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J fhwiolog.v (Puis) ( 1996) 90, 53-62 OElsevier. Paris Anteroposterior dynamic balance reactions induced by circular translation of the visual field A Skverac Cauquil, M Bessou, Ph Dupui, P Bessou Centre de Rechrrchr Cervenu et Cognition. FucultP de M&de&e dr Rangwil. UtGversitP Paul-Sabatirr. 133. route de Nnrbonnr. 31062 Toulo~tse cede.\. France (Received 16 May 1996: accepted I I June 19961 Summary - The anteroposterior sway of subjects under conditions of spontaneous dynamic balance on a wobbly platform was measured during visual stimulation by a visual target executing a circular trajectory in the frontal plane. The target was either a component of the whole moving visual scene or moving on a stationary background. With the former stimulation, obtained through the use of rotating prismatic glasses, every point of the visual field appeared to describe a circular trajectory around its real position so that the whole visual field appeared to be circularly translated, undistorted, inducing a binocular pursuit movement. Under these conditions, stereotyped anteroposterior dynamic balance reactions synchronous with the position of the stimulus were elicited. The latter stimulation consisted of pursuing a luminous target describing a trajectory similar to that of the fixation point seen through the rotating prisms on the same, this time stable, visual background. Although pursuit eye movements were comparable, as demonstrated by electro-oculographic recordings. no stereotyped equilibration reaction was induced. It is concluded that the translatory motion of the background image on the retina in the latter experiments contributed to the body’s stability as well as to the perception of a stable environment dynamic balance I visual field I eye movements I proprioception Introduction Vision coupled to eye movements provides complex sensory information to the central nervous system (CNS) from both retinal and extraretinal structures. Gaze-anchoring onto a target in the environmental space facilitates the body balance whereas severe reduction in visual acuity disturbs fixation and decreases subject stability (Brandt et al, 1985). Eye movements, by modifying visual information from retinal and extraretinal structures, interfere with balance according to the kind of eye movements used. Brandt er nl(l986) showed that the ocular pursuit of a single moving target within a stationary visual environment significantly impairs static balance, contrary to what happens with saccadic eye movements. Schulman et al (I 986) observed that the time spent by subjects in balance on an unstable platform was longer during saccades than during smooth pursuit eye movements. Under each condition, the image of the background sweeps across the retina with unequal velocity. Moreover, during a saccade in normal viewing conditions the blurred background image is obliterated (Campbell and Wurtz, 1978) whereas during pursuit the background is clearly perceived as steady. It can be thought that the slow displacement of the background image in pursuit movement jeopardises the body balance even if the subject perceives the environment as staying stable. The aim of the present work was to investigate the part played by the motion of the retinal image of the background in the balance responses induced by eye pursuit movements. Two conditions of visual tracking of a small target were tested, leading to identical eye pursuit movements. In the first case, the pursued target moved on a stationary visual background, inducing motion of the background image on the retina. In the second, the whole visual field described the same trajectory as the visual target, resulting in a stationary background image on the retina. ln these experiments a circular pursuit movement has been induced, both to obtain a movement of constant velocity, prolonged at will, and to simultaneously activate horizontal and vertical components of eye motricity known to be controlled by different parts of the reticular formation (Robinson, 198 1). Spontaneous dynamic balance was used to enhance the sensitivity of body stability to visual input: the sensitivity increases when the upright posture is difficult (Kapteyn, 1972; Amblard and Cremieux, 1976; Bles et al, 1980) and when the activation level of the central neuronal network increases (Soechting and Berthoz. 