Brainstem Commissures and Control of Time Constant of Vestibular Nystagmus

Motion sickness induced by off-vertical axis rotation (OVAR)

We tested the hypothesis that motion sickness is produced by an integration of the disparity between eye velocity and the yaw-axis orientation vector of velocity storage. Disparity was defined as the magnitude of the cross product between these two vectors. OVAR, which is known to produce motion sickness, generates horizontal eye velocity with a bias level related to velocity storage, as well as cyclic modulations due to re-orientation of the head re gravity. On average, the orientation vector is close to the spatial vertical. Thus, disparity can be related to the bias and tilt angle. Motion sickness sensitivity was defined as a ratio of maximum motion sickness score to the number of revolutions, allowing disparity and motion sickness sensitivity to be correlated. Nine subjects were rotated around axes tilted 10 degrees-30 degrees from the spatial vertical at 30 degrees/s-120 degrees/s. Motion sickness sensitivity increased monotonically with increases in the disparity due to changes in rotational velocity and tilt angle. Maximal motion sickness sensitivity and bias (6.8 degrees/s) occurred when rotating at 60 degrees/s about an axis tilted 30 degrees. Modulations in eye velocity during OVAR were unrelated to motion sickness sensitivity. The data were predicted by a model incorporating an estimate of head velocity from otolith activation, which activated velocity storage, followed by an orientation disparity comparator that activated a motion sickness integrator. These results suggest that the sensory-motor conflict that produces motion sickness involves coding of the spatial vertical by the otolith organs and body tilt receptors and processing of eye velocity through velocity storage.

Vestibular Perception and Navigation in the Congenitally Blind

Vestibular input is required for accurate locomotion in the dark, yet blind subjects’ vestibular function is unexplored. Such investigation may also identify visually dependent aspects of vestibular function. We assessed vestibular function perceptually in six congenitally blind (and 12 sighted) subjects. Cupula deflection by a transient angular, horizontal acceleration generates a related vestibular nerve signal that declines exponentially with time constant ≈4–7 s, which is prolonged to 15 s in the evoked vestibular-ocular reflex by the brain stem “velocity storage.” We measured perceptual velocity storage in blind subjects following velocity steps (overall perceptual vestibular time constant, experiment 1) and found it to be significantly shorter (5.34 s; range: 2.39–8.58 s) than in control, sighted subjects (15.8 s; P < 0.001). Vestibular navigation was assessed by subjects steering a motorized Bárány-chair in response to imposed angular displacements in a path-reversal task, “go-back-to-start” (GBS: experiment 2); and a path-completion task, “complete-the-circle” (CTC: experiment 3). GBS performances (comparing response vs. stimulus displacement regression slopes and r2) were equal between groups ( P > 0.05), but the blind showed worse CTC performance ( P < 0.05). Two blind individuals showed ultrashort perceptual time constants, high lifetime physical activity scores and superior CTC performances; we speculate that these factors may be inter-related. In summary, the vestibular velocity storage as measured perceptually is visually dependent. Early blindness does not affect path reversal performance but is associated with worse path completion, a task requiring an absolute spatial strategy. Although congenitally blind subjects are overall less able to utilize spatial mechanisms during vestibular navigation, prior extensive physical spatial activity may enhance vestibular navigation.

The normal distribution and projections of constitutive NADPH-d/NOS neurons in the brainstem vestibular complex of the rat

The vestibular system is a highly conserved sensory system in vertebrates that is largely responsible for maintenance of one's orientation in space, posture, and balance and for visual fixation of objects during motion. In light of the considerable literature indicating an involvement of nitric oxide (NO) in sensory systems, it is important to determine whether NO is associated with vestibular pathways. To study the relationship of NO to vestibular pathways, we first examined the normal distribution of constitutive NADPH-diaphorase (NADPH-d), a marker for nitric oxide synthase (NOS), in the vestibular complex (VC) and then examined its association with selected vestibular projection neurons. Survey of the four major vestibular nuclei revealed that only the medial vestibular nucleus contained significant numbers of perikarya stained for NADPH-d/NOS. By contrast, all the vestibular nuclei contained a network of fine processes that stained positive for NADPH-d, although the density of this network varied among the individual nuclei. To determine whether NADPH-d/NOS neurons project to vestibular efferent targets, injections of the retrograde tracer Fluoro-Gold were made into known targets of second-order vestibular neurons. Vestibular neurons containing constitutive NADPH-d/NOS were found to project predominantly to the oculomotor nucleus. A small number of neurons also participate in vestibulothalamic and intrinsic vestibular connections. These results indicate that NADPH-d/NOS neurons are prevalent in the MVN and that a subpopulation of these neurons project to the oculomotor complex. Nitric oxide is probably released locally from axons located throughout the vestibular complex but may play a particularly important role in vestibulo-ocular pathways.

