Dance Training and the Neuroplasticity of the Vestibular-Ocular Reflex: Preliminary Findingsâ€
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
This is an interesting paper which sought to deterimine if VOR adaptation occured in trained dancers with over six year experience. The paper is well written. The introduction is comprehensive and cites relevent past literature. The methods and results are also clear with the figures aiding the interpretation of the results. The discussion relates the findings to past literature.
The main limitation is the small sample size of 9 participants per group but the authors do state this as a limitation.
Author Response
We sincerely appreciate the time and effort of the editorial board and reviewers in evaluating our manuscript. Thank you for the opportunity to revise our work. We acknowledge that the reviewers’ insightful suggestions have strengthened our manuscript, and we have addressed each comment in a point-by-point response highlighted in red. We have also highlighted the changes made in the manuscript in red.
Reviewer 1:
Response: Thank you for your evaluation.
Comments: This is an interesting paper which sought to deterimine if VOR adaptation occured in trained dancers with over six year experience. The paper is well written. The introduction is comprehensive and cites relevent past literature. The methods and results are also clear with the figures aiding the interpretation of the results. The discussion relates the findings to past literature. The main limitation is the small sample size of 9 participants per group but the authors do state this as a limitation.
Response: Thank you for your positive and encouraging comments.
Reviewer 2 Report
Comments and Suggestions for Authors
Please refer to the attached PDF file.
Comments for author File: 
Comments.pdf
Author Response
We sincerely appreciate the time and effort of the editorial board and reviewers in evaluating our manuscript. Thank you for the opportunity to revise our work. We acknowledge that the reviewers’ insightful suggestions have strengthened our manuscript, and we have addressed each comment in a point-by-point response highlighted.
Reviewer 2:
Response: Thank you for your evaluation
Comment: This is an interesting study which has been well outlined in your introduction. Your detail of VOR function (and assessment techniques that can measure it accurately) is somewhat in-depth, but I think this is appropriate in introducing your study.
Response: Thank you for your positive and encouraging comments.
Comment: I do have a few comments which I feel should be addressed. In the abstract on line 17, you outlined an interesting observation that “most dancers reported a preference for right-sided pirouettes”. As it has been shown that there is a direct vestibular input into the hippocampus which bypasses the thalamus, and that this input is lateralized, it would be interesting to know if any of the dancers were left-handed.
Response: Thank you for highlighting this insightful concept. We asked participants about their dominant-writing hand and found that two dancers and two non-dancers were left-hand dominant. Among the left-hand dominant dancers, one preferred turning to the left and the other to the right, with confidence levels ranging from moderate to advanced respectively. We have added this information in the method section line 142-146.
Comment: Your explanation for your findings starting on line 276 is well laid out, but again, I wonder if handedness could possibly be an element in this as well. The methods section is also well laid out and appropriately detailed.
Response: Thank you for your insightful comment. We have added information on participants' dominant writing hand to the Methods section (lines 141–144). Two non-dancers were left-hand dominant. Among the left-hand dominant dancers, one preferred turning to the left and the other to the right, with confidence levels ranging from moderate to advanced respectively. While handedness may play a role, our current sample size limits further analysis. We agree with the reviewer and believe future studies with larger cohorts could provide more insight into this potential relationship.
Comment: On line 140, you outlined the criteria for being included in the study. You mentioned that subjects had to have “no known history of vestibular disorders”. Was there any history taken with respect to previous head injury? (Young athletic people can suffer an acute event leaving them with a subtle deficit which can be virtually asymptomatic due to the effectiveness of their compensation processes).
Response: Questions regarding history of concussion or head injury were asked, and none of the participants reported a history of either. For better clarity, we have added the following line in the methods section: "All participants had no history of ear-related, neurological, or vestibular issues, nor any head trauma or concussion," in lines 136-137.
Comment: In the section titled “implications”, beginning on line 293, you state “The earlier saccadic onset and reduced SHIMP VOR gain observed in dancers suggest a rewiring of the VOR network as a result of dance training.” This is just a thought from an untrained dancer, but is it possible that the reduced gain just signifies that the dancers are relying less on visual stabilization and more on their final predicted body position, as a result of their dance training (perhaps coupled with an enhanced (i.e. training related) predictability of their body movement so that they can anticipate their desired final position before their movement stops? In your conclusions, beginning on line 337, you state that “while dancers have an intact and healthy VOR similar to non-dancers, they may also possess enhanced voluntary control over these reflexes, allowing them to suppress the VOR more effectively than non-dancers”. This conclusion is interesting and I agree that it is supported by your data. However, again I don’t think you can say that this “suggests a rewiring of the VOR network”, as you stated on line 293.
Response: Thank you for your comment. We agree with the reviewer and have revised line as suggested. The line 294 reads “The earlier saccadic onset and reduced SHIMP VOR gain observed in dancers suggest a possible conscious modulation of the VOR network as an effect of dance training”.
