The Effect of Optokinetic Stimulation on Perceptual and Postural Symptoms in Visual Vestibular Mismatch Patients

• Published in: PloS one 2016-04, Vol.11 (4), p.e0154528-e0154528
• Main Authors: Van Ombergen, Angelique, Lubeck, Astrid J, Van Rompaey, Vincent, Maes, Leen K, Stins, John F, Van de Heyning, Paul H, Wuyts, Floris L, Bos, Jelte E
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Anxiety; Biology and Life Sciences; Care and treatment; Case-Control Studies; Complications and side effects; Disorientation; Dizziness; Dizziness - physiopathology; Equilibrium; Exposure; Fear & phobias; Female; Health sciences; Humans; Male; Medicine; Medicine and Health Sciences; Middle Aged; Nystagmus; Otolaryngology; Patients; Photic Stimulation; Postural Balance - physiology; Posture; Rehabilitation; Rolling motion; Signs and symptoms; Social Sciences; Spatial Processing - physiology; Stimulation; Studies; Vertigo; Vertigo - physiopathology; Vestibular diseases; Vestibular Diseases - physiopathology; Vestibular system; Visual stimuli
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0154528

Vestibular patients occasionally report aggravation or triggering of their symptoms by visual stimuli, which is called visual vestibular mismatch (VVM). These patients therefore experience discomfort, disorientation, dizziness and postural unsteadiness. Firstly, we aimed to get a better insight in the underlying mechanism of VVM by examining perceptual and postural symptoms. Secondly, we wanted to investigate whether roll-motion is a necessary trait to evoke these symptoms or whether a complex but stationary visual pattern equally provokes them. Nine VVM patients and healthy matched control group were examined by exposing both groups to a stationary stimulus as well as an optokinetic stimulus rotating around the naso-occipital axis for a prolonged period of time. Subjective visual vertical (SVV) measurements, posturography and relevant questionnaires were assessed. No significant differences between both groups were found for SVV measurements. Patients always swayed more and reported more symptoms than healthy controls. Prolonged exposure to roll-motion caused in patients and controls an increase in postural sway and symptoms. However, only VVM patients reported significantly more symptoms after prolonged exposure to the optokinetic stimulus compared to scores after exposure to a stationary stimulus. VVM patients differ from healthy controls in postural and subjective symptoms and motion is a crucial factor in provoking these symptoms. A possible explanation could be a central visual-vestibular integration deficit, which has implications for diagnostics and clinical rehabilitation purposes. Future research should focus on the underlying central mechanism of VVM and the effectiveness of optokinetic stimulation in resolving it.