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1 vestibulo-ocular reflex: VOR optokinetic nystagmus: OKN Vestibulo-optokinetic interaction: VOI) unilateral peripheral vestibular disfunction: UPVD VOI UPVD canal paresis: CP % VOR VOR OKN electro-oculography: EOG OKN OKN VOR p<0.01 OKN % VOI OKN vestibulo-optokinetic interaction

2 UPVD 1,2 3 optokinetic nystagmus: OKN OKN / 4) vestibulo-ocular reflex: VOR VOR FRO-02 VOR 5,6 VOR OKN OKN OKN Jung FO-02 OKN OKN 7,8 VOR OKN vestibulo-optokinetic interaction: VOI unilateral peripheral vestibular disfunction: % UPVD VOI HzOKNVOR OKN/

3 VOR OKN OKN EOG OKNEOG VOROKNEOG OKNVOR OKN OKN VOR Hz OKN

4 OKN electro-oculography: EOGPOLYGRPH SYSTEM Hz Hz 9) Mann- Whitney U OKN OKNVOR VOR VOROKN VOR VOR VOR

5 y= x e -3 x 2, R=0.999, P<0.001 y= x e -3 x 2, R=0.995, P<0.001 y= e -2 x e -3 x 2, R=0.978, P<0.001 y= x, R=0.994, P<0.001 y= x, R=0.994, P<0.001 y= x, R=0.978, P< VOR VOR OKN Hz VOR Hz / / VOROKN VOR OKN VORVOR VOR VOR VOR Hz / VOR Hz / VOR Hz / / VORVOR

6 VOR ** P<0.01, ***P<0.001 VOR * P<0.05, **P<0.01 VOR VORVOR VORVOR

7 Hz VOR VOR Hz 3 VOR OKN OKN VOR VOI OKNVOR VOI VOI VOI VOI 11 VOR Hz% Hz% Hz% UPVD CP directional preponderance: DP VOR 1,2 7,8 9, VOR VOR 3 VOR

8 VOI OKN OKN VOI VOR OKN VOI vestibulo-ocular reflex: VOR optokinetic nystagmus: OKN VOR vestibulo-optokinetic interaction: VOI. VOI OKN VOR VOROKN VOI VOI VOR p<0.01 VOI % VOI OKN CP DP % VOI VOI OKN

9 1936; 21: Dichgans J, Schmidt CL, Graf W: Visual input improves the speedometer function of vestibular nuclei in the goldfish. Exp Brain Res 1973; 18: Takahashi M, Uemura T, Fujishiro T: Compensatory eye movement and gaze fixation during active head rotation in patients with labyrinthine disorders. Ann Otol Rhinol netischen nystagmus. Arch Neerl Physiol Laryngol 1981; 90: Jenkins HA, Lau CG, Baloh RW, Honrubia V: 9. Implications of Ewald's second law for diagnosis of unilateral labyrinthine paralysis. Arch VOR 1984 supraliminal rotationokn Otolaryngol Head Neck Surg 1978; 43: Owens DE, Jenkins HA, Honrubia V: Differences between ampullofugal and ampullopeta Lau CG: Modification of constant optokinetic 10. Jenkins HA, Honrubia V, Baloh RW, Yee RD, stimulation of the horizontal semicircular nystagmus by vestibular stimulation. Arch canal: confirmation of Ewald's second law. Otolaryngol 1979; 105: Trans Amer Acad Ophthalmol Otolaryngol 11. Nakamura T, Kanayama R, Aoyagi M, Kato 1976; 82: I, Koike Y: Computer analysis for routine ENG 3. test. Acta Otolaryngol 1994; 511, , CLIENT Ter Braak JWG: Untersuchen uber optoki-

10 Yamagata Med J ) Takashi Nasu Department of Otolaryngology, Yamagata University School of Medicine, Yamagata, Japan ABSTRACT Purpose : There have been few reports examining vestibulo-optokinetic interaction (VOI), and there have been no reports using a functional test in the examination. VOI was examined in normal subjects and patients with unilateral peripheral vestibular disfunction (UPVD), and the possibility of determining the affected ear using VOI findings was also estimated. Subjects and methods : VOI was evaluated in 16 normal subjects and 30 patients with UPVD without spontaneous nystagmus or crosswise difference of the vestibulo-ocular reflex (VOR) gain, and an over-canal paresis of 30% in caloric tests. The slow-phase velocity of the optokinetic nystagmus (OKN) was measured under the stimuli of pendular rotation-induced VOR and simultaneous OKN stimuli, and the velocity was adjusted using a computer to maintain a constant value for the rotating subject. Results : Sinusoidal modulation of the OKN slow-phase velocity was observed during the VOR stimuli. The amplitude of the sinusoidal modulation was designated the modulation velocity, and a higher peak value of modulation was designated an increasing effect of VOR, while a trough was designated a decreasing effect. In the normal subjects, modulation velocities at the angular velocity of each rotation were fitted by a quadratic regression equation, and those at the angular acceleration of each rotation by a linear regression equation. In the patients, the increasing effect of the normal side stimulation was significantly higher (p<0.01) than that of the affected side stimulation, and the decreasing effect of the normal side stimulation tended to be lower than that of the affected side stimulation. The direction in which the increasing effect of the OKN slow-phase velocity was higher was the same among 80 90% of the patients with the normal side stimulation in the caloric tests. Conclusion : The affected side can be determined based on VOI findings in patients with UPVD without spontaneous nystagmus.

11 Key words : vestibulo-optokinetic interaction, pendular rotation, vestibulo-ocular reflex, optokinetic nystagmus, unilateral peripheral vestibular disfunction

新しい半規管機能検査法―video Head Impulse Test―

新しい半規管機能検査法―video Head Impulse Test― Equilibrium Res Vol. (1) video Head Impulse Test The video head impulse test as a novel semicircular canals function test Susumu Shindo 1)2), Kazuki Sugizaki 1)2), Akinori Itoh 2), Osamu Shibasaki 2),