Adaptation to rotating artificial gravity environments

A series of pioneering experiments on adaptation to rotating artificial gravity environments was conducted in the 1960s. The results of these experiments led to the general belief that humans with normal vestibular function would not be able to adapt to rotating environments with angular velocities above 3 or 4 rpm. By contrast, our recent work has shown that sensory-motor adaptation to 10 rpm can be achieved relatively easily and quickly if subjects make the same movement repeatedly. This repetition allows the nervous system to gauge how the Coriolis forces generated by movements in a rotating reference frame are deflecting movement paths and endpoints and to institute corrective adaptations. Independent mechanisms appear to underlie restoration of straight movement paths and of accurate movement endpoints. Control of head movements involves adaptation of vestibulo-collic and vestibulo-spinal mechanisms as well as adaptation to motor control of the head as an inertial mass. The vestibular adaptation has a long time constant and the motor adaptation a short one. Surprisingly, Coriolis forces generated by natural turning and reaching movements in our normal environment are typically larger than those elicited in rotating artificial gravity environments. They are not recognized as such because self-generated Coriolis forces during voluntary trunk rotation are perceptually transparent. After adaptation to a rotating environment is complete, the Coriolis forces generated by movements within it also become transparent and are not felt although they are still present.     

Sensorimotor aspects of high-speed artificial gravity: I. Sensory conflict in vestibular adaptation

Short-radius centrifugation offers a promising and affordable countermeasure to the adverse effects of prolonged weightlessness. However, head movements made in a fast rotating environment elicit Coriolis effects, which seriously compromise sensory and motor processes. We found that participants can adapt to these Coriolis effects when exposed intermittently to high rotation rates and, at the same time, can maintain their perceptual-motor coordination in stationary environments. In this paper, we explore the role of inter-sensory conflict in this adaptation process. Different measures (vertical nystagmus, illusory body tilt, motion sickness) react differently to visual-vestibular conflict and adapt differently. In particular, proprioceptive-vestibular conflict sufficed to adapt subjective parameters and the time constant of nystagmus decay, while retinal slip was required for VOR gain adaptation. A simple correlation between the strength of intersensory conflict and the efficacy of adaptation fails to explain the data. Implications of these findings, which differ from existing data for low rotation rates, are discussed.     

Vestibular adaptation to centrifugation does not transfer across planes of head rotation

Out-of-plane head movements performed during fast rotation produce non-compensatory nystagmus, sensations of illusory motion, and often motion sickness. Adaptation to this cross-coupled Coriolis stimulus has previously been demonstrated for head turns made in the yaw (transverse) plane of motion, during supine head-on-axis rotation. An open question, however, is if adaptation to head movements in one plane of motion transfers to head movements performed in a new, unpracticed plane of motion. Evidence of transfer would imply the brain builds up a generalized model of the vestibular sensory-motor system, instead of learning a variety of individual input/output relations separately. To investigate, over two days 9 subjects performed pitch head turns (sagittal plane) while rotating, before and after a series of yaw head turns while rotating. A Control Group of 10 subjects performed only the pitch movements. The vestibulo-ocular reflex (VOR) and sensations of illusory motion were recorded in the dark for all movements. Upon comparing the two groups we failed to find any evidence of transfer from the yaw plane to the pitch plane, suggesting that adaptation to cross-coupled stimuli is specific to the particular plane of head movement. The findings have applications for the use of centrifugation as a possible countermeasure for long duration spaceflight. Adapting astronauts to unconstrained head movements while rotating will likely require exposure to head movements in all planes and directions.     

Measurement of oscillopsia induced by vestibular Coriolis stimulation

We demonstrate a new method for measuring the time constant of head-movement-contingent oscillopsia (HMCO) produced by vestibular Coriolis stimulation. Subjects briskly rotated their heads around pitch or roll axes whilst seated on a platform rotating at constant velocity. This induced a cross-coupled vestibular Coriolis illusion. Simultaneous with the head movement, a visual display consisting of either a moving field of white dots on a black background or superimposed on a subject-stationary horizon, or a complete virtual room with conventional furnishings appeared. The scene's motion was driven by a simplified computer model of the Coriolis illusion. Subjects either nulled (if visual motion was against the illusory body rotation) or matched (if motion was in the same direction as the illusory motion) the sensation with the exponentially slowing scene motion, by indicating whether its decline was too fast or too slow. The model time constant was approximated using a staircase technique. Time constants comparable to that of the Coriolis vestibular ocular reflex were obtained. Time constants could be significantly reduced by adding subject-stationary visual elements. This technique for measuring oscillopsia might be used to quantify adaptation to artificial gravity environments. In principle more complex models can be used, and applied to other types of oscillopsia such as are experienced by BPPV patients or by astronauts returning to Earth.     

