Effects of prolonged roll-tilt on the subjective visual and haptic vertical in healthy human subjects

BACKGROUND While verticality perception is normally accurate when upright, a systematic bias ("post-tilt bias") is seen after prolonged roll-tilt. The source of the bias could either be central (shifting "null" position) or related to changes in torsional eye-position. OBJECTIVE To study the mechanisms of the post-tilt bias in vision-dependent and vision-independent paradigms and to characterize the impact of optokinetic stimulation. METHODS The subjective visual-vertical (SVV) and subjective haptic-vertical (SHV) were measured after static roll-tilt (±90deg ear-down ("adaptation") position; duration = 5 min; n = 9 subjects). To assess the effect of visual stimuli, a control condition (darkness) was compared with an optokinetic stimulus (clockwise/counter-clockwise rotation, 60deg/sec) during adaptation. RESULTS A significant post-tilt bias was more frequent for the SVV than the SHV (72% vs. 54%, p = 0.007) with shifts pointing towards or away from the adaptation position with similar frequency. Exponential-decay time-constants were comparable for both paradigms and directions of shifts. The optokinetic stimulus had no effect on the bias for either paradigm. CONCLUSIONS Emerging in both vision-dependent and vision-independent paradigms, the results support the hypothesis that the post-tilt bias results from a shift in the internal estimate of direction of gravity, while optokinetic nystagmus seems not to be a major contributor