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Khazali MF, Daddaoua N, Thier P. Nonhuman primates exploit the prior assumption that the visual world is vertical. J Neurophysiol 2023; 130:1252-1264. [PMID: 37823212 DOI: 10.1152/jn.00514.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/13/2023] Open
Abstract
When human subjects tilt their heads in dark surroundings, the noisiness of vestibular information impedes precise reports on objects' orientation with respect to Earth's vertical axis. This difficulty is mitigated if a vertical visual background is available. Tilted visual backgrounds induce feelings of head tilt in subjects who are in fact upright. This is often explained as a result of the brain resorting to the prior assumption that natural visual backgrounds are vertical. Here, we tested whether monkeys show comparable perceptual mechanisms. To this end we trained two monkeys to align a visual arrow to a vertical reference line that had variable luminance across trials, while including a large, clearly visible background square whose orientation changed from trial to trial. On ∼20% of all trials, the vertical reference line was left out to measure the subjective visual vertical (SVV). When the frame was upright, the monkeys' SVV was aligned with the gravitational vertical. In accordance with the perceptual reports of humans, however, when the frame was tilted it induced an illusion of head tilt as indicated by a bias in SVV toward the frame orientation. Thus all primates exploit the prior assumption that the visual world is vertical.NEW & NOTEWORTHY Here we show that the principles that characterize the human perception of the vertical are shared by another old world primate species, the rhesus monkey, suggesting phylogenetic continuity. In both species the integration of visual and vestibular information on the orientation of the head relative to the world is similarly constrained by the prior assumption that the visual world is vertical in the sense of having an orientation that is congruent with the gravity vector.
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Affiliation(s)
- Mohammad Farhan Khazali
- Epilepsy Center, Medical Center, University of Freiburg, Freiburg, Germany
- Center for Neural Science, New York University, New York, United States
| | - Nabil Daddaoua
- National Institute on Drug Abuse (NIDA) Intramural Research Program, Baltimore, Maryland, United States
| | - Peter Thier
- Hertie-Institute for Clinical Brain Research, Cognitive Neurology Laboratory, University of Tübingen, Tübingen, Germany
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Chen KT, Huang SY, Chen YJ, Chen YY. Primary Graviceptive System and Astasia: A Case Report and Literature Review. Brain Sci 2023; 13:1371. [PMID: 37891740 PMCID: PMC10605824 DOI: 10.3390/brainsci13101371] [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: 08/02/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Astasia refers to the inability to maintain upright posture during standing, despite having full motor strength. Impairment of the vestibulocerebellar pathway, graviceptive system, and cingulate motor area have been proposed to be related to astasia. However, the responsible neural pathways remain unclear. We hypothesize that there is a common neural network behind astasia. To test the hypothesis, we reviewed all reported cases with astasia, including ours, and focused on the correlation between anatomical destruction and symptom presentation. A total of 26, including ours, non-psychogenic astasia patients were identified in the English literature. Seventy-three percent of them were associated with other neurologic symptoms and sixty-two percent of reported lesions were on the right side. Contralateral lateropulsion was very common, followed by retropulsion, when describing astasia. Infarction (54%) was the most reported cause. The thalamus (65%) was the most reported location. Infarctions were the fastest to recover (mean: 10.6 days), while lesions at the brainstem needed a longer time (mean: 61.6 days). By combining the character of lateropulsion in astasia and the presentation of an interrupted graviceptive system, we concluded that the primary graviceptive system may be the common neural network behind astasia. Future studies on astasia should focus on the pathological changes in the perception of verticality in the visual world and the body.
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Affiliation(s)
- Ko-Ting Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Sheng-Yao Huang
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan;
| | - Yi-Jye Chen
- Department of Ophthalmology, China Medical University Hospital, Taichung 402, Taiwan;
| | - Ying-Yun Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital at Keelung, Keelung 204, Taiwan;
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Lafitte R, Jeager M, Piscicelli C, Dai S, Lemaire C, Chrispin A, Davoine P, Dupierrix E, Pérennou D. Spatial neglect encompasses impaired verticality representation after right hemisphere stroke. Ann N Y Acad Sci 2023; 1520:140-152. [PMID: 36478572 DOI: 10.1111/nyas.14938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Spatial neglect after right hemisphere stroke (RHS) was recently found to encompass lateropulsion, a deficit in body orientation with respect to gravity caused by altered brain processing of graviception. By analogy, we hypothesized that spatial neglect after RHS might encompass an altered representation of verticality. We also assumed a strong relation between body neglect and impaired postural vertical, both referring to the body. To tackle these issues, we performed contingency and correlation analyses between two domains of spatial neglect (body, extra-body) and two modalities of verticality perception (postural, visual) in 77 individuals (median age = 67) with a first-ever subacute RHS (1-3 months). All individuals with a transmodal (postural and visual) tilt in verticality perception (n = 26) had spatial neglect, but the reverse was not found. Correlation and multivariate analyses revealed that spatial neglect (and notably body neglect) was associated more with postural than visual vertical tilts. These findings indicate that after RHS, an impaired verticality representation results from a kind of graviceptive neglect, bearing first on somaesthetic graviception and second on vestibular graviception. They also suggest that the human brain uses not only a mosaic of 2D representations but also 3D maps involving a transmodal representation of verticality.
