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J Neurophysiol (December 1, 2002). 10.1152/jn.00404.2002
Submitted on 30 May 2002
Accepted on 15 August 2002
RAPID COMMUNICATION
Departments of 1Otolaryngology
Head and
Neck Surgery, 2Biomedical Engineering, and
3Neuroscience, The Johns Hopkins University
School of Medicine, Baltimore, Maryland 21287-0910
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ABSTRACT |
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Clendaniel, Richard A., David M. Lasker, and Lloyd B. Minor. Differential Adaptation of the Linear and Nonlinear Components of the Horizontal Vestibuloocular Reflex in Squirrel Monkeys. J. Neurophysiol. 88: 3534-3540, 2002. Previous work in squirrel monkeys has demonstrated the presence of linear and nonlinear components to the horizontal vestibuloocular reflex (VOR) evoked by high-acceleration rotations. The nonlinear component is seen as a rise in gain with increasing velocity of rotation at frequencies more than 2 Hz (a velocity-dependent gain enhancement). We have shown that there are greater changes in the nonlinear than linear component of the response after spectacle-induced adaptation. The present study was conducted to determine if the two components of the response share a common adaptive process. The gain of the VOR, in the dark, to sinusoidal stimuli at 4 Hz (peak velocities: 20-150°/s) and 10 Hz (peak velocities: 20 and 100°/s) was measured pre- and postadaptation. Adaptation was induced over 4 h with ×0.45 minimizing spectacles. Sum-of-sines stimuli were used to induce adaptation, and the parameters of the stimuli were adjusted to invoke only the linear or both linear and nonlinear components of the response. Preadaptation, there was a velocity-dependent gain enhancement at 4 and 10 Hz. In postadaptation with the paradigms that only recruited the linear component, there was a decrease in gain and a persistent velocity-dependent gain enhancement (indicating adaptation of only the linear component). After adaptation with the paradigm designed to recruit both the linear and nonlinear components, there was a decrease in gain and no velocity-dependent gain enhancement (indicating adaptation of both components). There were comparable changes in the response to steps of acceleration. We interpret these results to indicate that separate processes drive the adaptation of the linear and nonlinear components of the response.
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INTRODUCTION |
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The angular
vestibuloocular reflex (AVOR) will alter its behavior to minimize image
motion across the retina during head movements in response to natural
phenomenon such as aging or illness as well as in response to
experimental manipulations. Spectacles that either magnify or minimize
the visual world will lead to changes in the AVOR that are in the
appropriate direction to foster image stabilization on the retina
(Miles and Eighmy 1980
). For example, when tested in the
dark with sinusoidal rotations of 0.5-2.0 Hz, monkeys that wore ×2
spectacles developed increased AVOR gains (1.5-1.8), and monkeys that
wore ×0 minimizing spectacles developed decreased AVOR gains
(0.2-0.3) (Lisberger 1984
; Lisberger and Pavelko
1986
). The complexities of AVOR adaptation in response to
manipulations of the visual inputs have been described in numerous other studies (Bello et al. 1991
; Gonshor and
Melvill Jones 1976a
,b
; Khater et al. 1993
;
Melvill Jones and Davies 1976
; Shelhamer et al.
1992
; Yakushin et al. 2000
).
Frequency selectivity has been demonstrated in the process that
mediates AVOR adaptation. Monkeys that were rotated at a single frequency of either 0.2 or 2.0 Hz while wearing magnifying or minimizing spectacles and then tested over a range of frequencies (0.1-4 Hz) showed the greatest changes in gain at the adapting frequency (Lisberger et al. 1983
). When monkeys were
adapted using training frequencies of 0.5, 2, 5, 8, or 10 Hz, the
greatest changes in gain and the greatest degree of frequency
specificity were observed after adaptation with the lowest frequency
stimuli (Raymond and Lisberger 1996
). The gain changes
after adaptation at the higher frequencies were less robust and less
frequency specific.
We have recently described a velocity-dependent gain enhancement in the
horizontal AVOR for rotational frequencies >2 Hz (Minor et al.
