Viewing Target Distance Influences the Vestibulo-Ocular Reflex Gain when Assessed Using the Video Head Impulse Test.

Gaze stabilization during head movements is provided by the vestibulo-ocular reflex (VOR). Clinical assessment of this reflex is performed using the video Head Impulse Test (vHIT). To date, the influence of different fixation distances on VOR gain using the vHIT has not been explored. We assessed the effect of target proximity on the horizontal VOR using the vHIT. Firstly, we assessed the VOR gain in 18 healthy subjects with 5 viewing target distances (150, 40, 30, 20, and 10 cm). The gain increased significantly as the viewing target distance decreased. A second experiment on 10 subjects was performed in darkness whilst the subjects were imagining targets at different distances. There were significant inverse relationships between gain and distance for both the real and the imaginary targets. There was a statistically significant difference between light and dark gains for the 20- and 40-cm distances, but not for the 150-cm distance. Theoretical VOR gains for different target distances were calculated and compared with those found in light and darkness. The increase in gain observed for near targets was lower than predicted by geometrical calculations, implying a physiological ceiling effect on the VOR. The VOR gain in the dark, as assessed with the vHIT, demonstrates an enhancement associated with a reduced target distance.

Visually induced nausea causes characteristic changes in cerebral, autonomic and endocrine function in humans.

An integrated understanding of the physiological mechanisms involved in the genesis of nausea remains lacking. We aimed to describe the psychophysiological changes accompanying visually induced motion sickness, using a motion video, hypothesizing that differences would be evident between subjects who developed nausea in comparison to those who did not. A motion, or a control, stimulus was presented to 98 healthy subjects in a randomized crossover design. Validated questionnaires and a visual analogue scale (VAS) were used for the assessment of anxiety and nausea. Autonomic and electrogastrographic activity were measured at baseline and continuously thereafter. Plasma vasopressin and ghrelin were measured in response to the motion video. Subjects were stratified into quartiles based on VAS nausea scores, with the upper and lower quartiles considered to be nausea sensitive and resistant, respectively. Twenty-eight subjects were exposed to the motion video during functional neuroimaging. During the motion video, nausea-sensitive subjects had lower normogastria/tachygastria ratio and cardiac vagal tone but higher cardiac sympathetic index in comparison to the control video. Furthermore, nausea-sensitive subjects had decreased plasma ghrelin and demonstrated increased activity of the left anterior cingulate cortex. Nausea VAS scores correlated positively with plasma vasopressin and left inferior frontal and middle occipital gyri activity and correlated negatively with plasma ghrelin and brain activity in the right cerebellar tonsil, declive, culmen, lingual gyrus and cuneus. This study demonstrates that the subjective sensation of nausea is associated with objective changes in autonomic, endocrine and brain networks, and thus identifies potential objective biomarkers and targets for therapeutic interventions.

Pathophysiology and treatment of motion sickness.

PURPOSE OF REVIEW: Motion sickness remains bothersome in conventional transport and is an emerging hazard in visual information technologies. Treatment remains unsatisfactory but advances in brain imaging, neurophysiology, and neuropharmacology may provide insights into more effective drug and behavioural management. We review these major developments. RECENT FINDINGS: Recent progress has been in identifying brain mechanisms and loci associated with motion sickness and nausea per se. The techniques have included conventional neurophysiology, pathway mapping, and functional MRI, implicating multiple brain regions including cortex, brainstem, and cerebellum. Understanding of the environmental and behavioural conditions provocative of and protective against motion sickness and how vestibular disease may sensitize to motion sickness has increased. The problem of nauseogenic information technology has emerged as a target for research, motivated by its ubiquitous applications. Increased understanding of the neurophysiology and brain regions associated with motion sickness may provide for more effective medication in the future. However, the polysymptomatic nature of motion sickness, high interindividual variability, and the extensive brain regions involved may preclude a single, decisive treatment. SUMMARY: Motion sickness is an emerging hazard in information technologies. Adaptation remains the most effective countermeasure together with established medications, notably scopolamine and antihistamines. Neuropharmacological investigations may provide more effective medication in the foreseeable future.

Spatial anxiety contributes to the dizziness-related handicap of adults with peripheral vestibular disease.