1979). In the present paper, the balance responses were measured only in the sagittal plane because the reactions are relatively easy to understand on biomechanical grounds. Indeed they mainly result from flexion and extension movements that involve both body sides symmetrically. Besides, anteroposterior balance is more sensitive to some visual inputs (Severac, 1993; Paulus et cd, 1994). Part of these data have been presented before (Bessou ef al. 1995). 54 Materials and methods Circular translation of the visual field (CTVF) was elicited by means of goggles (fig IA) fitted with two 13-diopter Fresnel membrane prisms (Severac et al, 1994). A motor in each side of the goggles induced the rotation of the goggle glasses around their optical axis and consequently the rotation of the prisms they supported. Both motors were driven by a microcomputer. The angular speed of prism rotation was fixed at 45”/s so that the fixation target described its apparent circular trajectory in 8 s. All the objects in the visual field of the subjects were seen describing a circle with a 13-degree diameter (fig lB), so that the apparent circular trajectory was 90 cm diameter for all the objects situated in the plane of a wall 3.5 m distant in front of the subjects. A luminous bulb on the wall was used as a fixation target. Viewing through the prisms reduced visual acuity by approximately half. The size of the whole visual field including the binocular field was slightly diminished in the nasal direction and downward. Circular translation of the visual target alone (CTVT) was elicited by projecting on the wail in front of the subject a luminous spot which had about the same diameter and the same brightness as the fixation target under CTVF conditions. The projector was operated circularly so as to make the target describe the same trajectory as the fixation point seen through the rotating prisms, ie a 90 cm diameter circle (fig lC). Dynamic balance conditions were induced by using an unstable platform (stabilometer, Bessou et al, 1988) derived from Freeman platforms designed to develop calf muscle co-ordination (Freeman ef al, 1965). The device, consisting of a platform on a segment of cylinder (55 cm radius, 50 cm length) reduces the area of support of the subject on the ground into a 50-cm segment of line called the ‘pivot’ (fig 1D). The pivot constitutes, at a given instant. the contact of the system man-platform with the ground. It can be displaced on the ground perpendicularly to its direction by the subject himself, as a consequence of the platform tilt. The displacement of the pressure force exerted by the subject elicits a rotation of the cylinder and thus a platform tilt. Due to the system design and the low inertia of the stabilometer (small mass: 2 kg relative to the body mass), the position of the pivot on the ground may be considered as the instantaneous projection of the centre of pressure. The instability of the system required from the subject uninterrupted movement of the pivot, ie of the subject support on the ground, characterising the ‘dynamic balance conditions’. The dynamic balance conditions could be considered as spontaneous since no disturbing external force was applied to the system subject-stabilometer. In all the experiments the subject stood on the platform so that the pivot moved forwards-backwards (sagittal balance, fig IE). The resulting displacement of the pivot on the ground (stabilogram) was calculated from the measurement of the platform tilt, monitored by an optical encoder linked to a microcomputer with a dedicated program (sampling frequency 100 Hz. accuracy 7 IO-’ cm). The horizontal displacements of the head in the sagittal plane were simultaneously recorded using a device derived from the Wright ataxiameter (197 1) (fig 1D). The head movements were transmitted by a weighted string (20 g) to a pulley fixed to the shaft of an optical encoder linked to a microcomputer (sampling frequency 100 Hz, accuracy 2 IO-’ cm). Any forward or backward head displacement of a subject standing on the stabilometer resulted from the tuming action about the pivot of the gravity force exerted on the centre of mass. Our method did not offer the opportunity to assess postural adjustments at intermediate levels between the head and the pivot. The influence on head posture of possible moditications of intersegmental joints was inferred from the comparison between the measured head position and the theoretical head position, computed from the position of the pivot according to the model