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Beylergil SB, Noecker AM, Kilbane C, McIntyre CC, Shaikh AG. Does Vestibular Motion Perception Correlate with Axonal Pathways Stimulated by Subthalamic Deep Brain Stimulation in Parkinson's Disease? CEREBELLUM (LONDON, ENGLAND) 2024; 23:554-569. [PMID: 37308757 DOI: 10.1007/s12311-023-01576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
Perception of our linear motion - heading - is critical for postural control, gait, and locomotion, and it is impaired in Parkinson's disease (PD). Deep brain stimulation (DBS) has variable effects on vestibular heading perception, depending on the location of the electrodes within the subthalamic nucleus (STN). Here, we aimed to find the anatomical correlates of heading perception in PD. Fourteen PD participants with bilateral STN DBS performed a two-alternative forced-choice discrimination task where a motion platform delivered translational forward movements with a heading angle varying between 0 and 30° to the left or to the right with respect to the straight-ahead direction. Using psychometric curves, we derived the heading discrimination threshold angle of each patient from the response data. We created patient-specific DBS models and calculated the percentages of stimulated axonal pathways that are anatomically adjacent to the STN and known to play a major role in vestibular information processing. We performed correlation analyses to investigate the extent of these white matter tracts' involvement in heading perception. Significant positive correlations were identified between improved heading discrimination for rightward heading and the percentage of activated streamlines of the contralateral hyperdirect, pallido-subthalamic, and subthalamo-pallidal pathways. The hyperdirect pathways are thought to provide top-down control over STN connections to the cerebellum. In addition, STN may also antidromically activate collaterals of hyperdirect pathway that projects to the precerebellar pontine nuclei. In select cases, there was strong activation of the cerebello-thalamic projections, but it was not consistently present in all participants. Large volumetric overlap between the volume of tissue activation and the STN in the left hemisphere positively impacted rightward heading perception. Altogether, the results suggest heavy involvement of basal ganglia cerebellar network in STN-induced modulation of vestibular heading perception in PD.
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Affiliation(s)
- Sinem Balta Beylergil
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Angela M Noecker
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Camilla Kilbane
- Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA
- Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA
| | - Cameron C McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Aasef G Shaikh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
- National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
- Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA.
- Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA.
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2
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Tran S, Brooke C, Kim YJ, Perry SD, Nankoo JF, Rinchon C, Arora T, Tremblay L, Chen R. Visual and vestibular integration in Parkinson's disease while walking. Parkinsonism Relat Disord 2023; 116:105886. [PMID: 37866253 DOI: 10.1016/j.parkreldis.2023.105886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/24/2023]
Abstract
Postural control requires effective sensory integration. People with Parkinson's disease (PD) are reported to have impaired visual and vestibular perception. While self-motion perception is a key aspect of locomotion, visual-vestibular integration has not been directly characterized in people with PD during gait. We compared the ability of people with PD and healthy older adults (OA) to integrate multi-sensory information during straight-line walking in response to visual and vestibular perturbations, using continuous translations of the visual surround and galvanic vestibular stimulation within a virtual reality environment. We measured their endpoint deviations from midline and changes in gait parameters. We found that people with PD deviated more than OA when walking in a dark environment but did not show differences in deviations when walking in a virtual room with visual information. With visual and vestibular perturbations, people with PD did not differ from OA in endpoint deviations nor variabilities. However, people with PD did not adopt a more cautious gait when GVS was applied in a virtual room, unlike OA. Overall, we showed that people with mild PD did not perform worse than OA but did show differences in gait patterns, suggesting that visual-vestibular integration is relatively preserved during gait in PD.
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Affiliation(s)
- Stephanie Tran
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Calaina Brooke
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | | | - Stephen D Perry
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | | | - Cricia Rinchon
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Tarun Arora
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Canada
| | - Luc Tremblay
- Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Robert Chen
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.