In subjects with peripheral vestibular disease and controls, we assessed: 1. The relationship between spatial anxiety and perceived stress, and 2. The combined contribution of spatial anxiety, spatial perspective-taking, and individual cofactors to dizziness-related handicap. 309 adults participated in the study (153 with and 156 without peripheral vestibular disease), including patients with bilateral vestibular deficiency, unilateral deficiency (evolution <3 or ≥3 months), Meniere's disease, and Benign Paroxysmal Positional Vertigo. Assessments included: general health, personal habits, spatial anxiety (3-domains), perceived stress, spatial perspective-taking, dizziness-related handicap (3-domains), unsteadiness, sleep quality, motion sickness susceptibility, trait anxiety/depression, state anxiety, depersonalization/derealization. After bivariate analyses, analysis of covariance was performed (p ≤ 0.05). Spatial anxiety was related to unsteadiness and perceived stress, with an inverse relationship with trait anxiety (ANCoVA, adjusted R2 = 0.27-0.30, F = 17.945-20.086, p < 0.00001). Variability on perspective-taking was related to vestibular disease, trait and state anxiety, motion sickness susceptibility, and age (ANCoVA, adjusted R2 = 0.18, F = 5.834, p < 0.00001). All domains of spatial anxiety contributed to the Physical domain of dizziness-related handicap, while the Navigation domain contributed to the Functional domain of handicap. Handicap variability was also related to unsteadiness, spatial perspective-taking, quality of sleep, and trait anxiety/depression (ANCoVA, adjusted R2 = 0.66, F = 39.07, p < 0.00001). Spatial anxiety is related to perceived stress in adults both with and without vestibular disease, subjects with trait anxiety rated lower on spatial anxiety. State anxiety and acute stress could be helpful for recovery after peripheral vestibular lesion. Spatial anxiety and perspective-taking contribute to the Physical and Functional domains of dizziness-related handicap, possibly because it discourages behavior beneficial to adaptation.

Vertigo and dizziness from environmental motion: visual vertigo, motion sickness, and drivers' disorientation.

The normal vestibular system may be adversely affected by environmental challenges which have characteristics that are unfamiliar or ambiguous in the patterns of sensory stimulation they provide. A disordered vestibular system lends susceptibility even to quotidian environmental experiences as the sufferer becomes dependent on potentially misleading, nonvestibular sensory stimuli. In both cases, the sequelae may be vertigo, incoordination, imbalance, and unpleasant autonomic responses. Common environmental motion conditions include visual vertigo, motion sickness, and motorists' disorientation. The core therapy for visual vertigo, motion sickness, and drivers' disorientation is progressive desensitization within a cognitive framework of reassurance and explanation, plus anxiolytic tactics and autogenic control of autonomic symptoms.

Cognitive cues and visually induced motion sickness.

BACKGROUND: The importance of cognitive processing of orientation cues in visually induced motion sickness and vection is often overlooked. Upright versus inverted visual scenes containing cues of different levels of salience were compared. METHODS: Panoramic scenes of 360 degrees were projected in the visual equivalent to the nauseogenic situation of rotating about an axis tilted from the vertical with a field of view of 84 degrees rotating at 0.2 Hz (72 degrees x s(-1)). Exposures were for 10 min or until moderate nausea developed. The design was counterbalanced repeated measures. Pilot Study: Subjects (N = 12) viewed visual conditions: a distant bland coastline scene as from an aircraft, tilted 30 degrees (Up); the same scene but inverted (Invert); and the scene morphed with no obvious orientation cues (Abstract). Main Experiment: Subjects (N = 22) viewed a city street scene containing numerous unambiguous and strong verticality cues under two conditions: upright (Up) and inverted (Invert), with 18 degrees tilt of rotational axis. RESULTS: Pilot Study: there were no significant differences between conditions in time (mean +/- SD min) to nausea endpoint (Up: 7.4 +/- 3.1; Invert: 7.1 +/- 3.1;Abstract: 7.8 +/- 2.4), nor for total symptom scores, nor for vection. Main Experiment: the upright scene was significantly more nauseogenic than the inverted, with shorter times to nausea endpoint (Up: 8.7 +/- 2.3; Invert: 9.2 +/- 2.2) and greater total symptom scores. Vection was marginally greater for Up than Invert. CONCLUSIONS: Salient and unambiguous higher order cognitive cues may modulate the development of motion sickness induced by optokinetic stimuli. There was no one-to-one correspondence between vection and motion sickness.

Individual Cofactors and Multisensory Contributions to the Postural Sway of Adults with Diabetes.

