OBJECTIVE: To determine whether the cervico-ocular reflex contributes to gaze stability in patients with unilateral vestibular hypofunction. STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: Patients with unilateral vestibular hypofunction (n = 3) before and after vestibular rehabilitation and healthy subjects (n = 7). INTERVENTIONS: Vestibular rehabilitation. MAIN OUTCOME MEASURES: We measured the cervico-ocular reflex in patients with unilateral vestibular hypofunction before and after vestibular rehabilitation and in healthy subjects. To measure the cervico-ocular reflex, we recorded eye movements with a scleral search coil while the trunk moved at 0.3, 1.0, and 1.5 Hz beneath a stabilized head. To determine whether the head was truly stabilized, we measured head movement using a search coil. RESULTS: We found no evidence of cervico-ocular reflex in any of the seven healthy subjects or in two of the patients with unilateral vestibular hypofunction. In one patient with chronic unilateral vestibular hypofunction, the cervico-ocular reflex was present before vestibular rehabilitation only for leftward trunk rotation (relative head rotation toward the intact side). After 5 weeks of placebo exercises, there was no change in the cervico-ocular reflex. After an additional 5 weeks that included vestibular exercises, cervico-ocular reflex gain for leftward trunk rotation had increased threefold. In addition, there was now evidence of a cervico-ocular reflex for rightward trunk rotation, potentially compensating for the vestibular deficit. CONCLUSION: The cervico-ocular reflex appears to be a highly inconsistent mechanism. The change of the cervico-ocular reflex in one patient after vestibular exercises suggests that the cervico-ocular reflex may be adaptable in some patients.
OBJECTIVE: To determine whether the cervico-ocular reflex contributes to gaze stability in patients with unilateral vestibular hypofunction. STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: Patients with unilateral vestibular hypofunction (n = 3) before and after vestibular rehabilitation and healthy subjects (n = 7). INTERVENTIONS: Vestibular rehabilitation. MAIN OUTCOME MEASURES: We measured the cervico-ocular reflex in patients with unilateral vestibular hypofunction before and after vestibular rehabilitation and in healthy subjects. To measure the cervico-ocular reflex, we recorded eye movements with a scleral search coil while the trunk moved at 0.3, 1.0, and 1.5 Hz beneath a stabilized head. To determine whether the head was truly stabilized, we measured head movement using a search coil. RESULTS: We found no evidence of cervico-ocular reflex in any of the seven healthy subjects or in two of the patients with unilateral vestibular hypofunction. In one patient with chronic unilateral vestibular hypofunction, the cervico-ocular reflex was present before vestibular rehabilitation only for leftward trunk rotation (relative head rotation toward the intact side). After 5 weeks of placebo exercises, there was no change in the cervico-ocular reflex. After an additional 5 weeks that included vestibular exercises, cervico-ocular reflex gain for leftward trunk rotation had increased threefold. In addition, there was now evidence of a cervico-ocular reflex for rightward trunk rotation, potentially compensating for the vestibular deficit. CONCLUSION: The cervico-ocular reflex appears to be a highly inconsistent mechanism. The change of the cervico-ocular reflex in one patient after vestibular exercises suggests that the cervico-ocular reflex may be adaptable in some patients.
Authors: Sergei B Yakushin; Olga V Kolesnikova; Bernard Cohen; Dmitri A Ogorodnikov; Jun-Ichi Suzuki; Charles C Della Santina; Lloyd B Minor; Theodore Raphan Journal: Exp Brain Res Date: 2011-02-01 Impact factor: 1.972
Authors: Michael C Schubert; Americo A Migliaccio; Richard A Clendaniel; Amir Allak; John P Carey Journal: Arch Phys Med Rehabil Date: 2008-03 Impact factor: 3.966
Authors: Brian T Peters; Ajitkumar P Mulavara; Helen S Cohen; Haleh Sangi-Haghpeykar; Jacob J Bloomberg Journal: J Vestib Res Date: 2012-01-01 Impact factor: 2.435