Automatic classification and robust identification of vestibulo-ocular reflex responses: from theory to practice:...

The Vestibulo-Ocular Reflex (VOR) stabilizes images of the world on our retinae when our head moves. Basic daily activities are thus impaired if this reflex malfunctions. During the past few decades, scientists have modeled and identified this system mathematically to diagnose and treat VOR deficits. However, traditional methods do not analyze VOR data comprehensively because they disregard the switching nature of nystagmus; this can bias estimates of VOR dynamics. Here we propose, for the first time, an automated tool to analyze entire VOR responses (slow and fast phases), without a priori classification of nystagmus segments. We have developed GNL-HybELS (Generalized NonLinear Hybrid Extended Least Squares), an algorithmic tool to simultaneously classify and identify the responses of a multi-mode nonlinear system with delay, such as the horizontal VOR and its alternating slow and fast phases. This algorithm combines the procedures of Generalized Principle Component Analysis (GPCA) for classification, and Hybrid Extended Least Squares (HybELS) for identification, by minimizing a cost function in an optimization framework. It is validated here on clean and noisy VOR simulations and then applied to clinical VOR tests on controls and patients. Prediction errors were less than 1 deg for simulations and ranged from .69 deg to 2.1 deg for the clinical data. Nonlinearities, asymmetries, and dynamic parameters were detected in normal and patient data, in both fast and slow phases of the response. This objective approach to VOR analysis now allows the design of more complex protocols for the testing of oculomotor and other hybrid systems.