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PubMed1986

[Electronystagmography aspects of peripheral and central vestibular syndromes].

This report deals with what is to be known in applying ENG in the everyday office. From vestibular, visual and proprioceptive informations central neural processing evolve to stabilize images on the retina. ENG can perform an analysis of these systems, alone or interacting. Anatomical, neurophysiological backgrounds and experimental pathophysiology results are first described. The methodic rule of anamnesis is emphasized and the non instrumental examination is outlined. Concerning the technical aspects and the ENG achievement, some nonlinearities are stressed. Next, procedure of eye movements recording, oculomotor and vestibular testing are described. Alertness, stimulation order, gaze direction and drugs influence the response. The nystagmus responses are evaluated by quantitative parameters and morphological aspects. The variability of these implies the multiplication of the pathological arguments. Peripheral vestibular disturbances lead to labyrinthine paresis or paralysis and to nystagmus directional preponderance, sometimes alone, often combined. Thermic predominance may be associated and cause of some interpretation difficulty. Diagnosis of central neurological disturbances is submitted to four conditions: only specific criteria selection; complete oculomotor and vestibular testing; graduated conclusions in function of the criteria number; no etiological but only functional or topographical diagnosis. Central vestibular syndromes lead also to labyrinthine weakness or nystagmus directional preponderance but, first at all, to specific criteria who are: saccadic, pursuit and horizontal optokinetic abnormalities, central spontaneous or positional nystagmus, failure of fixation suppression, hyperreflexia, perverted nystagmus, slowing of the nystagmus fast phases, slowing-down of the nystagmus slow phases, anisonystagmus, vertical optokinetic deficits and retraction nystagmus. Finally, these dysfunctions incidence in personal observations with some multi or unifocal central pathologies is described and the correspondent more characteristic findings are outlined.

Animals↗

PubMed1982

Oculomotor response to rapid head oscillation (0.5-5.0 Hz) after prolonged adaptation to vision-reversal. "Simple" and "complex" effects.

This study examined long-term (up to 27 days) effects of maintained vision reversal on (i) smooth visual tracking with head still, (ii) oculomotor response to actively, generated head oscillation and (iii) "spontaneous" saccades. Dove prism goggles produced horizontal, but not vertical (sagittal plane), vision reversal. Eye movements were recorded by EOG; head movements by an electro-magnetic search coil. Both visual tracking and saccade dynamics remained unchanged throughout. In contrast, both the ocular response to active head oscillations (goggles off and subject looking at a stationary target) and associated retinal image blur showed substantial and retained adaptive changes, akin to those previously found in the vestibulo-ocular reflex as tested in darkness at 0.17 Hz. However, several addition unexpected results emerged. First, in the fully adapted state smooth eye movements tended to be of reversed phase in the range 0.5-1.0 Hz (in spite of normal vision during tests), but of normal phase from about 2 Hz and above (in spite of negligible visual tracking in this upper range). Second, after permanent removal of the inverting goggles, this peculiar frequency response of the fully adapted state quickly (36 h) reverted to a dynamically simpler condition manifest as retained (2-3 weeks) attenuation of gain (eye vel./head vel.) which, as in control conditions, was monotonically related to frequency. From these two findings it is inferred that the fully adapted state may have comprised two separate components: (i) A "simple element of monotonic and long-lasting gain attenuation and (ii) a "complex", frequency labile, element which could be quickly rejected. Dynamic characteristics of the putative "complex" element were estimated by vectorial subtraction of the "simple" one from that of the fully adapted condition. The outcome suggests that the inferred "complex" condition might represent a predictive element. Two further findings are reported: (i) Substantially different vectors of the adapted response were obtained with normal and reversed vision at 3.0 Hz head oscillation, indicating a novel visual tracking. (ii) During head oscillation in the vesicle sagittal plane (in which vision was not reversed) there was never any image blur, indicating high geometric specificity in the adaptive process.

Acoustic Stimulation↗

PubMed2001

Differential diagnosis of proprioceptive and vestibular deficits using dynamic support-surface posturography.

