Visual-vestibular Interaction Research Articles

Rotational chair instead of ENG as the primary vestibular test

Objectives: To present a rotational chair based testing algorithm for initial evaluation of dizzy patients. Methods: Retrospective chart review. Results: One thousand consecutive patients undergoing evaluation for dizziness and imbalance at a tertiary care, referral balance center were included. Rotatational chair testing was used as the primary vestibular study with ENG used as a confirmatory test instead of a vestibular screening test. The rotational chair protocol included an ocular screening battery, VOR (vestibulo-ocular reflex testing with sinusoidal and step velocity testing and visual-vestibular interaction testing including VVOR and visual fixation studies. Rotational chair data without ENG was adequate for confirming the vestibular pathology diagnosis in 70% of patients. Only 10% of patients with normal rotation chair results had abnormal ENG results. In nearly 40% of patients with rotational chair abnormalities, the ENG results were normal. Conclusions: Given the broader array of vestibular and visual-vestibular-interaction information available, rotational chair testing may be a better vestibular screening study than ENG in diagnosing dizzy patients. Prospective investigation of this topic is warranted.

Preserved visual-vestibular interaction in patients with bilateral vestibular failure.

During caloric vestibular stimulation, subjects showed bilateral activation of the vestibular cortex in the posterior insula and retroinsular region as well as concurrent deactivation of visual cortex areas bilaterally. This finding was the basis for the concept of a reciprocal inhibitory interaction between the vestibular and the visual systems. To analyze the modulations of this activation and deactivation pattern in patients with loss of vestibular input, that is, in patients with bilateral vestibular failure (BVF). Modulations of regional cerebral blood flow (rCBF) in PET were measured in nine patients with BVF and compared with those in healthy volunteers using statistical group as well as single-subject analyses (Statistical Parametric Mapping 96b). The group analysis of the BVF patients showed only one small region of activation in the posterior insula contralateral to the stimulated ear, whereas the other areas correlating with vestibular, autonomic, and ocular motor function were not activated. Furthermore, the concurrent rCBF decreases of the primary visual cortex seen in healthy volunteers were not found in the patients. These decreases seem to be dependent on an intact vestibular input with concurrent vestibular nystagmus. The results are compatible with the concept of a reciprocal inhibitory sensorisensory interaction between the vestibular and visual systems that normally act together for orientation in space and perception of motion. This interaction appears to be preserved in the patients at a significantly lower level, that is, with less activation and less deactivation.

空間識と可塑性（何が変わるか）

The vestibulo-ocular reflex (VOR) generates smooth eye movements that are compensatory for head movements to ensure gaze stabilization during head rotation. The VOR, which consists of semicircular-ocular reflex (ScOR) and otolith-ocular reflex (OOR), is adaptively controlled to correct VOR performance when visual-vestibular mismatch arises during head movement. Most studies have investigated horizontal ScOR gain adaptation after exposure to enhanced, reduced, or direction-reversed visual surround motion produced either by optical devices or by coupling altered visual surround motion with head movement in such a way as to reduce or eliminate retinal image slip during head movement. In natural head movement, not only the ScOR, but also the OOR must be used to keep the line of sight stationary in space. It remains unclear how human subjects combine input from the semicircular canals and otolith organs to establish spatial orientation. To investigate the synergy of the ScOR and the OOR, we examine the plasticity of the OOR using visual-vestibular interaction and the effect of adaptive plasticity in the OOR upon ScOR. We demonstrated a reason-ably consistent effect of adaptation of OOR sensitivity on the ScOR using a visual magnification paradigm. Our data suggest that the OOR and the ScOR partly share common neural pathways in such a way that a change in the synaptic efficacy of one pathway is accompanied by a change in the other. Recent data have also suggested the existence of a convergent neuron that receives input from both the semicircular canals and otolith organs in the cat. The role of a neural store that receives input from both the semicircular canals and the otolith organs to maintain a spatial orientation is discussed.

Multimodal signal integration in vestibular neurons of the primate fastigial nucleus.

The rostral fastigial nucleus contains vestibular neurons, which presumably are involved in spinal mechanisms (neck, gait, posture) and which are not modulated with individual eye movements. Single-unit recordings in the alert behaving monkey during natural stimulus conditions reveal that virtually all neurons demonstrate integration of several sensory inputs. This applies not only for canal-canal and canal-otolith interaction, but also for otolith-otolith interaction. There is also some evidence that most neurons receive not only an utriculus but also a sacculus input. Furthermore, most neurons also respond to large-field optokinetic stimulation, reflecting visual-vestibular interaction. Neurons are also affected by the head on trunk position, which would allow these neurons to operate in a body-centered rather than a head-centered reference frame. These complex, multisensory features could permit fastigial nucleus neurons to rather specifically affect spinal motor functions.

