Cervico-ocular reflex in normal subjects and patients with unilateral vestibular hypofunction. Export

@article{citeulike:3150624, abstract = {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.}, address = {Laboratory of Vestibular Neurophysiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.}, author = {Schubert, M. C. and Das, V. and Tusa, R. J. and Herdman, S. J.}, citeulike-article-id = {3150624}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/14724495}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=14724495}, issn = {1531-7129}, journal = {Otology \& neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology}, keywords = {cervico-ocular, vestibular}, month = {January}, number = {1}, pages = {65--71}, posted-at = {2008-08-23 11:13:20}, priority = {2}, title = {Cervico-ocular reflex in normal subjects and patients with unilateral vestibular hypofunction.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/14724495}, volume = {25}, year = {2004} }

TY - JOUR ID - citeulike:3150624 L3 - citeulike-article-id:3150624 N2 - 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. IS - 1 JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology SN - 1531-7129 AD - Laboratory of Vestibular Neurophysiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. EP - 71 TI - Cervico-ocular reflex in normal subjects and patients with unilateral vestibular hypofunction. VL - 25 SP - 65 KW - cervico-ocular KW - vestibular AU - Schubert, MC AU - Das, V AU - Tusa, RJ AU - Herdman, SJ PY - 2004/01// UR - http://view.ncbi.nlm.nih.gov/pubmed/14724495 ER -