To assess the interactions between individual cofactors and multisensory inputs on the postural sway of adults with type 2 diabetes and healthy subjects, 69 adults accepted to participate in the study (48 with/ 21 without diabetes). Assessments included neuro-otology (sinusoidal-rotation and unilateral-centrifugation), ophthalmology and physiatry evaluations, body mass index (BMI), physical activity, quadriceps strength, the ankle/brachial index and polypharmacy. Postural sway was recorded on hard/soft surface, either with eyes open/closed, or without/with 30° neck extension. The proportional differences from the baseline of each condition were analyzed using Multivariate and Multivariable analyses. Patients with polyneuropathy and no retinopathy showed visual dependence, while those with polyneuropathy and retinopathy showed adaptation. Across sensory challenges, the vestibulo-ocular gain at 1.28 Hz and the BMI were mainly related to changes in sway area, while the dynamic visual vertical was mainly related to changes in sway length. The ankle/brachial index was related to the effect of neck extension, with contributions from quadriceps strength/physical activity, polyneuropathy and polypharmacy. Across conditions, men showed less sway than women did. In conclusion, in adults with diabetes, sensory inputs and individual cofactors differently contribute to postural stability according to context. Rehabilitation programs for adults with diabetes may require an individualized approach.

Respiratory vulnerability to vehicle buffeting.

OBJECTIVE: Buffeting in a jerky ride in a bus or ambulance normally provokes a sustained tachypnoea driven by vibration and sensory mechanisms including vestibular signals. Tachypnoea reinforces the torso against mechanical shocks but results in overbreathing, causing a mild fall in CO(2). However, normal CO(2) is rapidly restored by a reduction in depth of breathing. We test the hypothesis that vulnerable subjects, exemplified by elderly individuals and patients with vestibular disorders, may fail to adapt to buffeting. METHODS: Respiratory and cardiovascular functions were recorded from five elderly subjects, two patients with bilateral loss of vestibular function and five patients with 'BPPV,' while being exposed to 15-min buffeting in a flight simulator which simulated transport in an ambulance over rough pavement. Results were compared with published norms. RESULTS: Some subjects sustained overbreathing during motion, through either tachypnoea or deep breathing, causing a marked reduction in CO(2) levels (3/5, 2/2 avestibular, 4/5 elderly, 4/5 BPPV). Others failed to raise breathing frequency which would render them susceptible to mechanical shock (4/5 elderly, 1/2 avestibular). Overbreathing was particularly evident in three anxious subjects. INTERPRETATION: Overbreathing during buffeting could be caused by (1) resetting of CO(2) rest levels lower; (2) change in receptor sensitivity; (3) adjustment of central drive to breathing; and (4) stiffening of posture because of motion discomfort reduced the ability to modulate breathing. The buffeting experienced was moderately violent. More profound hypocapnia and mechanical shock are likely to result in vulnerable individuals failing to adapt to severe buffeting in transport on unpaved roads, in war zones or by sea ambulance.

Off vertical axis rotation motion sickness and field dependence.

BACKGROUND: Our study probed the relationship between field dependence and the development of nausea in light and dark during whole-body, off vertical axis rotation (OVAR). METHODS: There were 24 subjects who underwent OVAR at 0.2 Hz, 18 degree tilt. Exposures were undertaken in both light and darkness in sessions spaced 5 d apart in balanced order design. During rotation, nausea was rated at 1-min intervals to a cut off at 20 min or a level of 'moderate nausea' was attained, at which point motion stopped. Before and after OVAR sessions field dependence was rated with the rod and frame test (RFT) with head upright or tilted 28 degree to induce a head-centric bias. RESULTS: Subjects tolerated OVAR longer in the light (mean 13.3 min +/- 6.8 SD) than in darkness (11.1 min +/- 7.2). Motion sickness susceptibility evaluated by questionnaire was inversely correlated with tolerance of OVAR in the light. There was a tendency for subjects who were visual field dependent to fare better with OVAR in the light than in darkness. Subjects whose RFT estimates with head tilted tended to incline the visual vertical to the direction of head tilt better tolerated OVAR in darkness. DISCUSSION: The results suggest that susceptibility, as evaluated by questionnaires probing motion sickness experiences in daily life, is influenced by visual factors. Assessments of sensitivity to reference frames for orientation, either visual or ego-centered, show promise for markers of motion sickness susceptibility according to the visual surround rather than to absolute levels of susceptibility to motion sickness.

Slalom walking with prism disorientation: impact on verbal and spatial tasks.

