Vergence-mediated modulation of the human angular vestibulo-ocular reflex is unaffected by canal plugging

The angular vestibulo-ocular reflex (AVOR) normally has an increased response during vergence on a near target. Some lines of evidence suggest that different vestibular afferent classes may contribute differentially to the vergence effect. For example, lesions that selectively affect those afferents sensitive to acceleration, i.e. irregular afferents, (galvanic ablation, intratympanic gentamicin) have been found to markedly reduce the vergence-mediated modulation of the AVOR. We hypothesized that a nonspecific and incomplete reduction in the AVOR response caused by canal plugging should have minimal effect on vergence-mediated modulation of the AVOR. The AVOR response to passive head impulses in canal planes (horizontal canals, left anterior-right posterior canals, right anterior-left posterior canals) while viewing a far (124 cm) or near (15 cm) target was measured in seven human subjects before and after anterior canal (AC) plugging to treat vertigo caused by dehiscence of the AC (i.e. superior canal dehiscence). The impulses were low amplitude (∼20°), high velocity (∼150°/s), high-acceleration (∼3,000°/s²) head rotations administered manually by the investigator. Binocular eye and head velocity were recorded using the scleral search coil technique. The AVOR gain was defined as inverted eye velocity divided by head velocity. Before plugging, AVOR gain for the dehiscent AC went from 0.87 ± 0.10 for far targets to 1.04 ± 0.13 for near targets (+19.1 ± 7.3%). After plugging, the AC AVOR gain went from 0.50 ± 0.10 for far targets to 0.59 ± 0.11 for near targets (+19.7 ± 6.1%). There was no difference in the vergence-mediated gain increase between pre- and post-plugged conditions (multi-way analysis of variance: P = 0.66). AC plugging also did not change the latency of the AVOR for either AC. We hypothesize that canal plugging, unlike gentamicin or galvanic ablation, has no effect on vergence-mediated modulation of the AVOR because plugging does not preferentially affect irregular afferents.