Use of a visual guide to improve the quality of VOR responses evoked by high-velocity rotational stimuli

High-velocity rotational stimuli have the potential to improve the diagnostic capabilities of clinical rotation testing by revealing nonlinear vestibulo-ocular reflex (VOR) responses that are indicative of asymmetric vestibular function. However, eye movements evoked by high-velocity rotations often are inconsistent over time and therefore do not yield reliable diagnostic measures. This study investigated whether use of a novel "visual guide" could improve the consistency and quality of VORs obtained during testing with pulse-step-sine (PSS) stimuli providing periodic high-velocity, horizontal-plane rotations with peak velocities up to 290 deg/s. The visual guide (narrow phosphorescent line spanning 180 degrees field of view) was mounted horizontally on the rotation chair at the subject's eye level. Eight healthy human subjects were tested either in complete darkness while performing an alerting task, or while viewing the visual guide in an otherwise dark room. We found that the visual guide improved the quality of VOR responses as shown by an increased proportion of slow-phase velocity data segments retained for analysis, by a decreased variance of the processed eye velocity data, and by a reduction of outlying VOR response measures. We also found that the visual guide did not induce visual suppression because VOR gain measures were not diminished.