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3
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Grove CR, Klatt BN, Wagner AR, Anson ER. Vestibular perceptual testing from lab to clinic: a review. Front Neurol 2023; 14:1265889. [PMID: 37859653 PMCID: PMC10583719 DOI: 10.3389/fneur.2023.1265889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Not all dizziness presents as vertigo, suggesting other perceptual symptoms for individuals with vestibular disease. These non-specific perceptual complaints of dizziness have led to a recent resurgence in literature examining vestibular perceptual testing with the aim to enhance clinical diagnostics and therapeutics. Recent evidence supports incorporating rehabilitation methods to retrain vestibular perception. This review describes the current field of vestibular perceptual testing from scientific laboratory techniques that may not be clinic friendly to some low-tech options that may be more clinic friendly. Limitations are highlighted suggesting directions for additional research.
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Affiliation(s)
- Colin R. Grove
- Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Division of Physical Therapy, Department of Physical Medicine and Rehabilitation School of Medicine, Emory University, Atlanta, GA, United States
| | - Brooke N. Klatt
- Physical Therapy Department, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrew R. Wagner
- Department of Otolaryngology—Head and Neck Surgery, Ohio State University Wexner Medical Center, Columbus, OH, United States
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH, United States
| | - Eric R. Anson
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States
- Physical Therapy Department, University of Rochester, Rochester, NY, United States
- Department of Neuroscience, University of Rochester, Rochester, NY, United States
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Beylergil SB, Gupta P, ElKasaby M, Kilbane C, Shaikh AG. Does visuospatial motion perception correlate with coexisting movement disorders in Parkinson's disease? J Neurol 2021; 269:2179-2192. [PMID: 34554323 DOI: 10.1007/s00415-021-10804-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
Postural instability and balance impairment are common in Parkinson's disease (PD). Multiple factors, such as increased tone, bradykinesia, freezing of gait, posture, axial stiffness, and involuntary appendicular movements, can affect balance. The recent studies found that PD patients have abnormal perception of self-motion in vestibular domain. We asked whether measures of balance function, such as perception of one's motion, correlate with specific movement disorders seen in PD. Moving retinal image or self-motion in space triggers the perception of self-motion. We measured one's linear motion (heading) perception when subjects were moved en bloc using a moving platform (vestibular heading). Similar motion perception was generated in the visual domain (visual heading) by having the subjects view a 3D optical flow with immersive virtual reality goggles. During both tasks, the subjects reported the motion direction in the two-alternative-forced-choice paradigm. The accuracy of perceived motion direction was calculated from the responses fitted to the psychometric function curves to estimate how accurately and precisely the subjects can perceive rightward versus leftward motion (i.e., threshold and slope). Response accuracies and psychometric parameters were correlated with the disease duration, disease severity (total Unified Parkinson's Disease Rating Scale-III, UPDRS-III), and tremor, rigidity, axial, gait/posture components of UPRDS-III. We also correlated heading perception with the number of falls and subjective assessment of balance confidence using the Activities-Specific Balance Component (ABC) Scale. Accuracy, threshold, and sensitivity of vestibular heading perception significantly correlated with the disease duration and severity, particularly the tremor. Correlations were stronger for leftward heading perception in the vestibular domain. The visual heading perception was correlated with ABC Scale, especially with its items concerning optic-flow processing. There was asymmetry in leftward versus rightward vestibular heading perception. The level of asymmetry correlated with the axial component of UPDRS-III. Differences in the clinical parameters that correlate with visual versus vestibular heading perception suggest that two heading perception processes have different mechanistic underpinnings. The correlation of discordance between vestibular and visual heading perception with disease severity and duration suggests that visual function can be utilized for balance rehab in PD patients.
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Affiliation(s)
- Sinem Balta Beylergil
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.,National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Palak Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.,National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Mohamed ElKasaby
- Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA.,Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA
| | - Camilla Kilbane
- Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA.,Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA
| | - Aasef G Shaikh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA. .,National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. .,Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA. .,Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA.
