The impact of head-worn devices in an auditory-aided visual search task.

Head-worn devices (HWDs) interfere with the natural transmission of sound from the source to the ears of the listener, worsening their localization abilities. The localization errors introduced by HWDs have been mostly studied in static scenarios, but these errors are reduced if head movements are allowed. We studied the effect of 12 HWDs on an auditory-cued visual search task, where head movements were not restricted. In this task, a visual target had to be identified in a three-dimensional space with the help of an acoustic stimulus emitted from the same location as the visual target. The results showed an increase in the search time caused by the HWDs. Acoustic measurements of a dummy head wearing the studied HWDs showed evidence of impaired localization cues, which were used to estimate the perceived localization errors using computational auditory models of static localization. These models were able to explain the search-time differences in the perceptual task, showing the influence of quadrant errors in the auditory-aided visual search task. These results indicate that HWDs have an impact on sound-source localization even when head movements are possible, which may compromise the safety and the quality of experience of the wearer.

Continuous monitoring of endotracheal tube position with near infrared light.

Significance: Endotracheal intubation is a common approach for airway management in critically ill patients. However, the position of the endotracheal tube (ETT) may be altered during the procedure due to head movements. Accidental displacement or dislodge of the ETT may reduce the airflow, leading to moderate to severe complications, and in some cases even fatality. Therefore, timely detection of changes in ETT position in the trachea is critical to ensure immediate and intermediate interventions to maintain the ETT in the proper position. Currently, there are no widely utilized tools for real-time monitoring of ETT positions. Aim: The goal of this study is to develop a cost-effective and easy-to-use near-infrared (NIR) device, named Opt-ETT, capable of continuously monitoring the ETT position in the trachea of a patient. Approach: A side-firing fiber is attached to the side of the ETT to illuminate the trachea tissue with NIR light, and a detector board containing five phototransistors is affixed to the chest skin to measure the intensity of diffusely transmitted light. Displacement of the ETT is estimated using second-order polynomial fitting to the ratios of the phototransistor readings. Monte Carlo simulations, ex vivo experiment on porcine tissue, and in vivo experiments using a swine model have been conducted to assess the feasibility of the device. Results: The design of the Opt-ETT device has been verified by the Monte Carlo simulations and ex vivo experiment. The estimation of displacement from in vivo experiments using the Opt-ETT exhibited a high degree of agreement with that measured by a reference sensor, with a discrepancy between -1.0 to +1.5 mm within a displacement range from -15 to +15 mm. Conclusions: The Opt-ETT device provides a potentially cost-effective solution for real-time and continuous monitoring of ETT position in patient during an intubation procedure.

A Comparison of Head Movement Classification Methods.

To understand human behavior, it is essential to study it in the context of natural movement in immersive, three-dimensional environments. Virtual reality (VR), with head-mounted displays, offers an unprecedented compromise between ecological validity and experimental control. However, such technological advancements mean that new data streams will become more widely available, and therefore, a need arises to standardize methodologies by which these streams are analyzed. One such data stream is that of head position and rotation tracking, now made easily available from head-mounted systems. The current study presents five candidate algorithms of varying complexity for classifying head movements. Each algorithm is compared against human rater classifications and graded based on the overall agreement as well as biases in metrics such as movement onset/offset time and movement amplitude. Finally, we conclude this article by offering recommendations for the best practices and considerations for VR researchers looking to incorporate head movement analysis in their future studies.

Head and Eye Movements Reveal Compensatory Strategies for Acute Binaural Deficits During Sound Localization.

The present study aimed to define use of head and eye movements during sound localization in children and adults to: (1) assess effects of stationary versus moving sound and (2) define effects of binaural cues degraded through acute monaural ear plugging. Thirty-three youth (MAge = 12.9 years) and seventeen adults (MAge = 24.6 years) with typical hearing were recruited and asked to localize white noise anywhere within a horizontal arc from -60° (left) to +60° (right) azimuth in two conditions (typical binaural and right ear plugged). In each trial, sound was presented at an initial stationary position (L1) and then while moving at ∼4°/s until reaching a second position (L2). Sound moved in five conditions (±40°, ±20°, or 0°). Participants adjusted a laser pointer to indicate L1 and L2 positions. Unrestricted head and eye movements were collected with gyroscopic sensors on the head and eye-tracking glasses, respectively. Results confirmed that accurate sound localization of both stationary and moving sound is disrupted by acute monaural ear plugging. Eye movements preceded head movements for sound localization in normal binaural listening and head movements were larger than eye movements during monaural plugging. Head movements favored the unplugged left ear when stationary sounds were presented in the right hemifield and during sound motion in both hemifields regardless of the movement direction. Disrupted binaural cues have greater effects on localization of moving than stationary sound. Head movements reveal preferential use of the better-hearing ear and relatively stable eye positions likely reflect normal vestibular-ocular reflexes.

