Vestibulo-ocular Reflex Asymmetry Research Articles

Assessment of auditory and vestibular functions after vestibular neurectomy for Menière's disease.

Fourteen patients (12 Meniere's disease, one delayed endolymphatic hydrops and one labyrinthitis) suffering from intractable vertigo were treated with retrosigmoid vestibular neurectomy (RSVN) in our institute. Dizziness was controlled completely in all patients. Hearing was preserved in 91.7% of the cases with pure tone threshold deteriorating by more than 10 dB in one case, remained unchanged in 10 cases and improved in one case during long term observation. Substantial decrease of tinnitus was observed in 78.6%. Vestibular compensation was chronologically analyzed with a stabilometer, ENG and vestibular rotation test (0.01-0.64 Hz). Vestibular compensation under static conditions was accomplished within 2 weeks, except for spontaneous nystagmus measured in the dark. Asymmetry of vestibulo-ocular reflex was noted 2 weeks after the operation but had disappeared after 4 weeks. However, for over 2 years the VOR time constant remained lower (4.3-5.2 s) than the pre-operative value (8.2 s). Electro-cochleogram (ECoG) was recorded before and after RSVN. The -SP/AP ratio tended to increase after RSVN in the operated ear, though there was no change in the contralateral ear. The efferent olivo-cochlear bundle was thought to play a potential role in this increase of the -SP/AP ratio.

Patterns of vestibular function following vestibular nerve section.

Bithermal caloric irrigations, low-frequency rotational chair stimulation, and posturography were performed on 20 patients before and after vestibular nerve section. Twelve patients demonstrated acute postoperative spontaneous nystagmus and rotational vestibulo-ocular reflex (VOR) asymmetry. Eight patients demonstrated minimal acute postoperative spontaneous nystagmus and VOR asymmetry. Four patients had suppression of all vestibular function characterized by an absent contralateral caloric response, low VOR gain, and falls on posturography when required to rely solely on vestibular input to maintain posture. Four patients had a severe preoperative vestibular loss and no acute change in vestibular function following surgery. Over time, 5 patients continued to manifest elevated spontaneous nystagmus, 2 patients manifested a persistent rotational VOR asymmetry, and 5 patients exhibited a return of caloric function in the operated ear. It is suggested that multiple clinical factors contributed to the variable vestibular responses demonstrated in this study.

Effects of posterior parietal lesions (area 7) on VOR in monkeys.

Unilateral ablations of area 7 were performed in three adult monkeys. Vestibulo-ocular reflex (VOR) was tested in the dark by sinusoidal rotations at different frequencies. Following lesion of area 7, spontaneous nystagmus was observed in the dark, with the fast phase directed toward the lesioned side. The same lesion induced a strong VOR asymmetry due to a gain decrease when the animal was rotated toward the side contralateral to the lesion and an increase when rotated toward the opposite side. These VOR deficits were transient: spontaneous nystagmus was no longer present after the first post-operative week whereas the VOR asymmetry lasted for 2 to 4 weeks after the lesion. It is concluded that area 7 might be involved in an ipsilateral control of the slow component of VOR. These results support the idea that posterior parietal cortex plays a role in body reference stabilization.

Cortical control of oculomotor functions. II. Vestibulo-ocular reflex and visual-vestibular interaction

The cortical control of the vestibulo-ocular reflex (VOR) and visual suppression of VOR was studied in 13 adult cats with unilateral lesions. VOR was tested in the dark by sinusoidal rotations of the animal at different frequencies. Visual suppression of VOR was tested in the light by keeping the visual field stationary with respect to the animal. No deficits of VOR and visual suppression of VOR appeared following unilateral ablations of visual cortex. Unilateral lesions of different parts of the suprasylvian cortex were made in the posterior and middle suprasylvian cortex involving area 7 and the lateral suprasylvian area (LSA). After middle suprasylvian cortex damage (particularly area 7), all the animals exhibited a VOR asymmetry due mainly to a gain decrease of slow phases directed towards the side of the lesion. In two animals, transitory spontaneous nystagmus was present in the dark with the fast phase directed toward the side of the lesion. Only when LSA was destroyed, could an asymmetry of the visual suppression of VOR be observed with a loss of the visual suppression during ipsilateral rotations. The VOR deficit was transient: spontaneous nystagmus disappeared within the first postoperative week, the vestibular asymmetry and the loss of visual suppression of VOR were no longer present after 2–3 weeks. We conclude that the middle suprasylvian cortex, particularly area 7, exerts an ipsilateral control on the VOR.