1999
). This nonlinear behavior of the horizontal AVOR is also
seen in the response to steps of acceleration, where the gain during
the acceleration portion of the stimulus is significantly greater than
that during the constant velocity portion of the stimulus. In addition,
the relationship between head and eye velocity during the initial
portion of an acceleration step is nonlinear, as it is best fit with a
polynomial equation containing a cubic term rather than a linear
equation. We have also shown that this nonlinear component of the
response demonstrates greater modification than the linear component
with adaptation to magnifying and minimizing spectacles
(Clendaniel et al. 2001
). After wearing magnifying spectacles for 1 wk, the squirrel monkeys not only demonstrated increases in gain, but there was a greater increase in the
velocity-dependent gain enhancement for responses to sinusoidal
rotations. In addition, during steps of acceleration, there was a
greater increase in gain during the acceleration portion of the
stimulus as compared with that during the constant velocity portion of
the stimulus. After similar adaptation with minimizing spectacles, the
velocity-dependent gain enhancement was abolished. Our mathematical
model of the vestibular system, developed to explain the behavioral
responses observed in normal monkeys and monkeys after unilateral
labyrinthectomy or canal plugging, and after spectacle-induced
adaptation, contains separate linear and nonlinear pathways, both of
which contain separate adaptation processes. Due to the greater changes
in the nonlinear component of the response after spectacle-induced
adaptation, we hypothesized that the two components of the response
could be adapted separately.
The purpose of the current experiment was to determine if the linear
and nonlinear components of the response were under differential adaptive control. By using the frequency- and velocity-dependent nature
of the nonlinear component, we were able to devise adaptation stimuli
that would invoke only the linear component or both the linear and
nonlinear components. If the neural signals that generate the linear
and nonlinear components of the response combine prior to the adaptive
element (1 central adaptation element
Fig.
1A), then adaptation paradigms
that only recruit the linear component should demonstrate adaptive
changes in both the linear and nonlinear components of the response. If
the neural signals that generate the linear and nonlinear components
combine after the adaptive elements (2 adaptation elements
Fig.
1B), then adaptation paradigms that only recruit the linear
component should demonstrate adaptive changes solely in the linear
component of the response. The results from the present experiment
support the later hypothesis. We show that there is modification of the
nonlinear component of the response only when the rotational stimuli
used during the adaptation process recruit that portion of the
response.
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METHODS |
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Surgical procedures and eye-movement recording
The surgical and experimental procedures used for recording eye
movements with the scleral search coil technique were identical to
those that have previously been described for this laboratory (Minor et al. 1999
). Each animal was seated in a plastic
chair with its head restrained by securing the implanted bolt to a
chair-mounted clamp. The chair was connected to a superstructure that
was mounted to the top surface of a servo-controlled rotation table
capable of generating a peak torque of 125 N-m (Acutronic, Pittsburgh, PA). The horizontal VOR was tested with the animal seated in the upright position in the superstructure and aligned such that the horizontal canals were in the earth-horizontal plane of rotation.
Rotational testing
The AVOR was measured in darkness pre- and postadaptation. The step stimuli consisted of 3,000°/s2 accelerations to a peak velocity of 150°/s followed by a plateau of head velocity lasting 0.9-1.1 s and then deceleration at 3,000°/s2 to rest. The direction, duration, and interstimulus interval were varied randomly from one trial to the next. Sinusoidal head rotations were 0.5-15 Hz, peak velocity 20-150°/s, and each stimulus frequency was given for 60 s. The order in which different frequencies and velocities were tested was varied.
Adaptation paradigms
To induce adaptation, monkeys were fit with minimizing (×0.45)
spectacles that were attached to the acrylic skullcap. Adaptation was
induced over 4 h with the minimizing spectacles combined with three different sum-of-sines stimuli. The high-frequency
high-velocity (HF-HV) stimulus had component signals of 2.3, 4.0, and 5.9 Hz, each
with a peak velocity of 30°/s. As we will show, this stimulus contained frequencies and velocities sufficient to recruit both the
linear and nonlinear components of the response. The
high-frequency
low-velocity (HF-LV) stimulus had component signals
with frequencies identical to the HF-HV paradigm, each with a peak
velocity of 10°/s. While this stimulus contained frequencies of
sufficient intensity, the velocities were below the threshold for the
nonlinear component of the response. The low-frequency
high-velocity
(LF-HV) stimulus had component signals of 0.3, 0.5, and 1.4 Hz, each
with a peak velocity of 30°/s. This stimulus contained velocities of
sufficient intensity, but the frequencies were below the level
necessary to engage the nonlinear component of the response.