Directional Plasticity Rapidly Improves 3D Vestibulo-Ocular Reflex Alignment in Monkeys Using a Multichannel Vestibular Prosthesis

Bilateral loss of vestibular sensation can be disabling. We have shown that a multichannel vestibular prosthesis (MVP) can partly restore vestibular sensation as evidenced by improvements in the 3-dimensional angular vestibulo-ocular reflex (3D VOR). However, a key challenge is to minimize misalignment between the axes of eye and head rotation, which is apparently caused by current spread beyond each electrode’s targeted nerve branch. We recently reported that rodents wearing a MVP markedly improve 3D VOR alignment during the first week after MVP activation, probably through the same central nervous system adaptive mechanisms that mediate cross-axis adaptation over time in normal individuals wearing prisms that cause visual scene movement about an axis different than the axis of head rotation. We hypothesized that rhesus monkeys would exhibit similar improvements with continuous prosthetic stimulation over time. We created bilateral vestibular deficiency in four rhesus monkeys via intratympanic injection of gentamicin. A MVP was mounted to the cranium, and eye movements in response to whole-body passive rotation in darkness were measured repeatedly over 1 week of continuous head motion-modulated prosthetic electrical stimulation. 3D VOR responses to whole-body rotations about each semicircular canal axis were measured on days 1, 3, and 7 of chronic stimulation. Horizontal VOR gain during 1 Hz, 50 °/s peak whole-body rotations before the prosthesis was turned on was <0.1, which is profoundly below normal (0.94 ± 0.12). On stimulation day 1, VOR gain was 0.4–0.8, but the axis of observed eye movements aligned poorly with head rotation (misalignment range ∼30–40 °). Substantial improvement of axis misalignment was observed after 7 days of continuous motion-modulated prosthetic stimulation under normal diurnal lighting. Similar improvements were noted for all animals, all three axes of rotation tested, for all sinusoidal frequencies tested (0.05–5 Hz), and for high-acceleration transient rotations. VOR asymmetry changes did not reach statistical significance, although they did trend toward slight improvement over time. Prior studies had already shown that directional plasticity reduces misalignment when a subject with normal labyrinths views abnormal visual scene movement. Our results show that the converse is also true: individuals receiving misoriented vestibular sensation under normal viewing conditions rapidly adapt to restore a well-aligned 3D VOR. Considering the similarity of VOR physiology across primate species, similar effects are likely to occur in humans using a MVP to treat bilateral vestibular deficiency.     

Threshold-based vestibular adaptation to cross-coupled canal stimulation

Prior experiments have demonstrated that people are able to adapt to cross-coupled accelerations associated with head movements while spinning at high rotation rates (e.g., 23 rpm or 138 degrees/s). However, while adapting, subjects commonly experience serious side effects, such as motion sickness, non-compensatory eye movements, and strong and potentially disorienting illusory body tilt or tumbling sensations. In the present study, we investigated the feasibility of adaptation using a threshold-based method, which ensured that the illusory tilt sensations remained imperceptible or just barely noticeable. This was achieved by incrementally increasing the angular velocity of the horizontal centrifuge while supine subjects made repeated consistent yaw head turns. Incremental adaptation phases started at centrifugation speeds of 3 rpm. Centrifuge speed was slowly increased in steps of 1.5 rpm until a light illusory tilt was experienced. At the end of the incremental procedure, subjects were able to make head turns while rotating 14 rpm without experiencing illusory tilt. Moreover, motion sickness symptoms could be avoided and a limited carry over of the adaptive state to stronger stimulation at 23 rpm was found. The results are compared to prior studies which adapted subjects to super-threshold stimuli.     