Effect of vestibular loss on head-on-trunk stability in individuals with vestibular schwannoma.

The vestibulo-collic reflex generates neck motor commands to produce head-on-trunk movements that are essential for stabilizing the head relative to space. Here we examined the effects of vestibular loss on head-on-trunk kinematics during voluntary behavior. Head and trunk movements were measured in individuals with vestibular schwannoma before and then 6 weeks after unilateral vestibular deafferentation via surgical resection of the tumor. Movements were recorded in 6 dimensions (i.e., 3 axes of rotation and 3 axes of translation) using small light-weight inertial measurement units while participants performed balance and gait tasks. Kinematic measures differed between individuals with vestibular schwannoma (at both time points) and healthy controls for the more challenging exercises, namely those performed in tandem position or on an unstable surface without visual input. Quantitative assessment of the vestibulo-ocular reflex (VOR) revealed a reduction in VOR gain for individuals with vestibular schwannoma compared to control subjects, that was further reduced following surgery. These findings indicated that the impairment caused by either the tumor or subsequent surgical tumor resection altered head-on-trunk kinematics in a manner that is not normalized by central compensation. In contrast, we further found that head-on-trunk kinematics in individuals with vestibular schwannoma were actually comparable before and after surgery. Thus, taken together, our results indicate that vestibular loss impacts head-on-trunk kinematics during voluntary balance and gait behaviors, and suggest that the neural mechanisms mediating adaptation alter the motion strategies even before surgery in a manner that may be maladaptive for long-term compensation.

Sound localization in noisy contexts: performance, metacognitive evaluations and head movements.

Localizing sounds in noisy environments can be challenging. Here, we reproduce real-life soundscapes to investigate the effects of environmental noise on sound localization experience. We evaluated participants' performance and metacognitive assessments, including measures of sound localization effort and confidence, while also tracking their spontaneous head movements. Normal-hearing participants (N = 30) were engaged in a speech-localization task conducted in three common soundscapes that progressively increased in complexity: nature, traffic, and a cocktail party setting. To control visual information and measure behaviors, we used visual virtual reality technology. The results revealed that the complexity of the soundscape had an impact on both performance errors and metacognitive evaluations. Participants reported increased effort and reduced confidence for sound localization in more complex noise environments. On the contrary, the level of soundscape complexity did not influence the use of spontaneous exploratory head-related behaviors. We also observed that, irrespective of the noisy condition, participants who implemented a higher number of head rotations and explored a wider extent of space by rotating their heads made lower localization errors. Interestingly, we found preliminary evidence that an increase in spontaneous head movements, specifically the extent of head rotation, leads to a decrease in perceived effort and an increase in confidence at the single-trial level. These findings expand previous observations regarding sound localization in noisy environments by broadening the perspective to also include metacognitive evaluations, exploratory behaviors and their interactions.

Inertial Measurement Unit-Based Romberg Test for Assessing Adults With Vestibular Hypofunction.