of the inverted pendulum. According to these assumptions, a forward head movement was considered as an overall body flexion (dorsiflexion of the ankle) whereas a backward head movement was taken as resulting from an extension movement (plantar flexion of the ankle). Eye movements were monitored by electro-oculography. Six adhesive electrodes were stuck on the skin at the edge of the eye sockets, Two electrodes were used for recording horizontal movements and four electrodes for vertical movements. Electrodes were connected to a bridge circuit derived from Remond et al (1957) a system that allowed proper dissociation of vertical and horizontal tracks. Calibration consisted in asking the subject to look successively at LEDs lighted alternately and situated at the extremities of a cross, IO” away from the centre, right, left, down and up. Amplified signals were recorded on paper for I2 subjects using an electrostatic trace recorder (Gould ES 1000, frequency response IO kHz) and collected for five subjects with a microcomputer at 10 ms sampling rate. Pilot experiments (Severac, 1993) having shown that the sagittal balance responses to CTVF or CTVT were independent of the direction of the target rotation (clockwise or counter-clockwise) or of the visual conditions (binocular or monocular vision), the following experiments were performed with counter-clockwise rotations and under binocular vision. With local ethics committee approval, experiments were performed on 64 subjects who gave their informed consent. In a first set, 32 subjects (12 men and 20 women) underwent counter-clockwise CTVF, with target motion starting either on the extreme right of its trajectory (3 o’clock, 16 subjects) or on the extreme left (9 o’clock, 16 subjects). Since an analysis of variance did not reveal any difference between the balance parameters (see below) calculated from measurements in both conditions, their values were subsequently pooled for statistical analysis. In a second set of experiments, 32 other subjects ( 15 men and 17 women) underwent counter-clockwise CTVT test, with target motion starting at 55 VISUAL FIELD E P * h.d. 0.e. STABILOMETER < Fig 1. A. The prismatic glasses. B. CTVF when prisms are rotating counter-clockwise, the bright spot (dotted circle) and every point of the visual field (eg dotted cross) describe a circle of the same radius around their real position (plain symbols). C. CTVT when the projector is rotating, the bright spot (circle) describes a circle on the stable background. D. The recording devices for area of support (stabilometer) movements: platform with a curved base in contact with the ground through a line. the pivot (p). When the platform tilts, a lever fixed to an extremity of the platform slides on the ground and rotates around its point of fixation. The rotation is assessed by an optic encoder (o-e). The ataxiameter is used to measure head linear displacement (hd) in the sagittal plane: string tightened between the head band fixed around the head and a pulley transmits head displacements to an optic encoder (oe) fixed to the shaft of the pulley. E. Position of the subject to assess dynamic balance in the anteroposterior plane. 3 o’clock. For both CTVF and CTVT experiments, each session lasted 50 s and included: a 10-s reference period (R) during which the prisms or the projected target were immobile; a 30-s stimulation period (ST) during which either the prisms or the target rotated and a 10-s post-stimulation period (P) of target or prism immobility. Individual records with the same starting point were averaged. The last procedure provided the advantage of enhancing the synchronised oscillations in the recordings and reducing the masking effects of the more rapid (=I Hz) oscillations that characterise the dynamic balance, since they are asynchronous from one record to another. 