Coordination of a step with a reach

Although natural reaching behavior can easily include forward body movement, most laboratory studies of reaching have constrained the body to be stationary. Recently, however, it has been shown that normal subjects exhibit a different pattern of errors when attempting to pinpoint remembered target locations, depending on whether or not the reach includes a step. In the study of Flanders et al., these errors appeared to be due to the strategy of eye/head/hand coordination which normally comes into play when the body is moving toward the target. Since the spatial positioning of the head was found to partially explain the errors in hand placement, the present study examined the movements of patients with bilateral vestibular deficits in order to further analyze the whole-body coordination. Somewhat surprisingly, the patients exhibited the same pattern of head movement and the same errors in hand placement as did the control subjects. Nevertheless, the patients' movements clearly exhibited evidence for an abnormal decomposition of elbow extension and trunk rotation. Furthermore the patients' (spatial) hand paths were significantly more curved than those of control subjects and, only in the patients, paths to remembered targets were significantly more curved than paths to visible targets. Thus for movements to remembered targets, the patients tended to move the hand to the same incorrect spatial positions as control subjects but spatiotemporal aspects of the arm and body movement differed. The results are consistent with the idea that vestibular patients are overly dependent upon visual cues, and support the hypothesis that this stepping and reaching behavior is largely dependent upon a visual reference signal.     

Eye-head coordination in darkness: formulation and testing of a mathematical model

Passive head rotation in darkness produces vestibular nystagmus, consisting of slow and quick phases. The vestibulo-ocular reflex produces the slow phases, in the compensatory direction, while the fast phases, in the same direction as head rotation, are of saccadic origin. We have investigated how the saccadic components of the ocular motor responses evoked by active head rotation in darkness are generated, assuming the only available sensory information is that provided by the vestibular system. We recorded the eye and head movements of nine normal subjects during active head rotation in darkness. Subjects were instructed to rotate their heads in a sinusoidal-like manner and to focus their attention on producing a smooth head rotation. We found that the desired eye position signal provided to the saccadic mechanism by the vestibular system may be modeled as a linear combination of head velocity and head displacement information. Here we present a mathematical model for the generation of both the slow and quick phases of vestibular nystagmus based on our findings. Simulations of this model accurately fit experimental data recorded from subjects.     

Eye movements during torso rotations in labyrinthine-defective subjects

The aim of this study was to examine whether the chronic loss of vestibular function modifies perceptual and oculomotor responses during torso rotations in darkness. Subjects (4 patients with complete vestibular loss and 7 healthy volunteers) were seated on a rotating chair. Stimuli consisted of sinusoidal chair rotations (+/-30 degrees, 0.1 Hz and 0.011 Hz). We used 2 conditions: space stationary head (neck stimulation) and space stationary head and shoulders (torso stimulation). Horizontal eye deviations and slow component of eye movements were analysed. The results showed that eye movements and perception of head motion in space during neck stimulation were similar to those during torso stimulation both in normal and labyrinthine-defective (LD) subjects. During low-frequency chair rotations (0.011 Hz) all subjects perceived illusory head or head and shoulder rotation in space (as if the lower part of the body was stationary relative to the room) and shifted their gaze in the direction of illusory head rotation. In these conditions there was no significant difference in eye movements between normal and LD subjects. During higher frequency chair rotations (0.1 Hz), LD subjects had significantly larger eye deviations as well as increases in the gain of the slow component of eye movements relative to normals. In these conditions patients mostly perceived illusory head or head and shoulder rotation in space while normal subjects mainly perceived the head as stationary in space. The results indicate that 1) neck and torso rotations can evoke similar ocular responses in LD subjects, 2) the chronic loss of vestibular function modifies the representation of axial body segment motion relative to space.     

