Vestibulo-Ocular Reflex Deficits to Rapid Head Turns Following Intratympanic Gentamicin Instillation

1997 ◽  
Vol 7 (5) ◽  
pp. 369-380
Author(s):  
R.S. Allison ◽  
M. Eizenman ◽  
R.D. Tomlinson ◽  
J. Nedzelski ◽  
J.A. Sharpe
Keyword(s):  
Second Law ◽  
Ocular Reflex ◽  
Intratympanic Gentamicin ◽  
Afferent Fibers ◽  
Vestibulo Ocular Reflex ◽  
Unilateral Vestibular Deafferentation ◽  
Ewald’S Second Law ◽  
Strong Asymmetry

The response of the vestibulo-ocular reflex following unilateral vestibular deafferentation by gentamicin ablation was studied using transient stimuli. The response to these rapid passive head turns showed a strong asymmetry with permanent, reduced gains toward the side of lesion. These gain reductions have large variation (gains of 0.26 to 0.83), which may result from preferential sparing of regularly firing afferent fibers following gentamicin ablation. Based on the size and nature of the nonlinearity, an explanation based on Ewald’s second law was discounted.

Implications of Ewald's Second Law for the Evaluation of Vestibular Function

1979 ◽  
Vol 87 (4) ◽  
pp. 453-458 ◽  
Author(s):  
Young S. Kim ◽  
Clifford G. Y. Lau ◽  
Herman A. Jenkins ◽  
Vicente Honrubia
Keyword(s):  
Vestibular System ◽  
Semicircular Canal ◽  
Piecewise Linear ◽  
Vestibular Function ◽  
Second Law ◽  
Horizontal Semicircular Canal ◽  
Transfer Characteristics ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Ewald’S Second Law

The significance of Ewald's second law in the evaluation of the vestibulo-ocular reflex (VOR) was Investigated using the transfer characteristics of the vestibular and VOR systems in normal rabbits and rabbits in which one horizontal semicircular canal had been blocked. The transfer characteristics of the vestibular system were derived from the experimental results reported by Goldberg and Fernandez in 1971. A comparison was made of the properties of the bilateral and monolateral VOR systems with the predictions of a piecewise linear model of the vestibular system. The data received quantitatively collaborate the prediction of Ewald's second law as ft applies to the VOR responses.

Head Impulses After Unilateral Vestibular Deafferentation Validate Ewald’s Second Law1

1991 ◽  
Vol 1 (2) ◽  
pp. 187-197
Author(s):  
G.M. Halmagyi ◽  
I.S. Curthoys ◽  
P.D. Cremer ◽  
C.J. Henderson ◽  
M. Staples
Keyword(s):  
Head Rotation ◽  
Normal Subjects ◽  
Head Movements ◽  
Afferent Neurons ◽  
Horizontal Semicircular Canal ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Unilateral Vestibular Deafferentation ◽  
Head Impulses ◽  
Stimulation Of

To determine the relative contributions of ampullofugal (AF) and ampullopetal (AP) stimulation of the horizontal semicircular canal (HSCC) to the horizontal vestibulo-ocular reflex (HVOR), 12 patients were studied 1 year after total unilateral vestibular deafferentation (UVD). Compensatory eye movement responses to impulses of horizontal head rotation were studied using magnetic search coils. The head impulses were rapid (up to 3000 deg/sec/sec) passive, unpredictable, step displacements of horizontal angular head position with respect to the trunk. Tbe results from these 12 patients were compared with results from 30 normal subjects. An HVOR deficit was found to each side. The HVOR in response to head impulses toward the deafferented side, a response generated exclusively by ampullofugal stimulation of the single functioning HSCC, was severely deficient with an average gain of 0.25; the HVOR in response to head impulses toward the intact side, a response generated exclusively by ampullopetal stimulation of the single functioning HSCC, was mildly but significantly deficient compared with normal subjects. These results show that rapid, unpredictable head movements, unlike slow, predictable head movements, do demonstrate the AP-AF HVOR asymmetry, which could be expected from consideration of the behavior of single vestibular afferent neurons, an asymmetry that is expressed by Ewald’s 2nd Law.