This work aims to explore the utility of wearable inertial measurement units (IMUs) for quantifying movement in Romberg tests and investigate the extent of movement in adults with vestibular hypofunction (VH). A cross-sectional study was conducted at an academic tertiary medical center between March 2021 and April 2022. Adults diagnosed with unilateral vestibular hypofunction (UVH) or bilateral vestibular hypofunction (BVH) were enrolled in the VH group. Healthy controls (HCs) were recruited from community or outpatient clinics. The IMU-based instrumented Romberg and tandem Romberg tests on the floor were applied to both groups. The primary outcomes were kinematic body metrics (maximum acceleration [ACC], mean ACC, root mean square [RMS] of ACC, and mean sway velocity [MV]) along the medio-lateral (ML), cranio-caudal (CC), and antero-posterior (AP) axes. A total of 31 VH participants (mean age, 33.48 [SD 7.68] years; 19 [61%] female) and 31 HCs (mean age, 30.65 [SD 5.89] years; 18 [58%] female) were recruited. During the eyes-closed portion of the Romberg test, VH participants demonstrated significantly higher maximum ACC and increased RMS of ACC in head movement, as well as higher maximum ACC in pelvic movement along the ML axis. In the same test condition, individuals with BVH exhibited notably higher maximum ACC and RMS of ACC along the ML axis in head and pelvic movements compared with HCs. Additionally, BVH participants exhibited markedly increased maximum ACC along the ML axis in head movement during the eyes-open portion of the tandem Romberg test. Conversely, no significant differences were found between UVH participants and HCs in the assessed parameters. The instrumented Romberg and tandem Romberg tests characterized the kinematic differences in head, pelvis, and ankle movement between VH and healthy adults. The findings suggest that these kinematic body metrics can be useful for screening BVH and can provide goals for vestibular rehabilitation.

What are the Key Phenomenological Clues to Diagnose Functional Tic-Like Behaviors in the Pandemic Era?

BACKGROUND: Functional tic-like behaviors (FTLBs) can be difficult to distinguish from tics. OBJECTIVES: To describe the phenomenology of FTLBs in youth and assess the movements and vocalizations most suggestive of the diagnosis. METHODS: We compared the phenomenology of tics between youth (<20 yr) with FTLBs and with primary tics from our Registry in Calgary, Canada. RESULTS: Two hundred and thirty-six youths were included: 195 with primary tics (75% males; mean age: 10.8 yr) and 41 with FTLBs (98% females; 16.1 yr). In the bivariate models, FTLBs were most associated with copropraxia (OR = 15.5), saying words (OR = 14.5), coprolalia (OR = 13.1), popping (OR = 11.0), whistling (OR = 9.8), simple head movements (OR = 8.6), and self-injurious behaviors (OR = 6.9). In the multivariable model, FTLBs were still associated with saying words (OR = 13.5) and simple head movements (OR = 6.3). Only 12.2% of youth with FTLBs had throat clearing tics (OR = 0.2). CONCLUSIONS: This study shall help physicians diagnose youth with FTLBs according to the presence/association of specific movements and vocalizations.

Objective Parameters in Attention Deficit Hyperactivity Disorder: Eye and Head Movements.

OBJECTIVE: We aimed to evaluate eye and head movements, which are objective parameters in ADHD. Method: While the children were watching the course video task, which included the relevant (teacher and smart board) and irrelevant (any regions outside the relevant area) areas of interest, their eye movements were evaluated through eye tracking, and video recordings were made simultaneous. Head position estimation was made using through video recordings. The proportion of total fixation duration on areas of interest (PFDAOI) and saccade count, amplitude, velocity for eye movements, number of total head movements and angular change of head movement in x-y-z axes for head movements were compared. RESULTS: Children with ADHD had lower PFDAOI on the relevant area, and had more saccade and head movements The angular change of head movement in the x-axis was higher in the ADHD group. CONCLUSION: In the assessment of ADHD, the eye and head movements may be particulary useful.

The motor apparatus of head movements in the Oleander hawkmoth (Daphnis nerii, Lepidoptera).

Head movements of insects play a vital role in diverse locomotory behaviors including flying and walking. Because insect eyes move minimally within their sockets, their head movements are essential to reduce visual blur and maintain a stable gaze. As in most vertebrates, gaze stabilization behavior in insects requires the integration of both visual and mechanosensory feedback by the neck motor neurons. Although visual feedback is derived from the optic flow over the retina of their compound eyes, mechanosensory feedback is derived from their organs of balance, similar to the vestibular system in vertebrates. In Diptera, vestibular feedback is derived from the halteres-modified hindwings that evolved into mechanosensory organs-and is integrated with visual feedback to actuate compensatory head movements. However, non-Dipteran insects, including Lepidoptera, lack halteres. In these insects, vestibular feedback is obtained from the antennal Johnston's organs but it is not well-understood how it integrates with visual feedback during head movements. Indeed, although head movements are well-studied in flies, the underlying motor apparatus in non-Dipteran taxa has received relatively less attention. As a first step toward understanding compensatory head movements in the Oleander hawkmoth Daphnis nerii, we image the anatomy and architecture of their neck joint sclerites and muscles using X-ray microtomography, and the associated motor neurons using fluorescent dye fills and confocal microscopy. Based on these morphological data, we propose testable hypotheses about the putative function of specific neck muscles during head movements, which can shed light on their role in neck movements and gaze stabilization.