Restoration of 3D vestibular sensation in rhesus monkeys using a multichannel vestibular prosthesis

Profound bilateral loss of vestibular hair cell function can cause chronically disabling loss of balance and inability to maintain stable vision during head and body movements. We have previously shown that chinchillas rendered bilaterally vestibular-deficient via intratympanic administration of the ototoxic antibiotic gentamicin regain a more nearly normal 3-dimensional vestibulo-ocular reflex (3D VOR) when head motion information sensed by a head-mounted multichannel vestibular prosthesis (MVP) is encoded via rate-modulated pulsatile stimulation of vestibular nerve branches. Despite significant improvement versus the unaided condition, animals still exhibited some 3D VOR misalignment (i.e., the 3D axis of eye movement responses did not precisely align with the axis of head rotation), presumably due to current spread between a given ampullary nerve's stimulating electrode(s) and afferent fibers in non-targeted branches of the vestibular nerve. Assuming that effects of current spread depend on relative orientation and separation between nerve branches, anatomic differences between chinchilla and human labyrinths may limit the extent to which results in chinchillas accurately predict MVP performance in humans. In this report, we describe the MVP-evoked 3D VOR measured in alert rhesus monkeys, which have labyrinths that are larger than chinchillas and temporal bone anatomy more similar to humans. Electrodes were implanted in five monkeys treated with intratympanic gentamicin to bilaterally ablate vestibular hair cell mechanosensitivity. Eye movements mediated by the 3D VOR were recorded during passive sinusoidal (0.2-5?Hz, peak 50°/s) and acceleration-step (1000°/s(2) to 150°/s) whole-body rotations in darkness about each semicircular canal axis. During constant 100?pulse/s stimulation (i.e., MVP powered ON but set to stimulate each ampullary nerve at a constant mean baseline rate not modulated by head motion), 3D VOR responses to head rotation exhibited profoundly low gain [(mean eye velocity amplitude)/(mean head velocity amplitude)?相似文献   

Fastigial evoked eye movement and brain stem neuronal behavior in the alert monkey.

Single units in the brain stem were recorded in the awake monkey during concomitant adequate vestibular stimulation, eye movement, and electrical stimulation of the fastigial nucleus in areas that produce short-latency horizontal saccades. Forty-eight percent of the recorded brain stem cells were associated with eye movements; 40% respond only to head rotation; and the remainder are unrelated to either. The activity of the majority of the eye movement-related cells was similar for spontaneously and fastigially evoked saccades. The activity of the head rotation and unrelated cells show no consistent relationship to fastigial stimulation.     

Gravity or translation: central processing of vestibular signals to detect motion or tilt

The processing and detection of tilts relative to gravity from actual motion (translational accelerations) is one of the most fundamental issues for understanding vestibular sensorimotor control in altered gravity environments. In order to better understand the nature of multisensory signals in detecting motion and tilt, we summarize here our recent studies regarding the central processing of vestibular signals during multi-axis rotational and translational stimuli. Approximately one fourth of the cells in the vestibular nuclei exclusively encoded rotational movements (Canal-Only neurons) and were unresponsive to translation. The Canal-Only central neurons encoded head rotation in canal afferent coordinates, exhibited no orthogonal canal convergence and were characterized by significantly higher sensitivities to rotation as compared to canal afferents. Another fourth of the neurons modulated their firing rates during translation (Otolith-Only cells). During rotations, these neurons typically only responded when the axis of rotation was earth-horizontal and the head was changing orientation relative to gravity. The remaining cells (approximately half of total population) were sensitive to both rotations and translations (Otolith+Canal neurons). Maximum sensitivity vectors to rotation were distributed throughout the 3D space, suggesting strong convergence from multiple semicircular canals. Only a small subpopulation (approximately one third) of these Otolith+Canal neurons seems to encode a true estimate of the translational component of the imposed passive head and body movement. These results provide the first step in further understanding multisensory convergence in normal gravity, as this task is fundamental to our appreciation of neurovestibular adaptation to altered gravity.     

Vestibulo-oculomotor reflex recording using the scleral search coil technique. Review of peripheral vestibular disorders

Our goal is to review vestibulo-oculomotor reflex (VOR) studies on several peripheral vestibular disorders (Ménière's disease, vestibular neuritis, benign paroxysmal positional vertigo, superior canal dehiscence syndrome, and vestibular neuroma), using the scleral search coil (SSC) technique. Head movements are detected by vestibular receptors and the elicited VOR is responsible for compensatory 3 dimensional eye movements. Therefore, to study the VOR it is necessary to assess the direction and velocity of 3 dimensional head and eye movements. This can be achieved using the SCC technique. Interaction between a scleral search coil and an alternating magnetic field generates an electrical signal that is proportional to eye position. Ideally, eye rotation axis is aligned with head rotation axis and VOR gain (eye velocity/head velocity) for horizontal and vertical head rotations is almost 1. The VOR gain, however, for torsional head rotations is smaller and about 0.7.     

