Astrid J.A. Lubeck

Cinerama sickness and postural instability

Motion sickness symptoms and increased postural instability induced by motion pictures have been reported in a laboratory, but not in a real cinema. We, therefore, carried out an observational study recording sickness severity and postural instability in 19 subjects before, immediately and 45 min after watching a 1 h 3D aviation documentary in a cinema. Sickness was significantly larger right after the movie than before, and in a lesser extent still so after 45 min. The average standard deviation of the lateral centre of pressure excursions was significantly larger only right afterwards. When low-pass filtered at 0.1 Hz, lateral and for-aft excursions were both significantly larger right after the movie, while for-aft excursions then remained larger even after 45 min. Speculating on previous findings, we predict more sickness and postural instability in 3D than in 2D movies, also suggesting a possible, but yet unknown risk for work-related activities and vehicle operation. Practitioner Summary: Watching motion pictures may be sickening and posturally destabilising, but effects in a cinema are unknown. We, therefore, carried out an observational study showing that sickness then is mainly an issue during the exposure while postural instability is an issue afterwards.

Motion in images is essential to cause motion sickness symptoms, but not to increase postural sway

Abstract Objective It is generally assumed that motion in motion images is responsible for increased postural sway as well as for visually induced motion sickness (VIMS). However, this has not yet been tested. To that end, we studied postural sway and VIMS induced by motion and still images. Method 15 Participants were exposed to motion- and still images in separate sessions. Motion images consisted of video clips taken from a first person shooter game. Still images consisted of stills taken every 10 s from these same clips. Before, during, and after exposure, VIMS was rated and postural sway was measured. Sway path length, standard deviation and short- and long-term scaling components of the centre of pressure were calculated as measures of postural sway. Results VIMS scores obtained during and after exposure to motion images were significantly higher compared to scores obtained before, and directly after exposure to still images. The sway path length, standard deviation in anteroposterior direction and short-term scaling components in mediolateral and anteroposterior direction increased significantly during exposure to motion and still images. Conclusion In this experiment motion- and still images caused different levels of VIMS, but comparable increases in postural sway. We assume VIMS was caused by a mismatch between visual and vestibular motion cues. The increase in sway during exposure to still images can be explained by visual effects present in still images. The lack of vection in the motion images may explain why sway was not larger when viewing these motion images as compared to viewing the still images.

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

Background 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. Objective 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. Methods 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. Results 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. Conclusions 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.

Differential effect of visual motion adaption upon visual cortical excitability

The objectives of this study were 1) to probe the effects of visual motion adaptation on early visual and V5/MT cortical excitability and 2) to investigate whether changes in cortical excitability following visual motion adaptation are related to the degree of visual dependency, i.e., an overreliance on visual cues compared with vestibular or proprioceptive cues. Participants were exposed to a roll motion visual stimulus before, during, and after visual motion adaptation. At these stages, 20 transcranial magnetic stimulation (TMS) pulses at phosphene threshold values were applied over early visual and V5/MT cortical areas from which the probability of eliciting a phosphene was calculated. Before and after adaptation, participants aligned the subjective visual vertical in front of the roll motion stimulus as a marker of visual dependency. During adaptation, early visual cortex excitability decreased whereas V5/MT excitability increased. After adaptation, both early visual and V5/MT excitability were increased. The roll motion-induced tilt of the subjective visual vertical (visual dependence) was not influenced by visual motion adaptation and did not correlate with phosphene threshold or visual cortex excitability. We conclude that early visual and V5/MT cortical excitability is differentially affected by visual motion adaptation. Furthermore, excitability in the early or late visual cortex is not associated with an increase in visual reliance during spatial orientation. Our findings complement earlier studies that have probed visual cortical excitability following motion adaptation and highlight the differential role of the early visual cortex and V5/MT in visual motion processing.NEW & NOTEWORTHY We examined the influence of visual motion adaptation on visual cortex excitability and found a differential effect in V1/V2 compared with V5/MT. Changes in visual excitability following motion adaptation were not related to the degree of an individuals visual dependency.