Effect of ethanol on visual-vestibular interactions during vertical linear body acceleration.

Ethanol led to disturbed dynamic visual acuity (DVA) during vertical linear acceleration (VLA; amplitude, 5 cm; frequency, 1.2 Hz). The aim of this study was to analyze whether suppression of visual-oculomotor or vestibular pathway is responsible for the disturbance of DVA. Twenty volunteers were investigated before and after ethanol consumption (mean breath alcohol concentration, 0.32 mg/liter). Vertical eye movements and linear head acceleration were recorded. Tested stimuli were vestibular (VLA in the dark), visual (smooth pursuit), and combined (VLA plus fixation on an earth-fixed target) stimulation; visual suppression (VLA plus fixation of a head-fixed target); static visual acuity; and DVA. Parameters of analysis were gain, sensitivity, eye velocity and amplitude, latency between onset of head acceleration and start of eye movement, correct and wrong answers during static visual acuity and DVA testing, feeling of drunkenness (FOD), and breath alcohol concentration. Both during isolated visual and during combined visual-vestibular stimulation, alcohol induced a significant latency increase. Furthermore, DVA was disturbed after ethanol consumption. Test subjects with a strong alcohol-induced disturbance of DVA presented during isolated visual stimulation a significantly higher latency change than volunteers with a minor alcohol-induced disturbance of DVA. On the basis of the FOD, two groups were formed (one with a slight and one with a strong FOD). The two groups differed significantly concerning the alcohol-induced latency increase during isolated visual stimulation and the alcohol-induced disturbance of DVA. Ethanol leads to a disturbance of the visual-oculomotor system and, thus, even during combined visual-vestibular stimulation, to a latency increase. This "delay" is responsible for the disturbance of DVA. This alcohol-induced suppression of the visual-oculomotor system and the disturbance of DVA show a significantly positive correlation with the subjective FOD.

Visual-vestibular interactions during linear vertical acceleration

Die Blickfeldstabilisierung ist eine der Hauptfunktionen des vestibulo-okulären Reflexes (VOR). Fehlt dieser, so kommt es im Rahmen von Körperbewegungen zu Oszillopsien (Dandy-Phänomen). Die bisher zum linearen VOR publizierten Untersuchungen beschäftigen sich überwiegend mit dem horizontalen und kaum mit dem vertikalen linearen VOR, obwohl der Mensch im täglichen Leben ständig vertikalen linearen Beschleunigungen (Gehen, Rennen) ausgesetzt ist. Ziel dieser Arbeit war es, den vertikalen linearen VOR in einem physiologischen Stimulusbereich (Amplitude 5 cm; Frequenz 1,2 Hz) zu untersuchen.

Cortical correlates of vestibulo-ocular reflex modulation: a PET study.

To elucidate cortical correlates of vestibulo-ocular reflex (VOR) modulation, we observed cortical activation during fixation suppression and habituation of caloric vestibular nystagmus in 12 normal subjects, using PET. Significant positive correlation between regional cerebral blood flow (rCBF) and slow phase eye velocity of caloric nystagmus was observed in the middle and posterior insula, inferior parietal lobule, temporal pole, right fusiform gyrus, lingual gyrus, and cerebellar vermis and hemisphere. The rCBF increase in the insular region and the inferior parietal lobule was lateralized depending on the direction of the nystagmus. Caloric nystagmus was suppressed as a result of visual fixation, during which time the area around the right frontal eye field, temporal pole, inferior temporal gyrus, a broad area in the visual cortex, including fusiform and lingual gyrus, cerebellar uvula/nodulus and flocculus, exhibited positive correlation with fixation suppression of caloric nystagmus, while vestibular cortices exhibited negative correlation. The caloric nystagmus habituated with repetition of stimulation. With habituation, we observed activation in the right anterior cingulate gyrus, left superior parietal lobule and right cuneus, and deactivation in the anterior insula, cingulate gyrus, inferior parietal lobule and occipito-temporal visual cortex. The region that showed significant co-activation with fixation suppression and habituation of caloric nystagmus was the right cuneus, and significant co-deactivation was observed in the anterior insula, cingulate gyrus, inferior parietal lobule and middle temporal visual cortex. The present results support previous observations that the parieto-insular cortex and inferior parietal lobule are involved in processing of vestibular information, and, in addition, suggest that activation may depend on the direction of nystagmus. Deactivation of vestibular cortices during visual fixation supports the concept of inhibitory visual-vestibular interaction in the cortex. Significant activation of the cingulate, superior parietal and visual cortices, and cerebellar vermis accompanying reduction of caloric response with repeated stimuli suggests possible involvement of these regions in vestibular habituation. Common activation of the cuneus in visual cortex and deactivation of vestibular and visuo-spatial association cortices by both visual suppression and habituation of VOR suggests that these two mechanisms are not completely independent but may share some cortical and subcortical regions.

