A modified two-dimensional sensory organization test that assesses both anteroposterior and mediolateral postural control

BackgroundThe Sensory Organization Test (SOT) was designed to measure changes in postural control in response to unreliable visual and/or proprioceptive feedback. However, secondary to the manipulation of sensory cues in only the sagittal plane, the SOT is capable of only describing postural control in a single direction. The present study aimed to characterize postural responses to a modified SOT designed to concurrently challenge both anteroposterior and mediolateral postural control.MethodsTwenty-one healthy adult volunteers (30.6 ± 10.2 years) completed the standard anteroposterior one-dimensional (1D) SOT, in addition to a modified SOT with the support surface sway-referenced to both anteroposterior and mediolateral postural sway (two-dimensional, 2D). Our primary analysis concerned a comparison of mediolateral, as well as anteroposterior postural sway measured during the standard one-dimensional (i.e., pitch tilt) and the novel two-dimensional (i.e., roll and pitch tilt) sway-referenced paradigms. Here, postural sway was quantified by calculating the root mean square distance (RMSD) of the center of pressure (CoP) during each trial.ResultsOur data showed that the 2D sway-referenced conditions yielded a selective increase in mediolateral postural sway relative to the standard 1D conditions for both wide (η2 = 0.66) and narrow (η2 = 0.78) stance conditions, with anteroposterior postural sway being largely unaffected (η2 = 0.001 to 0.103, respectively). The ratio between mediolateral postural sway in the sway-referenced conditions and postural sway in the corresponding stable support surface conditions was greater for the 2D (2.99 to 6.26 times greater) compared to 1D paradigms (1.25 to 1.84 times greater), consistent with a superior degradation of viable proprioceptive feedback in the 2D paradigm.ConclusionA modified 2D version of the SOT was shown to provide a greater challenge to mediolateral postural control relative to the standard 1D SOT protocol, putatively as a result of a superior capacity to degrade proprioceptive feedback in the mediolateral direction. Given these positive findings, future studies should investigate the clinical utility of this modified SOT as a means by which to better characterize sensory contributions to postural control in the presence of various sensorimotor pathologies, including vestibular hypofunction

Increased roll tilt thresholds are associated with subclinical postural instability in asymptomatic adults aged 21 to 84 years

BackgroundBalance assessments that intentionally alter the reliability of visual and proprioceptive feedback (e.g., standing on foam with eyes closed) have become a standard approach for identifying vestibular mediated balance dysfunction in older adults. However, such assessments cannot discern which specific element of the vestibular system (e.g., semicircular canal, otolith, or combined canal-otolith) underlies the observed age-related changes in balance performance. The present study was designed to determine the associations between specific sources of vestibular noise and quantitative measures of quiet stance postural control measured during standard “vestibular” balance conditions.MethodsA group of 52 asymptomatic adults (53.21 ± 19.7, 21 to 84 years) without a history of vestibular or neurologic disorders volunteered for this study. We measured a battery of five vestibular perceptual thresholds that assay vestibular noise with predominant contributions from the vertical canals, lateral canals, utricles, saccules, and the centrally integrated canal-otolith signal. In addition, participants completed two standard balance assessments that were each designed to prioritize the use of vestibular cues for quiet stance postural control—eyes closed on foam (Condition 4 of the Modified Romberg Balance Test) and eyes closed, on a sway referenced support surface (Condition 5 of the Sensory Organization Test).ResultsIn age adjusted models, we found strong positive associations between roll tilt vestibular thresholds, a measure of noise in the centrally integrated canal-otolith signal, and the root mean square distance (RMSD) of the anteroposterior and mediolateral center of pressure (CoP) captured during eyes closed stance on a sway referenced support surface. The strength of the association between roll tilt thresholds and the RMSD of the CoP was between 3-times and 30-times larger than the association between postural sway and each of the other vestibular thresholds measured.ConclusionWe posit that noise in the centrally estimated canal-otolith “tilt” signal may be the primary driver of the subclinical postural instability experienced by older adults during the “vestibular” conditions of balance assessments. Additional testing in adults with clinical balance impairment are needed to identify if roll tilt thresholds may also serve as a surrogate metric by which to detect vestibular mediated balance dysfunction and/or fall risk

Alignment of angular velocity sensors for a vestibular prosthesis

Vestibular prosthetics transmit angular velocities to the nervous system via electrical stimulation. Head-fixed gyroscopes measure angular motion, but the gyroscope coordinate system will not be coincident with the sensory organs the prosthetic replaces. Here we show a simple calibration method to align gyroscope measurements with the anatomical coordinate system. We benchmarked the method with simulated movements and obtain proof-of-concept with one healthy subject. The method was robust to misalignment, required little data, and minimal processing

Determining thresholds using adaptive procedures and psychometric fits: evaluating efficiency using theory, simulations, and human experiments