Vestibular adaptation studied with a prosthetic semicircular canal

We have developed and tested a prosthetic semicircular canal that senses angular head velocity and uses this information to modulate the rate of current pulses applied to the vestibular nerve via a stimulating electrode. In one squirrel monkey, the lateral canals were plugged bilaterally and the prosthesis was secured to the animal's head with the angular velocity sensor parallel to the axis of the lateral canals. In the first experiment, the stimulating electrode was placed near the ampullary nerve of one lateral canal. Over a period of two weeks, the gain of the horizontal VOR during yaw axis rotation gradually increased, although the response magnitude remained relatively small. In the second experiment, the stimulating electrode was placed near the ampullary nerve of the posterior canal, but the orientation of the velocity sensor remained parallel to the axis of the lateral canals. Over a one-week period, the axis of the VOR response gradually shifted towards alignment with the (yaw) axis of head rotation. Chronic patterned stimulation of the eighth nerve can therefore provide adequate information to the brain to generate a measurable VOR response, and this can occur even if the prosthetic yaw rotation cue is provided via a branch of the VIIIth nerve that doesn't normally carry yaw rotational cues. The results provided by this pilot study suggest that it may be feasible to study central adaptation by chronically modifying the afferent vestibular cue with a prosthetic semicircular canal.     

Head impulses after unilateral vestibular deafferentation validate Ewald's second law.

To determine the relative contributions of ampullofugal (AF) and ampullopetal (AP) stimulation of the horizontal semicircular canal (HSCC) to the horizontal vestibulo-ocular reflex (HVOR), 12 patients were studied 1 year after total unilateral vestibular deafferentation (UVD). Compensatory eye movement responses to impulses of horizontal head rotation were studied using magnetic search coils. The head impulses were rapid (up to 3000 deg/sec/sec) passive, unpredictable, step displacements of horizontal angular head position with respect to the trunk. The results from these 12 patients were compared with results from 30 normal subjects. An HVOR deficit was found to each side. The HVOR in response to head impulses toward the deafferented side, a response generated exclusively by ampullofugal stimulation of the single functioning HSCC, was severely deficient with an average gain of 0.25; the HVOR in response to head impulses toward the intact side, a response generated exclusively by ampullopetal stimulation of the single functioning HSCC, was mildly but significantly deficient compared with normal subjects. These results show that rapid, unpredictable head movements, unlike slow, predictable head movements, do demonstrate the AP-AF HVOR asymmetry, which could be expected from consideration of the behavior of single vestibular afferent neurons, an asymmetry that is expressed by Ewald's 2nd Law.     

Effect of microgravity on spatial orientation and posture regulation during Coriolis stimulation

OBJECTIVE: To elucidate spatial orientation and posture regulation under conditions of microgravity. MATERIAL AND METHODS: Coriolis stimulation was done with five normal subjects on the ground (1 g) and onboard an aircraft (under conditions of microgravity during parabolic flight). Subjects were asked to tilt their heads forward during rotation at speeds of 0, 50, 100 and 150 degrees/s on the ground and 100 degrees/s during flight. Body sway was recorded using a 3D linear accelerometer and eye movements using an infrared charge-coupled device video camera. Flight experiments were performed on 5 consecutive days, and 11-16 parabolic maneuvers were done during each flight. Two subjects boarded each flight and were examined alternately at least five times. RESULTS: Coriolis stimulation at 1 g caused body sway, nystagmus and a movement sensation in accordance with inertial inputs at 1 g. Neither body sway, excepting a minute sway due to the Coriolis force, nor a movement sensation occurred in microgravity, but nystagmus was recorded. CONCLUSIONS: Posture, eye movement and sensation at 1 g are controlled with reference to spatial coordinates that represent the external world in the brain. Normal spatial coordinates are not relevant in microgravity because there is no Z-axis, and the posture regulation and sensation that depend on them collapse. The discrepancy in responses between posture and eye movement under conditions of microgravity may be caused by a different constitution of the effectors which adjust posture and gaze.     