BACKGROUND: Slalom walking wearing distorting prisms has been used to study multitasking during adaptation to spatial disorientation. We address the hypothesis that slalom-prism walking could interfere specifically with concurrent spatial tasks. METHODS: Subjects (16 men, 16 women) sat for 30 s then slalom walked through 5 aligned batons. This exercise was performed with normal vision and with prisms deviating gaze laterally by 15.50 Both conditions were done without any tasks, with a verbal task (matching the sex of male and female names uttered by male and female voices), and a spatial task (matching laterality of the words 'right' and 'left' delivered to the right or left ear). Conditions were balanced with instructions to perform rapidly and accurately. RESULTS: Time to walk the slalom was extended by the prisms from 16 s to 33 s, but unaffected by tasks. Slalom increased error rates on the spatial task by 8% above baseline, but verbal task errors remained unchanged. Prisms did not affect task errors. The rates of processing cognitive task items were slowed by approximately 0.5 s by slalom and by 1 s slalom walking with prisms. Prisms increased task reaction times by 340 ms during slalom. Contact with the poles occurred when multitasking, with men making three times more contacts than women. CONCLUSIONS: Slowing of all performance parameters is consistent with a 'bottleneck' caused by task multiplexing. Competition for spatial processing resources and confusion because of similar features may cause interference between the lateralized spatial task and slalom.

Off-vertical axis rotation of the visual field and nauseogenicity.

BACKGROUND: Off-vertical axis rotation (OVAR) causes motion sickness which increases with angle of tilt and is most provocative around 0.2 Hz. The aim was to determine the tilt angle and frequency characteristics for visual OVAR, which is also known to be nauseogenic. METHODS: A computerized scene, as seen by a pilot at moderate altitude, rotated at different frequencies about an axis which could tilt as during OVAR. A concurrent visual detection task controlled attention. Exposures were for 10 min or until nausea developed. There were four experiments: Frequency tuning-visual motion at 0.05, 0.2, and 0.8 Hz, all at 18 degrees tilt of the axis of rotation (N = 14); gross visual tilt tuning-visual motion at 0, 45, and 90 degrees of tilt at 0.2 Hz (N = 12); fine visual tilt tuning -- 18, 36, 54, and 72 degrees tilts at 0.2 Hz (N = 24); and whole-body tilt of the participant at 0, 45, and 90 degrees, viewing rotation about a vertical axis at 0.2 Hz (N = 12). RESULTS: Nauseogenicity was significantly greater at 0.2 Hz than at lower or higher frequencies. Visual tilts 18 degrees to circa 45 degrees were significantly more nauseogenic. No differences were found between whole-body tilts. CONCLUSIONS: Nauseogenicity of visual OVAR peaks around 0.2 Hz, and increases with stimulus strength up to circa 45 degrees tilt, similar to real motion. With higher tilt angles, decreasing nauseogenicity suggests that the visual impact is partially quarantined because the motion would appear patently absurd and not a sensory conflict. Whole-body tilt may have failed to modulate nauseogenicity because of overriding somatosensory cues to Earth vertical.

Posterior parietal rTMS disrupts human Path Integration during a vestibular navigation task.

In contrast to vision, the neuro-anatomical substrates of vestibular perception are obscure. The vestibular apparati provide a head angular velocity signal allowing perception of self-motion velocity. Perceived change of angular position-in-space can also be obtained from the vestibular head velocity signal via a process called Path Integration (so-called since displacement is obtained by a mathematical temporal integration of the vestibular velocity signal). It is unknown however, if distinct cortical loci sub-serve vestibular perceptions of velocity versus displacement (i.e. Path Integration). Previous studies of human brain activity have not used head motion stimuli hence precluding localisation of vestibular cortical areas specialised for Path Integration distinct from velocity perception. We inferred vestibular cortical function by measuring the disrupting effect of repetitive transcranial magnetic stimulation on the performance of a displacement-dependent vestibular navigation task. Our data suggest that posterior parietal cortex is involved in encoding contralaterally directed vestibular-derived signals of perceived angular displacement and a similar effect was found for both hemispheres. We separately tested whether right posterior parietal cortex was involved in vestibular-sensed velocity perception but found no association. Overall, our data demonstrate that posterior parietal cortex is involved in human Path Integration but not velocity perception. We suggest that there are separate brain areas that process vestibular signals of head velocity versus those involved in Path Integration.

Guidance of visual direction by topographical vibrotactile cues on the torso.