Consequently, only the linear component was recruited during the HF-LV
and LF-HV stimulus paradigms. After postadaptation testing, the
spectacles were removed, and the monkeys were allowed to recover in
their normal environment. There was
1 wk between adaptation sessions. Each animal underwent a different sequence of adaptation paradigms.
Data analysis
The data were analyzed off-line using software that we wrote in
the Matlab (The Math Works) programming environment. The methods of
analysis are similar to those that we have described previously (Lasker et al. 1999
; Minor et al. 1999
).
Measurements of the gain of the VOR for the
3000°/s2 to 150°/s steps were made during two
components of the stimulus: the acceleration portion of the stimulus
and after the plateau of head velocity had been reached. The
acceleration gain of the VOR, GA, was
measured for each trial as the ratio of the slope of a line through the
eye-velocity points to the slope of a line through the head-velocity
points during a 20-ms period starting 20 ms after the onset of the
stimulus. The velocity gain of the VOR,
GV, was measured from the ratio of the
mean slow component eye and head velocity evaluated 100-300 ms after
the plateau head velocity had been reached for each trial.
To determine the relationship between head and eye velocity during the
initial portion of the step of acceleration, an average response to the
steps of acceleration was obtained from 10 to 30 trials in each
direction. First- through fifth-order polynomial fits were made to the
head- and eye-velocity data extending from 10 to 40 ms after the onset
of the stimulus. The order of the polynomial necessary and sufficient
to account for the trajectory of the response was specified by the
Bayesian information criterion (BIC) (Cullen et al.
1996
; Galiana et al. 1995
; Schwarz
1978
). This analytic method takes into account the decrease in
the difference between the fit and the data that will occur simply from
the addition of high-order parameters to the model and weighs this
decrease against the order of the model (Schwarz 1978
).
A reduction in BIC value justifies the use of a more complex (higher
order) model, whereas an unchanged or increased value of BIC indicates
that no additional information is obtained from an increase in the complexity of the model.
For the sinusoidal rotations, eye-position data were differentiated
with a four-point central difference algorithm to obtain eye velocity.
Saccades were removed through an interactive program from responses at
frequencies <4 Hz, and an average cycle was obtained based on the data
representing slow phase eye velocity at each point in time. Responses
at frequencies
4 Hz were not desaccaded, and only cycles without
saccades were included in the analysis. Successive cycles were
averaged. The amplitude and phase of the response fundamental were
obtained from a Fourier analysis as were the corresponding values for
the head-velocity signal. Gains and phases for eye with respect to head
velocity were expressed with the convention that a unity gain and zero phase imply a perfectly compensatory VOR. A negative phase indicates that eye movements lag head movements.
Statistical analysis
Results were described as means ± SD. Repeated-measures ANOVA was used to compare the data from more than two groups. Post hoc t-tests or one-way ANOVA tests were performed when the ANOVA demonstrated significant main effects or interactions, and the post hoc analyses are reported in RESULTS. Paired t-tests were used when preadaptation and postadaptation data in each animal were analyzed.
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RESULTS |
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Responses to sinusoidal rotations
There was a significant reduction in gain after all three
adaptation paradigms. During sinusoidal testing from 0.5 to 12 Hz (peak
velocity of 20°/s), there was on average a 23.8% decrease in gain
(Fig. 2A). The gain values at
each testing frequency under a given adaptation paradigm were analyzed
using a one-way ANOVA to determine if there were any frequency-specific
effects. There was no significant effect of frequency under any
adaptation paradigm (P values ranged from 0.59 to 0.95). In
addition, post hoc analyses with Fisher's pairwise comparisons
revealed no significant difference between any two frequencies. Thus
the gain was uniform across testing frequencies, indicating that there
was no frequency-specific adaptation as a result of the different
stimulus parameters. There was no difference in the overall reduction
in gain among the different adaptation paradigms when tested at
20°/s. Analysis of the responses to 4-Hz stimuli with peak velocities
of 20, 50, 100, and 150°/s are depicted in Fig. 2B. After
adaptation with the HF-LV stimulus, there was a marked reduction in
gain, yet the velocity-dependent gain enhancement was still present
(20°/s = 0.56 ± 0.12; 150°/s = 0.72 ± 0.16, P < 0.05). A similar reduction in gain, with
preservation of the velocity-dependent gain enhancement, was noted
postadaptation with the LF-HV stimulus (20°/s = 0.56 ± 0.09; 150°/s = 0.69 ± 0.09, P < 0.05).
