Can a plantar pressure–based tongue-placed electrotactile biofeedback improve postural control under altered vestibular and neck proprioceptive conditions?

We investigated the effects of a plantar pressure-based tongue-placed electrotactile biofeedback on postural control during quiet standing under normal and altered vestibular and neck proprioceptive conditions. To achieve this goal, 14 young healthy adults were asked to stand upright as immobile as possible with their eyes closed in two Neutral and Extended head postures and two conditions of No-biofeedback and Biofeedback. The underlying principle of the biofeedback consisted of providing supplementary information related to foot sole pressure distribution through a wireless embedded tongue-placed tactile output device. Center of foot pressure (CoP) displacements were recorded using a plantar pressure data acquisition system. Results showed that (1) the Extended head posture yielded increased CoP displacements relative to the Neutral head posture in the No-biofeedback condition, with a greater effect along the anteroposterior than mediolateral axis, whereas (2) no significant difference between the two Neutral and Extended head postures was observed in the Biofeedback condition. The present findings suggested that the availability of the plantar pressure-based tongue-placed electrotactile biofeedback allowed the subjects to suppress the destabilizing effect induced by the disruption of vestibular and neck proprioceptive inputs associated with the head extended posture. These results are discussed according to the sensory re-weighting hypothesis, whereby the CNS would dynamically and selectively adjust the relative contributions of sensory inputs (i.e. the sensory weights) to maintain upright stance depending on the sensory contexts and the neuromuscular constraints acting on the subject.     

Modeling postural instability with Galvanic vestibular stimulation

In this study the effect of a pseudorandom binaural bipolar Galvanic stimulus generated by a sum of nonharmonically related sine waves on postural control was functionally assessed using computerized dynamic posturography (CDP), and the results compared to vestibulopathic patient populations and astronauts exposed to microgravity. The standardized CDP test battery comprised six sensory organization tests (SOTs) that combined three visual conditions (eyes open, eyes closed, and sway-referenced vision) with two proprioceptive conditions (fixed and sway-referenced support surfaces). Subjects (12) performed 18 randomized trials (three trials of each of the six SOTs) as a baseline, repeated the 18 trials with Galvanic vestibular stimulation (GVS), and then performed a post-GVS baseline. A 10 min rest period was inserted between each test battery. Anterioposterior postural sway increased significantly and was in the abnormal range (fifth percentile) during GVS for SOTs where visual input was compromised (sway-referenced surround) or absent. Postural stability returned to baseline when GVS was removed. An analysis of sensory input scores (somatosensory, visual, and vestibular) demonstrated the specificity of GVS in distorting vestibular input to postural control. The SOT scores observed in astronauts on landing day did not differ significantly to that generated by GVS in our normal subjects. GVS also induced a similar pattern of instability on CDP as profound bilateral vestibular loss, although not as severe. The results suggest that unpredictably varying GVS quantitatively and qualitatively models postural instability of vestibular origin.     

Sensory supplementation system based on electrotactile tongue biofeedback of head position for balance control

The present study aimed at investigating the effects of an artificial head position-based tongue-placed electrotactile biofeedback on postural control during quiet standing under different somatosensory conditions from the support surface. Eight young healthy adults were asked to stand as immobile as possible with their eyes closed on two Firm and Foam support surface conditions executed in two conditions of No-biofeedback and Biofeedback. In the Foam condition, a 6-cm thick foam support surface was placed under the subjects’ feet to alter the quality and/or quantity of somatosensory information at the plantar sole and the ankle. The underlying principle of the biofeedback consisted of providing supplementary information about the head orientation with respect to gravitational vertical through electrical stimulation of the tongue. Centre of foot pressure (CoP) displacements were recorded using a force platform. Larger CoP displacements were observed in the Foam than Firm conditions in the two conditions of No-biofeedback and Biofeedback. Interestingly, this destabilizing effect was less accentuated in the Biofeedback than No-biofeedback condition. In accordance with the sensory re-weighting hypothesis for balance control, the present findings evidence that the availability of the central nervous system to integrate an artificial head orientation information delivered through electrical stimulation of the tongue to limit the postural perturbation induced by alteration of somatosensory input from the support surface.     

