For prognosis of the diagnostic possibilities of the stop stimulus and trapezoidal rotation programs with respect to the nystagmus response, 24 healthy young persons with normal auditory and vestibular analysers were studied experimentally. The trapezoidal program more accurately reflects the function and tone balance of the vestibular system than the stop stimulus program and causes the subject no unpleasant sensations during the study. Some optimum couples, acceleration and armchair rotation rate, necessary for effective deviation of the cupuloendolymphatic system were determined. The maximum angular velocity of the slow nystagmus component was more informative than nystagmus duration. The trapezoidal program is recommended for otoneurological practice and the maximum angular velocity of the slow nystagmus component as the basic index

Grigorova, V. K.

Popov, V. K.

Todorova, V. S.

English

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By
NASA TECHNICAL MEMORANDUM
	
NASA TM-76336
COMPARATIVE ASSESSMENT OF PROGNOSIS OF THE DIAGNOSTIC POSSIBILITIES
OF THE STOP-STIMULUS AND TRAPEZOIDAL ROTATION PROGRAMS
V.K. Grigorova, V.K. Popov and V.S. Todorova
Translation of "Sravnitel'naya otsenka dlya prognoza diag-
nosticheskikh vozmozhnostey vrashchatel'nykh programm--
stop-stimula i trapetseydal'noy," Vestnik Otorinolaringologii,
No. 2, Mar-Apr 1980, pp 30-33
(NASA-TM -76336) COMPARATIVE ASSESSMENT OF 	 N81-15676
PROGNOSIS OF ThL STUP 5114ULUS AND
TRAPEZOIDAL ROTA` 1ON PROGRAMS (National
Aeronautics and Space Administration) 9 p 	 Unclas
HC A02/MF A01	 CSCL 06E G5/52 13013
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NATIONAL AERONAUTICS AND SPACE ADMINISTRATION
WASHINGTON, D.C.	 SEPTEMBER 1980
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P«taalr»
 Orfewa .eNew GMTIES OF THE STOP-STIMULUS AND TRAPEZOI-
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I. AWhedd	 ,
 V.K.  Grigerov	 , V. K . Popov and ^. '..1.„.lM orrM•elaeq 4"wo me.
V.S. Todorova, Vestibular System Biome-
chanics Section, Institute of Mechanics
». MeAt Wit me,
and Biomechanics, Bulgarian Academy of
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Translation
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National Aeronautics and Space Adminis- 14. ^ a apweyCWO
tration, Washington, D.C.
	 20546
li. 2vhl...wt«^ NeNe
Translation of "Sravnitel e naya otsenka dlya prognoza diag-
nosticheskikh vozmozhnostey vrashchatel r nykh programm --
stop-stimula i trapetseydal e noy," Vestnik Otorinolai•ingologii,
No.	 2, Mar-Apr 1980, pp 30--33
Is	 A► •rreer
kor prognosis of the diagnostic possibilities of the stop-stimulus and
trapeobidal rotation programs, with respect to the nystagmus response,
24 healthy young persons with normal auditory and vestibular analysers
were studie4 experimentally. 	 The trapezoidal program more a0curatealy
reflects the function and tone-balance of the vestibular system than the
stop-stimulus program and causes the subject no unpleasant senoations
during the study.	 Some optimum couploo, acceleration and airmehair rota-
tion rate, necessary for effective deviatioci of the eupuloendolymphatic
system, were determiiied.	 'rho maximum angular velocity of the olow
nyata6puo oomporzent was more inform.xtive than tzyzetaa^,-nuo duration.	 llie -
trapezoidal prodi-am is L re'vummendo(i for otoneurolo ical practice acid the
maximum angular velocity .of the slow nvata 6muo compo notit, as the basic
index.
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ANNOTATION
An experimental study was conducted for prognosis of the diagnostic
possibilities of two rotation programs (stop-stimulus and trapezoidal)
with respect to the nystagmus response. Twenty-four healthy young
persons with normal auditory and vestibular analyzers were studied. It
is evident from the results obtained that the trapezoidal program re-
flects the function and tone balance of the vestibular system more
accurately than the stop-stimulus program, and that it causes the test
subjects no unpleasant sensations during the study. Some optimum
couples also were determined (acceleration and armchair rotation rate),
necessary for effective deviation of the cupuloendolymphatic system.
Of the two indices considered, itie maximum angular velocity of the slow
nystagmus component is more informative than nystagmus duration. The
trapezoidal program is recommended for otoneurological practice and the
maximum angular velocity of the slow nystagmus component, as the basic
index.
11