Effects of Unilateral Vestibular Deafferentation on the Linear Vestibulo-Ocular Reflex Evoked by Impulsive Eccentric Roll Rotation

2003 ◽  
Vol 89 (2) ◽  
pp. 969-978 ◽  
Author(s):  
S. T. Aw ◽  
M. J. Todd ◽  
L. A. McGarvie ◽  
A. A. Migliaccio ◽  
G. M. Halmagyi
Keyword(s):  
Rotation Axis ◽  
Normal Subjects ◽  
Stimulus Onset ◽  
Whole Body ◽  
Viewing Distance ◽  
Ocular Reflex ◽  
Significant Difference ◽  
Vestibulo Ocular Reflex ◽  
Unilateral Vestibular Deafferentation ◽  
Eye Velocity

The effects of unilateral vestibular deafferentation (UVD) on the linear vestibulo-ocular reflex (LVOR) were studied by measuring three-dimensional eye movements in seven UVD subjects evoked by impulsive eccentric roll rotation while viewing an earth-fixed target at 200, 300, or 600 mm and comparing their responses to 11 normal subjects. The stimulus, a whole-body roll of approximately 1°, with the eye positioned 815 mm eccentric to the rotation axis, produced an inter-aural linear acceleration of approximately 0.5 g and a roll acceleration of approximately 360°/s2. The responses generated by the LVOR comprise horizontal eye rotations. Horizontal eye velocity at 100 ms from stimulus onset in UVD subjects was significantly lower than in normal subjects for all viewing distances, with no significant difference between ipsilesional and contralesional responses. LVOR acceleration gain, defined as the slope of actual horizontal eye velocity divided by the slope of ideal horizontal eye velocity during a 30-ms period starting 70 ms from stimulus onset, was bilaterally significantly reduced in UVD subjects at all viewing distances. Acceleration gain from all viewing distances was 1.04 ± 0.28 in normal subjects, and in UVD subjects was 0.49 ± 0.23 for ipsilesional and 0.63 ± 0.27 for contralesional acceleration. LVOR enhancement in the first 100 ms by near viewing was still present in UVD subjects. LVOR latency in UVD subjects (approximately 39 ms) was not significantly different from normal subjects (approximately 36 ms). After UVD, LVOR is bilaterally and largely symmetrically reduced, but latency remains unchanged and modulation by viewing distance is still present.

scholarly journals Pre-habilitation Before Vestibular Schwannoma Surgery—Impact of Intratympanal Gentamicin Application on the Vestibulo-Ocular Reflex

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexander A. Tarnutzer ◽  
Christopher J. Bockisch ◽  
Elena Buffone ◽  
Alexander M. Huber ◽  
Vincent G. Wettstein ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Vestibular Function ◽  
Loss Of Function ◽  
Saccadic Amplitude ◽  
Vestibular Loss ◽  
Horizontal Canal ◽  
Ocular Reflex ◽  
Intratympanic Gentamicin ◽  
Vestibulo Ocular Reflex ◽  
Anterior Canal