Effects of reversible shutdown of the monkey flocculus on the retention of adaptation of the horizontal vestibulo-ocular reflex

There are two different proposals regarding the role of the cerebellar flocculus in the adaptation of the vestibulo-ocular reflex: that the flocculus is the site for both the induction and retention of the adaptation, or that the flocculus plays an important role in the induction, but the vestibular nuclei to which the flocculus issues its efferences are the site of retention. To locate the memory trace for the adaptation of the vestibulo-ocular reflex, we determined effects of acute pharmacological shutdown of the bilateral cerebellar flocculi in four Macaca fuscata. The gain of the horizontal vestibulo-ocular reflex was measured by sinusoidal oscillation of the turntable by 10° (peak-to-peak) at 0.33 Hz in the dark. Two hours of 0.33 Hz–10° sinusoidal oscillation of the turntable while viewing the stationary checked-pattern screen through a ×2.2 magnifying lens adaptively increased the horizontal vestibulo-ocular reflex gain by 0.2 on the average. The gain increase lasted for 1 h when the monkeys were left with their heads fixed in darkness, but it disappeared within 24 h after the monkeys were returned to their cages where they had free movements. The effects of injections of 5 or 10% lidocaine chloride into the bilateral floccular areas (8 μl for each side) immediately after adaptation occurred were determined in nine sessions. The gain of the horizontal vestibulo-ocular reflex immediately decreased to the level before the adaptation. These effects of lidocaine lasted for at least 1 h. On the contrary, injections of the same amount of Ringer’s solution, tested in eight sessions, hardly affected gain of the horizontal vestibulo-ocular reflex over 1-h period. These depressant effects of lidocaine injections were specific to the gains increased by adaptation. These results suggest that the memory trace for the short-term adaptation of the horizontal vestibulo-ocular reflex gain induced by 2 h of sustained visual-vestibular interactions resides within the flocculus.

Plasticity of the vertical VOR: a system identification approach to localizing the adaptive sites.

The vestibulo-ocular reflex (VOR) stabilizes the visual image on the retina during head movement by counter-rotating the eyes in the head. The VOR is under adaptive control and has been extensively used to investigate sensorimotor transformations and motor learning. The cerebellar flocculus (FL) is intimately involved in VOR motor control and learning, because its sole output, the Purkinje cell firing pattern, modulates during visual-vestibular interaction paradigms that induce motor learning, and flocculectomy impairs the ability to modify the VOR. However, the role of the FL in VOR motor learning and the possibility of another neuronal site responsible for learning have been controversial. Currently, we performed single unit recordings of FL Purkinje cells during adaptation of the vertical (V) VOR in squirrel monkeys and used a system identification approach to localize the adaptable neuronal sites responsible for VVOR motor learning. We demonstrated that there are multiple adaptive sites: one upstream or in the FL, another in the non-FL pathway; change in the former site is in the wrong direction to cause the observed VVOR gain change, whereas that in the latter site is in the correct direction. The possibility that FL Purkinje cells convey an error signal to their target neurons that can be used to aid learning is discussed.

FMRI signal increases and decreases in cortical areas during small-field optokinetic stimulation and central fixation