Ultrastructure of vestibular commissural neurons related to velocity storage in the monkey

The angular vestibulo-ocular reflex maintains gaze during head movements. It is thought to be mediated by two components: direct and velocity storage pathways. The direct angular vestibulo-ocular reflex is conveyed by a three neuron chain from the labyrinth to the ocular motoneurons. The indirect pathway involves a more complex neural network that utilizes a portion of the vestibular commissure. The purpose of the present study was to identify the ultrastructural characteristics of commissural neurons in the medial vestibular nucleus that are related to the velocity storage component of the angular vestibulo-ocular reflex. Ultrastructural studies of degenerating medial vestibular nucleus neurons were conducted in monkeys following midline section of rostral medullary commissural fibers with subsequent behavioral testing. After this lesion, oculomotor and vestibular functions attributable to velocity storage were abolished, whereas the direct angular vestibulo-ocular reflex pathway remained intact. Since this damage was functionally discrete, degenerating neurons were interpreted as potential participants in the velocity storage network. Ultrastructural observations indicate that commissural neurons related to velocity storage are small and medium sized cells having large nuclei with deep indentations and relatively little cytoplasm, which are located in the lateral crescents of rostral medial vestibular nucleus. The morphology of degenerating dendritic profiles varied. Some contained numerous round or tubular mitochondria in a pale cytoplasmic matrix with few other organelles, while others had few mitochondria but many cisterns and vacuoles in dense granular cytoplasm. The commissural nature of these cells was further suggested by the presence of two different types of degenerating axon terminals in the rostral medial vestibular nucleus: those with a moderate density of large spherical synaptic vesicles, and those with pleomorphic, primarily ellipsoid synaptic vesicles. The recognition of two types of degenerating terminals further supports our interpretation that at least two morphological types of commissural neurons participate in the velocity storage network. The degenerating boutons formed contacts with a variety of postsynaptic partners. In particular, synapses were observed between degenerating boutons and non-degenerating dendrites, and between intact terminals and degenerating dendrites. However, degenerating pre- and postsynaptic elements were rarely observed in direct contact, suggesting that additional neurons are interposed in the indirect pathway commissural system. On the basis of these ultrastructural observations, it is concluded that vestibular commissural neurons involved in the mediation of velocity storage have distinguishing ultrastructural features and synaptology, that are different from those of direct pathway neurons.

The ultrastructure of GABA-immunoreactive vestibular commissural neurons related to velocity storage in the monkey

The purpose of the present study was to visualize the synaptic interactions of GABAergic neurons involved in the mediation of velocity storage. In the previous report, ultrastructural studies of degenerating neurons were conducted following midline section of rostral medullary commissural fibers with subsequent behavioral testing. The midline lesion caused functionally discrete damage to the velocity storage component, but not to the direct pathway, of the angular vestibulo-ocular reflex, and the degenerating neurons were interpreted as potential participants in the velocity storage network. We concluded that at least some of the commissural axons mediating velocity storage originate from clusters of neurons in the lateral crescents of the rostral medial vestibular nucleus. In the present report, immunocytochemical evidence is presented that many vestibular commissural neurons, putatively involved in mediating velocity storage, are GABAergic. These cells have large nuclei, small round or narrow tubular mitochondria, occasional cisterns and vacuoles, but few other organelles. Their axons are thinly-myelinated, and terminate in boutons containing mitochondria of similar ultrastructural appearance and a moderate density of round/pleomorphic synaptic vesicles. Such terminals often form axoaxonic synapses, and less frequently axodendritic contacts, with non-GABAergic elements. On the basis of the present results, we conclude that a portion of the commissural neurons of the velocity storage pathway is GABAergic. The observation of GABAergic axoaxonic synapses in this pathway is interpreted as a structural basis for presynaptic inhibition of medial vestibular nucleus circuits by velocity storage-related commissural neurons. Conversely, substantial ultrastructural evidence for postsynaptic inhibition of non-GABAergic commissural cells argues for a dual role for GABAergic terminals mediating velocity storage: presynaptic inhibition of non-GABAergic vestibular cells by GABAergic velocity storage commissural axons, and postsynaptic inhibition of non-GABAergic velocity storage cells by GABAergic axons. Both pre- and postsynaptic inhibitory arrangements could provide the morphologic basis for disinhibitory activation of the velocity storage network within local neuronal circuits.