Sensory supplementation system based on electrotactile tongue biofeedback of head position for balance control

The present study aimed at investigating the effects of an artificial head position-based tongue-placed electrotactile biofeedback on postural control during quiet standing under different somatosensory conditions from the support surface. Eight young healthy adults were asked to stand as immobile as possible with their eyes closed on two Firm and Foam support surface conditions executed in two conditions of No-biofeedback and Biofeedback. In the Foam condition, a 6-cm thick foam support surface was placed under the subjects' feet to alter the quality and/or quantity of somatosensory information at the plantar sole and the ankle. The underlying principle of the biofeedback consisted of providing supplementary information about the head orientation with respect to gravitational vertical through electrical stimulation of the tongue. Centre of foot pressure (CoP) displacements were recorded using a force platform. Larger CoP displacements were observed in the Foam than Firm conditions in the two conditions of No-biofeedback and Biofeedback. Interestingly, this destabilizing effect was less accentuated in the Biofeedback than No-biofeedback condition. In accordance with the sensory re-weighting hypothesis for balance control, the present findings evidence that the availability of the central nervous system to integrate an artificial head orientation information delivered through electrical stimulation of the tongue to limit the postural perturbation induced by alteration of somatosensory input from the support surface.     

Head position-based electrotactile tongue biofeedback affects postural responses to Achilles tendon vibration in humans

The purpose of the present experiment was to investigate whether postural responses to ankle proprioceptive perturbation Achilles tendon vibration were affected by the availability of augmented sensory information about head orientation/motion with respect to gravitational vertical, i.e., normally provided by the vestibular system. To achieve this goal, ten standing subjects were exposed to Achilles tendon vibration in two No Biofeedback and Biofeedback conditions. The No Biofeedback condition served as a control condition. In the Biofeedback condition, subjects performed the postural task using a head position-based electrotactile tongue-placed biofeedback system. Center of foot pressure (CoP) displacements were recorded using a force platform. Results showed that (1) Achilles tendon vibration increased CoP displacements in the No Biofeedback condition and (2) this destabilizing effect was less accentuated in the Biofeedback condition. These results are consistent with and discussed in terms of sensory re-weighting mechanisms involved in postural control. In the condition of Achilles tendon vibration, which renders ankle proprioceptive information less reliable for controlling posture, the central nervous system was able to integrate alternatively available augmented sensory information suitable and usable in upright postural control to reduce the destabilizing effect of the ankle proprioceptive perturbation.     

Generalizability of perturbation-evoked cortical potentials: Independence from sensory,motor and overall postural state

Following disturbances to postural stability, balance recovery reactions are evoked by numerous sensory inputs and characterized by motor reactions involving different patterns of activity, depending on postural task conditions. It remains unknown whether well-documented cortical responses to instability share common spatio-temporal characteristics, despite variations in the sensory, motor, and postural components of the reactions. The objective was to explore the spatio-temporal profile of cortical potentials evoked by instability requiring either upper- or lower-limb compensatory responses. The hypothesis that upper- and lower-limb balance-correcting reactions are associated with evoked cortical potentials (N1, P2) featuring similar spatio-temporal characteristics was tested by inducing postural perturbations in seated (SIT) or standing (STAND) positions. For both conditions, N1 amplitude was greatest at FCz, with no significant differences in the timing of N1 peak (SIT: 142.4 ± 7.95 ms; STAND: 148.4 ± 4.10 ms) or N1 amplitude (SIT: 37.16 ± 6.99 μV; STAND: 39.08 ± 4.51 μV). The amplitude of the P2 potential (measured at CPz) was significantly larger in the STAND condition (37.87 ± 6.14 μV) than in the SIT (23.66 ± 6.21 μV) condition. Significant differences in P2 peak time between tasks were absent (SIT: 319.9 ± 11.45 ms; STAND: 322.7 ± 7.61 ms). Though differences in the amplitude of components of evoked potentials may reflect the extent of cortical involvement in different aspects of postural control, similarities in the spatio-temporal components of cortical potentials between tasks reflects generalizable cortical processing of unexpected stimuli independent of the sensory, motor, or postural aspects of the response.     