Comment: Your limitations section (Section 6, beginning on line 320) is written well and addresses several of the concerns raised in the paper. For example, it did strike me that it would that have been interesting to compare different kinds of dancing; for example ballet versus salsa? (although as mentioned I am not a professional dancer). Your suggestion of assessing male dancers is also interesting. As mentioned, it would also be interesting to look at handedness. Rather than stating that the VOR is being “rewired”, perhaps you should say that it is being consciously modulated by the dance training. For example, it is also possible that suggests some evidence of augmented input to the VOR (?possibly suppression by brainstem pause neurons or some other mechanism). Dance training may instill the sensation that the result of twirling will be on unpredictability of the VOR, so it should not be relied upon. As mentioned, your finding is interesting but I don’t think you should draw the conclusion that this represents a VOR “rewiring”.
Response: Thank you for your insightful suggestion. We have revised the line as suggested. The line 294 reads, “The earlier saccadic onset and reduced SHIMP VOR gain observed in dancers suggest a possible conscious modulation of the VOR network as an effect of dance training”.
Reviewer 3 Report
Comments and Suggestions for Authors
This study investigates the impact of dance training on brainstem-mediated vestibular reflexes, with a focus on vestibulo-ocular reflex (VOR) function and suppression during high-speed head movements, similar to spotting techniques used by dancers. The study included 18 female college students (9 trained dancers and 9 non-dancers), and VOR was assessed using the Head Impulse Paradigm (HIMP) and Suppression Head Impulse Paradigm (SHIMP).
The results showed no significant difference in overall VOR gain between dancers and non-dancers, although dancers exhibited greater variability in SHIMP gains. A negative correlation was observed between years of dance training and right-side SHIMP gain, and dancers with over 15 years of training demonstrated earlier anti-compensatory saccade latencies (~75 ms).
The authors speculate that dancers may develop enhanced voluntary control over VOR suppression, and the earlier saccadic onset suggests neural adaptations in eye-head coordination. While these findings align with previous research, the study highlights the need for further investigation with larger samples of professional dancers.
Limitations:
Several limitations affect the generalizability of the findings:
Small sample size restricts statistical power.
Lack of professional dancers prevents more definitive conclusions.
Variability in dance styles and experience levels needs better control.
No male participants, leaving potential gender differences unexplored.
Dance style differences may influence results; future studies should focus on more homogeneous dancer groups.
Longitudinal studies are required to assess long-term training effects on VOR plasticity.
Figure 3:
Since latency data can be extracted from the ICS Impulse database, the authors should present not only graphical representations but also actual latency values in the results to improve data transparency and reproducibility.
Author Response
We sincerely appreciate the time and effort of the editorial board and reviewers in evaluating our manuscript. Thank you for the opportunity to revise our work. We acknowledge that the reviewers’ insightful suggestions have strengthened our manuscript, and we have addressed each comment in a point-by-point response highlighted.
Reviewer 3
Response: Thank you for your evaluation.
Comment: This study investigates the impact of dance training on brainstem-mediated vestibular reflexes, with a focus on vestibulo-ocular reflex (VOR) function and suppression during high-speed head movements, similar to spotting techniques used by dancers. The study included 18 female college students (9 trained dancers and 9 non-dancers), and VOR was assessed using the Head Impulse Paradigm (HIMP) and Suppression Head Impulse Paradigm (SHIMP).
Response: Thank you for your comments.
Comments: The results showed no significant difference in overall VOR gain between dancers and non-dancers, although dancers exhibited greater variability in SHIMP gains. A negative correlation was observed between years of dance training and right-side SHIMP gain, and dancers with over 15 years of training demonstrated earlier anti-compensatory saccade latencies (~75 ms).
The authors speculate that dancers may develop enhanced voluntary control over VOR suppression, and the earlier saccadic onset suggests neural adaptations in eye-head coordination. While these findings align with previous research, the study highlights the need for further investigation with larger samples of professional dancers.
Response: Thank you for your comments.
Comments: Limitations:
Several limitations affect the generalizability of the findings:
Small sample size restricts statistical power.
Lack of professional dancers prevents more definitive conclusions.
Variability in dance styles and experience levels needs better control.
No male participants, leaving potential gender differences unexplored.
Dance style differences may influence results; future studies should focus on more homogeneous dancer groups.
Longitudinal studies are required to assess long-term training effects on VOR plasticity.
Response: Thank you for your comments. We acknowledge the limitations mentioned and have stated them in the limitations section. While the current study has the above limitations, the outcomes of the study have provided a preliminary evidence of reorganizational changes in the brainstem mediated reflexes and have sparked new ideas and opportunities for future research.
Comment: Figure 3: Since latency data can be extracted from the ICS Impulse database, the authors should present not only graphical representations but also actual latency values in the results to improve data transparency and reproducibility.
Response: We appreciate the reviewer’s suggestion to include actual latency values to enhance data transparency and reproducibility. However, we currently do not have access to the ICS Impulse database to extract these values. We acknowledge the importance of this analysis and suggest that future studies on SHIMP consider incorporating latency quantification for a more comprehensive evaluation. To address this, we have added a statement in the limitations and future directions section. Lines 334–336 now read: “Future studies examining quantified latency-based analyses of the SHIMP anti-compensatory saccade could offer deeper insights into VOR reorganization.”
