A clinical test of otolith function: static ocular counterroll with passive head tilt

When roll-tilted around the naso-occipital axis, humans exhibit compensatory torsional rotation of the eyes in the opposite direction owing to the torsional vestibulo-ocular reflex. In the static condition (sustained head roll), the utricles act as responsible sensors for 'static ocular counterroll'. Contributions of cervico-ocular reflexes remain unknown. To find an easy, clinically useful test of utricular function, we induced ocular counterroll in 10 healthy study participants (two men, mean age 27+/-2 years) under three stimulation conditions (active/passive head tilt and passive whole body tilt in roll plane), used three-dimensional video-oculography to measure it, and compared values. Active head-tilt-induced ocular counterroll varied most and was thus less reliable than passive head and body tilt-induced ocular counterroll. Utricular function can thus be tested simply by measuring passive head tilt with video-oculography.