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5
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Beylergil SB, Noecker AM, Petersen M, Gupta P, Ozinga S, Walker MF, Kilbane C, McIntyre CC, Shaikh AG. Subthalamic deep brain stimulation affects heading perception in Parkinson's disease. J Neurol 2021; 269:253-268. [PMID: 34003373 DOI: 10.1007/s00415-021-10616-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/25/2022]
Abstract
Parkinson's disease (PD) presents with visuospatial impairment and falls. It is critical to understand how subthalamic deep brain stimulation (STN DBS) modulates visuospatial perception. We hypothesized that DBS has different effects on visual and vestibular perception of linear motion (heading), a critical aspect of visuospatial navigation; and such effects are specific to modulated STN location. Two-alternative forced-choice experiments were performed in 14 PD patients with bilateral STN DBS and 19 age-matched healthy controls (HC) during passive en bloc linear motion and 3D optic-flow in immersive virtual reality measured vestibular and visual heading. Objective measure of perception with Weibull psychometric function revealed that PD has significantly lower accuracy [L: 60.71 (17.86)%, R: 74.82 (17.44)%] and higher thresholds [L: 16.68 (12.83), R: 10.09 (7.35)] during vestibular task in both directions compared to HC (p < 0.05). DBS significantly improved vestibular discrimination accuracy [81.40 (14.36)%] and threshold [4.12 (5.87), p < 0.05] in the rightward direction. There were no DBS effects on the slopes of vestibular psychometric curves. Visual heading perception was better than vestibular and it was comparable to HC. There was no significant effect of DBS on visual heading response accuracy or discrimination threshold (p > 0.05). Patient-specific DBS models revealed an association between change in vestibular heading perception and the modulation of the dorsal STN. In summary, DBS may have different effects on vestibular and visual heading perception in PD. These effects may manifest via dorsal STN putatively by its effects on the cerebellum.
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Affiliation(s)
- Sinem Balta Beylergil
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Angela M Noecker
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Mikkel Petersen
- Department of Clinical Medicine-Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Palak Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Sarah Ozinga
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Mark F Walker
- National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
- Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA
| | - Camilla Kilbane
- Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA
- Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA
| | - Cameron C McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Aasef G Shaikh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
- National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
- Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA.
- Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA.
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6
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Grove CR, Heiderscheit BC, Pyle GM, Loyd BJ, Whitney SL. The Gait Disorientation Test: A New Method for Screening Adults With Dizziness and Imbalance. Arch Phys Med Rehabil 2020; 102:582-590. [PMID: 33338462 DOI: 10.1016/j.apmr.2020.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To develop and evaluate a new method for identifying gait disorientation due to vestibular dysfunction. DESIGN The gait disorientation test (GDT) involves a timed comparison of the ability to walk 6.096 m with eyes open versus eyes closed. In this prospective study, participants were grouped based on vestibular function. All participants completed a clinical examination, self-report- and performance-based measures relevant to vestibular rehabilitation, and the tasks for the GDT. Vestibular-impaired participants underwent the criterion standard, videonystagmography and/or rotational chair testing. SETTING Ambulatory clinic, tertiary referral center. PARTICIPANTS Participants (N=40) (20 vestibular-impaired, 30 women, 49.9±16.1years old) were enrolled from a convenience/referral sample of 52 adults. MAIN OUTCOME AND MEASURE(S) We determined test-retest reliability using the intraclass correlation coefficient model 3,1; calculated the minimal detectable change (MDC); examined concurrent validity through Spearman correlation coefficients; assessed criterion validity with the area under the curve (AUC) from receiver operator characteristic analysis; and computed the sensitivity, specificity, diagnostic odds ratio (DOR), likelihood ratios for positive (LR+) and negative (LR-) tests, and posttest probabilities of a diagnosis of vestibulopathy. The 95% confidence interval demonstrates measurement uncertainty. RESULTS Test-retest reliability was 0.887 (0.815, 0.932). The MDC was 3.7 seconds. Correlations with other measures ranged from 0.59 (0.34, 0.76) to -0.85 (-0.92, -0.74). The AUC was 0.910 (0.822, 0.998), using a threshold of 4.5 seconds. The sensitivity and specificity were 0.75 (0.51, 0.91) and 0.95 (0.75, 1), respectively. The DOR=57 (6, 541.47), LR+ =15 (2.18, 103.0), and LR- =0.26 (0.12, 0.9). Positive posttest probabilities were 89%-94%. CONCLUSIONS AND RELEVANCE The GDT has good reliability, excellent discriminative ability, strong convergent validity, and promising clinical utility.