When measuring thresholds, careful selection of stimulus amplitude can increase efficiency by increasing the precision of psychometric fit parameters (e.g., decreasing the fit parameter error bars). To find efficient adaptive algorithms for psychometric threshold (“sigma”) estimation, we combined analytic approaches, Monte Carlo simulations, and human experiments for a one-interval, binary forced-choice, direction-recognition task. To our knowledge, this is the first time analytic results have been combined and compared with either simulation or human results. Human performance was consistent with theory and not significantly different from simulation predictions. Our analytic approach provides a bound on efficiency, which we compared against the efficiency of standard staircase algorithms, a modified staircase algorithm with asymmetric step sizes, and a maximum likelihood estimation (MLE) procedure. Simulation results suggest that optimal efficiency at determining threshold is provided by the MLE procedure targeting a fraction correct level of 0.92, an asymmetric 4-down, 1-up staircase targeting between 0.86 and 0.92 or a standard 6-down, 1-up staircase. Psychometric test efficiency, computed by comparing simulation and analytic results, was between 41 and 58 % for 50 trials for these three algorithms, reaching up to 84 % for 200 trials. These approaches were 13–21 % more efficient than the commonly used 3-down, 1-up symmetric staircase. We also applied recent advances to reduce accuracy errors using a bias-reduced fitting approach. Taken together, the results lend confidence that the assumptions underlying each approach are reasonable and that human threshold forced-choice decision making is modeled well by detection theory models and mimics simulations based on detection theory models.National Institute on Deafness and Other Communication Disorders (U.S.) (Grants R01-DC04158, R56-DC12038 and R03-DC013635

The role of vestibular cues in postural sway

Controlling posture requires continuous sensory feedback about body motion and orientation, including from the vestibular organs. Little is known about the role of tilt vs. translation vs. rotation vestibular cues. We examined whether intersubject differences in vestibular function were correlated with intersubject differences in postural control. Vestibular function was assayed using vestibular direction-recognition perceptual thresholds, which determine the smallest motion that can be reliably perceived by a subject seated on a motorized platform in the dark. In study A, we measured thresholds for lateral translation, vertical translation, yaw rotation, and head-centered roll tilts. In study B, we measured thresholds for roll, pitch, and left anterior-right posterior and right anterior-left posterior tilts. Center-of-pressure (CoP) sway was measured in sensory organization tests (study A) and Romberg tests (study B). We found a strong positive relationship between CoP sway and lateral translation thresholds but not CoP sway and other thresholds. This finding suggests that the vestibular encoding of lateral translation may contribute substantially to balance control. Since thresholds assay sensory noise, our results support the hypothesis that vestibular noise contributes to spontaneous postural sway. Specifically, we found that lateral translation thresholds explained more of the variation in postural sway in postural test conditions with altered proprioceptive cues (vs. a solid surface), consistent with postural sway being more dependent on vestibular noise when the vestibular contribution to balance is higher. These results have potential implications for vestibular implants, balance prostheses, and physical therapy exercises.NEW & NOTEWORTHY Vestibular feedback is important for postural control, but little is known about the role of tilt cues vs. translation cues vs. rotation cues. We studied healthy human subjects with no known vestibular pathology or symptoms. Our findings showed that vestibular encoding of lateral translation correlated with medial-lateral postural sway, consistent with lateral translation cues contributing to balance control. This adds support to the hypothesis that vestibular noise contributes to spontaneous postural sway

The Confidence Database

Understanding how people rate their confidence is critical for the characterization of a wide range of perceptual, memory, motor and cognitive processes. To enable the continued exploration of these processes, we created a large database of confidence studies spanning a broad set of paradigms, participant populations and fields of study. The data from each study are structured in a common, easy-to-use format that can be easily imported and analysed using multiple software packages. Each dataset is accompanied by an explanation regarding the nature of the collected data. At the time of publication, the Confidence Database (which is available at https://osf.io/s46pr/) contained 145 datasets with data from more than 8,700 participants and almost 4 million trials. The database will remain open for new submissions indefinitely and is expected to continue to grow. Here we show the usefulness of this large collection of datasets in four different analyses that provide precise estimations of several foundational confidence-related effects

Environmental Noise in Advanced LIGO Detectors

The sensitivity of the Advanced LIGO detectors to gravitational waves can be affected by environmental disturbances external to the detectors themselves. Since the transition from the former initial LIGO phase, many improvements have been made to the equipment and techniques used to investigate these environmental effects. These methods have aided in tracking down and mitigating noise sources throughout the first three observing runs of the advanced detector era, keeping the ambient contribution of environmental noise below the background noise levels of the detectors. In this paper we describe the methods used and how they have led to the mitigation of noise sources, the role that environmental monitoring has played in the validation of gravitational wave events, and plans for future observing runs

Balance Screening of Vestibular Function in Subjects Aged 4 Years and Older: A Living Laboratory Experience

To better understand the various individual factors that contribute to balance and the relation to fall risk, we performed the modified Romberg Test of Standing Balance on Firm and Compliant Support, with 1,174 participants between 4 and 83 years of age. This research was conducted in the Living Laboratory® at the Museum of Science, Boston. We specifically focus on balance test condition 4, in which individuals stand on memory foam with eyes closed, and must rely on their vestibular system; therefore, performance in this balance test condition provides a proxy for vestibular function. We looked for balance variations associated with sex, race/ethnicity, health factors, and age. We found that balance test performance was stable between 10 and 39 years of age, with a slight increase in the failure rate for participants 4–9 years of age, suggesting a period of balance development in younger children. For participants 40 years and older, the balance test failure rate increased progressively with age. Diabetes and obesity are the two main health factors we found associated with poor balance, with test condition 4 failure rates of 57 and 19%, respectively. An increase in the odds of having fallen in the last year was associated with a decrease in the time to failure; once individuals dropped below a time to failure of 10 s, there was a significant 5.5-fold increase in the odds of having fallen in the last 12 months. These data alert us to screen for poor vestibular function in individuals 40 years and older or suffering from diabetes, in order to undertake the necessary diagnostic and rehabilitation measures, with a focus on reducing the morbidity and mortality of falls