The vestibular system is integral in regulating plastic alterations in the pressor response to free drop mediated by the nonvestibular system

Microgravity resulting from free drop elicits a pressor response that involves both vestibular and nonvestibular pathways. In rats reared under a 3G environment for 2 weeks, plastic alterations in both vestibular- and nonvestibular-mediated responses are induced; specifically, the pressor responses involving both pathways are reduced [C. Abe, K. Tanaka, C. Awazu, H. Chen, H. Morita, Plastic alteration of vestibulo-cardiovascular reflex induced by 2 weeks of 3-G load in conscious rats, Exp. Brain Res. 181 (2007) 639–646]. It is currently unknown whether plastic alterations in the nonvestibular system depend on the vestibular system. To examine this topic, the pressor response to free drop was compared between rats with and without vestibular lesion (VL) reared under 1G or 3G environments. The pressor response to free drop was 34 ± 3 mmHg in vestibular intact rats reared under 1G, and was significantly attenuated in rats reared under a 3G environment for 2 weeks (13 ± 3 mmHg); however, the pressor response was similar between VL-1G (18 ± 3 mmHg) and VL-3G (19 ± 3 mmHg) rats. Therefore, the 3G environment induced plastic alterations in the pressor response to free drop mediated by both the vestibular and nonvestibular systems, and the vestibular system is indispensable for induction of the plastic alteration of the nonvestibular-meidated pressor response to free drop.     

Limited control strategies with the loss of vestibular function

When subjects stand on an unstable or compliant support surface, rather than a stable one, vestibular information becomes more important for the control of posture. We investigated how subjects with bilateral vestibular loss (BVL) controlled their upright posture, with and without light-touch contact at the fingertip, while standing on a support surface, sinusoidally rotating at different frequencies. Subjects stood with eyes closed on a platform that rotated +/-1.2 degrees around an axis directly beneath the midline of the ankle for frequencies ranging from 0.01 to 0.4 Hz for two sensory conditions: (1) with light, nonsupportive touch (less than 1 N vertical force) on a stationary surface; or (2) with the fingertip held in a position directly above the contact surface (no contact). Gain, phase, and variability of the center of mass (CoM) and the finger were analyzed to compare BVL subjects with healthy controls in the no-touch and light-touch conditions. Three important results were observed: First, CoM gain and variability of BVL subjects was distinctly higher than control subjects with no-touch contact, particularly at the higher platform frequencies. Second, with light-touch contact, BVL and control subjects showed equivalent gain, variability, and phase. Third, multiple relationships between the finger and the CoM were observed in control subjects, whereas BVL subjects implemented a single finger/CoM control scheme. The results are explained in terms of three interacting factors: the transfer function of the vestibular system, a sensory reweighting mechanism, and the inertial properties of the body. Moreover, multiple control strategies observed in control subjects suggest a more flexible control system than that of individuals with severely diminished vestibular function.     

The effects of stochastic galvanic vestibular stimulation on human postural sway

 Galvanic vestibular stimulation serves to modulate the continuous firing level of the peripheral vestibular afferents. It has been shown that the application of sinusoidally varying, bipolar galvanic currents to the vestibular system can lead to sinusoidally varying postural sway. Our objective was to test the hypothesis that stochastic galvanic vestibular stimulation can lead to coherent stochastic postural sway. Bipolar binaural stochastic galvanic vestibular stimulation was applied to nine healthy young subjects. Three different stochastic vestibular stimulation signals, each with a different frequency content (0–1 Hz, 1–2 Hz, and 0–2 Hz), were used. The stimulation level (range 0.4–1.5 mA, peak to peak) was determined on an individual basis. Twenty 60-s trials were conducted on each subject – 15 stimulation trials (5 trials with each stimulation signal) and 5 control (no stimulation) trials. During the trials, subjects stood in a relaxed, upright position with their head facing forward. Postural sway was evaluated by using a force platform to measure the displacements of the center of pressure (COP) under each subject’s feet. Cross-spectral measures were used to quantify the relationship between the applied stimulus and the resulting COP time series. We found significant coherency between the stochastic vestibular stimulation signal and the resulting mediolateral COP time series in the majority of trials in 8 of the 9 subjects tested. The coherency results for each stimulation signal were reproducible from trial to trial, and the highest degree of coherency was found for the 1- to 2-Hz stochastic vestibular stimulation signal. In general, for the nine subjects tested, we did not find consistent significant coherency between the stochastic vestibular stimulation signals and the anteroposterior COP time series. This work demonstrates that, in subjects who are facing forward, bipolar binaural stochastic galvanic stimulation of the vestibular system leads to coherent stochastic mediolateral postural sway, but it does not lead to coherent stochastic anteroposterior postural sway. Our finding that the coherency was highest for the 1- to 2-Hz stochastic vestibular stimulation signal may be due to the intrinsic dynamics of the quasi-static postural control system. In particular, it may result from the effects of the vestibular stimulus simply being superimposed upon the quiet-standing COP displacements. By utilizing stochastic stimulation signals, we ensured that the subjects could not predict a change in the vestibular stimulus. Thus, our findings indicate that subjects can act as ”responders” to galvanic vestibular stimulation. Received: 13 March 1998 / Accepted: 8 October 1998     

