Spectral fingerprints of correct vestibular discrimination of the intensity of body accelerations.

Perceptual decision-making is a complex task that requires multiple processing steps performed by spatially distinct brain regions interacting in order to optimize perception and motor response. Most of our knowledge on these processes and interactions were derived from unimodal stimulations of the visual system which identified the lateral intraparietal area and the posterior parietal cortex as critical regions. Unlike the visual system, the vestibular system has no primary cortical areas and it is associated with separate multisensory areas within the temporo-parietal cortex with the parieto-insular vestibular cortex, PIVC, being the core region. The aim of the presented experiment was to investigate the transition from sensation to perception and to reveal the main structures of the cortical vestibular system involved in perceptual decision-making. Therefore, an EEG analysis was performed in 35 healthy subjects during linear whole-body accelerations of different intensities on a motor-driven motion platform (hexapod). We used a discrimination task in order to judge the intensity of the accelerations. Furthermore, we manipulated the expectation of the upcoming stimulus by indicating the probability (25%, 50%, 75%, 100%) of the motion direction. The analysis of the vestibular evoked potentials (VestEPs) showed that the decision-making process leads to a second positive peak (P2b) which was not observed in previous task-free experiments. The comparison of the estimated neural generators of the P2a and P2b components showed significant activity differences in the anterior cingulus, the parahippocampal and the middle temporal gyri. Taking into account the time courses of the P2 components, the physical properties of the stimuli, and the responses given by the subjects we conclude that the P2b likely reflects the transition from the processing of sensory information to perceptual evaluation. Analyzing the decision-uncertainty reported by the subjects, a persistent divergence of the time courses starting at 188 â€‹ms after the acceleration was found at electrode Pz. This finding demonstrated that meta-cognition by means of confidence estimation starts in parallel with the decision-making process itself. Further analyses in the time-frequency domain revealed that a correct classification of acceleration intensities correlated with an inter-trial phase clustering at electrode Cz and an inter-site phase clustering of theta oscillations over frontal, central, and parietal cortical areas. The sites where the phase clustering was observed corresponded to core decision-making brain areas known from neuroimaging studies in the visual domain.

Street crossing behavior in younger and older pedestrians: an eye- and head-tracking study.

BACKGROUND: Crossing a street can be a very difficult task for older pedestrians. With increased age and potential cognitive decline, older people take the decision to cross a street primarily based on vehicles' distance, and not on their speed. Furthermore, older pedestrians tend to overestimate their own walking speed, and could not adapt it according to the traffic conditions. Pedestrians' behavior is often tested using virtual reality. Virtual reality presents the advantage of being safe, cost-effective, and allows using standardized test conditions. METHODS: This paper describes an observational study with older and younger adults. Street crossing behavior was investigated in 18 healthy, younger and 18 older subjects by using a virtual reality setting. The aim of the study was to measure behavioral data (such as eye and head movements) and to assess how the two age groups differ in terms of number of safe street crossings, virtual crashes, and missed street crossing opportunities. Street crossing behavior, eye and head movements, in older and younger subjects, were compared with non-parametric tests. RESULTS: The results showed that younger pedestrians behaved in a more secure manner while crossing a street, as compared to older people. The eye and head movements analysis revealed that older people looked more at the ground and less at the other side of the street to cross. CONCLUSIONS: The less secure behavior in street crossing found in older pedestrians could be explained by their reduced cognitive and visual abilities, which, in turn, resulted in difficulties in the decision-making process, especially under time pressure. Decisions to cross a street are based on the distance of the oncoming cars, rather than their speed, for both groups. Older pedestrians look more at their feet, probably because of their need of more time to plan precise stepping movement and, in turn, pay less attention to the traffic. This might help to set up guidelines for improving senior pedestrians' safety, in terms of speed limits, road design, and mixed physical-cognitive trainings.

Roll tilt self-motion direction discrimination training: First evidence for perceptual learning.