Vestibular perception of angular velocity in normal subjects and in patients with congenital nystagmus

A technique is described for the assessment of vestibular sensation. The two main goals of the study were (i) to compare the perception of angular velocity with the eye velocity output of the vestibulo-ocular reflex and (ii) to study vestibular function in patients with congenital nystagmus; this was needed since most previous studies, based on eye movement recordings, have been inconclusive. Subjects indicated their perceived angular velocity by turning by hand a wheel connected to a tachometer. The vestibular stimuli used consisted of sudden deceleration from rotation at a constant horizontal velocity of 90 degrees /s ('stopping' responses). Eye movements were recorded simultaneously with electro-oculography. In normal subjects the perceived angular velocity decayed from the moment of deceleration in an exponential fashion. The mean time constant of sensation decay was approximately 16 s. Eye movement velocity decayed with a similar exponential trajectory (time constant 16 s). Congenital nystagmus patients showed markedly shortened vestibular sensation (mean time constant 7 s). The following conclusions can be drawn: (i) the similarity of the eye velocity and perceptual responses suggests that these two systems receive a vestibular signal which has been similarly processed; (ii) the time constant of the responses indicates that this vestibular signal probably originates in the same brainstem 'velocity storage' integrator; (iii) the technique described is useful for clinical assessment of vestibular function, particularly in patients with ocular motility disorders; (iv) patients with congenital nystagmus have short vestibular time constants, which is probably due to changes induced in velocity storage processing by the persistent retinal image motion present in these patients.

The nucleus of the optic tract. Its function in gaze stabilization and control of visual-vestibular interaction

1. Electrical stimulation of the nucleus of the optic tract (NOT) induced nystagmus and after-nystagmus with ipsilateral slow phases. The velocity characteristics of the nystagmus were similar to those of the slow component of optokinetic nystagmus (OKN) and to optokinetic after-nystagmus (OKAN), both of which are produced by velocity storage in the vestibular system. When NOT was destroyed, these components disappeared. This indicates that velocity storage is activated from the visual system through NOT. 2. Velocity storage produces compensatory eye-in-head and head-on-body movements through the vestibular system. The association of NOT with velocity storage implies that NOT helps stabilize gaze in space during both passive motion and active locomotion in light with an angular component. It has been suggested that "vestibular-only" neurons in the vestibular nuclei play an important role in generation of velocity storage. Similarities between the rise and fall times of eye velocity during OKN and OKAN to firing rates of vestibular-only neurons suggest that these cells may receive their visual input through NOT. 3. One NOT was injected with muscimol, a GABAA agonist. Ipsilateral OKN and OKAN were lost, suggesting that GABA, which is an inhibitory transmitter in NOT, acts on projection pathways to the brain stem. A striking finding was that visual suppression and habituation of contralateral slow phases of vestibular nystagmus were also abolished after muscimol injection. The latter implies that NOT plays an important role in producing visual suppression of the VOR and habituating its time constant. 4. Habituation is lost after nodulus and uvula lesions and visual suppression after lesions of the flocculus and paraflocculus. We postulate that the disappearance of vestibular habituation and of visual suppression of vestibular responses after muscimol injections was due to dysfacilitation of the prominent NOT-inferior olive pathway, inactivating climbing fibers from the dorsal cap to nodulouvular and flocculoparafloccular Purkinje cells. The prompt loss of habituation when NOT was inactivated, and its return when the GABAergic inhibition dissipated, suggests that although VOR habituation can be relatively permanent, it must be maintained continuously by activity of the vestibulocerebellum.

Evidence for inhibitory amino acid receptors on guinea pig medial vestibular nucleus neurons in vitro

There is little evidence to indicate the identity of the inhibitory receptors which mediate inhibitory interaction between the two medial vestibular nuclei ('brainstem commissural inhibition'). In the present study we tested the hypothesis that medial vestibular nucleus (MVN) neurons have gamma-aminobutyric acid (GABA) or glycine receptors by recording from single MVN neurons in isolated guinea pig MVN slices maintained in vitro while superfusing with GABA (10(-8) M) and the non-competitive GABAA antagonist picrotoxin (10(-6) M or 2 x 10(-6) M), or glycine (10(-6) M) and the competitive glycine antagonist strychnine (10(-6) M). Forty-four % (16/36) of the neurons tested with GABA showed a decrease in firing; in 7 out of 8 cases in which a decrease in firing occurred, the addition of the antagonist picrotoxin completely blocked the effect of the GABA alone. Fifty % (7/14) of the neurons tested with glycine showed a decrease in firing; in 4 out of 6 cases where a decrease occurred, the addition of the antagonist strychnine completely blocked the effect of the glycine alone. In one case only did a cell respond both to GABA and glycine (8 neurons tested with both). These results are consistent with the hypothesis that some MVN neurons have GABA or glycine receptors (but in most cases not both), which may mediate brainstem commissural inhibition.