56 Three parameters were measured from head (H) and pivot (P) recordings: the length of the linear displacement (LD), HLD and PLD (cm), obtained by summation of absolute values of the displacements between two successive measurements (Granat et al, 1990); the maximum oscillation amplitude (MA), HMA and PMA (cm); and the average position (AvP) around which the records oscillate, HAvP and PAvP (cm). The ST period was subdivided for convenience of data analysis into three periods of 10 s (ST], ST2, ST3). The comparison of the effects of CTVF and CTVT on dynamic balance parameters were statistically assessed by means of a two-way analysis of variance (ANOVA). One factor was the factor ‘period’ with repeated measurements (five levels: R, STI, ST2, ST3, P). The other factor was the factor ‘test’ (two levels: CTVF, CTVT). P < 0.05 denoted significance (*). For each stimulus condition, the differences between the periods were assessed by a one-way ANOVA with repeated measurements: factor period (R, STl, ST2, ST3, P) and method of contrasts. Results Ocular movements and dynamic balance of a subject during circular translation of the fixation point Figure 2 presents EOG recordings (two upper traces) and dynamic balance recordings (two lower traces) of a subject asked to binocularly fixate a target either through prisms (fig 2A, CTVF) or with the naked eyes (fig 2B, CTVT). When the target is stationary (R period) it appears that under both the A and B conditions neither the eye fixation task nor the dynamic body balance are disturbed. When the target is circularly translated (ST periods), either on a stationary background (fig 2B, CTVT) or simultaneously with the whole background due to a dioptric change (fig 2A, CTVF), EOG recordings indicated eye pursuit movements were similar under both conditions. The maximal amplitude of the vertical eye movement signal was smaller than the horizontal one. This might be due to a shunt effect of the bridge circuit used to isolate ho+ zontal and vertical movements. At the same time, dynamic balance recordings show some modifications characterised by the appearance of slow oscillations in the first two cycles of the target rotation. The oscillations were much more noticeable in CTVF recordings than in CTVT recordings and their periodicity, calculated by counting peaks, was found to be close to 8 s. Changes of mean parameters of anteroposterior dynamic balance during ocular pursuit movement Results of the two-way ANOVA performed on the three dynamic balance parameters for head and pivot are summarised in table I. For two parameters of the head (HMA, HLD) and of the pivot (PMA, PLD) both ‘test’ and ‘period’ effects were significant and showed a significant interaction (P < 0.001). Only the ‘period’ factor was significant for the parameter AvP (P < 0.001). Figure 3 gives the mean values (n = 32) of the three dynamic balance parameters for the five periods of CTVF and CTVT tests, for the head and for the pivot recordings. Statistical difference between periods assessed by the method of contrasts is indicated. During R period, HLD, HMA, PLD, PMA slightly differed according to the test condition. These parameters statistically increased during ST periods. However, this increase was much larger in the CTVF than in the CTVT condition. As a summary, fixation of a target while wearing the unmoving prisms increased moderately the MA and LD parameters (70%) but when the prisms were rotating, the parameter increases were 200% and 400%, respectively. During the P period of CTVF tests, PLD, PMA, HMA were still slightly higher than during the R period. Head and pivot underwent a clear forwards displacement (HAvP, PAvP) during ST periods. No significant difference was found between the effects of CTVF and CTVT for this parameter. At the end of the visual Table I. Results of the two-way ANOVA with repeated measurements ns, non significant. Balance pammeters PLD HLD PMA HMA PAvP HAvP Factor F = F = F = F = ‘test’ 66; P < 0.001 143; P < 0.001 90; P < 0.001 99; P < 0.001 F= 1;ns F = 0.1; ns performed on the measured dynamic balance parameters. Factor Interaction ‘period’ F = 38; P < 0.001 F = 50; P < 0.001 F = 64; P < 0.001 F = 55; P < 0.001 F = 9; P < 0.001 F = 7; P < 0.001 F F F F = = = = 33; 42; 37; 37; F= F = P P P P < 0.001 < 0.001 < 0.001 < 0.001 1;ns 0.5; ns 57 CTVF Q .*.*.*.*.*.*.*..Q .*.*.*.*.e.*.e.0 % 0 Amplitude (deg) (deg) “1 r*, Left “1 Left 0 -10 Amplitude CTVT B Right 0 I 1 20 10 I I 30 1 50 40 Time (s) -10 I 10 I 20 I 30 Backward I I 0 10 20 I 30 0 I I 40 50 Time (s) (cm) (cm) 5- Forward Backward -5 J 5- Forward O-1 Stabilogram _5 Backward 0 10 R -5 20 ST1 30 ST2 50 40 Time (s) ST3 P I 40 I 50 Time (s) R ST1 ST2 ST3 P Fig 2. Vertical and horizontal EOG: four upper traces. Ataxiograms and stabilograms in the anteroposterior plane: four lower traces. Traces were recorded simultaneously from subject 6 during fixation of the target: immobile (R and P) and describing a circular trajectory, either illusory (subjects wearing rotating prisms (A) or real (naked eyes, B) (ST). The dots indicate the instantaneous position of the fixation target during A or B. 58 HEAD PLD (cm) Linear Displacement ( LD ) 1 90 80 60 HLD (cm) 40: -****- CNF . 