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

Michael C. Schubert, Vallabh Das, Ronald J. Tusa, Susan J. Herdman

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)65-71
Number of pages7
JournalOtology and Neurotology
Volume25
Issue number1
DOIs
StatePublished - Jan 2004

Keywords

  • Cervico-ocular reflex
  • Vestibular hypofunction

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

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