Perceptual learning, the ability to improve the sensitivity of sensory perception through training, has been shown to exist in all sensory systems but the vestibular system. A previous study found no improvement of passive self-motion thresholds in the dark after intense direction discrimination training of either yaw rotations (stimulating semicircular canals) or y-translation (stimulating otoliths). The goal of the present study was to investigate whether perceptual learning of self-motion in the dark would occur when there is a simultaneous otolith and semicircular canal input, as is the case with roll tilt motion stimuli. Blindfolded subjects (n = 10) trained on a direction discrimination task with 0.2-Hz roll tilt motion stimuli (9 h of training, 1,800 trials). Before and after training, motion thresholds were measured in the dark for the trained motion and for three transfer conditions. We found that roll tilt sensitivity in the 0.2-Hz roll tilt condition was increased (i.e., thresholds decreased) after training but not for controls who were not exposed to training. This is the first demonstration of perceptual learning of passive self-motion direction discrimination in the dark. The results have potential therapeutic relevance as 0.2-Hz roll thresholds have been associated with poor performance on a clinical balance test that has been linked to more than a fivefold increase in falls.

Do we truly see what we think we see? The role of cognitive bias in pathological interpretation.

In the histomorphological grading of prostate carcinoma, pathologists have regularly assigned comparable scores for the architectural Gleason and the now-obsolete nuclear World Health Organization (WHO) grading systems. Although both systems demonstrate good correspondence between grade and survival, they are based on fundamentally different biological criteria. We tested the hypothesis that this apparent concurrence between the two grading systems originates from an interpretation bias in the minds of diagnostic pathologists, rather than reflecting a biological reality. Three pathologists graded 178 prostatectomy specimens, assigning Gleason and WHO scores on glass slides and on digital images of nuclei isolated out of their architectural context. The results were analysed with respect to interdependencies among the grading systems, to tumour recurrence (PSA relapse > 0.1 ng/ml at 48 months) and robust nuclear morphometry, as assessed by computer-assisted image analysis. WHO and Gleason grades were strongly correlated (r = 0.82) and demonstrated identical prognostic power. However, WHO grades correlated poorly with nuclear morphology (r = 0.19). Grading of nuclei isolated out of their architectural context significantly improved accuracy for nuclear morphology (r = 0.55), but the prognostic power was virtually lost. In conclusion, the architectural organization of a tumour, which the pathologist cannot avoid noticing during initial slide viewing at low magnification, unwittingly influences the subsequent nuclear grade assignment. In our study, the prognostic power of the WHO grading system was dependent on visual assessment of tumour growth pattern. We demonstrate for the first time the influence a cognitive bias can have in the generation of an error in diagnostic pathology and highlight a considerable problem in histopathological tumour grading.

Distorted mental spatial representation of multi-level buildings - Humans are biased towards equilateral shapes of height and width.

A distorted model of a familiar multi-level building with a systematic overestimation of the height was demonstrated earlier in psychophysical and real world navigational tasks. In the current study we further investigated this phenomenon with a tablet-based application. Participants were asked to adjust height and width of the presented buildings to best match their memory of the dimensional ratio. The estimation errors between adjusted and true height-width ratios were analyzed. Additionally, familiarity with respect to in- and outside of the building as well as demographic data were acquired. A total of 142 subjects aged 21 to 90 years from the cities of Bern and Munich were tested. Major results were: (1) a median overestimation of the height of the multi-level buildings of 11%; (2) estimation errors were significantly less if the particular building was unknown to participants; (3) in contrast, the height of tower-like buildings was underestimated; (4) the height of long, flat shaped buildings was overestimated. (5) Further features, such as the architectonical complexity were critical. Overall, our internal models of large multi-level buildings are distorted due to multiple factors including geometric features and memory effects demonstrating that such individual models are not rigid but plastic with consequences for spatial orientation and navigation.

Widening of the excitable gap during pharmacological cardioversion of atrial fibrillation in the goat: effects of cibenzoline, hydroquinidine, flecainide, and d-sotalol.