COMPARATIVE ASSESSMENT OF PROGNOSIS OF THE DIAGNOSTIC POSSIBILITIES
OF THE STOP-STIMULUS AND TRAPEZOIDAL ROTATION PROGRAMS
V.K. Grigorova, V.K. Popov and V.S. Todorova
Vestibular System Biomechanics Section, Institute of Mechanics
and Biomechanics, Bulgarian Academy of Sciences, Sofia
The Barany test [11 is one of the basic tests which, in connection
	 /!
with the simplicity of the equipment used and procedure, is used in
otoneurological practice. With improvement in the design and introduc-
tion of special electrical rotating armchairs with recording devices,
the trapezoidal program has become popular. In using it, the rotational
and postrotational nystagmus is recorded simultaneously, and the test
subject does not have such a degree of pronounced unpleasant sensations
as in stop-stimulus.
Various experimenters use stimuli of varied magnitude in the
trapezoidal program. i,'or example, A.Ye. Kurashvili and V.I. Babnyak
[41 used a 20 0 /sec angular acceleration and an 80°/sec maximum angular
rotation rate in their studies.
According to the principle of Mulder [1908], the deviation of the
cupula equals the product of the acceleration and the time of action.
The question arises as to which are the most effective and informative
limits, within which the principle of Mulder is utilized.
Material and Method
The study was conducted on healthy people (24 men from 17 to 28
years old), withoc.t sulective or objective data on diseases of the
auditory or vestibular analyzers. Two rotation programs were performed,
by mean: of a Tonnies type electrically rotating armchair: stop-stimulus
from rotation at an nnFaA lar velocity of 90 0 1sec to the rlgjit and left,
and trapezoidal rotation with the following angular accelerations and
2	 1	 ,
velocities:	 4 1 /sec , 40°!sec; 8 0 jsec ` , q 0 o /sec; 12 0 1' sec ' , 120 011 sec;
Numbers in the margin indicate pagination I.n the foreign text.
1
20°/sect, 160 0 /sec; 30°/sec 2 , 180 0 /sec; 40°/sec t , 1800 /sec. Rotation
was performed in both directions ( alternation of left and right rota-
tion). Each program was performed on different days. 	 Postrotational
nystagmus was recorded for the stop response after rotation in both
directions. In performance of the trapezoidal program, the rotational
(during positive acceleration) and postrotational ( during negative accel-
eration) nystagmus was recorded for each acceleration.
In both rotation programs, we noted 2 nystagmus indices, the dura-
tion of the response and the maximum angular velocity of the slow
nystagmus component. Selection of the indices was determined by the
fac t; tha t the duration of :, response was .letermined to a greater ex-
tent by the functional state of the central nervous system than by
processes in the peripheral vestibular system 131 and, on the other
hand, the angular velocity of the slow nystagmus f^omponent completely
reflects the activity of the receptors of the vestibular system
[Henriksson, 19551.
Results and Discussion
The average duration of nystagmus in both programs is presented in
Table 1. The results obtained and statistical processing according to
Student-Fisher indicate the lack of significant difference in the dura-
tion of the nystagmus response, despite stimuli of different strengths.
The regularities determined are consistent with the statement of
Mittermaier [1965], according to whom, thp duration of the response
depends little on stimulus strength.
After calculating the percent asymmetry between the rotational and
postrotational nystagmus separately for both rotations in the trapezoidal
program, according to the formula of Visser [5], we determined that the
postrotational nystagmus (with negative acceleration) is longer than the
rotational (with positive acceleration) nystagmus, in accordance with
the hypothesis of Rg rany [1] and the theory of V.I. Hoyachek [2], on
detonations in the vestibular centers.
Hp sed on the results obtained, it can te stated that the duration
f
of the response is a poorly informative index. The ratio of the dura-
tion of the rotational and postrotational nystagmus in the trapezoidal
program is more informative. A perturbation of this relationship, with
the development of asymmetry in favor of rotational nystagmus and u
difference of 15% or more, can be a pathological manifestation in the
vestibular system. However, this requires experimental confirmation.
TABLE 1. DURATION OF NYSTAGMUS (SEC) IN USE OF
TRAPEZOIDAL AND STOP-STIMULUS ROTATION PROGRAMS
b
5 ^.:.... HO,
f
a
C AfNMMe7Q011, %
g apantenne