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Affiliation(s)
- Colin R Grove
- School of Medicine and Public Health, Department of Surgery, University of Wisconsin-Madison, Madison, WI; Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.
| | - Bryan C Heiderscheit
- Institute for Clinical and Translational Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - G Mark Pyle
- School of Medicine and Public Health, Department of Surgery, University of Wisconsin-Madison, Madison, WI
| | - Brian J Loyd
- Department of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, MT; Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
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7
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Fernandez-Baizan C, Paula Fernandez Garcia M, Diaz-Caceres E, Menendez-Gonzalez M, Arias JL, Mendez M. Patients with Parkinson's Disease Show Alteration in their Visuospatial Abilities and in their Egocentric and Allocentric Spatial Orientation Measured by Card Placing Tests. JOURNAL OF PARKINSONS DISEASE 2020; 10:1807-1816. [PMID: 33016894 DOI: 10.3233/jpd-202122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Visuospatial skills are impaired in Parkinson's disease (PD). Other related skills exist, such as spatial orientation have been poorly studied. The egocentric (based on internal cues) and allocentric frameworks (based on external cues) are used in daily spatial orientation. Depending on PD onset, the allocentric framework may have a higher level of impairment in tremor-dominant and the egocentric one in akinetic-rigid. OBJECTIVE To evaluate spatial orientation and visuospatial functions in PD patients and controls, and to assess whether their performance is related to disease duration and the PD subtype (tremor-dominant and akinetic-rigid). METHODS We evaluated egocentric and allocentric spatial orientation (Egocentric and Allocentric Spatial Memory Tasks) and visuospatial abilities, span and working memory in 59 PD patients and 51 healthy controls. RESULTS Visuospatial skills, visuospatial span, and egocentric and allocentric orientation are affected in PD. Visuospatial skills and allocentric orientation undergo deterioration during the first 5 years of the disease progression, while egocentric orientation and visuospatial span do so at later stages (9-11 years). The akinetic-rigid subtype presents worse results in all the spatial abilities that were measured when compared to controls, and worse scores in visuospatial working memory, visuospatial abilities and allocentric orientation when compared to the tremor-dominant group. The tremor-dominant group performed worse than controls in egocentric and allocentric orientation. CONCLUSION PD patients show deficits in their visuospatial abilities and in their egocentric and allocentric spatial orientation compared to controls, specifically in akinetic-rigid PD. Only spatial orientation are affected in tremor-dominant PD patients. Allocentric orientation is affected earlier in the progression of the disease.
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Affiliation(s)
- Cristina Fernandez-Baizan
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - M Paula Fernandez Garcia
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Elena Diaz-Caceres
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.,Servicio de Rehabilitación, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Manuel Menendez-Gonzalez
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.,Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.,Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA), Oviedo, Spain.,Department of Morphology and Cell Biology, University of Oviedo, Oviedo, Spain
| | - Jorge L Arias
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Marta Mendez
- Department of Psychology, University of Oviedo, Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
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Beylergil SB, Shaikh AG. Visual Perception of Heading in the Syndrome of Oculopalatal Tremor. THE CEREBELLUM 2020; 20:788-795. [PMID: 32740743 DOI: 10.1007/s12311-020-01176-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Perception of our linear motion, heading, relies on convergence from multiple sensory systems utilizing visual and vestibular signals. Multisensory convergence takes place in the visuo-vestibular areas of the cerebral cortex and posterior cerebellar vermis. Latter closely connected with the inferior olive may malfunction in disorders of olivo-cerebellar hypersynchrony, such as the syndrome of oculopalatal tremor (OPT). We had recently shown an impairment in vestibular heading perception in the subjects with OPT. Here we asked whether the hypersynchrony in the inferior-olive cerebellar circuit also affects the visual perception of heading, and the impairment is coupled with the deficits in vestibular heading perception. Three subjects with OPT and 11 healthy controls performed a two-alternative forced-choice task in two separate experiments; one when they were moved en bloc in a straight-ahead forward direction or at multiple heading angles to the right or the left; and second when under virtual reality goggle they experienced the movement of star cloud leading to the percept of heading straight, left or to the right at the heading angles similar to those utilized in the vestibular task. The resultant psychometric function curves, derived from the two-alternative-forced-choice task, revealed abnormal threshold to perceive heading direction, abnormal sensitivity to the change in heading direction compared to straight ahead, and a bias towards one side. Although the impairment was present in both visual and vestibular heading perception, the deficits were not coupled.