After adaptation with the HF-HV stimulus, there was both a decrease in
gain and a loss of the velocity-dependent gain enhancement
(20°/s = 0.52 ± 0.02; 150°/s = 0.54 ± 0.08, P > 0.1). These results indicate that the adaptation
paradigms that only recruit the linear component of the response were
sufficient to induce a decrease in gain but were not sufficient to
cause adaptation of the nonlinear component. When adapted with stimuli sufficient to recruit both the linear and nonlinear components, there
was a reduction in gain as well as a reduction in the
velocity-dependent gain enhancement of the nonlinear component of the
response. The response to adaptation with the HF-HV stimulus was
similar to that seen after long-term (5-7 days) adaptation with ×0.45
minimizing spectacles (Clendaniel et al. 2001
).
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Because one of the frequencies that composed the sum-of-sines stimulus during the high-frequency paradigms was 4 Hz, the difference in the 4-Hz test results could be a frequency-specific effect. This is an unlikely explanation for the observed behavior, however, as results similar to those at 4 Hz were observed when the VOR was measured at a frequency that was not used in the adaptation paradigm. The responses to sinusoidal rotations at 10 Hz (peak velocities of 20 and 100°/s) are depicted in Fig. 2C. There were significant reductions in gain with all adaptation paradigms. However, the velocity-dependent gain enhancement was present after adaptation with the HF-LV and LF-HV paradigms. After adaptation with the HF-LV paradigm, the mean gain at 20°/s was 0.53 ± 0.10 and the gain at 100°/s was 0.64 ± 0.15 (P < 0.1). The mean gain after adaptation with the LF-HV paradigm at 20°/s was 0.49 ± 0.07,and the gain at 100°/s was 0.57 ± 0.02 (P < 0.05). After adaptation with the HF-HV paradigm, there was a reduction in gain and an additional loss of the velocity-dependent gain enhancement, consistent with adaptation of both the linear and nonlinear components of the response (20°/s = 0.51 ± 0.02; 100°/s = 0.52 ± 0.06, P > 0.45).
Responses to steps of acceleration
There were significant reductions in response gain during both the acceleration (GA) and constant velocity (GV) portions of the 3,000°/s2 to 150°/s steps of acceleration after each of the adaptation paradigms. Preadaptation the mean acceleration gain was 1.03 ± 0.19 and the velocity gain was 0.84 ± 0.08 for the three monkeys. After adaptation with the HF-LV paradigm, GA was 0.90 ± 0.16 and GV was 0.72 ± 0.08 (Fig. 3A). This represents 13 and 14% decreases in GA and GV, respectively. Postadaptation with the LF-HV paradigm (Fig. 3B), GA was 0.87 ± 0.18 and GV was 0.68 ± 0.07. This represents 15 and 19% decreases in GA and GV. Adaptation with the HF-HV paradigm induced a decrease in GV and a greater decrease in GA (Fig. 3C). Postadaptation GA was 0.66 ± 0.13, a 36% decrease in gain, and GV was 0.64 ± 0.08, a 24% decrease in gain. ANOVA was used to determine the statistical significance of the gain changes. Compared to the preadaptation condition, the LF-HV and HF-LV paradigms induced significant changes (P < 0.01) in gain and significant differences (P < 0.01) between GA and GV, but no significant interaction among GA, GV, and the adapted state. In both instances, the decrease in GA was no different from the decrease in GV, which is consistent with adaptation of the linear, but not the nonlinear, component of the response. In comparison to the preadaptation condition, the HF-HV paradigm induced significant differences in gain, between GA and GV, as well as a significant interaction among terms (P < 0.01 in all cases). The significant reduction in gain is consistent with adaptation of the linear component, and the significant interaction term is consistent with adaptation of the nonlinear component of the response. The summary data are plotted in Fig. 3D.
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A second method of demonstrating the nonlinear component of the AVOR,
which has been used in previous investigations (Clendaniel et
al. 2001
; Lasker et al. 1999
), is to analyze the
relationship between eye and head velocity during the initial portion
of the acceleration steps. As seen in earlier work describing responses to these stimuli in normal monkeys (Minor et al. 1999
),
a polynomial equation containing a cubic term provided a significantly
better fit to the data than did either linear or second-order
polynomial equations. The relationship between eye velocity and head
velocity can be described by a third-order polynomial of the general
form
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(1) |
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DISCUSSION |
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Squirrel monkeys demonstrate a velocity-dependent gain enhancement
during sinusoidal rotations >2 Hz, such that the gain of the AVOR
increases with increasing velocity of rotation (Minor et al.
