Altered visual conscious awareness in patients with vestibular dysfunctions; a cross-sectional observation study.

BACKGROUND: Patients with vestibular dysfunctions often experience visual-induced symptoms. Here we asked whether such visual dependence can be related to alterations in visual conscious awareness in these patients. METHODS: To measure visual conscious awareness, we used the effect of motion-induced blindness (MIB,) in which the perceptual awareness of the visual stimulus alternates despite its unchanged physical characteristics. In this phenomenon, a salient visual target spontaneously disappears and subsequently reappears from visual perception when presented against a moving visual background. The number of perceptual switches during the experience of the MIB stimulus was measured for 120 s in 15 healthy controls, 15 patients with vestibular migraine, 15 patients with benign positional paroxysmal vertigo (BPPV) and 15 with migraine without vestibular symptoms. RESULTS: Patients with vestibular dysfunctions (i.e., both vestibular migraine and BPPV) exhibited increased perceptual fluctuations during MIB compared to healthy controls and migraine patients without vertigo. In VM patients, those with more severe symptoms exhibited higher fluctuations of visual awareness (i.e., positive correlation), whereas, in BPPV patients, those with more severe symptoms had lower fluctuations of visual awareness (i.e., negative correlation). IMPLICATIONS: Taken together, these findings show that fluctuations of visual awareness are linked to the severity of visual-induced symptoms in patients with vestibular dysfunctions, and distinct pathophysiological mechanisms may mediate visual vertigo in peripheral versus central vestibular dysfunctions.

The basis of report-difference superiority in delayed perceptual comparison tasks.

A major role for visual short-term memory (VSTM) is to mediate perceptual comparisons of visual information across successive glances and brief temporal interruptions. Research that has focused on the comparison process has noted a marked tendency for performance to be better when participants are required to report a difference between the displays rather than report the absence of a difference (i.e. a sameness). We refer to this performance asymmetry as report-difference superiority (RDS). It has been suggested that RDS reflects the operation of a reflexive mechanism that generates a mismatch signal during the comparison of visual input with information maintained in VSTM. This bottom-up mechanism therefore gives evidence for the presence of a feature change but not for the absence of such a change; consequently, a sameness is harder to detect than a difference between two displays. We test this explanation, and determine whether by itself it is a sufficient explanation of the RDS. In a delayed comparison task we find the RDS effect is most prevalent when items retain the same display locations; however, the effect does persist even when compared item locations were scrambled across memory and test arrays. However, with a conjunction task this scrambling of locations was effective in wholly abolishing the RDS effect. We consider that the RDS effect is a consequence of local comparisons of features, as well as global statistical comparisons.