The objective of this study was to evaluate how effective dynamic support-surface posturography could be as a diagnostic tool in patients with balance disorders (proprioceptive or vestibular deficits). Specifically, we studied whether measures of trunk control and simple toe-up rotational perturbations, selected using statistical techniques, could provide a better diagnostic yield than either the analysis of lower-body movements or use of a "nulled" ankle input paradigm. The test subjects were 15 control subjects, five patients with bilateral peripheral vestibular loss (VL) and five patients with selective bilateral, lower-leg proprioceptive loss (PL). Amplitudes and onset latencies of bursts of EMG activity in upper and lower-leg muscles, paraspinals and trapezius muscles, concurrent changes in ankle torque, and peak amplitudes of upper-leg, lower-leg, and trunk angular-velocities were measured. Stimuli included three different types of sudden movements of the support surface, a "nulled" ankle input paradigm, a simple toe-up rotation paradigm, and a combined toe-up rotation and backwards translation of the support surface. All stimuli were tested under eyes-open and eyes-closed conditions. For each type of movement and condition the diagnostic classification accuracy (i.e. the overall sensitivity and specificity) was calculated based on those posturography measures providing the highest diagnostic separation between the three populations. Both patient groups showed increased trunk sway, changed support-surface reaction forces and muscle amplitudes compared with controls for toe-up and "nulled" test conditions. Measures providing the greatest diagnostic utility were the amplitude of trunk-angular velocity (increased in VL subjects, less so in PL), the amplitude of balance-correcting paraspinal responses (increased in VL subjects, decreased in PL subjects), the amplitude of trapezius stabilising responses (increased in both patient groups) for simple toe-up rotations under eyes-closed conditions. We conclude, that diagnosis of balance disorders using dynamic posturography is best achieved using measures of trunk control following pure toe-up rotational perturbations tested under eyes-closed conditions.

Adult↗

PubMed1999

Subjective visual vertical in peripheral unilateral vestibular diseases.

In humans, the perception of vertical is provided by input from various sensorineural organs and pathways: vision, eye-movements, and proprioceptive and vestibular cues, particularly from the otolithic organs and graviceptive pathways. Well known in several types of brainstem lesions, subjective visual vertical (SVV) abnormalities may also be observed after peripheral vestibular lesions, such as surgical deafferentation, with a deviation directed toward the operated ear. Subjective visual vertical abnormalities are presumably related to a lesion of the otolithic organs and/or to changes in the afferent graviceptive pathways. The goal of this prospective study was to measure the SVV and to define the influence of the otolithic organs in patients suffering from various types of peripheral vestibular diseases: unilateral sudden cochleo-vestibular loss, so-called "viral labyrinthitis" (VL), sudden idiopathic unilateral peripheral vestibular loss, so-called "vestibular neuritis" (Ne). Data were compared with findings after unilateral surgical deafferentations such as vestibular neurectomy (VN) and labyrinthectomy (Lab). Subjective visual vertical was measured with a binocular test (vertical frame) and a monocular test (Maddox rod). In all patients, after VN and Lab, the SVV showed a 10-30 degrees tilt with the vertical frame (N: 0 +/- 2 degrees), 5-15 degrees with the Maddox rod (N: 0 +/- 4 degrees). With the vertical frame, SVV was tilted > 2 degrees in VL (47%) and in Ne (37%); the Maddox rod showed a > 4 degrees tilt in VL (41%) and in Ne (42%). The tilt was directed toward the affected ear. Our results demonstrate that SVV is frequently tilted in acute peripheral vestibulopathies such as VL and Ne. These findings suggest that otolithic function is implicated in the deficit depending on the extent and/or the localisation of the peripheral vestibular lesion.

Adult↗

PubMed2006

A cognitive intersensory interaction mechanism in human postural control.