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.     

Multichannel Vestibular Prosthesis Employing Modulation of Pulse Rate and Current with Alignment Precompensation Elicits Improved VOR Performance in Monkeys

An implantable prosthesis that stimulates vestibular nerve branches to restore the sensation of head rotation and the three-dimensional (3D) vestibular ocular reflex (VOR) could benefit individuals disabled by bilateral loss of vestibular sensation. Our group has developed a vestibular prosthesis that partly restores normal function in animals by delivering biphasic current pulses via electrodes implanted in semicircular canals. Despite otherwise promising results, this approach has been limited by insufficient velocity of VOR response to head movements that should inhibit the implanted labyrinth and by misalignment between direction of head motion and prosthetically elicited VOR. We report that significantly larger VOR eye velocities in the inhibitory direction can be elicited by adapting a monkey to elevated baseline stimulation rate and current prior to stimulus modulation and then concurrently modulating (“co-modulating”) both rate and current below baseline levels to encode inhibitory angular head velocity. Co-modulation of pulse rate and current amplitude above baseline can also elicit larger VOR eye responses in the excitatory direction than do either pulse rate modulation or current modulation alone. Combining these stimulation strategies with a precompensatory 3D coordinate transformation improves alignment and magnitude of evoked VOR eye responses. By demonstrating that a combination of co-modulation and precompensatory transformation strategies achieves a robust VOR response in all directions with significantly improved alignment in an animal model that closely resembles humans with vestibular loss, these findings provide a solid preclinical foundation for application of vestibular stimulation in humans.     

Low-frequency loud acoustic stimulation and goal-directed arm movements

Objective To analyse the effects of low-frequency loud acoustic stimulation on goal-directed movements involving the arm. Low-frequency sound stimulation impairs eye stability, evokes a subjective tilt of the visual surround in subjects presenting Tullio's phenomenon and induces, in normal subjects, short-latency evoked potentials in the neck and limb muscles.

Material and Methods Healthy subjects performed goal-directed movements in the horizontal plane with the right (dominant) arm to a fixed 3°-wide target positioned at an angle of 30°, with the instruction to perform fast and accurate movements to the target and to hold the final position. This fast-pointing task was performed in association with sound-induced vestibular–otolithic stimulation (110 dB SPL, 500 Hz) in the absence of visual guidance (i.e. pointing at a memorized target in the absence of target or pointer cues). Pointing errors were analysed by computing the constant errors made by the subjects (mean error). Pointing errors were also correlated with movement kinematics (movement duration, peak velocity, time to peak velocity) and with the reaction time of movement.

Results The low-frequency loud acoustic stimulation modified the final position of the arm-pointing task at the memorized target in the absence of vision.

Conclusion Goal-directed movements are achieved by means of sensory interactions between visual, somatosensory and vestibular information and the vestibular–otolithic signals contribute to the accuracy of voluntary arm movements.     

A comparison between oculomotor rehabilitation and vestibular electrical stimulation in unilateral peripheral vestibular deficit

Rehabilitation therapy is proved to be effective in reducing disability in patients with persistent symptoms of disequilibrium after acute unilateral peripheral vestibular deficit. The aim of this study was to evaluate the effects of oculomotor rehabilitation (group 2) on static balance and a dizziness handicap and to compare those with the effects to vestibular electrical stimulation (group 1). Before and after therapy, we tested 28 patients, using static posturography and.the dizziness handicap inventory short form. After therapy, all subjects reported a reduction of symptoms (p = .00019). In group 1, the reductions seen in eyes-opened length of the oscillations and eyes-opened and eyes-closed surface of the body sway were statistically significant, respectively (p = .04; p = .02; p = .02). Group 2 patients revealed better stability on all parameters, and the reductions of eyes-opened length and of eyes-opened correlation function between length and surface were statistically significant (p = .01 and p = .01, respectively). Analysis of the equilibrium system subcomponents did not show any variation. Oculomotor exercises,employed in most rehabilitative protocols and including head movements to improve vestibular adaptation, have proved to reduce the perceived overall impairment and postural sway in patients with recent unilateral vestibular disorders, even though the disorders are not associated with head movements. Comparison of our two study groups did not show any significant difference, revealing that both forms of therapy are effective.