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Affiliation(s)
- Rémi Lafitte
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Marie Jeager
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Céline Piscicelli
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Shenhao Dai
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Camille Lemaire
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Anne Chrispin
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Patrice Davoine
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Eve Dupierrix
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Dominic Pérennou
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
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4
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Wada Y, Shiozaki T, Yamanaka T, Kitahara T. Gravity perception disturbance in patients with unilateral Meniere disease. Laryngoscope Investig Otolaryngol 2023; 8:212-219. [PMID: 36846418 PMCID: PMC9948591 DOI: 10.1002/lio2.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/05/2022] [Accepted: 12/31/2022] [Indexed: 01/18/2023] Open
Abstract
Objective To investigate gravity perception disturbance (GPD) in patients with Meniere disease (MD), we classified GPD type based on the results of the head-tilt perception gain (HTPG) and the head-upright subjective visual vertical (HU-SVV) evaluated by the head-tilt SVV (HT-SVV) test in patients with unilateral MD. Methods We conducted the HT-SVV test on 115 patients with unilateral MD and 115 healthy controls. Among the 115 patients, the period from the first vertigo episode to the examination (PFVE) was known for 91 patients. Results The HT-SVV test classified 60.9% and 39.1% of patients with unilateral MD as GPD and non-GPD, respectively. GPD was classified according to HTPG/HU-SVV combinations as follows: Type A GPD (21.7%, normal HTPG/abnormal HU-SVV), Type B GPD (23.5%, abnormal HTPG/normal HU-SVV), and Type C GPD (15.7%, abnormal HTPG/abnormal HU-SVV). As the PFVE became longer, patients with non-GPD and Type A GPD decreased; however, those with Types B and C GPD increased. Conclusion This study provides novel information on unilateral MD from the perspective of gravity perception by classifying GPD based on the results of the HT-SVV test. This study's findings suggest that overcompensation for vestibular dysfunction in patients with unilateral MD exhibited by large HTPG abnormalities may be strongly associated with persistent postural-perceptual dizziness. Level of Evidence 3b.
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Affiliation(s)
- Yoshiro Wada
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityKashiharaJapan,Wada ENT ClinicOsakaJapan
| | - Tomoyuki Shiozaki
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityKashiharaJapan
| | - Toshiaki Yamanaka
- Department of OtolaryngologyKindai University Faculty of MedicineOsaka‐SayamaJapan
| | - Tadashi Kitahara
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityKashiharaJapan
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赵 雅, 陈 钢, 吴 佳, 杨 捷, 周 丽, 李 莹. [Clinical application progress of subjective visual vertical test]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:884-892. [PMID: 36347586 PMCID: PMC10127558 DOI: 10.13201/j.issn.2096-7993.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Indexed: 06/16/2023]
Abstract
Subjective visual vertical test is considered as an effective technique to evaluate otolith organ function and central pathway of gravity perception. This test is non-invasive, easy to operate and has little stimulation. At present, there are few such studies in China. This paper reviews the concept, measurement principle and method, influencing factors, application, advantages and disadvantages of subjective visual vertical test.