BACKGROUND: Previous studies suggest that the antifibrillatory action of class I and III drugs is due to prolongation of the atrial wavelength. The aim of the present study was to directly evaluate the electrophysiological action of antifibrillatory drugs in a goat model of chronic atrial fibrillation (AF). METHODS AND RESULTS: Six goats were instrumented with multiple atrial electrodes, and sustained AF was induced by electrical remodeling. During sustained AF, the effects of intravenous infusion of cibenzoline, hydroquinidine, flecainide, and d-sotalol on AF cycle length (AFCL), refractory period (RP(AF)), conduction velocity (CV(AF)), pathlength (PL(AF)), wavelength (WL(AF)), temporal (AFCL-RP(AF)), and spatial (PL(AF)-WL(AF)) excitable gap were studied. The RP(AF) was measured by determining the earliest moment at which single stimuli could capture the fibrillating atria. CV(AF) was measured during regional entrainment of AF. Contrary to our expectation, cardioversion of AF could not be attributed to prolongation of WL(AF). Hydroquinidine and d-sotalol did not affect WL(AF) significantly, whereas cibenzoline and flecainide even shortened WL(AF) by 18% and 36%, respectively. PL(AF) was increased by hydroquinidine and d-sotalol by 30%, whereas cibenzoline and flecainide did not prolong PL(AF). The only parameter that correlated consistently with cardioversion of AF was a widening of the temporal excitable gap (cibenzoline 176%, hydroquinidine 105%, flecainide 86%, d-sotalol 88%). CONCLUSIONS: Pharmacological cardioversion of AF cannot be explained by prolongation of WL(AF). An alternative explanation for the antifibrillatory effect of class I and III drugs may be a widening of the temporal excitable gap.

Methods for determining the refractory period and excitable gap during persistent atrial fibrillation in the goat.

BACKGROUND: Recently, the temporal excitable gap during atrial fibrillation (AF) has been identified as a vulnerable parameter for cardioversion of AF. In this study, we evaluated 5 methods to measure the refractory period (RP(AF)) and the excitable period (EP(AF)) during persistent AF. METHODS AND RESULTS: In 11 goats instrumented with 83 epicardial atrial electrodes, persistent AF (43+/-34 days) was induced with a median AF cycle length (CL) of 98+/-14 ms. To measure RP(AF), premature stimuli were applied to the center of the electrode array on the right or left atrium. The RP(AF) measured by mapping of premature stimuli was 70+/-12 ms ("gold standard"). The RP(AF) determined during entrainment of AF was 77+/-17 ms (R(2)=0.88, P<0.01). Statistical analysis of the effects of synchronized stimuli (each coupling interval x100) on the AFCL histogram yielded an RP(AF) of 70+/-13 ms (R(2)=0.94, P<0.01). A further simplification was to apply slow fixed-rate pacing (1 Hz) during AF. For each stimulus (n=250 to 500), the paced AFCL was plotted against its coupling interval, and capture was determined by statistical shortening of the AFCL (RP(AF) 71+/-17 ms, R(2)=0.84, P<0.01). The 5th percentile of the AFCL histogram as an index of RP(AF) was 77+/-12 ms (R(2)=0.90, P<0.01). CONCLUSIONS: During persistent AF with an AFCL of 98+/-14 ms, the RP(AF) determined by mapping of synchronized premature stimuli (gold standard) was 70+/-12 ms, with an excitable period of 28+/-8 ms. Although the indirect methods to measure RP(AF) all correlated well with the gold standard, slow fixed-rate pacing seems to be the most attractive technique because of the ease of acquiring the data and the clear graphic result.

In the presence of others: Self-location, balance control and vestibular processing.

The degree to which others in our environment influence sensorimotor processing has been a particular focus of cognitive neuroscience for the past two decades. This process of self-other resonance, or shared body representation, has only recently been extended to more global bodily processes such as self-location, self-motion perception, balance and perspective taking. In this review, we outline these previously overlooked areas of research to bridge the distinct field of social neuroscience with global self-perception, vestibular processing and postural control. Firstly, we outline research showing that the presence and movement of others can modulate two fundamental experiences of the self: self-location (the experience of where the self is located in space) and self-motion perception (the experience that oneself has moved or has been moved in space). Secondly, we outline recent research that has shown perturbations in balance control as a result of instability in others in our environment. Conversely to this, we also highlight studies in virtual reality demonstrating the potential benefits of the presence of others in our environment for those undergoing vestibular rehabilitation. Thirdly, we outline studies of first- and third-person perspective taking, which is the ability to have or take a visuo-spatial perspective within and out-with the confines of our own body. These studies demonstrate a contamination of perspective taking processes (i.e. automatic, implicit, third-person perspective taking) in the presence of others. This collection of research highlights the importance of social cues in the more global processing of the self and its accompanying sensory inputs, particularly vestibular signals. Future research will need to better determine the mechanisms of self-other resonance within these processes, including the role of individual differences in the susceptibility to the influence of another.