20 . 30 *** * I***- 7 70 A -*** PIVOT 50 - 40 r***, +-A_ F-c * ---- *** --- 30 20 R B CNT ST1 ST2 ST3 R HLD (cm) PLD (cm) 20. 20. -*- . I--** 0-T ” 5+.-e R ST1 ST2 Maximal Amplitude ( MA ) HMA (cm) A 10 ” ST3 m1 *-I k** P 10 IL I-* 10 0 ST1 ST2 ST3 P ST1 ST2 ST3 P I 10 . 0 P I R PMA (cm) 12 CTVF 6 6 4 0 R HMA (cm) 61 B -***- ST1 ST2 ST3 P ST2 ST3 P ** - R ST1 ST2 PMA (cm) -*** 7 -t* -*-Y Average Position ( AvP CNF ST1 HAvP (cm) Forward ) - *** R ST3 P ST1 ST2 ST3 P PAvP (cm) Forward 7 1.5 1.5 1 1 .5 .5 0 -***-r ***- 0 R ST1 ST2 ST3 P HAVP (cm) Forward R 1.5 ***- CNT . 1- R ST1 ST1 ST2 ST3 P ST3 P PAvP (cm) Forward -**_ B -I CNT R A k I-* l ** 2 ST2 ST3 P -**- v****- R *** ST1 - ST2 Fig 3. Means and standard deviations of sagittal balance parameters for 10-s periods: before (R), during (STs) and after (P) counter-clockwise target rotation. STs, tracking periods while wearing prisms (A) or naked eye (B) conditions. Significance of difference between two periods: *P < 0.05; **P < 0.01: ***P < 0.001. Reference position (O), head and stabilometer fixed horizontal. A Amplitude (cm) CTVF Ataxiagram 0 5 0 / Stabilogram Time (s) B Amplitude (cm) CTVT 5 Forward , , , , , , , , , I , , Ataxiagram Stabilogram -5 3ackward I I I I I , I , , , , I , , 10 20 I I I , , ,,‘I I t I I I , I , 30 I , I 40 - I 50 Time (s) Fig 4. Average (n = 16 subjects) sagittal ataxiagram and stabilogram (continuous curves) before (R), during (STs) and after (P) counter-clockwise target rotation starting at 3 o’clock due to prism rotation (A) or projector rotation (B). Dotted lines. mean-standard deviation. Dots. target position every 2 s (l/4 period). Crosses, theoretical position of the head for a rigid body, 60 stimulation neither the head nor the pivot returned to their initial position. Averaged stabi~ograms and ataxiograms Figure 4 illustrates the averaged recordings under the CTVF (A, IZ = 16) and under the CTVT condition (B, II = 16) with the same starting point: 3 o’clock. Under both conditions, continuous traces show mean ataxiogram and stabilogram while the intervals between a continuous trace and the corresponding dotted trace give the negative standard deviation from the mean. Standard deviations are approximately of the same amplitude in A and B. During R periods, under both conditions the stabilogram and the ataxiogram were almost flat. During the ST periods, modulation of the traces by circular translation of the target was observed. Under CTVF conditions the peak-to-peak deflections were large: about 7 cm for the pivot and 8 cm for the head. Under CTVT conditions they were small, approximately 1.5 cm in both curves, and in any case not greater than the standard deviation in these points (approximately 2.5 cm). The dynamic balance responses were stereotyped: head and pivot were at the backward maximum of their displacement when the gaze through prisms was deviated upward and conversely they were at their forward maximum when the gaze was downward. The amplitude of synchronous oscillations of the head was of greater amplitude than that of the pivot. It is worth noting that the theoretical values (indicated by crosses) of the head position computed from pivot position with the hypothesis of a rigid body are very close to the actual measured values. This suggests that the head stabilisation by angulation changes of the lower body segments could be considered as ineflicient. At the end of the circular translation of the target, the return of head and pivot traces to the zero reference level was longer in CTVF than in CTVT tests for which sagittal dynamic balance was little disturbed. Discussion The present work provides evidence that during visual pursuit of the target describing a circular translation, the movement of the background with the target (as in CTVF) is a factor of strong body instability and of synchronous oscillations in sagittal dynamic balance. The similar eye pursuit movements with a stationary background (as in CTVT) appear to be responsible for some instability, though for a lesser degree, which is in agreement with the results of Schulmann et al (1986). The experimental situations differed in the stimulus used to obtain the pursuit movements. The stimulus used in CTVT conditions (a small bright spot moving on a stationary background) is a typical pursuit stimulus. The stimulus