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Affiliation(s)
- Sinem Balta Beylergil
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.,National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell' Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Aasef G Shaikh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA. .,National VA Parkinson Consortium Center, Neurology Service, Daroff-Dell' Osso Ocular Motility and Vestibular Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. .,Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA. .,Movement Disorders Center, Neurological Institute, University Hospitals, Cleveland, OH, USA.
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9
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Halperin O, Israeli‐Korn S, Yakubovich S, Hassin‐Baer S, Zaidel A. Self‐motion perception in Parkinson's disease. Eur J Neurosci 2020; 53:2376-2387. [DOI: 10.1111/ejn.14716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Orly Halperin
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
| | - Simon Israeli‐Korn
- Department of Neurology Movement Disorders Institute Sheba Medical Center Ramat Gan Israel
- The Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Sol Yakubovich
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
| | - Sharon Hassin‐Baer
- Department of Neurology Movement Disorders Institute Sheba Medical Center Ramat Gan Israel
- The Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Adam Zaidel
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
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10
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Beylergil SB, Gupta P, Shaikh AG. Does Inferior-Olive Hypersynchrony Affect Vestibular Heading Perception? THE CEREBELLUM 2020; 20:744-750. [PMID: 31939030 DOI: 10.1007/s12311-020-01103-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Multisensory integration is critical for resolving ambiguities in isolated sensory systems assuring accurate perception of one's own linear motion, i.e., heading. The vestibular signal, a critical source of information for heading perception, is transformed in appropriate coordinates suitable for multisensory integration-such transformation takes place under cerebellar supervision. Deficiency in cerebellar function due to Purkinje cell loss results in inaccurate multisensory integration and impaired heading perception. Here, we predict that a classic movement disorder, the syndrome of oculopalatal tremor (OPT), also presents with inaccurate heading direction perception. The characteristic feature of oculopalatal tremor is pseudohypertrophic inferior olive that constantly sends spontaneous, hypersynchronous, abnormal, and meaningless signals to the cerebellum. Such malicious olive signal can impair heading perception. We examined vestibular heading perception in 6 individuals with OPT and 9 age-matched healthy controls (HC). We used a two-alternative forced choice task performed during passive en bloc translation. Compared with age-matched HC, OPT group had significantly higher heading direction perception threshold indicating a less sensitive vestibular system to variations in heading direction. Using computational simulations, we show that the addition of the abnormal noise into the cerebellar system results in decreased spatiotemporal tuning behavior of the cerebellar output. Such impairment in spatiotemporal tuning causes reduced ability to perceive heading direction. Hyperactivity in the inferior-olive cerebellar pathway impairs the heading direction perception. We suggest that this impairment stems from abnormal noise into the cerebellum due to hypersynchronized inferior olive.
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Affiliation(s)
- Sinem Balta Beylergil
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.,Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, National VA Parkinson Consortium Center, Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Palak Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.,Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, National VA Parkinson Consortium Center, Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Aasef G Shaikh
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA. .,Daroff-Dell'Osso Ocular Motility and Vestibular Laboratory, National VA Parkinson Consortium Center, Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. .,Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44110, USA. .,Neurological Institute, University Hospitals, Cleveland, OH, USA.
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