Adaptation of the cervico- and vestibulo-ocular reflex in whiplash injury patients

The aim of this study was to investigate the underlying mechanisms of the increased gains of the cervico-ocular reflex (COR) and the lack of synergy between the COR and the vestibulo-ocular reflex (VOR) that have been previously observed in patients with whiplash-associated disorders (WAD). Eye movements during COR or VOR stimulation were recorded in four different experiments. The effect of restricted neck motion and the relationship between muscle activity and COR gain was examined in healthy controls. The adaptive ability of the COR and the VOR was tested in WAD patients and healthy controls. Reduced neck mobility yielded an increase in COR gain. No correlation between COR gain and muscle activity was observed. Adaptation of both the COR and VOR was observed in healthy controls, but not in WAD patients. The increased COR gain of WAD patients may stem from a reduced neck mobility. The lack of adaptation of the two stabilization reflexes may result in a lack of synergy between them. These abnormalities may underlie several of the symptoms frequently observed in WAD, such as vertigo and dizziness.