Small-field optokinetic nystagmus (OKN) was performed in seven healthy volunteers in order to analyze the activation and deactivation patterns of visual motion, ocular motor, and multisensory vestibular cortex areas by means of fMRI during coherent visual motion stimulation. BOLD signal decreases (deactivations) were found in the first and second long insular gyri and retroinsular areas (the human homologue of the parietoinsular vestibular cortex and the visual posterior sylvian area in the monkey) of both hemispheres, extending into the transverse temporal gyrus and inferior-anterior parts of the superior temporal gyrus (BA 22), and the precentral gyri at two separate sites (BA 4 and 6). Further deactivations were found in cranioposterior parts of the superior temporal gyrus (BA 22) and the adjacent inferior parietal lobule (BA 40), anterior cingulate gyrus, hippocampus, and corpus callosum. Most of these BOLD signal decreases involved parts of the "multisensory vestibular cortical circuit". These findings support the concept of a reciprocally inhibitory visual-vestibular interaction that has now been demonstrated not only for large-field visual motion stimulation that induces vection (without eye movements) but also for optokinetically induced eye movements (without vection). The functional significance of this concept may be related to the perception of self-motion, since both large-field visual motion stimulation and optokinetic nystagmus are linked to the visual control of self-motion. With respect to activation of the cortical ocular motor system two separate and distinct areas of activations were delineated in the precentral sulcus of both hemispheres, one ventrolaterally (in BA 9) and the other dorsomedially at the junction of the superior frontal sulcus with the precentral sulcus (in BA 6). Both probably correspond to different subregions of the frontal eye field and the premotor cortex for the ocular motor performance of OKN.

Visual-vestibular interaction during OVAR in the elderly

This study assessed visual-otolith interaction in healthy older humans and compared responses from older subjects to those of younger subjects. Using off-vertical axis rotation (OVAR) to stimulate the otolith organs, eye movement responses, measured using electro-oculography, were recorded during rotation in the dark, rotation with an earth-fixed lighted visual surround, and rotation with a subject-fixed fixation target. Results indicated that older subjects, like young subjects, exhibit a modulation component that was as large during rotation with a lighted earth-fixed visual surround as that seen in the dark and a modulation component during rotation with a subject-fixed visual target that was incompletely suppressed. The modulation component was, in general, larger in the older subjects. This study confirms findings from a previous study of visual-otolith interaction in young subjects and suggests that older subjects, like young subjects, have difficulty visually suppressing the modulation component induced by off-vertical axis rotation.

Visual-vestibular interactions in postural control during the execution of a dynamic task.

The purpose of this experiment was to determine the interaction between visual and vestibular information during the transition from quiet standing to the completion of a forward step. Six subjects were asked to take one step forward at the sound of an audio tone, with their eyes open or closed, and terminate the step in a standing position. During stimulation trials, galvanic vestibular stimulation (GVS) was delivered 1500 ms before the auditory cue. GVS was delivered at an intensity three-fold that of each subject's quiet stance threshold with either stimulus right, left or no stimulation. Force data were collected from three forceplates for the calculation of centre of pressure (CoP), and kinematic data were used to calculate centre of mass (CoM) and body trajectories. In quiet stance all subjects responded to the GVS perturbation by demonstrating upper body segment roll and whole body sway towards the anode electrode. Unexpectedly, in the presence of vision during quiet stance, the upper body roll response was not attenuated, even though the CoP sway patterns were reduced when vision was available. During the initiation phase of the step, despite ongoing GVS stimulation, there were no significant effects seen in CoM, CoP or upper body roll responses. During step execution, however, both CoM displacement and upper body roll demonstrated significant effects and both responses were significantly reduced when subjects' eyes were open. Analysis of the medio-lateral CoP integrals also indicated a strong stimulation effect between conditions late in the execution phase, which were largely attenuated with vision. The results suggest that the importance of visual and vestibular information varies depending on the phase of the task. In addition, the different integration between visual and vestibular input during quiet standing suggests a dual role for vestibular information. We propose that vestibular information in quiet standing has a role in maintaining whole body postural stability, as well as playing an integral role in the alignment of the body segments in preparation for proper movement execution. Vision was demonstrated to differentially attenuate these responses based on the phase of the task. Thus, visual and vestibular information appear to be integrated differently across the different phases of a forward-stepping task.

Integration of visual and vestibulo-tactile inputs affecting apparent self-motion around the line of sight.

We investigated the effects of visual and vestibulo-tactile inputs on perceived self-motion. Each of 23 subjects was exposed to an optical pattern rotating around the roll axis (i.e., line of sight) while the chair, in which the subject was placed, was rotated back and forth between +/-70 degrees (i.e., large rolling) or between +/-35 degrees (i.e., small rolling) from the gravitational vertical. Each subject judged perceived velocity of self-motion under each of 16 combinations of pattern velocity and chair velocity. The main results were the following: (1) The mean estimation increased with pattern velocity, and it also increased with chair velocity, (2) to attain a constant perceived velocity of self-motion, pattern velocity was traded for chair velocity, and for the large rolling of the chair, visual inputs were more effective than vestibulo-tactile inputs, whereas for the small rolling, the inverse was true; (3) analyses of multiple regression, when applied to the mean estimations, showed that for both rollings of the chair, the visual component dominated over the vestibulo-tactile component, but for the small rolling of the chair, the difference in effectiveness between the two components was attenuated. We discuss these findings in terms of visual-vestibular interaction.