Assessing otolith function by the subjective visual vertical.

The effects of peripheral vestibular diseases on the subjective visual vertical (SVV) are resumed and provide the basis for some insights into the otolith pathophysiology. With a normal range of 0 +/- 2 deg (when measured in an upright body position), the SVV was shifted by 11 +/- 6 deg toward the ipsilateral ear in 40 patients following an acute unilateral vestibular deafferentiation (UVD), but in the opposite direction in 9 of 52 patients after stapes surgery. These opposite effects suggest a push-pull mechanism of the pairs of otolith organs with respect to the SVV. The dissociation between the SVV and the perception of body position indicates influences by unconscious reflexive mechanisms such as ocular cyclotorsion on the SVV. In chronic UVD patients, lateral shifts of the subjects during constant angular velocity rotation into various eccentric positions (+/- 16 cm) revealed a shift of the "center of graviception" close to the remaining intact contralateral inner ear. To date, this seems to be the most consistent test for clinical identification of a chronic compensated unilateral loss of otolith function. The findings regarding asymmetries in otolithic sensitivity to medially and laterally directed roll-tilts remain controversial, probably mainly because of influences of extravestibular cues.

Visual mental imagery interferes with allocentric orientation judgements.

The subjective visual vertical is determined when a subject judges the orientation of an indicator (e.g. a short line segment) as apparently vertical. The mechanisms that underlie this perceptual performance are usually assumed to be based predominantly on bottom-up processing of primarily vestibular and visual information. However, it is also possible that top-down processes play a role in such abilities. We used an interference paradigm in order to investigate the effects of mental images on the perception of the visual vertical. The results demonstrate for the first time that visual mental imagery can exert the same directional influence on the subjective visual vertical as a perception of the corresponding stimulus.

Perceived body position and the visual horizontal.

This contribution examines the relation between the subjective visual vertical, the subjective visual horizontal, and the perceived body position of human subjects. Firmly fixed on a tiltable chair with head and torso restrained, 11 healthy subjects were rolled sideways and indicated their subjective horizontal body position. In these positions the subjects were also asked to adjust a luminous line alternately to the vertical and to the horizontal. The adjustments of the subjective horizontal body position cluster around a mean of 96.3 degrees with a remarkably broad range (SD: 19.7 degrees). In the subjective horizontal body position, the luminous line does not appear horizontal when in line with one's own spinal axis. It is set further down by 27.4 degrees on average and, therefore, perpendicular to the subjective visual vertical. This finding supports the idea that the judgement of the own body position and the judgement of the orientation of a seen object respective to gravity are based on different references. Contradictory to other investigations [23,24], is the empirical fact that the individual subjects were not able to adjust the horizontal body position with the reported accuracy (range of mean adjustments 77.5 to 117.6 degrees).

Can a unilateral loss of otolithic function be clinically detected by assessment of the subjective visual vertical?

Asymmetries in the settings of the subjective visual vertical after unilateral vestibular neurectomy during eccentric centrifugation [3] might provide a clinical test for unilateral otolithic function. This study investigates whether these asymmetries can also be revealed by a technically much easier practicable roll tilt of the subject relative to gravity instead of a roll tilt of the gravitational force on a human centrifuge. Twenty-seven normal subjects and 13 patients before surgery indicated verticality very accurately in the upright position. In 26 degrees roll positions (subjects seated on a slanted chair), they were only slightly more variable with no asymmetries larger than 5.3 and 7.8 degrees in normals and preoperative patients, respectively, between the roll positions toward the healthy and toward the affected ear. One week after surgical unilateral vestibular deafferentation, there was a consistent shift (mean 11.9 degrees) of the subjective vertical toward the affected ear in all patients and in all body positions. When the settings in the two roll tilt positions were referred to the setting in upright position, the group means of the patients were symmetrical although single subjects revealed asymmetries up to 22.4 degrees. Only one of four patients who were tested also during eccentric rotation revealed an important asymmetry with decreased sensitivity for tilts of the gravitational vector toward the affected ear. Measuring the subjective visual vertical assesses only asymmetrical tonic otolithic input, while a simple clinical test for unilateral otolithic sensitivity still has to be found.

Geometrical reconstruction of images obtained with electronic endoscopy.