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Affiliation(s)
- 雅楠 赵
- 山西医科大学护理学院(太原,030001)College of Nursing, Shanxi Medical University, Taiyuan, 030001, China
| | - 钢钢 陈
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 佳鑫 吴
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 捷 杨
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 丽媛 周
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
| | - 莹 李
- 山西医科大学第一医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University
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Conrad J, Boegle R, Ruehl RM, Dieterich M. Evaluating the rare cases of cortical vertigo using disconnectome mapping. Brain Struct Funct 2022; 227:3063-3073. [PMID: 35838791 DOI: 10.1007/s00429-022-02530-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/26/2022] [Indexed: 12/26/2022]
Abstract
In rare cases, cortical infarcts lead to vertigo. We evaluated structural and functional disconnection in patients with acute vertigo due to unilateral ischemic cortical infarcts compared to infarcts without vertigo in a similar location with a focus on the connectivity of the vestibular cortex, i.e., the parieto-opercular (retro-)insular cortex (PIVC). Using lesion maps from the ten published case reports, we computed lesion-functional connectivity networks in a set of healthy individuals from the human connectome project. The probability of lesion disconnection was evaluated by white matter disconnectome mapping. In all ten cases with rotational vertigo, disconnections of interhemispheric connections via the corpus callosum were present but were spared in lesions of the PIVC without vertigo. Further, the arcuate fascicle was affected in 90% of the lesions that led to vertigo and spared in lesions that did not lead to vertigo. The lesion-functional connectivity network included vestibulo-cerebellar hubs, the vestibular nuclei, the PIVC, the retro-insular and posterior insular cortex, the multisensory vestibular ventral intraparietal area, motion-sensitive areas (temporal area MT+ and cingulate visual sulcus) as well as hubs for ocular motor control (lateral intraparietal area, cingulate and frontal eye fields). However, this was not sufficient to differentiate between lesions with and without vertigo. Disruption of interhemispheric connections of both PIVC via the corpus callosum and intra-hemispheric disconnection via the arcuate fascicle might be the distinguishing factor between vestibular cortical network lesions that manifest with vertigo compared to those without vertigo.
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Affiliation(s)
- Julian Conrad
- Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. .,German Center for Vertigo and Balance Disorders (DSGZ), Munich University Hospital, LMU Munich, Munich, Germany.
| | - Rainer Boegle
- Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,Graduate School for Systemic Neuroscience (GSN-LMU), LMU Munich, Munich, Germany
| | - Ria Maxine Ruehl
- Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), Munich University Hospital, LMU Munich, Munich, Germany
| | - Marianne Dieterich
- Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), Munich University Hospital, LMU Munich, Munich, Germany.,Graduate School for Systemic Neuroscience (GSN-LMU), LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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7
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White matter volume loss drives cortical reshaping after thalamic infarcts. Neuroimage Clin 2022; 33:102953. [PMID: 35139478 PMCID: PMC8844789 DOI: 10.1016/j.nicl.2022.102953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/10/2022] [Accepted: 02/01/2022] [Indexed: 11/24/2022]
Abstract
White matter volume loss after unilateral thalamic infarcts shows the trajectories of sensory and ocular motor input from the brainstem to the thalamus and their thalamocortical connections. The extensive volume loss drives reshaping of the cortex more than grey matter atrophy. Associated ocular motor and vestibular symptoms are compensated over time due to their redundant and intermingled connectivity and an early integration with other sensory modalities. Associated ocular motor and vestibular symptoms are compensated over time due to their redundant and intermingled connectivity and an early integration with other sensory modalities.
Objective The integration of somatosensory, ocular motor and vestibular signals is necessary for self-location in space and goal-directed action. We aimed to detect remote changes in the cerebral cortex after thalamic infarcts to reveal the thalamo-cortical connections necessary for multisensory processing and ocular motor control. Methods Thirteen patients with unilateral ischemic thalamic infarcts presenting with vestibular, somatosensory, and ocular motor symptoms were examined longitudinally in the acute phase and after six months. Voxel- and surface-based morphometry were used to detect changes in vestibular and multisensory cortical areas and known hubs of central ocular motor processing. The results were compared with functional connectivity data in 50 healthy volunteers. Results Patients with paramedian infarcts showed impaired saccades and vestibular perception, i.e., tilts of the subjective visual vertical (SVV). The most common complaint in these patients was double vision or vertigo / dizziness. Posterolateral thalamic infarcts led to tilts of the SVV and somatosensory deficits without vertigo. Tilts of the SVV were higher in paramedian compared to posterolateral infarcts (median 11.2° vs 3.8°). Vestibular and ocular motor symptoms recovered within six months. Somatosensory deficits persisted. Structural longitudinal imaging showed significant volume reduction in subcortical structures connected to the infarcted thalamic nuclei (vestibular nuclei region, dentate nucleus region, trigeminal root entry zone, medial lemniscus, superior colliculi). Volume loss was evident in connections to the frontal, parietal and cingulate lobes. Changes were larger in the ipsilesional hemisphere but were also detected in homotopical regions contralesionally. The white matter volume reduction led to deformation of the cortical projection zones of the infarcted nuclei. Conclusions White matter volume loss after thalamic infarcts reflects sensory input from the brainstem as well the cortical projections of the main affected nuclei for sensory and ocular motor processing. Changes in the cortical geometry seem not to reflect gray matter atrophy but rather reshaping of the cortical surface due to the underlying white matter atrophy.
