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In this study data of voluntary eye movements 62 patients (mean age was 49.6 years) with Meniere's disease and 38 healthy control subjects were examined. Pseudo-random smooth pursuit (PRPEM) tests were conducted with frequency combination of 0.25 and 0.425 Hz. Saccades at constant targets and pseudo-randomly shifting targets were evaluated. In logistic regression analysis constant saccades correctly classified the cases in 57% as saccadic latency discriminating the groups best, latency being longer in Meniere group. In pseudo-random saccades, correct classification was achieved in 75.4% of all cases as latency discriminating the groups best, and latency was longer in Meniere group. In PRPEM, correct classification was achieved in 65.3% of all cases as gain by amplitude (GA), discriminating the groups best, and GA was smaller in Meniere group. Pseudo-random saccade test is a demanding task and that may explain why a peripheral vestibular lesion may interfere visual tracking and scanning performance. Latency is the most vulnerable of parameters to be lesioned. Results indicate that a peripheral vestibular lesion influences the control of voluntary eye movements and may explain the complaints of visual targeting on objects that patients with Meniere's disease have.

Summary Objective To study the effects of voice treatment including brief voice therapy for 12 months in two groups of voice patients: organic and functional. Design and Methods A clinical prospective follow-up study with repeated measurements in five phases: medical session, first voice therapy session, last voice therapy session, and 6 months and 12 months after voice therapy. The mean number of voice therapy sessions was 3.4. The main outcome measures were the Voice Activity and Participation Profile (VAPP) and the Symptom Questionnaire. Of consenting patients (n = 141) with chronic voice disorders, 46 dropped out during follow-up. Ninety-five patients formed the study group. Forty-one of them received only voice therapy, but the rest of them received combined treatment (medication, amplifiers, and voice massage), but also experienced life events affecting voice. Patients with any laryngeal pathology formed the organic group (n = 47), others had a functional voice disorder. Results Using the improvement criterion that the change of the VAPP score should exceed standard error of measurement, the percentage of individual patients achieving improvement was 47% in the mild, 59% in the moderate, and 75% in the severe disorder groups. Effect size for VAPP total score was 0.89. The positive effect continued to progress after the therapy ended. Patients with functional or organic voice disorder improved almost equally, although minor findings indicate that functional patients benefited more. Conclusions Voice treatment had a progressive effect for 1 year in half of our patients. No statistical difference was found between the functional and organic patient groups.

We have investigated the effects of mental set on predictive capabilities using a saccade square-wave tracking paradigm with ten normal subjects, comparing three amplitudes (10, 20, and 40 degrees ) and five inter-stimulus intervals (ISIs) (400, 500, 625, 1000, and 2000 ms). Subjects were instructed simply to "follow the lights" (passive, reflexive instruction) or explicitly "move your eyes in time with the lights" (active, volitional instruction). Saccades were defined as reflexive (latency100 ms), predictive (-200 mslatency100 ms), or anticipatory (latency-200 ms). We also calculated arrival time (saccade latency+saccade duration). Instructions had a striking effect on predictive performance. The effects were greatest with the longest ISIs (1000 and 2000 ms) and the largest target displacement (40 degrees ). With the active instruction there were more predictive and anticipatory saccades and with the passive instruction more reflexive saccades. Furthermore, with the active instruction subjects could take into account the duration of the impending saccade so that the eyes would arrive closer to the appearance of the target no matter what the amplitude of the required saccade. In sum, cognitive set, as determined by the specific instructions given to the subject, has a striking effect on predictive saccade behavior, which has important implications for interpreting physiological and imaging correlates of predictive behavior in normals and in patients with neurological disease.

Objective: In patients with migraine, neurotologic symptoms and signs occur commonly. The authors’ aim was to determine whether neurotologic findings are in accordance with the type of migraine and whether test findings differ from those of healthy controls. Methods: The authors examined 36 patients with various types of migraine classified by International Headache Society criteria. Comprehensive neurotologic tests were performed between attacks: video-oculography (VOG), electronystagmography, static posturography, and audiometry on 12 patients with migraine with aura (MA) and 24 patients with migraine without aura (MO). Results were compared to those of test-specific nonmigrainous control groups. Only eight migraineurs (six with MA and two with MO) had vertigo or dizziness. Results: Despite the absence of clinical neurotologic symptoms, most of the patients with migraine (83%) showed abnormalities in at least one of these tests. Both migraine types differed significantly from the control group (in VOG, in saccadic accuracy, and in static posturography). Vestibular findings tended to be more severe in MA than in MO. Conclusions: These data suggest that interictal neurotologic dysfunction in MA and MO share similar features and that the defective oculomotor function is mostly of vestibulocerebellar origin.

Artificial obstruction of the nose can make the nasal cavity a cul-de-sac resonator, which has clearly audible consequences. The present study compares videonasendoscopic views of the velopharyngeal mechanism in test words uttered with the nose open and obstructed in 20 subjects with a Pierre Robin sequence and in 6 subjects without this sequence. A velopharyngeal flap was constructed on 12 subjects. Videonasendoscopic findings were assessed by 3 judges with acceptable agreement. The results indicated that impairment of velopharyngeal function occurred significantly more often in subjects with a velopharyngeal flap. This was attributed to aerodynamic reasons. Clinical implications of the results are discussed.

We studied predictive and pseudo random saccades in patients with cerebellopontine angle tumor. Target for the saccades was a laser beam which was reflected on the wall in front of the subject, and the stimulus was controlled by a computer. The fixed target was spaced at a distance of +/- 30 to each side of the subject. The random saccades jumped 20 degrees/40 degrees/60 degrees in an unpredictable manner. The saccade analysis program was based on pattern recognition. In the random saccade test none of the mean values of saccadic reaction time (SRT), saccadic accuracy (SA) and saccadic peak velocity (SPV) to the right or left differed significantly between the two groups. In the predictable saccade test there was statistically significant differences for certain variables: in right SRT (p0.01) and in left SRT (p0.01); in right SA (0.001p0.01) and in left SA (p0.001). The mean peak velocity (right SPV and left SPV) did not differ significantly between the two groups. When the stimulus is predictable, the saccades in a healthy subject are more timely spaced and accurate than in a patient. When the stimulus is unpredictable, "the memory of the past" has no importance and cannot help in saccade programming, and variability in the healthy subjects increases.