Compensation of horizontal canal related activity in the medial vestibular nucleus following unilateral labyrinth ablation in the decerebrate gerbil. II. Type II neurons

The spontaneous activity and dynamic responses to sinusoidal horizontal head angular acceleration of type II horizontal semicircular canal related neurons in the medial vestibular nucleus (MVN) were recorded bilaterally in decerebrate Mongolian gerbils (Meriones unguiculatus) under three experimental conditions: normal labyrinths intact, acutely following unilateral labyrinthine lesion, and four to seven weeks following labyrinthine lesion. The number of type II neurons detected contralateral to the lesion was greatly reduced both in the acutely hemilabyrinthectomized animals and following compensation. The gain of the responses was depressed bilaterally acutely following the lesion. A greater reduction in response gain was noted in cells contralateral to the lesion. The gain of the contralateral type II responses increased with time such that in the compensated animal bilaterally symmetric gains were recorded. While the significant changes which occur in the gain of type II neurons with recovery from peripheral vestibular lesions can largely be attributed to type I neurons on the other side of the midline, changes in type I neurons were not entirely reflected in the type II population. The spontaneous activity of type II neurons did not undergo any significant changes following the labyrinthine lesion. We present a model utilizing the dynamic responses to estimate the functional recovery of commissural connections in compensated animals. The overall gain of the contralateral type I to ipsilateral type I commissural polysynaptic pathway appears to improve, while the efficacy in the reverse direction remains depressed, suggesting that modifications in commissural connections, particularly involving the type II to type I connections within the MVN on the injured side, mediate aspects of behavioral recovery.

The dynamics of the vestibulo-ocular reflex in patients with vestibular neuritis

The dynamics of the vestibulo-ocular reflex (VOR) were studied in 14 patients at the onset of vestibular neuritis, and at follow-up 1 year later. A velocity step stimulus of 150 degrees/s was used to investigate the VOR time constant and gain, and the results were related to the caloric response. In the acute, vertiginous phase of the disease, the VOR time constant was reduced but was almost normalized 1 year later, both among patients who regained normal caloric side-difference and among those who did not. However, the increase in VOR time constant was greater among those who regained normal caloric excitability, and regression analysis showed a correlation between the prolongation of the VOR time constant and the recovery of caloric excitability. These findings suggest that VOR dynamics are modulated during the acute phase of vestibular neuritis, and that there is recovery with vestibular compensation. Furthermore, the recovery of the VOR time constant is not solely dependent on the recovery of normal caloric excitability. This implies that central storage of velocity information may be involved in the VOR, even in cases of asymmetric vestibular input after vestibular compensation.

Effects on the vestibulo- and opto-oculomotor system in rats by lesions of the commissural vestibular fibres

Eye movements were recorded from rats with a magnetic search coil system before and after sectioning of the midline commissural pathways in the brain stem at the level of the vestibular nuclei. After lesion, the findings were as follows: 1) During sinusoidal vestibular stimulation the eyes moved in a sinusoidal way similar to the head movement without any regular saccades. There was a reduced gain and a phase lead. 2) During optokinetic stimulation the eyes moved in the stimulus direction to an excentric position and stayed there until stimulation ceased. 3) During acceleratory/deceleratory rotation in the light there was a drift of the eyes in the direction of the expected slow phase movement to an excentric position. In some animals there was a directional asymmetry. The findings may be explained by a failure of the central neural integrator for horizontal eye movements. The results support the hypothesis that vestibular commissural fibres are of crucial importance for the function of this integrator system.

Development of the vestibulo-ocular reflex from infancy to adulthood

The time constants and gains of the vestibulo-ocular reflex were computed from the primary nystagmus evoked by constant angular acceleration in 79 normal infants and children, ranging in age from 2 months to 11 years old, and 10 normal adults. There were significant changes in both time constant and gain in respect to development. The time constants increased while the gains decreased as a function of the logarithm of age. The time constants of the youngest infants were close to the cupular time constant. The lengthening of the time constant with increasing age was discussed in respect to maturation of inhibitory brainstem reticular formation mechanisms.

