Brain, Vol. 125, No. 9, 2005-2011,
September 2002
© 2002 Guarantors of Brain
Suppression of eye movements improves balance
0 Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany
Correspondence to: Michael Strupp, MD, University of Munich, Department of Neurology, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany E-mail: kjahn{at}nefo.med.uni-muenchen.de
The aim of this study was to investigate the possible interaction of vestibulo-ocular and vestibulo-spinal functions. Spontaneous eye movements and anteriorposterior and lateral body sway were recorded simultaneously in 10 patients with vestibular neuritis (Experiment 1) and in 11 healthy subjects (Experiment 2) while all subjects wore a mask that allowed fixation of a head-fixed target. For the healthy subjects, there was no significant difference in postural sway for the conditions of eyes open in darkness and fixation of the head-fixed target. For the patients, the question was whether transient suppression of the spontaneous nystagmus by fixating the target affected excessive body sway or whether modulation of nystagmus and postural sway were largely independent. The mean peak slow-phase velocity of the spontaneous nystagmus decreased from 13.5 ± 5.6 to 4.3 ± 2.4°/s during fixation. The suppression of nystagmus also reduced postural sway while standing on foam rubber. Mean value decreased from 25.2 ± 7.6 to 16.2 ± 7.7 mm (rightleft root mean square values; ANOVA, P = 0.003). Since a head-fixed target was used to suppress spontaneous eye movements, the data cannot be explained by any stabilizing effect of afferent visual cues. Instead, ocular motor efference copy signals or reafferences may have contributed to the postural instability of patients with vestibular neuritis, which would explain the reduction of postural sway during fixation suppression of the nystagmus. Thus, ocular motor signals rather than afferent visual cues about retinal slip are used for visual control of postural sway, at least in this experimental paradigm.
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