Short-term learning of the vestibulo-ocular reflex induced by a custom interactive computer game.

Retinal image slip during head rotation drives motor learning in the rotational vestibulo-ocular reflex (VOR) and forms the basis of gaze-stability exercises that treat vestibular dysfunction. Clinical exercises, however, are unengaging, cannot easily be titrated to the level of impairment, and provide neither direct feedback nor tracking of the patient's adherence, performance, and progress. To address this, we have developed a custom application for VOR training based on an interactive computer game. In this study, we tested the ability of this game to induce VOR learning in individuals with normal vestibular function, and we compared the efficacy of single-step and incremental learning protocols. Eighteen participants played the game twice on different days. All participants tolerated the game and were able to complete both sessions. The game scenario incorporated a series of brief head rotations, similar to active head impulses, that were paired with a dynamic acuity task and with a visual-vestibular mismatch (VVM) intended to increase VOR gain (single-step: 300 successful trials at ×1.5 viewing; incremental: 100 trials each of ×1.13, ×1.33, and ×1.5 viewing). Overall, VOR gain increased by 15 ± 4.7% (mean ± 95% CI, P < 0.001). Gains increased similarly for active and passive head rotations, and, contrary to our hypothesis, there was little effect of the learning strategy. This study shows that an interactive computer game provides robust VOR training and has the potential to deliver effective, engaging, and trackable gaze-stability exercises to patients with a range of vestibular dysfunctions.NEW & NOTEWORTHY This study demonstrates the feasibility and efficacy of a customized computer game to induce motor learning in the high-frequency rotational vestibulo-ocular reflex. It provides a physiological basis for the deployment of this technology to clinical vestibular rehabilitation.

An easy-to-implement, non-invasive head restraint method for monkey fMRI.

Functional magnetic resonance imaging (fMRI) in behaving monkeys has a strong potential to bridge the gap between human neuroimaging and primate neurophysiology. In monkey fMRI, to restrain head movements, researchers usually surgically implant a plastic head-post on the skull. Although time-proven to be effective, this technique could create burdens for animals, including a risk of infection and discomfort. Furthermore, the presence of extraneous objects on the skull, such as bone screws and dental cement, adversely affects signals near the cortical surface. These side effects are undesirable in terms of both the practical aspect of efficient data collection and the spirit of "refinement" from the 3R's. Here, we demonstrate that a completely non-invasive fMRI scan in awake monkeys is possible by using a plastic head mask made to fit the skull of individual animals. In all of the three monkeys tested, longitudinal, quantitative assessment of head movements showed that the plastic mask has effectively suppressed head movements, and we were able to obtain reliable retinotopic BOLD signals in a standard retinotopic mapping task. The present, easy-to-make plastic mask has a strong potential to simplify fMRI experiments in awake monkeys, while giving data that is as good as or even better quality than that obtained with the conventional head-post method.

The Complexity of Head Movement is Correlated with Learning about Affordances for Walking.

We asked whether the quantitative kinematics of standing postural activity might be related to short-term learning of affordances. Standing participants viewed a narrow path for 15 s, and then gave perceptual reports about the distance that they could walk along the path while wearing a weighted vest (novel affordance) or while not wearing the vest (familiar affordance). In a control condition, participants gave perceptual reports about egocentric distance along the path. During the 15 s viewing intervals, we measured the kinematics of head and torso movement as standing participants made a series of 12 perceptual reports. Perceptual reports improved across trials, but only in the condition in which participants were asked to perceive a novel affordance. The dynamical complexity of head movement changed across trials as participants gave perceptual reports about the novel affordance, but did not change systematically when perceiving a familiar affordance, or a non-affordance egocentric distance. We argue that the dynamical complexity of postural activity may have served an exploratory function supporting the learning of a novel affordance. Our results are consistent with the broader hypothesis that affordances are learned through active engagement with the environment, rather than (for example) through abstract cognitive processing.