Transdermally administered scopolamine vs. dimenhydrinate. II. Effect on different types of nystagmus

The effects of transdermally administered scopolamine (TTS-scopolamine) (release rate 5 micrograms/h, one and two patches) and dimenhydrinate (100 mg) on caloric, angular acceleration induced and optokinetic nystagmus were examined in 16 volunteers in a randomized double-blind study. All drugs induced a statistically significant decrease in maximum velocity of caloric nystagmus, as compared with placebo. In the rotatory test, two TTS-scopolamine and dimenhydrinate reduced the vestibular gain significantly. No changes were observed in time constant. In the optokinetic test, all drugs tended to reduce the responses, but a statistically significant reduction was found only after two TTS-scopolamine. The results indicate that the drugs effective against motion sickness reduce the nystagmic response, which at least partly explains the mode of action of the drugs. The target organ of the drugs is presumably the vestibular nucleus, where vestibular and visual impulses are integrated to ensure optimal gain for vestibular orientation reflexes.

Clinical evaluation of dysrhythmia of postrotatory nystagmus

Postrotatory responses of nystagmus were analysed in an exponential model by utilizing linear regression analysis. Four nystagmus qualities (velocity and duration of slow and fast phases) were studied in 10 patients with vestibular peripheral lesions, 10 patients with frontal lobe lesions and 10 patients with brain-stem lesions, together with 10 control subjects. In addition, pauses during the responses were quantified. Patients with frontal lobe lesions differed from other groups by scoring higher values of slow phase velocity and by exhibiting more pauses. The time constant was significantly shorter in patients with brain-stem lesion than in any other group. As regards other qualities, e.g. slow phase duration and fast phase velocity, or duration, no differences were observed. The pathological dysrhythmia may therefore be presented as changes in the gain and time constant of slow phase velocity as well as in pauses during nystagmus. Since all these changes may be encountered in normal subjects, one should be cautious in interpreting these changes as being pathological in each individual case.

Changes in the human vestibulo-ocular reflex after loss of peripheral sensitivity

Quantitative rotational testing was used to study changes in the vestibulo-ocular reflex of patients with unilateral and bilateral peripheral vestibular lesions. Compared with normal subjects, the patients exhibited a characteristic pattern of decreased gain and increased phase lead at low frequencies of sinusoidal stimulation and decreased time constants on impulsive stimulation. By contrast, gain and phase measurements on high-frequency-low-amplitude sinusoidal stimulation were often normal. In the patients with bilateral lesions, the results of caloric testing correlated with the results of low-frequency rotational testing but not with the results of high-frequency testing. There are two main clinical implications of these findings. First, patients with absent response to caloric stimulation (unilateral or bilateral) may have a normal response to high-frequency sinusoidal rotation (i.e., the frequencies that constitute most natural head movements). This probably explains why such patients do not report oscillopsia. Second, low-frequency sinusoidal rotational testing and caloric testing are more sensitive than high-frequency sinusoidal or impulsive rotational testing for detecting early loss of vestibular sensitivity due, for example, to ototoxic drugs.

Vestibulo-oculomotor characteristics in surgically treated patients with cerebellar haemangioblastoma (Lindau tumor)

In a survey of 18 patients that were operated on because of a cerebellar haemangioblastoma (Lindau tumor) 94% showed characteristic cerebellar oculomotor deficits when DC EOG recordings were analyzed. Only 22.1% showed also clinically cerebellar deficits. We studied the vestibular ocular reflex (VOR) with and without visual interaction, and also saccades and pursuit eye movements in our patients with lesions involving one cerebellar hemisphere (n = 14) or the vestibulocerebellum (n = 4). Gain of dysmetric saccades ipsilateral to the side of the lesion was significantly increased; gain of pursuit eye movements, that were often saccadic, was decreased contralaterally. Our patients showed highly increased responses for all three conditions of visual-VOR-interaction (sinusoidal or steplike rotation in the dark, in the light with fixed surround, or in the dark with head fixed fixation point) ipsilateral to the lesion, together with a remarkable inability to modulate their VOR with vision on this side. With movements contralateral to the side of the lesion they showed a larger variability of test responses than normals, but only for fixation suppression of the VOR a significantly increased gain. The very similar time constants of slow phase decay after a step change in chair velocity indicated a similar poor modulation of visual-VOR-interaction under these 3 conditions for stimulations ipsilateral to the lesion. Contrariwise, optokinetic step stimulation demonstrated a generally impaired response that was significantly lowered towards the side contralateral to the lesion. Our results indicate the critical function of the cerebellum for voluntary fast and slow eye movements as well as for visual-vestibular interaction in humans.