Postural strategies associated with somatosensory and vestibular loss

Summary This study examines the roles of somatosensory and vestibular information in the coordination of postural responses. The role of somatosensory information was examined by comparing postural responses of healthy control subjects prior to and following somatosensory loss due to hypoxic anesthesia of the feet and ankles. The role of vestibular information was evaluated by comparing the postural responses of control subjects and patients with bilateral vestibular loss. Postural responses were quantified by measuring 1) spatial and temporal characteristics of leg and trunk EMG activation; 2) ankle, knee, and hip joint kinematics, and 3) surface forces in response to anterior and posterior surface translations under different visual and surface conditions. Results showed that neither vestibular nor somatosensory loss resulted in delayed or disorganized postural responses. However, both types of sensory deficits altered the type of postural response selected under a given set of conditions. Somatosensory loss resulted in an increased hip strategy for postural correction, similar to the movement strategy used by control subjects while standing across a shortened surface. Vestibular loss resulted in a normal ankle strategy but lack of a hip strategy, even when required for the task of maintaining equilibrium on a shortened surface. Neither somatosensory nor vestibular loss resulted in difficulty in utilizing remaining sensory information for orientation during quiet stance. These results support the hypothesis that cutaneous and joint somatosensory information from the feet and ankles may play an important role in assuring that the form of postural movements are appropriate for the current biomechanical constraints of the surface and/or foot. The results also suggest that vestibular information is necessary in controlling equilibrium in a task requiring use of the hip strategy. Thus, both somatosensory and vestibular sensory information play important roles in the selection of postural movement strategies appropriate for their environmental contexts.     

Role of somatosensory and vestibular cues in attenuating visually induced human postural sway

The purpose of this study was to determine the contribution of visual, vestibular, and somatosensory cues to the maintenance of stance in humans. Postural sway was induced by full-field, sinusoidal visual surround rotations about an axis at the level of the ankle joints. The influences of vestibular and somatosensory cues were characterized by comparing postural sway in normal and bilateral vestibular absent subjects in conditions that provided either accurate or inaccurate somatosensory orientation information. In normal subjects, the amplitude of visually induced sway reached a saturation level as stimulus amplitude increased. The saturation amplitude decreased with increasing stimulus frequency. No saturation phenomena were observed in subjects with vestibular loss, implying that vestibular cues were responsible for the saturation phenomenon. For visually induced sways below the saturation level, the stimulus-response curves for both normal subjects and subjects experiencing vestibular loss were nearly identical, implying (1) that normal subjects were not using vestibular information to attenuate their visually induced sway, possibly because sway was below a vestibular-related threshold level, and (2) that subjects with vestibular loss did not utilize visual cues to a greater extent than normal subjects; that is, a fundamental change in visual system gain was not used to compensate for a vestibular deficit. An unexpected finding was that the amplitude of body sway induced by visual surround motion could be almost 3 times greater than the amplitude of the visual stimulus in normal subjects and subjects with vestibular loss. This occurred in conditions where somatosensory cues were inaccurate and at low stimulus amplitudes. A control system model of visually induced postural sway was developed to explain this finding. For both subject groups, the amplitude of visually induced sway was smaller by a factor of about 4 in tests where somatosensory cues provided accurate versus inaccurate orientation information. This implied (1) that the subjects experiencing vestibular loss did not utilize somatosensory cues to a greater extent than normal subjects; that is, changes in somatosensory system gain were not used to compensate for a vestibular deficit, and (2) that the threshold for the use of vestibular cues in normal subjects was apparently lower in test conditions where somatosensory cues were providing accurate orientation information.     