Contactless Monitoring of Respiratory Rate and Breathing Absence from Head Movements Using an RGB Camera.

Contactless vital sign monitoring is more demanding for long-term, continuous, and unobtrusive measurements. Camera-based respiratory monitoring is receiving growing interest with advanced video technologies and computational power. The volume variations of the lungs for airflow changes create a periodic movement of the torso, but identifying the torso is more challenging than face detection in a video. In this paper, we present a unique approach to monitoring respiratory rate (RR) and breathing absence by leveraging head movements alone from an RGB video because respiratory motion also influences the head. Besides our novel RR estimation, an independent algorithm for breathing absence detection using signal feature extraction and machine learning techniques identifies an apnea event and improves overall RR estimation accuracy. The proposed approach was evaluated using videos from 30 healthy subjects who performed various breathing tasks. The breathing absence detector had 0.87 F1 score, 0.9 sensitivity, and 0.85 specificity. The accuracy of spontaneous breathing rate estimation increased from 2.46 to 1.91 bpm MAE and 3.54 to 2.7 bpm RMSE when combining the breathing absence result with the estimated RR.Clinical relevance- Our contactless respiratory monitoring can utilize a consumer RGB camera to offer a significant benefit in continuous monitoring of neonatal monitoring, sleep monitoring, telemedicine or telehealth, home fitness with mild physical movement, and emotion detection in the clinic and remote locations.

The Effect of Muscle Artifact Reduction Methods on Few-channel SSVEPs during Head Movements.

Brain-computer interfaces (BCIs) with steady-state visual evoked potentials (SSVEPs) caused by flickering stimuli have caught attention as communication tools between human brains and external machines through a head-mounted display (HMD). When applying SSVEP-based BCIs to real-life environments, the head must be moved to watch the stimuli displayed in an HMD, which generates muscular artifacts and significantly reduces BCI performance. In this study, we examined four-class SSVEP identification accuracies by using four artifact reduction methods in the situation of moving the head for both simulation and real datasets. In the simulation dataset, we found that artifact subspace reconstruction (ASR) and multi-scale dictionary learning (MSDL) showed better results especially at low signal-to-noise ratio. In the real dataset, we observed that reducing muscular artifacts resulted in performance degradation for independent component analysis-based methods, while ASR and MSDL showed relatively limited degradation and in some cases improved performance. Our future work is to improve ASR and MSDL for high performance with real data and to apply them to an online SSVEP-based BCI where the user moves his/her head.

Impaired stationarity perception is associated with increased virtual reality sickness.

Stationarity perception refers to the ability to accurately perceive the surrounding visual environment as world-fixed during self-motion. Perception of stationarity depends on mechanisms that evaluate the congruence between retinal/oculomotor signals and head movement signals. In a series of psychophysical experiments, we systematically varied the congruence between retinal/oculomotor and head movement signals to find the range of visual gains that is compatible with perception of a stationary environment. On each trial, human subjects wearing a head-mounted display execute a yaw head movement and report whether the visual gain was perceived to be too slow or fast. A psychometric fit to the data across trials reveals the visual gain most compatible with stationarity (a measure of accuracy) and the sensitivity to visual gain manipulation (a measure of precision). Across experiments, we varied 1) the spatial frequency of the visual stimulus, 2) the retinal location of the visual stimulus (central vs. peripheral), and 3) fixation behavior (scene-fixed vs. head-fixed). Stationarity perception is most precise and accurate during scene-fixed fixation. Effects of spatial frequency and retinal stimulus location become evident during head-fixed fixation, when retinal image motion is increased. Virtual Reality sickness assessed using the Simulator Sickness Questionnaire covaries with perceptual performance. Decreased accuracy is associated with an increase in the nausea subscore, while decreased precision is associated with an increase in the oculomotor and disorientation subscores.

Sound externalization in dynamic binaural listening: A comparative behavioral and EEG study.