Human control of upright body posture involves inputs from several senses (visual, vestibular, proprioceptive, somatosensory) and their central interactions. We recently studied visual effects on posture control and their intersensory interactions and found evidence for the existence of an indirect and presumably cognitive mode of interaction, in addition to a direct interaction (we found, e.g., that a 'virtual reality' visual stimulus has a weaker postural effect than a 'real world' scene, because of its illusory character). Here we focus on the presumed cognitive interaction mechanism. We report experiments in healthy subjects and vestibular loss patients. We investigated to what extent a postural response to lateral platform tilt is modulated by tilt of a visual scene in an orthogonal rotational plane (anterior-posterior, a-p, direction). The a-p visual stimulus did not evoke a lateral postural response on its own. But it enhanced the response to the lateral platform tilt (i.e., it increased the evoked body excursion). The effect was related to the velocity of the visual stimulus, showed a threshold at 0.31 degrees /s, and increased monotonically with increasing velocity. These characteristics were similar in normals and patients, but body excursions were larger in patients. In conclusion, the orthogonal stimulus arrangement in our experiments allowed us to selectively assess a cognitive intersensory interaction that upon co-planar stimulation tends to be merged with direct interaction. The observed threshold corresponds to the conscious perceptual detection threshold of the visual motion, which is clearly higher than the visual postural response threshold. This finding is in line with our notion of a cognitive phenomenon. We postulate that the cognitive mechanism in normals interferes with a central visual-vestibular interaction mechanism. This appears to be similar in vestibular loss patients, but patients use less effective somatosensory instead of vestibular anti-gravity mechanisms.

Adult↗

PubMed1997

Segmental and propriospinal projection systems of frog lumbar interneurons.

Spinal interneuronal networks have been implicated in the coordination of reflex behaviors and limb postures in the spinal frog. As a first step in defining these networks, retrograde transport of horseradish peroxidase (HRP) was used to examine the anatomical organization of interneuronal circuitry in the lumbar spinal cord of the frog. Following neuronal degeneration induced by spinal transection and section of the dorsal and ventral roots, HRP was placed at different locations in the spinal cord and the positions of labeled neuronal cell bodies plotted using a Eutectics Neuron Tracing System. We describe four spinal interneuronal systems, three with cell bodies located in the lumbar cord and one with descending projections to the lumbar cord. Interneurons with cell bodies located in the lumbar cord include: (1) Lumbar neurons projecting rostrally. Those projecting to thoracic segments tended to be located in the lateral and ventrolateral gray and in the lower two-thirds of the dorsal horn, with projections that were predominantly uncrossed. Those projecting to the brachial plexus and beyond were located in the dorsal part of the dorsal horn (uncrossed) and in the lateral, ventrolateral, and ventromedial gray (crossed). (2) Lumbar neurons with segmental projections within the lumbar cord. These neurons, which were by far the most numerous, had both uncrossed and crossed projections and were distributed throughout the dorsal, lateral, ventrolateral, and ventromedial gray matter. (3) Lumbar neurons projecting to the sacral cord. This population, which arose mainly from the dorsal horn and lateral or ventrolateral gray, was much smaller than in the other systems. Neuronal density of some of these populations of lumbar interneurons appeared to vary with rostrocaudal level. Finally, a population of neurons with cell bodies in the brachial and thoracic segments that projects to the lumbar cord is described. The most rostral of these neurons were multipolar cells with uncrossed projections, while those with crossed projections were confined almost exclusively to the ventral half of the cord. The distribution of spinal interneurons reported here will provide guidance for future studies of the role of interneuronal networks in the control of movements using the spinal frog as a model system.

Animals↗

PubMed1991

Sensitivity of external cuneate neurons to neck rotation in three-dimensional space.