Effects of a two-diopter vertical prism on posture

Postural control in upright stance requires the central integration of visual, vestibular, somatosensory (as cutaneous receptors) and proprioceptive (as joint receptors) inputs. Clinical studies seem to indicate an association between vertical heterophoria (VH) and balance control. The purpose of the study was to simulate a VH and examine its influence on body stabilisation in quiet stance. We studied 15 healthy subjects (25.6 ± 3.0 years). The postural stability was measured with a platform under the following conditions: normal viewing, with a two-diopter prism base down placed on the dominant eye (PDE) or the non-dominant eye (PNDE). Both eyes were open in all conditions. All conditions were run at two distances: 200 and 40 cm. The results showed: (i) PNDE increased the antero-posterior body sway for both distances; this result could be related to sensory processing of disparity and/or to inappropriate eye movement response to the disparity induced by the prism; (ii) PDE improved the postural stability only at far distance (reduction of the center-of-pressure excursion area and of the lateral body sway). Such positive result could be due to appropriate sensory processing of disparity and/or eye movement response; the latter would reduce vertical disparity and modify the dynamic and tonic eye muscle activity relative to normal viewing at far distance. We conclude that: (i) experimentally induced vertical phoria does indeed influence postural control; (ii) vertical prisms, even of small power, can have complex effects, positive or negative, depending on the eye wearing it and at the distance fixated.     

Effects of bilateral vestibular loss on podokinetic after-rotation

We asked what the role of the vestibular system is in adaptive control of locomotor trajectory in response to walking on a rotating disc. Subjects with bilateral vestibular loss (BVL) were compared to age- and gender-matched controls (CTRL). Subjects walked in place on the surface of a rotating disc for 15 min and then attempted to step in place without vision on a stationary surface for 30 min. CTRL subjects demonstrated podokinetic after-rotation (PKAR), involuntarily and unknowingly turning themselves in circles while attempting to step in place. PKAR in CTRLs was characterized by a rapid rise in turning velocity over the first 1–2 min, followed by a gradual decay over the remaining 28 min. Subjects with BVL also demonstrated PKAR and had no knowledge of their turning. However, PKAR in BVLs was characterized by an extremely rapid, essentially instantaneous rise. Subjects with BVL immediately turned at maximum velocity and exhibited a gradual decay throughout the entire 30 min period. Despite this difference in the initial portion of PKAR in BVLs, their responses were not significantly different from CTRLs during minutes 2 to 30 of the response. These results suggest that vestibular inputs normally suppress PKAR velocity over the first 1–2 min of the response, but do not greatly influence PKAR decay. PKAR is therefore a process mediated primarily by somatosensory information and vestibular inputs are not required for its expression. Additionally, the absence of vestibular inputs does not result in increased somatosensory sensitivity that alters podokinetic intensity or decay time constants.     

Improving balance function using vestibular stochastic resonance: optimizing stimulus characteristics

Stochastic resonance (SR) is a phenomenon whereby the response of a non-linear system to a weak periodic input signal is optimized by the presence of a particular non-zero level of noise. Stochastic resonance using imperceptible stochastic vestibular electrical stimulation, when applied to normal young and elderly subjects, has been shown to significantly improve ocular stabilization reflexes in response to whole-body tilt; improved balance performance during postural disturbances and optimize covariance between the weak input periodic signals introduced via venous blood pressure receptors and the heart rate responses. In our study, 15 subjects stood on a compliant surface with their eyes closed. They were given low-amplitude binaural bipolar stochastic electrical stimulation of the vestibular organs in two frequency ranges of 1–2 and 0–30 Hz over the amplitude range of 0 to ±700 μA. Subjects were instructed to maintain an upright stance during 43-s trials, which consisted of baseline (zero amplitude) and stimulation (non-zero amplitude) periods. Measures of stability of the head and trunk using inertial motion unit sensors attached to these segments and the whole body using a force plate were measured and quantified in the mediolateral plane. Using a multivariate optimization criterion, our results show that the low levels of vestibular stimulation given to the vestibular organs improved balance performance in normal healthy subjects in the range of 5–26% consistent with the stochastic resonance phenomenon. In our study, 8 of 15 and 10 of 15 subjects were responsive for the 1–2- and 0–30-Hz stimulus signals, respectively. The improvement in balance performance did not differ significantly between the stimulations in the two frequency ranges. The amplitude of optimal stimulus for improving balance performance was predominantly in the range of ±100 to ±400 μA. A device based on SR stimulation of the vestibular system might be useful as either a training modality to enhance adaptability or skill acquisition, or as a miniature patch-type stimulator that may be worn by people with disabilities due to aging or disease to improve posture and locomotion function.     