Binaural reproduction aims at recreating a realistic sound scene at the ears of the listener using headphones. Unfortunately, externalization for frontal and rear sources is often poor (virtual sources are perceived inside the head, instead of outside the head). Nevertheless, previous studies have shown that large head-tracked movements could substantially improve externalization and that this improvement persisted once the subject had stopped moving his/her head. The present study investigates the relation between externalization and evoked response potentials (ERPs) by performing behavioral and EEG measurements in the same experimental conditions. Different degrees of externalization were achieved by preceding measurements with 1) head-tracked movements, 2) untracked head movements, and 3) no head movement. Results showed that performing a head movement, whether the head tracking was active or not, increased the amplitude of ERP components after 100 ms, which suggests that preceding head movements alters the auditory processing. Moreover, untracked head movements gave a stronger amplitude on the N1 component, which might be a marker of a consistency break in regards to the real world. While externalization scores were higher after head-tracked movements in the behavioral experiment, no marker of externalization could be found in the EEG results.

A dynamic sequence of visual processing initiated by gaze shifts.

Animals move their head and eyes as they explore the visual scene. Neural correlates of these movements have been found in rodent primary visual cortex (V1), but their sources and computational roles are unclear. We addressed this by combining head and eye movement measurements with neural recordings in freely moving mice. V1 neurons responded primarily to gaze shifts, where head movements are accompanied by saccadic eye movements, rather than to head movements where compensatory eye movements stabilize gaze. A variety of activity patterns followed gaze shifts and together these formed a temporal sequence that was absent in darkness. Gaze-shift responses resembled those evoked by sequentially flashed stimuli, suggesting a large component corresponds to onset of new visual input. Notably, neurons responded in a sequence that matches their spatial frequency bias, consistent with coarse-to-fine processing. Recordings in freely gazing marmosets revealed a similar sequence following saccades, also aligned to spatial frequency preference. Our results demonstrate that active vision in both mice and marmosets consists of a dynamic temporal sequence of neural activity associated with visual sampling.

Interpersonal coordination analysis in bat-and-ball sports under a real game situation: Asymmetric interaction and delayed coupling.

This study investigated the interpersonal coordination between the pitcher and the batter in bat-and-ball sports. Although the importance of interpersonal coordination is widely accepted in many sports, no studies have investigated it in bat-and-ball sports because the dominant task constraints surrounding the interaction between pitcher and batter make it difficult to apply conventional analytic techniques. To address the issue, this study proposes a new analytical framework to investigate interpersonal coordination in bat-and-ball sports under a real game situation with two main characteristics: asymmetric interaction and delayed coupling. First, the dynamic time warping technique was used to evaluate the stability of the head movement pattern of the pitcher and batter, and cross-correlation analysis was used to quantify the temporal relationship between them. We found that the head movement pattern of batters was significantly more unstable than that of pitchers, and approximately 60% of the variance of the change in the head movement pattern of batters could be explained by that of the pitchers. Moreover, expert batters followed a pitcher's movements with a specific time delay of approximately 250 ms. These findings highlight the characteristics of interpersonal coordination in bat-and-ball sports: the pitcher can make a pre-patterned stable motion, whereas the batter needs to follow and adjust their movement to it. Although the effects of prediction ability need to be investigated to understand its detailed mechanism, the contribution of this study is that it revealed the existence of the interpersonal coordination between the pitcher and batter of bat-and-ball sports under a real game situation.

Comparing Inertial Measurement Units to Markerless Video Analysis for Movement Symmetry in Quarter Horses.

BACKGROUND: With an increasing number of systems for quantifying lameness-related movement asymmetry, between-system comparisons under non-laboratory conditions are important for multi-centre or referral-level studies. This study compares an artificial intelligence video app to a validated inertial measurement unit (IMU) gait analysis system in a specific group of horses. METHODS: Twenty-two reining Quarter horses were equipped with nine body-mounted IMUs while being videoed with a smartphone app. Both systems quantified head and pelvic movement symmetry during in-hand trot (hard/soft ground) and on the lunge (left/right rein, soft ground). Proportional limits of agreement (pLoA) were established. RESULTS: Widths of pLoA were larger for head movement (29% to 50% in-hand; 22% to 38% on lunge) than for pelvic movement (13% to 24% in-hand; 14% to 24% on lunge). CONCLUSION: The between-system pLoAs exceed current "lameness thresholds" aimed at identifying the affected limb(s) in lame horses. They also exceed published limits of agreement for stride-matched data but are similar to repeatability values and "lameness thresholds" from "non-lame" horses. This is encouraging for multi-centre studies and referral-level veterinary practice. The narrower pLoA values for pelvic movement asymmetry are particularly encouraging, given the difficulty of grading hind limb lameness "by eye".