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Article type: Research Article
Authors: Yang, Alexander Hui Xianga | Khwaounjoo, Prashannaa; b | Cakmak, Yusuf Ozgura; b; c; d; *
Affiliations: [a] Department of Anatomy, University of Otago, Dunedin, New Zealand | [b] Medtech Core NZ, Auckland, New Zealand | [c] Brain Health Research Centre, Dunedin, New Zealand | [d] Centre for Health Systems and Technology, Dunedin, New Zealand
Correspondence: [*] Corresponding author. Yusuf Ozgur Cakmak, Department of Anatomy, Dunedin 9054, New Zealand. E-mail: yusuf.cakmak@otago.ac.nz.
Abstract: BACKGROUND:Neural circuits allow whole-body yaw rotation to modulate vagal parasympathetic activity, which alters beat-to-beat variation in heart rate. The overall output of spinning direction, as well as vestibular-visual interactions on vagal activity still needs to be investigated. OBJECTIVE:This study investigated direction-dependent effects of visual and natural vestibular stimulation on two autonomic responses: heart rate variability (HRV) and pupil diameter. METHODS:Healthy human male subjects (n = 27) underwent constant whole-body yaw rotation with eyes open and closed in the clockwise (CW) and anticlockwise (ACW) directions, at 90°/s for two minutes. Subjects also viewed the same spinning environments on video in a VR headset. RESULTS:CW spinning significantly decreased parasympathetic vagal activity in all conditions (CW open p = 0.0048, CW closed p = 0.0151, CW VR p = 0.0019,), but not ACW spinning (ACW open p = 0.2068, ACW closed p = 0.7755, ACW VR p = 0.1775,) as indicated by an HRV metric, the root mean square of successive RR interval differences (RMSSD). There were no direction-dependent effects of constant spinning on sympathetic activity inferred through the HRV metrics, stress index (SI), sympathetic nervous system index (SNS index) and pupil diameter. Neuroplasticity in the CW eyes closed and CW VR conditions post stimulation was observed. CONCLUSIONS:Only one direction of yaw spinning, and visual flow caused vagal nerve neuromodulation and neuroplasticity, resulting in an inhibition of parasympathetic activity on the heart, to the same extent in either vestibular or visual stimulation. These results indicate that visual flow in VR can be used as a non-electrical method for vagus nerve inhibition without the need for body motion in the treatment of disorders with vagal overactivity. The findings are also important for VR and spinning chair based autonomic nervous system modulation protocols, and the effects of motion integrated VR.
Keywords: Vestibular system, heart rate variability, vagal activity, stress index, RMSSD, virtual reality, visual flow, direction, laterality, rotation, barany chair, spinning chair, pupil diameter, pupil size, cardiac responses, autonomic modulation, neuromodulation, vestibular stimulation
DOI: 10.3233/VES-201574
Journal: Journal of Vestibular Research, vol. 31, no. 6, pp. 479-494, 2021
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