Vibration on localised areas of skin can be used to signal spatial orientation, multi-directional motion and also to guide arm and hand movements. This study investigated the possibility that vibration at loci on the skin might also be used to cue gaze direction. Eight subjects made eye or (head + eye) gaze saccades in the dark cued by vibration stimulation at discrete loci spaced on a horizontal contour across the chest. Saccade and gaze amplitudes, latencies, and directions were analysed. In the first experiment, performed without training, subjects could only use vibration cues to direct their gaze in cardinal directions and gross quadrature. There was a high variability in the relationship between locus on the trunk and gaze direction in space, both within and between subjects. Saccade latencies ranged from 377 to 433 ms and were related to the loci of vibration; the further from the body midline the quicker the response. Since the association of skin loci with gaze direction did not appear intuitive a sub-group of four subjects were retested after intensive training with feedback until they attained criterion on midline identical with 0 degrees and 15 cm (to right/left of midline) identical with 45 degrees gaze shifts right and left. Training gave a moderate improvement in directional specificity of gaze to a particular locus on the skin. Gaze direction was linearly rescaled with respect to skin loci but variability and saccade latencies remained high. The uncertainty in the relationship between vibration locus and gaze direction and the prolonged latencies of responses indicate circuitous neuronal processing. There appears to be no pre-existing stimulus-response compatibility mapping between loci on the skin and gaze direction. Vibrotactile cues on the skin of the trunk only serve a gross indication of visual direction in space.

Spinal stability is improved by inducing a lumbar lordosis in boys with Duchenne Muscular Dystrophy: a pilot study.

The development of scoliosis in boys with Duchenne Muscular Dystrophy (DMD) is a significant, morbid event in the progression of the disease caused by progressive spinal musculature weakness. As an alternative to muscle activity, the spine can also be stabilised by locking the articular facet joints, which is achieved when the body is supported on a seat tilted anteriorly using a 'wedge', of the kind commonly recommended for low back pain. We tested spinal stability when using a seat tilted 15 degrees anteriorly in eight boys with DMD, without significant scoliosis, by measuring the ability to support a lateral load applied to the thorax through a sling and hawser. All eight boys tolerated lateral loading better with wedged seating and were able to support an average additional load of 95 g per kilogram of body weight compared to normal seating. Lateral load bearing was improved in 10 normal control boys by an average of 40 g per kilogram of body weight. These encouraging pilot findings indicate that there is a need for further studies on the effectiveness of passive mechanical factors in spinal stabilisation to delay the development of scoliosis in boys with DMD.

Nauseogenicity of off-vertical axis rotation vs. equivalent visual motion.

INTRODUCTION: Off-vertical axis rotation (OVAR) provokes motion sickness. The visual motion equivalent to OVAR in simulators is also nauseogenic. Our experiment compared the nauseogenicity of OVAR vs. visual motion. METHODS: There were 12 subjects who undertook the following conditions: A) OVAR in darkness at 0.2 Hz, 18 degrees tilt; B) same OVAR with eyes open in the light; and C) stationary, seated upright, watching a video of the visual motion experienced in B. The conditions were counterbalanced and performed at the same time of day with a minimum 5-d separation between conditions. Stimulation was stopped at moderate nausea with a 20-min maximum cut-off. Motion sickness susceptibility was rated on a standardized questionnaire (MSSQ). RESULTS: Time (mean +/- SD minutes) to moderate nausea was significantly shorter for real OVAR conditions (A: 7.1 +/- 5.5; B: 7.7 +/- 6.7) vs. video (C: 15.7 +/- 6.4). Subjects with relatively low susceptibilities to motion sickness developed nausea more slowly with vision (B-A time difference correlated with MSSQ scores r = -0.7, P < 0.05). Headache was more prominent with visual field motion (C). CONCLUSIONS: OVAR was twice as nauseogenic as visual motion. Headache during visual motion suggests mechanisms in common with migraine. We hypothesize that subjects who fared better in the light used visual cues to resolve sensory conflict, whereas subjects who were equally susceptible in light and dark made poor use of visual cues; perhaps a form of 'field dependency'. This may explain why some people prefer 'a view of the road ahead' to help against motion sickness whereas others shut their eyes.

Using vibrotactile feedback of instability to trigger a forward compensatory stepping response.