Background: Patients with vestibular schwannoma that show residual peripheral-vestibular function before surgery may experience sudden and substantial vestibular loss of function after surgical resection. To alleviate the sudden loss of peripheral-vestibular function after vestibular-schwannoma (VS) resection, pre-surgical intratympanic gentamicin application was proposed.Objective: We hypothesized that this approach allows for a controlled reduction of peripheral-vestibular function before surgery but that resulting peripheral-vestibular deficits may be canal-specific with anterior-canal sparing as observed previously in systemic gentamicin application.Methods: Thirty-four patients (age-range = 27–70 y) with unilateral VS (size = 2–50 mm) were included in this retrospective single-center trial. The angular vestibulo-ocular reflex (aVOR) was quantified before and after (29.7 ± 18.7 d, mean ± 1SD) a single or two sequential intratympanic gentamicin applications by use of video-head-impulse testing. Both aVOR gains, cumulative saccadic amplitudes, and overall aVOR function were retrieved. Statistical analysis was done using a generalized linear model.Results: At baseline, loss of function of the horizontal (20/34) and posterior (21/34) canal was significantly (p < 0.001) more frequent than that of the anterior canal (5/34). After gentamicin application, loss of function of the horizontal (32/34) or posterior (31/34) canal remained significantly (p ≤ 0.003) more frequent than that of the anterior canal (18/34). For all ipsilesional canals, significant aVOR-gain reductions and cumulative-saccadic-amplitude increases were noted after gentamicin. For the horizontal canal, loss of function was significantly larger (increase in cumulative-saccadic-amplitude: 1.6 ± 2.0 vs. 0.8 ± 1.2, p = 0.007) or showed a trend to larger changes (decrease in aVOR-gain: 0.24 ± 0.22 vs. 0.13 ± 0.29, p = 0.069) than for the anterior canal.Conclusions: Intratympanic gentamicin application resulted in a substantial reduction in peripheral-vestibular function in all three ipsilesional canals. Relative sparing of anterior-canal function noted at baseline was preserved after gentamicin treatment. Thus, pre-surgical intratympanic gentamicin is a suitable preparatory procedure for reducing the drop in peripheral-vestibular function after VS-resection. The reasons for relative sparing of the anterior canal remain unclear.

Evidence a shared mechanism mediates ipsi- and contralesional compensatory saccades and gait after unilateral vestibular deafferentation

2020 ◽  
Vol 123 (4) ◽  
pp. 1486-1495 ◽  
Author(s):  
Andrew R. Wagner ◽  
Michael C. Schubert
Keyword(s):  
Gait Speed ◽  
Vestibular Function ◽  
Head Rotation ◽  
Common Mechanism ◽  
Walk Test ◽  
Vestibular Loss ◽  
Study Objective ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Unilateral Vestibular Deafferentation

The study objective was to understand how the contralesional labyrinth contributes to gaze and gait stability after unilateral vestibular deafferentation (UVD). Head impulse testing (vHIT) was completed in 37 individuals [22 women (59%); age 52.13 ± 11.59 yr, mean ± SD] with UVD from vestibular schwannoma resection. Compensatory saccades (CS) and vestibulo-ocular reflex (VOR) gain were analyzed for both ipsilesional and contralesional impulses. Gait speed (10-m walk test) and endurance (2-min walk test) were collected for 35 individuals. CS were recruited during contralesional head rotation regardless of VOR gain on either the ipsilesional [ρ = 0.21 (−0.14, 0.57); Spearman rank (95% confidence interval)] or contralesional side [ρ = −0.04 (−0.42, 0.35)]. Additionally, the latency of these CS (151.19 ± 52.41 ms) was similar to that of CS generated during ipsilesional rotation (165.65 ± 21.62 ms; P = 0.159). CS recruited during ipsilesional vHIT were of a higher velocity ( P < 0.001) and greater frequency ( P < 0.001) compared with contralesional CS. VOR gain asymmetry was significantly correlated with gait speed [ρ = −0.37 (−0.73, −0.01)], yet individual VOR gain was not correlated [ipsilesional: ρ = 0.17 (−0.20, 0.55); contralesional: ρ = −0.18 (−0.52, 0.15)]. Our data reveal CS are recruited at similar latencies without correlation to VOR gain or direction of head rotation, and that the central integration of ipsilesional and contralesional vestibular afference correlates with gait. Together, our data suggest the brain considers vestibular afference from both sides when generating related behavioral output after UVD. NEW & NOTEWORTHY After unilateral vestibular deafferentation, compensatory saccades (CS) have similar latencies regardless of the direction of head rotation, and those CS generated during contralesional head rotation are unrelated to extent of vestibular loss. Additionally, the extent of asymmetry in residual vestibular function, not the extent of vestibular loss, correlates with gait speed. Our data suggest a common mechanism is responsible for the generation of CS and restoration of gait speed in vestibular compensation.

Sign in / Sign up

Export Citation Format

Share Document