Impaired speech perception in noise in patients with a normal audiogram.

Patients with normal hearing acuity but complaining of impaired speech perception in noisy conditions were submitted to a test battery including the measurement of the speech reception threshold in noise and central auditory tests. In 95% of the cases the complaint was corroborated by an abnormal speech reception threshold (SRT) in noise. Central auditory tests were abnormal in 65% of the patients. Auditory brainstem-evoked potentials were measured in some of these patients and showed normal results in almost all cases. No specific relationship could be found between an elevated SRT in noise or an abnormal central test result.

Human gaze stability in the horizontal, vertical and torsional direction during voluntary head movements, evaluated with a three-dimensional scleral induction coil technique.

The stability of gaze in three dimensions (horizontal, vertical and torsion) was measured with a new type of scleral search coil in eight emmetropic observers. Subjects held the head still or oscillated it at 0.16-0.67 Hz (amplitude about 10 deg) in the horizontal, vertical or torsional plane while fixating a point target at optical infinity. Veridical gaze and head coordinates were calculated with full correction for non-linear goniometric relations and for cross-coupling artifacts due to misalignments of the coil on the eye. The amount of gaze instability in the horizontal and vertical direction was virtually identical. With the head still, in either of these directions the mean standard deviation of gaze position (inclusive saccades) was about 7 min arc; mean non-saccadic retinal image speeds were 20-30 min arc/sec. During head oscillation these values increased to about 16 min arc and 1 deg/sec; a mean of about 2.5% of the head motion remained uncorrected by the compensatory eye movements. These findings agree well with our earlier results for the horizontal plane; the effect of the corrections was relatively small because the adventitious cross-coupling of horizontal and vertical to torsional head movements proved to be usually smaller than 10%. However, the corrections were important when head torsion was deliberately produced. Gaze stability in the torsional plane was considerably inferior to that in the horizontal and vertical plane. With the head held still, the mean SD of torsional gaze position was about 17 min arc; mean torsional non-saccadic retinal image speed was about 46 min arc/sec. Gain of the torsional compensatory eye movements was frequency dependent and rose from about 0.26 in static conditions (0 Hz) to about 0.42 at 0.16 Hz and 0.64 at 0.67 Hz. Accordingly, position instability and speed of the retinal image in torsion were about an order of magnitude larger than in the horizontal and vertical direction.

A direct test of Listing's law--I. Human ocular torsion measured in static tertiary positions.

The validity of Listing's law was reinvestigated by means of a direct test. Horizontal, vertical and torsional eye movements were measured simultaneously with a recently developed scleral induction coil. Either eye of 4 subjects was measured monocularly. Eye position were measured in Fick coordinates and ocular torsion values were compared to the theoretical ones predicted by Listing's law. During consecutive measurements in the primary position torsion values were close to zero although considerable fluctuations of torsion were seen. Torsion values in the secondary positions were also close to zero. In the tertiary positions torsion in the direction as predicted by Listing's law and increasing with eccentricity was recorded. In the temporal quadrants mean torsion was quantitatively in agreement with Listing's law; torsion values in the nasal quadrants however showed systematically larger values and this discrepancy increased with eccentricity to more than 50%. Statistical support for this finding however, was seen only in 4 out of 8 eyes. Symmetry could be obtained by shifting the chosen horizontal primary position (gaze parallel to the midplane) in the temporal direction; as a consequence all measured torsion values would exceed the ones specified by Listing's law. Torsion values varied idiosyncratically among subjects and among the left and right eyes of any one subject. It is concluded that Listing's law specifies ocular torsion only approximately: physiological eye movements show considerable stochastical as well as systematical deviations from this law.

A direct test of Listing's law--II. Human ocular torsion measured under dynamic conditions.

Ocular torsion was recorded with a scleral search coil technique in five normal subjects. The dynamic aspects of torsion were investigated during monocular fixation, blinking, smooth pursuit and saccades. Torsion near the primary position showed considerable short-term (SD about 0.25 deg) and a much larger long-term fluctuation (SD about 2.3 deg). During saccades between diagonally opposite tertiary positions torsion transiently reached values approximating those in the sustained primary position. During smooth pursuit across the primary position, the minimal values of torsion varied with the direction and the trajectory of pursuit, in violation of Donder's law. Changes in torsion associated with horizontal and vertical saccades and during the aftermath of blinks often had a sluggish, exponential time course. During eye movements around a circular or square trajectory torsion showed hysteresis. During clockwise pursuit the right eye showed relative intorsion compared to counterclockwise pursuit. It is proposed that central nervous control of torsion is usually imprecise, and that the eye follows Listing's and Donder's laws only approximately.

Human ocular counterroll: assessment of static and dynamic properties from electromagnetic scleral coil recordings.

Static and dynamic components of ocular counterroll as well as cyclorotatory optokinetic nystagmus were measured with a scleral search coil technique. Static counterroll compensated for about 10% of head roll when the head was tilted to steady positions up to 20 deg from the upright position. The dynamic component of counterroll, which occurs only while the head is moving, is much larger. It consists of smooth compensatory cyclorotation opposite to the head rotation, interrupted frequently by saccades moving in the same direction as the head. During voluntary sinusoidal head roll, cyclorotation compensated from 40% to more than 70% of the head motion. In the range 0.16 to 1.33 Hz, gain increased with frequency and with the amount of visual information. The lowest values were found in darkness. The gain increased in the presence of a visual fixation point and a further rise was induced by a structured visual pattern. Resetting saccades were made more frequently in the dark than in the light. These saccades were somewhat slower than typical horizontal saccades. Cyclorotatory optokinetic nystagmus could be induced by a patterned disk rotating around the visual axis. It was highly variable even within a same subject and had in general a very low gain (mean value about 0.03 for stimulus velocities up to 30 deg/s). It is concluded that cyclorotational slip velocity on the retina is considerably reduced by counterroll during roll of the head, although the residual cyclorotation after the head has reached a steady position is very small.