h aneao	 1i anpaao
J	 _.
Y''	 50
4.	 ^.C'F
1Cs r o- 90
t t'. t1^ 5^,0 7,35.D 1,61-+S
1'.36 14,63-1) 5,03--s
4	 ,75 92 45,33 I3.37--o!) 7,61— S
4", 9^ ":^ 46,33 12.8-+I) 15,71^S
44.75 :;:,,;, 42,42 16,61-.D 9,58-45
44,42
_
3:	 .
T
4-,50 1	 I6,13--D 12,33-+S
4 7 .52	 1 1^,39	 I I	 3,73--oD
Note: Here and in Table 2, - ►D is predominance of nystagmus
duration to the rigr.t; ^S is predominance of nystagmus dura-
tion to the left.
Key:	 a. Acceleration, degree/sec t g. Rotation
b. Acceleration h. To the left
c. Asymmetry, % i. To the right
d. Initial J. During left rotation
e. Final k. During right rotation
f. Direction of nystagmus 1. Stop from 90
What can be said of the magnitude of the stimulus and its dura-
tion? Data are presented in Table 2, on the averaged maximum angular
velocities of the slow component of the nystagmus response, after the
stop-stimulus and during rotation in the trapezoidal program. The
asymmetry between the rotational and postrotational nystagmus was
calculated separately for left and right rotation, by the formula of
Visser [5].
/32
ORIGINAL PAGE IS
	 3
OF POOR QUALITY
TABLE 2. MAXIMUM ANGULAR VELOCITY OF SLOW NYSTAGMUS
COMPONENT (DEGREE/SEC 2 ) DURING USE OF THE TRAPEZOIDAL
AND STOP--STIMULUS ROTATICN PROGRAMSb; 
n . exec	
pp	
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i enrae^	 ha.1eao h avean i anpaao
^::	 a;:.,:	 rfHU n.ocn
	 kn,a n,ao;easri n nraan
4	 Y4,82	
1
36,4 40,1 33.1 2-+S 8,7-►D
t5,., 44 ,s7 49,89 43,6 I -.S 6,7- D
60,48 ,',85 63.37 57,63 _^ 2-+S 4,7- D0
2	 91 .34 89,77 93,2 58.9 1-+S
30	 101,87) 518,47 108.79	 i 106,06 1,7-*S
n	 1.,0	 140	 ,^	 ^	 :	 .-^>	 ;	 _,1	 ^ x•26	nr^,s.	 ^ 109,34 a .9-.s 7,a-.D
1 CTOn OT 90  64,28 65,22 t1,73-►S
Key:	 a. Acceleration, degree/sec 2 g. Rotation
b. Acceleration h. To the left
c. Asymmetry, % i. To the right
d. Initial J. During left rotation
e. Final k. During right rotation
f. Direction of nystagmus 1. Stop from 90
During rotation with a 30 0 /sec 2 acceleration and 180 0 /sec velocity,
i.e., during a 6 sec stimulus time, almost symmetrical nystagmus
responses are obtained in both directions. Consequently, during the
so called physiological acceleration of 30 0 /sec 2 , in the time required
for effective deviation of the cupuloendolymphatic system, a tone
balance is observed in healthy persons, which is expressed by the max-
imum velocity of the slow nystagmus component. However, the magnitude
of this acceleration is substantial, and its use in clinical practice
is not advisable.
In connection with what was stated above on the stimulus and its
duration, an optimum couple must be selected (acceleration and rotation
rate), which simultaneously is sufficient to reach the maximum angular
velocity of the slow nystagmus component, i.e., effective deviation of
the cupuloendolymphatic system.
For this purpose, we studied groups of healthy persons in the
trapezoidal program, with a series of experimental accelerations. The
following optimum pairs were obtained (acceleration and rotation rate):
4
. .
4 0 4'sec
2
, BO O /see; 60/sec 2 1000 /sec; 8°/sect, 120 0 /sec; 12°/sect,
150°/sec; 200 /sec , 160 0sec; 30 0 /sec 2 , 180 0 /sec. The results presented
above concern only positive accelerations.
For clinical diagnosis, a pair (acceleration and velocity) must
be selected, which is the most appropriate for a given case.
Conclusions
1. The trapezoidal program is more informative than the stop-
stimulus, since it more accurately reflects the function and tone
balance of both vestibular systems, and it does not cause the test
subject unpleasant sensations.
2. The maximums angular velocity of the slow nystagmus component
in the trapezoidal program gives considerable information on the func-
tion and excitability of the vestibular system, and it can be used as /33
the basic index in otoneurological diagnosis.
REFERENCES
1. Barany, R., Mschr. Ohrenheilk. 40, 127 (1906).
2. Boyachek, V.I., Zh. ushi., nos. i gorl. bol. 3-4, 121-248 (1927).
3. Khilov, K.L., Funktsiya organa ravnovesiya i bolezn'_ge_redvizheni-ra
[Function of the Organ of qu	 r um and Motion Sicknessj,
Leningrad, 1969•
4. Kurashvili, A.Ye. and V.I. Babiyak, Fiziolo icheski a funktsii
vestibul arno sistem
	
[Physiological unct ons of the
eat u aL= Systemj, Leningrad, 1975.
5. Visser, S.Z., Psychiat. Neurol. Neurochir. 66, 24 (1963).
I/
*7o
 c ,AIo fiR , Ale' s ^^ ^^,	 •
6


Comparative assessment of prognosis of the stop stimulus and trapezoidal rotation programs

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