Low-level Taekwondo practitioners have better somatosensory organisation in standing balance than sedentary people

Sports training, especially for those requiring fast and skilled movements have been reported to improve one’s postural control, but the underlying sensory integration mechanism is unknown. The purpose is to explore the sensory organisation strategies for maintaining standing balance in Taekwondo practitioners, and to examine the quasi-static and dynamic balance performance in subjects with and without TKD training. Case–control study was used as a study design. Eleven subjects with low level of Taekwondo training for 1–3 years, and eleven sedentary healthy subjects were assessed with the sensory organisation tests (SOT) under six visual and somatosensory input conditions and their balance upon landing from self- or operator-triggered drop test with the eyes closed condition. The SOT measured the equilibrium scores, whereas the drop test assessed the time to stabilisation (TTS), normalised peak force and distance of antero-posterior and medial–lateral centre of pressure on landing. Results for the SOT test revealed that Taekwondo subjects performed better during stance with eyes closed on a fixed support than the untrained group (p = 0.011). For the drop tests, the untrained group was slower in postural correction as revealed by the longer TTS than the Taekwondo group after the operator-triggered drops (p = 0.018). All subjects had a larger normalised peak force in operator-triggered than self-triggered drops. In conclusion, we observed that people with low-level Taekwondo training have better balance performance than untrained subjects as shown in the SOT results and shorter TTS with the drop test. They may rely more on the somatosensory and vestibular inputs for maintaining balance. People with balance problems may benefit from Taekwondo training.     

Vestibular influences on human postural control in combinations of pitch and roll planes reveal differences in spatiotemporal processing

The present study examined the influence of bilateral peripheral vestibular loss (BVL) in humans on postural responses to multidirectional surface rotations in the pitch and roll planes. Specifically, we examined the effects of vestibular loss on the directional sensitivity, timing, and amplitude of early stretch, balance correcting, and stabilizing reactions in postural leg and trunk muscles as well as changes in ankle torque and trunk angular velocity following multidirectional rotational perturbations of the support surface. Fourteen normal healthy adults and five BVL patients stood on a dual axis rotating platform which rotated 7.5° at 50°/s through eight different directions of pitch and roll combinations separated by 45°. Directions were randomized within a series of 44 perturbation trials which were presented first with eyes open, followed by a second series of trials with eyes closed. Vestibular loss did not influence the range of activation or direction of maximum sensitivity for balance correcting responses (120–220 ms). Response onsets at approximately 120 ms were normal in tibialis anterior (TA), soleus (SOL), paraspinals (PARAS), or quadriceps muscles. Only SOL muscle activity demonstrated a 38- to 45-ms delay for combinations of forward (toe-down) and roll perturbations in BVL patients. The amplitude of balance correcting responses in leg muscles between 120 and 220 ms was, with one exception, severely reduced in BVL patients for eyes open and eyes closed conditions. SOL responses were decreased bilaterally for toe-up and toe-down perturbations, but more significantly reduced in the downhill (load-bearing) leg for combined roll and pitch perturbations. TA was significantly reduced bilaterally for toe-up perturbations, and in the downhill leg for backward roll perturbations. Forward perturbations, however, elicited significantly larger TA activity in BVL between 120 and 220 ms compared to normals, which would act to further destabilize the body. As a result of these changes in response amplitudes, BVL patients had reduced balance correcting ankle torque between 160 and 260 ms and increased torque between 280 and 380 ms compared to normals. There were no differences in the orientation of the resultant ankle torque vectors between BVL and normals, both of which were oriented primarily along the pitch plane. For combinations of backward (toe-up) and roll perturbations BVL patients had larger balance correcting and stabilizing reactions (between 350 and 700 ms) in PARAS than normals and these corresponded to excessive trunk pitch and roll velocities. During roll perturbations, trunk velocities in BVL subjects after 200 ms were directed along directions different from those of normals. Furthermore, roll instabilities appeared later than those of pitch particularly for backward roll perturbations. The results of the study show that combinations of roll and pitch surface rotations yield important spatiotemporal information, especially with respect to trunk response strategies changed by BVL which are not revealed by pitch plane perturbations alone. Our results indicate that vestibular influences are earlier for the pitch plane and are directed to leg muscles, whereas roll control is later and focused on trunk muscles. Electronic Publication     