We use an electronic video endoscope (Fujinon EG7-HR2) to image the mitral valve in situ in an isolated pig heart preparation. From video recordings, images are digitized and analysed with a computer. A complication encountered during the study concerned the geometric wide angle distortion caused by the device. The present paper describes a method developed to reconstruct the image, and to correct for this distortion. In order to quantify the relation between object and image, model equations were formulated based on mild assumptions. Points in object space are transformed through a non-linear relation to corresponding points in image space. Furthermore, an oblique camera view, and an aspect ratio correction factor, are accounted for. As a test object, a regular grid of points was recorded at several distances from the camera. The images of the grid points were digitized, and the model equations were fitted to these data. From test measurements, carried out in air as well as in water, it was concluded that the distortion could be quantified by three parameters. Application of the straightforward correction procedure enables us to obtain quantitative information from endoscopic images.

Chronic unilateral loss of otolith function revealed by the subjective visual vertical during off center yaw rotation.

Assessing the subjective visual vertical, SVV, in a static upright position is an easy clinical test in which a deviation of some 10 degrees from true vertical indicates an acute loss of unilateral (otolithic) vestibular function on the side to which the SVV is tilted. Because this deviation of the SVV is compensated during the following months, patients with chronic unilateral vestibular loss do no longer differ from normal subjects. This study presents an experimental set-up that allows for clear detection of compensated chronic loss of unilateral otolithic function by testing the SVV. 21 normals and 17 unilaterally vestibular deafferentiated (UVD) patients (vestibular neurectomies) were first rotated on a human centrifuge about an earth vertical yaw axis through the midsagittal plane of the head (240 degrees/s). This induced tilts of the gravito-inertial force (GIF) vectors, which differed at the two inner ears by 8 degrees. During constant velocity rotation, the subjects were moved in pseudo-randomized steps laterally up to 16 cm apart from the rotation axis, inducing roll tilts of the GIF vectors up to 16 degrees. Normal subjects set their SVV to pre-centrifugation values at positions with the midsagittal plane of their head close to the rotation axis, while chronic UVD patients indicated pre-centrifugation values during positions with the rotation axis 5.9 +/- 2.5 cm paramedian on the side of the intact ear. Tilts of the GIF vectors shifted the SVV with a gain of 0.70 in normals and only 0.32 in UVD patients. Roll gains for laterally directed GIF vectors relative to the intact inner ear did not differ from medially directed roll gains in the UVD patients. The roll gains observed in this experimental set-up were lower than those observed with static body tilts or during eccentric rotation with a larger radius, which might be at least partially due to conflicting stimulation between otolithic and extra-vestibular cues.

An analysis of ocular counterrolling in response to body positions in three-dimensional space.

Four normal subjects underwent ocular counterrolling testing in a tiltable chair. Measurements were taken in 62 different body positions in steps of 30 degrees varied rolls and pitches. In each body position the eyes were recorded on video and their roll angle was determined automatically by computer analysis. The ocular counterrolling profile showed a periodic characteristic with maximal amplitude at roll tilts of 60 degrees. In this study we can clearly show that the eyes' rolling response is not systematically affected when lateral body tilts are combined with any tilts in the pitch direction. This undoubtedly implies that the ocular counterrolling was mainly stimulated by the subject's roll angle. As an empirical contribution, this study provides new data specially to be used in modelling and simulating the function of otolith organs.

Sensorimotor aspects of high-speed artificial gravity: II. The effect of head position on illusory self motion.

The effects of cross-coupled stimuli on the semicircular canals are shown to be influenced by the position of the subject's head with respect to gravity and the axis of rotation, but not by the subject's head position relative to the trunk. Seventeen healthy subjects made head yaw movements out of the horizontal plane while lying on a horizontal platform (MIT short radius centrifuge) rotating at 23 rpm about an earth-vertical axis. The subjects reported the magnitude and duration of the illusory pitch or roll sensations elicited by the cross-coupled rotational stimuli acting on the semicircular canals. The results suggest an influence of head position relative to gravity. The magnitude estimation is higher and the sensation decays more slowly when the head's final position is toward nose-up (gravity in the subject's head x-z-plane) compared to when the head is turned toward the side (gravity in the subject's head y-z-plane). The results are discussed with respect to artificial gravity in space and the possible role of pre-adaptation to cross-coupled angular accelerations on earth.