Visual‐Vestibular and Visuovisual Cortical Interaction

PET and fMRI studies have revealed that excitation of the vestibular system by caloric or galvanic stimulation not only activates the parietoinsular vestibular cortex but also bilaterally deactivates the occipital visual cortex. Likewise, visual motion stimulation not only activates the visual cortex but also deactivates the parietoinsular vestibular cortex. These findings are functionally consistent with the hypothesis of an inhibitory reciprocal visual-vestibular interaction for spatial orientation and motion perception. Transcallosal visuovisual interaction between the two hemispheres was found by using half-field visual motion stimulation: activation of motion-sensitive areas hMT/V5 and deactivations of the primary visual cortex contralateral to the stimulated hemisphere. The functional significance of these inter- and intra-sensory interactions could be that they (A) allow a shift of the sensorial weight between two incongruent sensory inputs and (B) ensure a correspondence of the two hemispheres during evaluation of contradictory motion stimulation of the right and left hemifields. In terms of mathematical modeling, these findings may reflect the concepts of a sensory conflict mechanism or a mismatch between expected and actual sensory input.

Using sensory weighting to model the influence of canal, otolith and visual cues on spatial orientation and eye movements

The sensory weighting model is a general model of sensory integration that consists of three processing layers. First, each sensor provides the central nervous system (CNS) with information regarding a specific physical variable. Due to sensor dynamics, this measure is only reliable for the frequency range over which the sensor is accurate. Therefore, we hypothesize that the CNS improves on the reliability of the individual sensor outside this frequency range by using information from other sensors, a process referred to as "frequency completion." Frequency completion uses internal models of sensory dynamics. This "improved" sensory signal is designated as the "sensory estimate" of the physical variable. Second, before being combined, information with different physical meanings is first transformed into a common representation; sensory estimates are converted to intermediate estimates. This conversion uses internal models of body dynamics and physical relationships. Third, several sensory systems may provide information about the same physical variable (e.g., semicircular canals and vision both measure self-rotation). Therefore, we hypothesize that the "central estimate" of a physical variable is computed as a weighted sum of all available intermediate estimates of this physical variable, a process referred to as "multicue weighted averaging." The resulting central estimate is fed back to the first two layers. The sensory weighting model is applied to three-dimensional (3D) visual-vestibular interactions and their associated eye movements and perceptual responses. The model inputs are 3D angular and translational stimuli. The sensory inputs are the 3D sensory signals coming from the semicircular canals, otolith organs, and the visual system. The angular and translational components of visual movement are assumed to be available as separate stimuli measured by the visual system using retinal slip and image deformation. In addition, both tonic ("regular") and phasic ("irregular") otolithic afferents are implemented. Whereas neither tonic nor phasic otolithic afferents distinguish gravity from linear acceleration, the model uses tonic afferents to estimate gravity and phasic afferents to estimate linear acceleration. The model outputs are the internal estimates of physical motion variables and 3D slow-phase eye movements. The model also includes a smooth pursuit module. The model matches eye responses and perceptual effects measured during various motion paradigms in darkness (e.g., centered and eccentric yaw rotation about an earth-vertical axis, yaw rotation about an earth-horizontal axis) and with visual cues (e.g., stabilized visual stimulation or optokinetic stimulation).

視覚誘発性自己回転感における周辺視野の重要性

Visually induced self-motion (vection) is of theoretical interest in understanding the neural basis of visual-vestibular interaction. Recently, vection is also of practical importance in developing virtual reality systems that provide users with a compelling experience of "presence" in a virtual environment. The purpose of this paper was to investigate the role of the central and peripheral retina in visually induced self-rotation (circular vection, CV). Six patients aged 52-78 years all with pathological peripheral visual defects due to retinitis pigmentosa or glaucoma, and an age-matched control group of eight elderly subjects aged 47-71 years were examined. Monocular visual field defects were verified with the Goldmann perimeter by kinetic perimetry. The device used to induce CV was a random dot pattern projected onto a hemispherical dome with a radius of 75 cm. The pattern was rotated horizontally at a constant acceleration of 1 deg/s2. Monocular stimuli were randomly repeated twice in both the temporal-nasal (T-N) and nasal-temporal (N-T) directions. In the age-matched control group, all subjects experienced CV. There were no significant differences in CV latencies between the right and left eyes in either stimulus direction (p>0.05, Student paired t test). In patients with bilateral deficits of the whole visual periphery and intact central visual fields, CV was absent in both stimulus directions. In patients with bilateral and asymmetric deficits of the visual periphery, CV was either missing or markedly prolonged, depend-ing on the extent of the peripheral visual field defect. In patients with unilateral deficits of about half the visual periphery, CV was missing only for the affected eyes. These findings are compatible with the theory of peripheral dominance and size dependence of CV. In the discussion, our results will be compared to previous experiments with masking in normal subjects and with studies in other kinds of self-motion.

