Yang et al, 2015). The VOR receives positional input from the vestibular afferents (Ischebeck et al, 2017(Ischebeck et al, , 2018 and sends signals to the eye muscles and cerebellum, which send feedback signals to modulate or fine-tune the VOR (Wallace and Lifshitz, 2016). Thus, the position of the eyes affects the movement of the head.…”

Patient-reported outcomes measured with and without dizziness associated with non-specific chronic neck pain: implications for primary care

“…Recently, the cervico-ocular reflex was shown to be increased in both patients with chronic non-traumatic neck pain without dizziness and patients with chronic traumatic neck pain due to whiplash with associated dizziness. The role of reflexes should be compared in patients who suffer from NSCNP with or without associated dizziness for future studies (Ischebeck et al, 2018). In addition, a very relevant aspect in cervical dizziness which was not measured in the present study is the cervical movement.…”