A functionally meaningful vestibular-neck interaction, such as it has been demonstrated for postural reflexes and self-motion perception, requires the spatial and temporal response characteristics of vestibular and neck signals to be similar. We investigated the spatial coding in neurons of the external cuneate nucleus (ECN) with natural neck and vestibular stimulations, and compared them to that of neurons in the descending and medial vestibular nuclei (DVN and MVN, respectively) obtained with vestibular stimulation. Neurons were recorded extracellularly in chronically prepared cats held under light barbiturate anesthesia. Neck stimulation was performed by sinusoidally rotating the animals' trunk relative to the earth-fixed head in six different vertical planes and in the horizontal plane. Vestibular stimulation was elicited by whole-body rotations in the corresponding planes. During neck stimulation in the vertical planes, most ECN neurons showed an approximately sinusoidal discharge modulation about resting rate, which became maximal during rotation in a specific plane. Off this plane, the response declined along a cosine function and reached zero in the orthogonal plane. The majority of these ECN neurons also responded to horizontal neck rotation; the resulting "optimal" direction of rotation in three-dimensional space varied considerably among the neurons. Yet, there was a certain preference; the majority of these ECN neurons fired maximally if trunk rotation in the yaw plane stretched the neck on the ipsilateral side, if roll brought the contralateral shoulder closer to the head, and if pitch brought the back closer to the occiput. A minority of ECN neurons showed more complex response patterns which could not be described by a single, optimal direction. About one third of the neck-sensitive ECN neurons tested showed weak responses during whole body rotation, which might stem from a weak vestibular input to this nucleus. In the DVN and MVN, the optimal direction in three-dimensional space with vestibular stimulation typically had a cosine-like spatial tuning. The spatial distribution of these directions clearly differed from that of neck-sensitive neurons in the ECN. We therefore assume that a further processing of the two input signals takes place at later stages in the CNS (e.g., in the vestibulo-cerebellum) in order to yield a functionally useful vestibular-neck interaction.

Animals↗

PubMed1992

A postural model of balance-correcting movement strategies.

The patterns of joint torques and movement strategies underlying human balance corrections were examined using a postural model. Two types of support-surface perturbation, dorsiflexion rotation (ROT) and rearward translation (TRANS), were employed. These two perturbations were adjusted to produce similar profiles of ankle dorsiflexion in order to obtain information on the role of lower leg proprioceptive inputs on triggering balance corrections. In addition, the dependence of balance control on head angular and linear accelerations was investigated by comparing the responses of normal and vestibularly deficient subjects under eyes-closed and eyes-open conditions. Differences in ROT and TRANS movement strategies were examined in three ways First, the amplitude and polarity of active joint torques were analysed. These were obtained by altering joint torques applied to a postural model until movements of the model accurately duplicated those of measured responses. Second, the pattern of body-segment angular movements depicted by stick figures moving in response to the computed joint torques was investigated. Third, the peak amplitude and patterns of crosscorrelations between joint torques were measured. Active ankle, knee, and hip joint torques computed for normal subjects rotated the body forward for ROT. In the case of TRANS, computed active torques in normals were of opposite polarity to those of ROT and reversed the forward motion of the body. Subjects with vestibular deficits had lower amplitude torques for ROT and failed to counter the platform rotation. Hip torques for TRANS in vestibular deficient subjects were of opposite polarity to those of normal subjects and resulted in excessive forward trunk rotation. Normally, neck torques acted to stabilize the head in space when trunk angular velocity peaked. Vestibular deficient subjects displayed head movements in response to ROT similar to those generated when neck torques were absent. For TRANS, these same subjects exhibited overcompensatory neck torques. Stick figures of normal responses indicated a stiffening of the body into a leg and a trunk-head link for ROT and a flexible multilink motion for TRANS. Likewise, normal response strategies, defined by using crosscorrelations of joint torques, differed for ROT and TRANS. All joint torque crosscorrelations were significant for TRANS. Neck torques led those of all other joint torques by 40 ms or more, and hip joint led ankle torques by 30 ms. Joint torque correlations for ROT were organised around hip and ankle torques without a major correlation to neck torques. Fundamental changes in all torque crosscorrelations occurred for vestibularly deficient subjects under both eyes-open and eyes-closed conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

Biomechanical Phenomena↗

PubMed1985

Effects of passive flexion of the forepaw on the response gain of limb extensors to sinusoidal stimulation of labyrinth receptors.