Framing visual roll-motion affects postural sway and the subjective visual vertical

Effects of visual roll-motion on postural sway and the subjective visual vertical (SVV) often is studied using mechanical devices, whereas electronic displays offer cheaper and more flexible alternatives. These devices typically emit and reflect light scattered by the edges of the screen, providing Earth-fixed cues of verticality. These cues may decrease the effects of rotating stimuli, a possibility that has not been studied explicitly before in one experimental design. We exposed 16 participants to a visual dot pattern, either stationary, or rotating in roll, that was or was not surrounded by a visible Earth-fixed reference frame. To eliminate unintended visual cues, the experiment was performed in complete darkness and participants wore neutral density goggles passing only 1% of light. Postural sway was measured using a force platform. SVV measurements were obtained from a visible rod. To monitor the participants, motion sickness severity was obtained with an 11-point rating scale. Results showed that the presence of an Earth-fixed frame significantly decreased the effect of the rotating pattern on postural sway and SVV deviations. Therefore, when studying subjective verticality related effects of visual stimuli, it is imperative that all visual Earth-fixed cues are not just minimized but completely eliminated. The observation that an Earth-fixed frame significantly decreased the effect of the rotating pattern on both postural sway and the SVV points towards a common neural origin, possibly involving a neural representation of verticality. Finally, we showed that an electronic screen can yield similar effect sizes as those taken from the literature using mechanical devices.

Interaction between Depth Order and Density Affects Vection and Postural Sway

Objective Vection, a feeling of self-motion while being physically stationary, and postural sway can be modulated by various visual factors. Moreover, vection and postural sway are often found to be closely related when modulated by such visual factors, suggesting a common neural mechanism. One well-known visual factor is the depth order of the stimulus. The density, i.e. number of objects per unit area, is proposed to interact with the depth order in the modulation of vection and postural sway, which has only been studied to a limited degree. Methods We therefore exposed 17 participants to 18 different stimuli containing a stationary pattern and a pattern rotating around the naso-occipital axis. The density of both patterns was varied between 10 and 90%; the densities combined always added up to 100%. The rotating pattern occluded or was occluded by the stationary pattern, suggesting foreground or background motion, respectively. During pattern rotation participants reported vection by pressing a button, and postural sway was recorded using a force plate. Results Participants always reported more vection and swayed significantly more when rotation was perceived in the background and when the rotating pattern increased in density. As hypothesized, we found that the perceived depth order interacted with pattern density. A pattern rotating in the background with a density between 60 and 80% caused significantly more vection and postural sway than when it was perceived to rotate in the foreground. Conclusions The findings suggest that the ratio between fore- and background pattern densities is an important factor in the interaction with the depth order, and it is not the density of rotating pattern per se. Moreover, the observation that vection and postural sway were modulated in a similar way points towards a common neural origin regulating both variables.

Treatment of vestibular disorders with weak asymmetric base-in prisms : An hypothesis with a focus on Ménière’s disease

BACKGROUND Regular treatments of Ménières disease (MD) vary largely, and no single satisfactory treatment exists. A complementary treatment popular among Dutch and Belgian patients involves eyeglasses with weak asymmetric base-in prisms, with a perceived high success rate. An explanatory mechanism is, however, lacking. OBJECTIVE To speculate on a working mechanism explaining an effectiveness of weak asymmetric base-in prims in MD, based on available knowledge. METHODS After describing the way these prisms are prescribed using a walking test and its effect reported on, we give an explanation of its underlying mechanism, based on the literature. RESULTS The presumed effect can be explained by considering the typical star-like walking pattern in MD, induced by a drifting after-image comparable to the oculogyral illusion. Weak asymmetric base-in prisms can furthermore eliminate the conflict between a net vestibular angular velocity bias in the efferent signal controlling the VOR, and a net re-afferent ocular signal. CONCLUSIONS The positive findings with these glasses reported on, the fact that the treatment itself is simple, low-cost, and socially acceptable, and the fact that an explanation is at hand, speak in favour of elaborating further on this treatment.