Menstrual cycle effects on postural stability but not optokinetic function

We investigated the effects of the menstrual cycle on visual-vestibular interaction by measuring optokinetic function and postural stability at different phases of the cycle. Menstrual cycle phase had no significant effect on gaze-holding, optokinetic nystagmus slow phase velocity, amplitude or frequency, circularvection latency or optokinetic afternystagmus frequency, amplitude or duration. While menstrual cycle phase had no significant effect on anterior-posterior sway, it did significantly affect lateral sway ( P<0.001), with sway on day 5 significantly greater than on days 12 and 21 ( P<0.05 and 0.01, respectively), and sway on day 25 significantly greater than that on day 21 ( P<0.05).

Velocity not acceleration of self-motion mediates vestibular-visual interaction.

We investigated the influence of vestibular stimulation with different angular accelerations and velocities on the perception of visual motion direction. Constant accelerations resulting in different angular velocities and constant angular velocities obtained at different accelerations were combined in twenty healthy subjects. Random-dot kinematograms with coherently moving pixels and randomly moving pixels were used as visual stimuli during whole-body rotations. The smallest percentage of coherently moving pixels leading to a clear perception of motion direction was taken as the perception threshold. Perception thresholds significantly increased with increasing angular velocity. Increased acceleration, however, had no significant effect on the perception thresholds. We conclude that the achieved angular velocity, and not acceleration, is the predominant factor in the processing of vestibular-visual interaction.

Effects of cholinergic neuromodulation in cerebellar flocculus on transparent motion processing in the rabbit.

The way a rabbit moves its eyes in response to a stimulus consisting of two moving random dot patterns largely depends on the relative luminances of the two patterns. Concurrent rotation of the animal enhances the response to the visual pattern that represents the same head movement as the vestibular stimulation. In this paper we investigate the role that the flocculus plays in this behaviour. We injected the non-selective acetylcholine agonist carbachol into the flocculus. These injections are known to increase the gain of the optokinetic reflex, but have a smaller effect on the vestibulo-ocular reflex. We investigated the effect on the oculomotor response to (vestibulo-) transparent stimuli, where one pattern oscillated sinusoidally and the other pattern was stable with respect to the head. We found that the injections caused a higher response gain at a lower luminance of the oscillating pattern. Furthermore the influence of concurrent vestibular stimulation decreased. These findings agree with a role of the flocculus that is downstream of the visual normalisation, but upstream of the visual-vestibular interaction.

Dynamic visual acuity during linear acceleration along the inter-aural axis

We investigated visual-vestibular interactions during linear acceleration along the inter-aural axis. Eighteen healthy volunteers and two patients with central neurological diseases were subjected to transaural linear acceleration in the direction of gravity force (frequency: 0.5-1.5 Hz; amplitude: 5 cm). During linear acceleration, eye movements were recorded under three test conditions: eyes closed (EC), while staring at an imaginary target (IT) and during the testing of dynamic visual acuity (DVA). As parameters of evaluation we used the amplitude of horizontal eye movements, phase shift and the decrease of DVA threshold (DVAT). Under all test conditions, eye amplitude increased with rising stimulus frequency and exceeded, especially in the higher frequency range, a hypothetically calculated eye amplitude for smooth pursuit. The combination of a visual and vestibular input (DVA and IT) led to a better compensation (lower phase shift) than under vestibular stimulation alone (EC). Eye movements during low-frequency stimulation depended more on the visual system while responses in the higher frequency range were mainly triggered by the otolith organ. At 1.5 Hz the compensatory function of the visual-vestibular system was limited (rising phase shift) and DVAT decreased even in a significant number of healthy subjects. Patients with diseases of the central nervous system showed a higher phase shift and thus a stronger decrease of DVAT (two levels) already at a stimulus frequency of 1.25 Hz.