The effect of water immersion on postural and visual orientation.

BACKGROUND: The subjective visual vertical (SVV) and the subjective horizontal body position (SHP) perceptually dissociate and may therefore be based on a differential participation of graviceptive references. This study focuses primarily on the effects that are caused by an alteration of somatosensory information on the skin surface induced by water immersion. We expect the SHP to be selectively affected during water immersion while the SVV remains unchanged. METHODS: Four diving subjects took part in the experiments. An underwater apparatus (UWA) allowed for a determination of the SHP and the SVV during water immersion. On land, the adjustments of the SHP and SVV were made in a tilt chair apparatus (TCA). RESULTS: Three of four subjects show a significant head-upward shift between 7 degrees and 20.3 degrees of the SHP when tested under water (p < 0.02). The adjustments of the SVV were compared within corresponding physical roll inclinations and did not differ with the exception of one subject who showed a significant change of the SVV toward the physical vertical. CONCLUSIONS: The SHP and SVV perceptually dissociate on land and, as we determined for the first time, also under water. Water immersion leads to an increased roll tilt perception as measured by the SHP. However, a systematic influence on SVV could not be observed under water thus supporting the assumption that the SVV and SHP depend on gravitoreceptive information that is selectively altered during water immersion.

[Information provision for the biomedical sciences in the Netherlands faces an uncertain future]. / Informatievoorziening voor de biomedische wetenschappen in Nederland op losse schroeven.

The availability of biomedical information in the Netherlands is largely guaranteed by the libraries of the eight medical faculties and related university hospitals together with the Netherlands Institute for Scientific Information Services (Dutch acronym: NIWI). The acquisition of biomedical journals has always been coordinated at a national level. Up until now the NIWI has played a central role in filling in the gaps left by the other collections. It also functions as a national archive and a main document delivery centre. The NIWI receives financial support from the Dutch government to perform these tasks. Recently, NIWI announced that it intends to terminate its acquisition and document delivery service for the biomedical sciences. The remaining eight libraries foresee a number of negative effects if no alternatives to the present NIWI service are developed. We are of the opinion that this situation necessitates a national, biomedical information strategy.

The human vestibular cortex revealed by coordinate-based activation likelihood estimation meta-analysis.

The vestibular system contributes to the control of posture and eye movements and is also involved in various cognitive functions including spatial navigation and memory. These functions are subtended by projections to a vestibular cortex, whose exact location in the human brain is still a matter of debate (Lopez and Blanke, 2011). The vestibular cortex can be defined as the network of all cortical areas receiving inputs from the vestibular system, including areas where vestibular signals influence the processing of other sensory (e.g. somatosensory and visual) and motor signals. Previous neuroimaging studies used caloric vestibular stimulation (CVS), galvanic vestibular stimulation (GVS), and auditory stimulation (clicks and short-tone bursts) to activate the vestibular receptors and localize the vestibular cortex. However, these three methods differ regarding the receptors stimulated (otoliths, semicircular canals) and the concurrent activation of the tactile, thermal, nociceptive and auditory systems. To evaluate the convergence between these methods and provide a statistical analysis of the localization of the human vestibular cortex, we performed an activation likelihood estimation (ALE) meta-analysis of neuroimaging studies using CVS, GVS, and auditory stimuli. We analyzed a total of 352 activation foci reported in 16 studies carried out in a total of 192 healthy participants. The results reveal that the main regions activated by CVS, GVS, or auditory stimuli were located in the Sylvian fissure, insula, retroinsular cortex, fronto-parietal operculum, superior temporal gyrus, and cingulate cortex. Conjunction analysis indicated that regions showing convergence between two stimulation methods were located in the median (short gyrus III) and posterior (long gyrus IV) insula, parietal operculum and retroinsular cortex (Ri). The only area of convergence between all three methods of stimulation was located in Ri. The data indicate that Ri, parietal operculum and posterior insula are vestibular regions where afferents converge from otoliths and semicircular canals, and may thus be involved in the processing of signals informing about body rotations, translations and tilts. Results from the meta-analysis are in agreement with electrophysiological recordings in monkeys showing main vestibular projections in the transitional zone between Ri, the insular granular field (Ig), and SII.