Effects of immersion in virtual reality on postural control

In the present study, we examined the effects of the time lag between visual scene and the head movement in the virtual reality (VR) world on motion sickness and postural control in healthy volunteers. After immersion in VR with additional time lags (from 0 to 0.8 s) to the inherent delay (about 250 ms), the visual-vestibular conflict induced a slight motion sickness in experimental subjects, but no change was noticed in the body sway path with eyes open and closed. However, Romberg ratio of body sway path with eyes closed divided by that with eyes open after immersion in VR was significantly decreased in comparison with that before immersion in VR. Since Romberg ratio is an index of visual dependency on postural control, this finding indicates that the immersion in VR decreases the visual dependency on postural control. It is suggested that adaptation to visual-vestibular conflict in VR immersion increases the contribution of vestibular and somatosensory inputs to postural control by ignoring the conflicting delayed visual input in the VR world. VR may be a promising treatment for visual vertigo in vestibular patients with unsuccessful compensation by its ability to induce vestibular and somatosensory reweighing for postural control.     

Bilateral vestibular loss in cats leads to active destabilization of balance during pitch and roll rotations of the support surface

Although the balance difficulties accompanying vestibular loss are well known, the underlying cause remains unclear. We examined the role of vestibular inputs in the automatic postural response (APR) to pitch and roll rotations of the support surface in freely standing cats before and in the first week after bilateral labyrinthectomy. Support surface rotations accelerate the body center of mass toward the downhill side. The normal APR consists of inhibition in the extensors of the uphill limbs and excitation in the downhill limbs to decelerate the body and maintain the alignment of the limbs with respect to earth-vertical. After vestibular lesion, cats were unstable during rotation perturbations and actively pushed themselves downhill rather than uphill, using a postural response that was opposite to that seen in the control trials. The extensors of the uphill rather than downhill limbs were activated, whereas those of the downhill limbs were inhibited rather than being excited. We propose that vestibular inputs provide an important reference to earth-vertical, which is critical to computing the appropriate postural response during active orientation to the vertical. In the absence of this vestibular information, subjects orient to the support surface using proprioceptive inputs, which drives the body downhill resulting in instability and falling. This is consistent with current models of sensory integration for computation of body posture and orientation.     

Cell proliferation and survival in the vestibular nucleus following bilateral vestibular deafferentation in the adult rat

Cell proliferation and neurogenesis in the brainstem vestibular nucleus complex (VNC) has previously been reported following unilateral vestibular neurectomy in the cat. In this study, we examined the rate of cell proliferation and survival in the adult rat VNC following bilateral vestibular deafferentation (BVD), using injections of bromodeoxyuridine (BrdU) and stereological cell counting. We measured cell proliferation at 24, 48, 72 h and 1 week following BVD and found that it was significantly greater than in sham controls (P = 0.002) and that it varied significantly over time (P = 0.01), peaking at 48 h in the BVD group. Of note was that sham surgery was also associated with an increase in cell proliferation, which changed over time. When we compared the survival of new cells at 1 month after BrdU injection, there was no significant difference in survival between the sham and BVD groups. These results raise questions about the potential functional significance of cell proliferation in the VNC following vestibular lesions.     

Internal models of self-motion: computations that suppress vestibular reafference in early vestibular processing

In everyday life, vestibular sensors are activated by both self-generated and externally applied head movements. The ability to distinguish inputs that are a consequence of our own actions (i.e., active motion) from those that result from changes in the external world (i.e., passive or unexpected motion) is essential for perceptual stability and accurate motor control. Recent work has made progress toward understanding how the brain distinguishes between these two kinds of sensory inputs. We have performed a series of experiments in which single-unit recordings were made from vestibular afferents and central neurons in alert macaque monkeys during rotation and translation. Vestibular afferents showed no differences in firing variability or sensitivity during active movements when compared to passive movements. In contrast, the analyses of neuronal firing rates revealed that neurons at the first central stage of vestibular processing (i.e., in the vestibular nuclei) were effectively less sensitive to active motion. Notably, however, this ability to distinguish between active and passive motion was not a general feature of early central processing, but rather was a characteristic of a distinct group of neurons known to contribute to postural control and spatial orientation. Our most recent studies have addressed how vestibular and proprioceptive inputs are integrated in the vestibular cerebellum, a region likely to be involved in generating an internal model of self-motion. We propose that this multimodal integration within the vestibular cerebellum is required for eliminating self-generated vestibular information from the subsequent computation of orientation and posture control at the first central stage of processing.