Measurement of vestibular ocular reflex (VOR) time constants with a caloric step stimulus.

A protocol is described for measuring responses to a broad-band (1-2 Hz) caloric step stimulus from which the vestibular ocular reflex (VOR) and adaptation time constants can be estimated. This novel stimulation is the caloric equivalent to a rotatory step of head acceleration. In this protocol, the ear is irrigated continuously for 5 min with water at a constant temperature. During the initial 2-min period of irrigation the subject is seated and leaning forward in a nonstimulable position (horizontal canals in a horizontal plane). This irrigation phase establishes a steady-state thermal gradient across the horizontal canal, effectively eliminating thermal dynamic properties of the caloric transmission as a confounding factor. At the end of this phase, the subject is rapidly reclined to a stimulable position (horizontal canals in vertical plane) that elicits the VOR nystagmus response to an on-step of force on the cupula. Consistent with adaptation processes, the VOR response first increases and then declines gradually over the 2-min period that the step of force is maintained. Four minutes after the onset of irrigation, the subject is rapidly returned to the nonstimulable position (off-step), which is then maintained for a final 1 min. The response after the off-step, which releases the force on the cupula, reveals reversed after-nystagmus due to adaptation. Five subjects provided caloric step responses for 26 caloric temperature conditions spanning the range from 28.4 to 43.0 degrees C. The resulting responses were fitted with an adaptation model similar to models applied to rotatory acceleration step responses. Estimates of the model parameters for robust caloric stimulation, including time constants for the VOR (18.3 sec) and for vestibular adaptation (153.2 sec), are considered in relation to corresponding values reported in the literature for rotatory and caloric vestibular stimulation. The results suggest that caloric step stimulation can be used successfully to probe VOR dynamics.