1999
). We previously reported that after adaptation for 5-10
days with ×0.45 minimizing spectacles, squirrel monkeys demonstrate an
overall decrease in gain and a loss of the velocity-dependent gain
enhancement (Clendaniel et al. 2001
). This loss of the
velocity-dependent gain enhancement was hypothesized to represent
adaptation of the nonlinear component response gain to a value of zero.
This same decrease in gain and loss of the velocity-dependent gain
enhancement is seen after short-term adaptation (4 h) with the HF-HV
stimulus paradigm combined with the ×0.45 minimizing spectacles. A
decrease in gain, with preservation of the gain enhancement at higher
velocities, was seen after the HF-LV and LF-HV stimulus paradigms. Thus
adaptation of the nonlinear component of the response is dependent on
the characteristics of the head movements. Motion that is of
insufficient frequency or velocity to recruit the nonlinear component,
when paired with altered visual inputs, leads only to adaptation of the
linear portion of the AVOR. If head-movement stimuli, sufficient to
recruit both the linear and nonlinear components, are paired with
altered visual inputs, then both the linear and nonlinear components of
the AVOR will undergo adaptation.
It is unlikely that the observed results are a form of either
frequency-specific adaptation (Lisberger et al. 1983
;
Raymond and Lisberger 1998
) or context-specific
adaptation (Shelhamer et al. 1992
; Yakushin et
al. 2000
), where one would expect to see the effects of the
adaptation only under conditions which mimic the adapting stimuli.
First, the changes in gain were uniform across the tested frequencies
(0.5-12 Hz, when tested with a peak velocity of 20°/s) regardless of
the adaptation paradigm. This differs from previous reports of
frequency-specific adaptation (Lisberger et al. 1983
;
Raymond and Lisberger 1998
) and is most likely due to
the fact that the adapting stimulus was a sum-of-sines stimulus
composed of three component frequencies rather than one specific
frequency. The variation in the component frequencies may have been
sufficient to prevent a frequency-specific effect. Second, the results
observed at 4 Hz (a component frequency of the adaptation stimulus in 2 of the 3 paradigms) were also seen at 10 Hz (a frequency not used in
the adaptation paradigms). Third, one might argue that even though the
frequencies and velocities of stimulation during the adaptation
paradigms were different, if the accelerations of the HF-LV and LF-HV
stimuli were similar and differed substantially from the HF-HV stimuli,
then acceleration could be used as a contextual cue for the adaptation
process. If this was the case, one might expect the observed
postadaptation responses. However, for the HF-LV paradigm, the peak
accelerations of the component frequencies were 144, 251, and
370°/s2, and the peak acceleration during
the sum-of-sines stimulus was 758°/s2.
The peak accelerations of the component frequencies for the LF-HV
paradigm were 57, 94, and 264°/s2, and the peak
acceleration during the sum-of-sines stimulus was 405°/s2. Although there was some overlap in the
component accelerations between the LF-HV and the HF-LV stimuli, the
accelerations in the two conditions were markedly different. Thus a
form of context-specific adaptation, where acceleration is used as a
context cue, cannot explain the postadaptation results.
Is there an anatomical basis to the linear and nonlinear components of
the response? The model we have used to simulate the observed behavior
in the horizontal AVOR in squirrel monkeys (with normal vestibular
function, after unilateral plugging of the three semicircular canals,
after unilateral labyrinthectomy, and after spectacle-induced
adaptation) contains inputs to the reflex from what we term linear and
nonlinear pathways (Clendaniel et al. 2001
;
Lasker et al. 1999
, 2000
; Minor et al.