used in CTVF conditions (a bright spot simultaneously moving with the background) is not so common a stimulus. However, it has been used by .Kowler et al (1984) to obtain smooth eye movements. During translation of the visual field the subjects never experienced self-motion in the opposite direction and the scene itself never appeared to stop moving, two characteristic features of visually-induced vection (Mach, 1875; Hehnholtz, 1896). This differs from the roll vection elicited by visual scene rotation around the observer’s line of sight (Dichgans and Brandt, 1978; van Asten et al. 1988). Although visual acuity underwent some reduction in CTVF, the target was conspicuous, even on the structured background. From subjects’ reports, the whole visual field, including the spot and the background, was always distinctly seen describing a circular trajectory. EOG recordings confirmed that eye movements elicited by the illusory displacements of the target were similar to those elicited by real target displacement (CTVT). Maximal amplitudes of horizontal and vertical signals were always comparable for each subject in CTVF and CTVT conditions. The similarity of eye movements in both cases allowed us to evaluate the role of retinal information in balance effects. In CTVF the large synchronous oscillations in body motion cannot be considered as retinal in origin since there is no significant motion information provided on the retina except for the small fluctuations in velocity error required for the pursuit task. Motion information is necessary to initiate but not to maintain the pursuit since a mechanism of prediction is involved (Barnes and Asselman, 1991). That suggests that the information from the oculomotor system plays a determinant role in somatic responses to the visual pursuit task whether this information comes from the extraocular muscle afferents (Cooper et al, 1955) or from neural oculomotor centres through corollary discharge or efferent copy (MC Closkey, 1981). A relationship between the contraction of extraocular muscles and postural muscles has been proposed by Gagey (1988). Roll et al (1991) showed that vibration of the inferior recti, equivalent to a muscle lengthening and consequently to an eye movement upwards, made subjects fall backwards. This is congruent with our results since, because of the platform configuration (see Materials and methods) it may be ascertained that an upward movement elicits primarily an extensor response (tilt backwards) whereas, in contrast, a downward movement of the visual target elicits 61 a flexor response (tilt forwards). So the eye movements could induce, without any motion retinal afferents, a signal responsible for the dynamic balance response. The present results suggest that under CTVT conditions, the simultaneous presence, along with the retinal stimulus initiating the pursuit task of retinal stimuli giving rise to information about motion in the opposite direction, suppressed the large synchronised responses induced by the ocular motor system. The motion of the image on the peripheral retina was also responsible for the suppression of motion perception of the visual field. Thus, there could be a relationship between visual motion perception and body stabilisation. In CTVF, the large synchronous oscillations that accompany the perception of visual field motion could be termed ‘postural pursuit’. Gregory (1975) has emphasised that the brain picks out features of the visual patterns that combine with its internal hypothesis to provide an adapted program of action. So the activities that require visual pursuit of a vertically moving target must be facilitated, by reducing synchronous oscillations of dynamic balance in the sag&al plane when the visual field is stationary and by enhancing these oscillations when the visual field is vertically moving in synchrony with the target. It is worth noting that such a pattern could be involved during locomotion. Twice in the step cycle the head of a subject describes in a frontal plane an elliptical translation movement with vertical axis (Steindler, 1964) and consequently the eyes of the subject looking at the goal towards which he walks describe an elliptical translation in the opposite direction. During the step period between midstance and toe-off the head is moving downwards and the eyes are moving upwards. At that time, all plantar flexor muscles are active. 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