The main aim of the present study was to find out whether the dynamic characteristics of responses of limb extensor muscles to labyrinth stimulation were modified by the proprioceptive input elicited by appropriate displacements of the corresponding limb extremity. In cats decerebrated at precollicular or intercollicular level, the multiunit EMG activity of the medial head of the triceps brachii was recorded during roll tilt of the animal at the frequency of 0.15 Hz, +/- 10 degrees leading to selective stimulation of labyrinth receptors. This stimulation was then tested several times at regular intervals of 2 to 6 min for several hours while maintaining the ipsilateral forelimb in the horizontal extended position, i.e. with the plantar surface of the foot lying on the tilting table, or during passive flexion of the forepaw in plantar or dorsal direction. In all the experiments in which the forelimb was in the control position, the multiunit EMG responses of the triceps brachii were characterized by an increased activity during side-down tilt of the animal and a decreased activity during side up tilt. These responses were related to animal position and not to the velocity of animal displacement, thus being attributed to stimulation of macular, utricular receptors. Static displacement of limb extremities following plantar flexion of the forepaw greatly decreased the amplitude of the EMG modulation and thus the gain of the first harmonic component of the multiunit EMG responses of the ipsilateral triceps brachii to animal tilt. This reduced gain was due not only to a reduced number of motor units recruited during labyrinth stimulation, but also to a reduced modulation of firing rate of the active motor units, as shown by recording the activity of individual motor units. On the other hand, displacement of the same extremity in the opposite direction, i.e. following dorsiflexion of the forepaw, enhanced the amplitude of the EMG modulation and thus the gain of the multiunit EMG responses of the ipsilateral triceps brachii to animal tilt. This finding was mainly due to an increased recruitment of motor units during side-down tilt, although an increased modulation of the firing rate of individual motor units could not be excluded. In both instances, no changes in the phase angle to the responses were observed. The changes in response gain described above depended on the amount of passive displacement of the forepaw and persisted unmodified throughout the new maintained position.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1997

Dynamics of neurons controlling movements of a locust hind leg II. Flexor tibiae motor neurons.

Imposed movements of a proprioceptor that monitors the relative position of the tibia about the femur, the femorotibial chordotonal organ (FeCO), evoke resistance reflexes in the motor neurons that control the movements of the tibia of the locust. The response dynamics of one pool of motor neurons, the flexor tibiae motor neurons, which are located in three groups (anterior, lateral, and posterior), have been analyzed by the Wiener kernel method. First- and second-order kernels that represent the linear and nonlinear responses, respectively, were computed by a cross-correlation between the intracellularly recorded synaptic responses in the motor neurons and the white noise stimulus applied to the FeCO, and were used to define the input-output characteristics of the motor neurons. The posterior fast, intermediate, and slow and the anterior fast and intermediate flexor tibiae motor neurons had biphasic first-order kernels with initial negative phases, indicating that they are velocity sensitive. The falling phases of the kernels had distinct shoulders, indicating that the responses of the motor neurons also had delayed low-pass components, i.e., position sensitivity. The anterior slow flexor motor neuron had a monophasic, low-passed, first-order kernel, indicating that it is position sensitive. The linear component of the motor neuron responses, predicted by convolving the first-order kernels with the stimulus signal, strongly resembled the actual response, whereas the second-order nonlinear component was small, particularly at > 10 Hz. The power spectra of the fast motor neurons showed that they had the highest cutoff frequencies (at > 8 Hz), whereas the slow flexor motor neurons had a gradual roll-off at 1 Hz. The intermediate flexor motor neuron had an intermediate cutoff frequency of approximately 2-3 Hz. The linear responses of the flexor motor neurons could be decomposed into low- and high-frequency components. The high-frequency components (> 10 Hz) were velocity dependent and linear, whereas the low-frequency components (< 10 Hz) were position dependent and nonlinear. The nonlinearity was a signal compression (or half-wave rectification). The results show that although the flexor motor neurons receive many common inputs during FeCO stimulation, each individual has specific dynamic response properties. The responses of the motor neurons are fractionated so that a given individual within the pool will respond best to position, whereas others will respond better to velocity. Likewise, some motor neurons respond best at low frequencies, whereas others respond best at higher frequencies of stimulation.

Animals↗