1999
). These signals are then combined centrally and project to
the oculomotor neurons. There are several behavioral reasons for
dividing the inputs into separate pathways and for suggesting that
these pathways may be described by known anatomical components of the
AVOR. The regularly discharging vestibular afferents display a constant
rotational sensitivity with respect to frequency and velocity and are
not driven into inhibitory cutoff for a wide range of stimulus
intensities (Hullar and Minor 1999
). This fits with the
observed behavior of the AVOR across frequencies at 20°/s peak
stimulus velocity (Lasker et al. 2000
). The irregularly
discharging afferents, on the other hand, display an increase in
response gain with increasing frequency, are easily driven into
inhibitory cutoff, and demonstrate an acceleration-deceleration
asymmetry (Fernandez and Goldberg 1971
; Goldberg
and Fernandez 1971
; Hullar et al. 2001
). Thus
the behavioral differences between the responses to
3,000°/s2 acceleration and deceleration stimuli
and the asymmetry between ipsi- and contralesional responses after
unilateral canal plugging or labyrinthectomy are consistent with the
firing patterns of the irregularly discharging afferents
(Clendaniel et al. 2001
; Lasker et al. 1999
,
2000
). Because the velocity-dependent gain enhancement is not
seen in the response properties of either the regularly or irregularly
discharging afferents, this aspect of the behavior must be conferred by
central vestibular neurons.
It is possible that the linear and nonlinear components of the response are not separated at this early stage in the AVOR signal processing. It is conceivable that a signal representing head velocity is carried by the vestibular afferents to two subtypes of central vestibular neurons, one of which has greater nonlinear response dynamics than the other. The differences in the central vestibular neuron response dynamics could then account for the observed behaviors. Identification of the neuronal elements involved in these pathways will require data from single-unit recordings of the peripheral and central neurons involved in the control of the AVOR at stimuli similar to those employed in these studies and from experiments that selectively ablate the irregular afferents.
Regardless of the origin of the nonlinear component (peripheral or
central), the results of the present experiment support the hypothesis
that there are separate linear and nonlinear pathways controlling the
horizontal AVOR and that there is differential adaptive control over
the two pathways. One possible mechanism to explain the differential
adaptive control of the linear and nonlinear pathways is that central
vestibular neurons, presumably eye-head-velocity (EHV) cells/floccular
target neurons (FTN), may receive a preponderance of either regularly
or irregularly discharging vestibular afferents. The resulting changes
in adaptation would then be dependent on which central neurons were
active during the rotational stimuli. Another mechanism for the
differential adaptive control could be the two classes of glutamate
receptors (
-amino-3-hydroxy-5-methyl-4-isoxazole-proppionic acid,
AMPA, and N-methyl-D-aspartate, NMDA) found at
the primary afferent-secondary vestibular neuron synapse and the
interaction with
-aminobutyric acid (GABAB)
receptors (Kinney et al. 1994
; Peterson et al.
1996
). If there were differences in the glutamate receptor
subtypes between the regularly discharging afferent-secondary
vestibular neuron synapse and the irregularly discharging
afferent-secondary vestibular neuron synapse, then there would be
potential for differential adaptation. Regardless of the actual
cellular mechanism involved, to induce adaptation in the nonlinear
component, the animal must experience head-movement stimuli, paired
with altered visual inputs, that are of sufficient frequency and
velocity to recruit the nonlinear component of the AVOR. If the animal
is not exposed to stimuli that will recruit the nonlinear component of
the response, then this component of the response will not adapt. Why
would the animal need these separate linear and nonlinear components to
control the AVOR? The squirrel monkey naturally makes head movements
that are of very high acceleration,
2,000-10,000°/s2, with peak velocities of
100-200°/s (Armand and Minor 2002
). Because many of
the movements are ballistic in nature rather than sustained, the linear
pathway alone will not generate a response that is as compensatory as
the combination of the linear and nonlinear pathways. Recall that in
normal squirrel monkeys the gain during the constant velocity portion
of the acceleration step (GV) is less
than one, and the gain during the acceleration portion of the
acceleration step (GA) is essentially
equal to one (Minor et al. 1999
). Consequently, the
nonlinear component may have evolved to generate the required eye
movements for these high-acceleration, high-frequency stimuli. Given
the behavioral importance of this aspect of the response, it is
reasonable to suppose that this component would be highly modifiable to
optimize the animal's ability to maintain image stabilization on the retina.
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ACKNOWLEDGMENTS |
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This work was supported by National Institute on Deafness and Other Communication Disorders Grants K08 DC-00150 and R01 DC-02390, and the National Aeronautics and Space Administration Cooperative Agreement NCC 9-58 with the National Space Biomedical Research Institute.
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FOOTNOTES |
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Address for reprint requests: R. A. Clendaniel; Dept. of
Otolaryngology
Head and Neck Surgery, Johns Hopkins Medicine, 601 N. Caroline St; Rm. 6245, Baltimore, MD 21287-0910 (E-mail:
rclenda{at}jhmi.edu).
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REFERENCES |
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