Threat effects on human oculo-motor function.

Neuro-anatomical evidence supports the potential for threat-related factors, such as fear, anxiety and vigilance, to influence brainstem motor nuclei controlling eye movements, as well as the vestibular nuclei. However, little is known about how threat influences human ocular responses, such as eye saccades (ES), smooth pursuit eye tracking (SP), and optokinetic nystagmus (OKN), and whether these responses can be facilitated above normal baseline levels with a natural source of threat. This study was designed to examine the effects of height-induced postural threat on the gain of ES, SP and OKN responses in humans. Twenty participants stood at two different surface heights while performing ES (ranging from 8° to 45° from center), SP (15, 20, 30°/s) and OKN (15, 30, 60°/s) responses in the horizontal plane. Height did not significantly increase the slope of the relationship between ES peak velocity and initial amplitude, or the gain of ES amplitude. In contrast height significantly increased SP and OKN gain. Significant correlations were found between changes in physiological arousal and OKN gain. Observations of changes with height in OKN and SP support neuro-anatomical evidence of threat-related mechanisms influencing both oculo-motor nuclei and vestibular reflex pathways. Although further study is warranted, the findings suggest that potential influences of fear, anxiety and arousal/alertness should be accounted for, or controlled, during clinical vestibular and oculo-motor testing.

Vestibulo-spinal and vestibulo-ocular reflexes are modulated when standing with increased postural threat.

We investigated how vestibulo-spinal reflexes (VSRs) and vestibulo-ocular reflexes (VORs) measured through vestibular evoked myogenic potentials (VEMPs) and video head impulse test (vHIT) outcomes, respectively, are modulated during standing under conditions of increased postural threat. Twenty-five healthy young adults stood quietly at low (0.8 m from the ground) and high (3.2 m) surface height conditions in two experiments. For the first experiment (n = 25) VEMPs were recorded with surface EMG from inferior oblique (IO), sternocleidomastoid (SCM), trapezius (TRP), and soleus (SOL) muscles in response to 256 air-conducted short tone bursts (125 dB SPL, 500 Hz, 4 ms) delivered via headphones. A subset of subjects (n = 19) also received horizontal and vertical head thrusts (∼150°/s) at each height in a separate session, comparing eye and head velocities by using a vHIT system for calculating the functional VOR gains. VEMP amplitudes (IO, TRP, SOL) and horizontal and vertical vHIT gains all increased with high surface height conditions (P < 0.05). Changes in IO and SCM VEMP amplitudes as well as horizontal vHIT gains were correlated with changes in electrodermal activity (ρ = 0.44-0.59, P < 0.05). VEMP amplitude for the IO also positively correlated with fear (ρ = 0.43, P = 0.03). Threat-induced anxiety, fear, and arousal have significant effects on VSR and VOR gains that can be observed in both physiological and functional outcome measures. These findings provide support for a potential central modulation of the vestibular nucleus complex through excitatory inputs from neural centers involved in processing fear, anxiety, arousal, and vigilance.

Increased gain of vestibulospinal potentials evoked in neck and leg muscles when standing under height-induced postural threat.

OBJECTIVE: To measure changes in amplitudes of vestibular evoked myogenic potentials (VEMPs) elicited from neck, upper and lower limb muscles during a quiet standing task with increased postural threat achieved by manipulating surface height. METHODS: Twenty eight subjects were tested while standing on a platform raised to 0.8 m and 3.2 m from the ground. Surface electromyography was recorded from the ipsilateral sternocleidomastoid (SCM), biceps brachii (BB), flexor carpi radialis (FCR), soleus (SOL) and medial gastrocnemius (MG) muscles. Stimulation was with air-conducted short tone bursts (4 ms). After controlling for background muscle activity, VEMP amplitudes were compared between heights and correlated with changes in state anxiety, fear and arousal. RESULTS: VEMP amplitude significantly increased in SCM (9%) and SOL (12.7%) with increased surface height (p<0.05). These modest increases in SCM VEMP amplitude were significantly correlated with anxiety (Rho=0.57, p=0.004) and confidence (Rho=-0.38, p=0.047) and those for SOL were significantly correlated with anxiety (Rho=0.33, p=0.049) and fear (Rho=0.36, p=0.037). CONCLUSION: Postural threat significantly increased vestibulospinal reflex (VSR) gains. Results demonstrate that VEMPs can be used to test different VSR pathways simultaneously during stance. Since fear and anxiety are prevalent with vestibular disorders, they should be considered as potential contributing factors for clinical vestibular outcome measures.