High-Velocity Angular Vestibulo-Ocular Reflex Adaptation to Position Error Signals

Vestibular rehabilitation strategies including gaze stabilization exercises have been shown to increase gain of the angular vestibulo-ocular reflex (aVOR) using a retinal slip error signal (ES). The identification of additional ESs capable of promoting substitution strategies or aVOR adaptation is an important goal in the management of vestibular hypofunction. Position ESs have been shown to increase both aVOR gain and recruitment of compensatory saccades (CSs) during passive whole body rotation. This may be a useful compensatory strategy for gaze instability during active head rotation as well. In vestibular rehabilitation, the imaginary target exercise is often prescribed to improve gaze stability. This exercise uses a position ES; however, the mechanism for its effect has not been investigated. We compared aVOR gain adaptation using 2 types of small position ES: constant versus incremental.