We evaluated the effectiveness of vibrotactile feedback to enhance protective stepping with a view to developing a prosthesis for patients with balance disorders. Subjects standing on a moving walkway were exposed to an unpredictable, abrupt backwards translation of the support surface that required a step response to remain standing. The subjects were 15 normal young, 15 normal elderly and 9 patients with either bilateral vestibular loss or peripheral neuropathy. The initial passive displacement of the body was recorded by a gyroscope placed on the leg which triggered a vibration pulse to the trigeminal distribution on the forehead to cue a forwards step. Stepping responses and postural sway, with and without vibration feedback, were compared. Vibration produced significantly shorter stepping reaction times only in the elderly normals with naturally slower stepping. Patients did not benefit in any way. We conclude that the effectiveness of vibration biofeedback appears limited. Any enhancement of compensatory stepping might be triggered by speeding the decision to step rather than by creating a specific stimulus-response loop.

Predictors of clinical recovery from vestibular neuritis: a prospective study.

We sought to identify predictors of symptomatic recovery in vestibular neuritis. Forty VN patients were prospectively studied in the acute phase (median = 2 days) and 32 in the recovery phase (median = 10 weeks) with vestibulo-ocular reflex, vestibular-perceptual, and visual dependence tests and psychological questionnaires. Clinical outcome was Dizziness Handicap Inventory score at recovery phase. Acute visual dependency and autonomic arousal predicted outcome. Worse recovery was associated with a combination of increased visual dependence, autonomic arousal, anxiety/depression, and fear of bodily sensations, but not with vestibular variables. Findings highlight the importance of early identification of abnormal visual dependency and concurrent anxiety.

Cardio-respiratory responses evoked by transient linear acceleration.

INTRODUCTION: Predictive control of the responses to re-orientating stimuli and its interaction with vestibular signals may be an important factor in protecting against spatial disorientation. Here we evaluated the influence of stimulus predictability on the cardio-respiratory responses to transient fore-aft linear accelerations. METHODS: There were 13 normal subjects and 6 patients with bilateral loss of vestibular function who were exposed to linear acceleration of +0.26 Gx peak while seated upright and restrained on a motorized bogie. Accelerations were: (1) 'unpredictable', triggered by the experimenter either at the end of expiration or at the end of inspiration; or (2) 'predictable', triggered by the subjects pressing a button. The two conditions included false trials when nothing would happen. Respiratory frequency, electrocardiogram, and trunk acceleration were recorded. RESULTS: For unpredictable accelerations, in all subjects, the RR interval decreased within the first to second beat after acceleration onset. In normal subjects this decrease was maintained or more evident during the third, fourth, or fifth heart beat after onset. Cardiac responses were not significantly different when acceleration was triggered at the end of inspiration or at the end of expiration. Self-triggered acceleration also provoked prolonged, but attenuated, heart rate responses in healthy subjects, while responses were absent in the patients. All subjects responded with a consistent rapid inspiration to the onset of acceleration, whether predictable or not. DISCUSSION: A vestibulo-cardiac response is evoked by transient linear acceleration, independently from the phase of the breathing cycle and from the predictability of the stimulus. A vestibular signal of motion appears to be required to produce a prolonged increase in heart rate.

Biodynamic Hypothesis for the Frequency Tuning of Motion Sickness.

INTRODUCTION: Motion sickness is often provoked by oscillatory translational (linear) acceleration. For humans, motion frequencies around 0.2-0.3 Hz are the most provocative. A current explanation for this frequency band is that it spans a region of maximum ambiguity concerning the interpretation of vestibular signals. Below 0.2-0.3 Hz, linear accelerations are interpreted as 'tilt', whereas at higher frequencies accelerations are interpreted as 'translation', i.e., linear motion through space. This is termed the 'tilt-translation' hypothesis. However, the origin of this particular frequency range is unclear. We investigated whether the differential perceptions of oscillations at different frequencies derives from the biodynamics of active self-initiated whole body motion. METHODS: Video-films were taken of subjects running slaloms of various combinations of lengths/amplitudes to provoke a range of temporal frequencies of slalom (reciprocal of time to run a cycle). RESULTS: The usual tactic for cornering at frequencies <0.25 Hz was whole-body tilt, whereas >0.4 Hz lateropulsion of the legs with torso erect was observed. Between these frequencies subjects showed variable tactics, mixing components of both tilt and lateropulsion. CONCLUSIONS: This uncertainty in selecting the appropriate tactic for movement control around 0.2-0.3 Hz is the possible origin of 'tilt-translation' ambiguity. It also follows that externally imposed motion around these frequencies would challenge both perception and motor control, with the consequence of motion sickness.