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Conrad J, Habs M, Ruehl RM, Boegle R, Ertl M, Kirsch V, Eren O, Becker-Bense S, Stephan T, Wollenweber F, Duering M, Dieterich M, Zu Eulenburg P. Reorganization of sensory networks after subcortical vestibular infarcts - A longitudinal symptom-related VBM study. Eur J Neurol 2022; 29:1514-1523. [PMID: 35098611 DOI: 10.1111/ene.15263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND We aimed to delineate common principles of reorganization after infarcts of the subcortical vestibular circuitry related to the clinical symptomatology. Our hypothesis was that the recovery of specific symptoms is associated with changes in distinct regions within the core vestibular, somatosensory and visual cortical and subcortical networks. METHODS We used voxel- and surface-based morphometry to investigate structural reorganization of subcortical and cortical brain areas in 42 patients with a unilateral, subcortical infarct with vestibular and ocular motor deficits in the acute phase. The patients received structural neuroimaging and clinical monitoring twice (acute phase and after 6 months) to detect within-subject changes over time. RESULTS In patients with vestibular signs such as tilts of the subjective visual vertical (SVV) and ocular torsion in the acute phase, significant volumetric increases in the superficial white matter around the parieto-(retro-)insular vestibular cortex (PIVC) were found at follow-up. In patients with SVV tilts, spontaneous nystagmus and rotatory vertigo in the acute phase gray matter volume decreases were located in the cerebellum and the visual cortex bilaterally at follow-up. Patients with saccade pathology demonstrated volumetric decreases in cerebellar, thalamic and cortical centers for ocular motor control. CONCLUSIONS The findings support the role of the PIVC as the key hub for vestibular processing and reorganization. The volumetric decreases represent the reciprocal interaction of the vestibular, visual and ocular motor systems during self-location and egomotion detection. A modulation in vestibular and ocular motor as well as visual networks was induced independent of the vestibular lesion site.
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Affiliation(s)
- Julian Conrad
- Department of Neurology, University Hospital, LMU Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Maximilian Habs
- Department of Neurology, University Hospital, LMU Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Ria Maxine Ruehl
- Department of Neurology, University Hospital, LMU Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Rainer Boegle
- Department of Neurology, University Hospital, LMU Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Germany
| | - Matthias Ertl
- Department of Psychology, University of Bern, Switzerland
| | - Valerie Kirsch
- Department of Neurology, University Hospital, LMU Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Germany
| | - Ozan Eren
- Department of Neurology, University Hospital, LMU Munich, Germany
| | - Sandra Becker-Bense
- German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Thomas Stephan
- Department of Neurology, University Hospital, LMU Munich, Germany
| | - Frank Wollenweber
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany.,Department of Neurology, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany.,Medical Image Analysis Center (MIAC) and qbig, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Marianne Dieterich
- Department of Neurology, University Hospital, LMU Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Peter Zu Eulenburg
- German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Germany.,Institute for Neuroradiology LMU Munich, Germany
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Chronic Central Vestibulopathies for the Otolaryngologist. Otolaryngol Clin North Am 2021; 54:939-948. [PMID: 34538359 DOI: 10.1016/j.otc.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Central vestibulopathies involve disorders of the central nervous system that lead to problems with balance, often manifested as dizziness, vertigo, and gait difficulty. Central vestibulopathies can be distinguished from peripheral vestibulopathies with the use of certain tests, including nystagmography and posturography. The neuroanatomy of individuals with central vestibulopathies can reveal structural abnormalities in the posterior cerebrum or cerebellum. Various medications can be used to manage central vestibulopathies, including vestibular migraine.
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10
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Results of subjective visual vertical tests in patients with vertigo/dizziness. Auris Nasus Larynx 2021; 49:342-346. [PMID: 34509307 DOI: 10.1016/j.anl.2021.08.010] [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: 07/09/2021] [Revised: 08/18/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We previously established the head-tilt subjective visual vertical (HT-SVV) test to evaluate head-tilt perception gain (HTPG) in addition to the original head-upright SVV (HU-SVV) test (Wada-Y et al.: Laryngoscope Investig Otolaryngol, 2020). In this study, we aimed to investigate the HU-SVV and HT-SVV abnormality rates among patients with vertigo/dizziness. METHODS Between July 2014 and December 2020, 357 patients were hospitalized for examining the HU-SVV and HT-SVV at our vertigo/dizziness center. Among these patients, 120 had Meniere's disease (MD), 99 had unilateral vestibular disease (UVD), 76 had benign paroxysmal positional vertigo (BPPV), 14 had vestibular migraine (VM), 13 had orthostatic dysfunction (OD), 12 had bilateral vestibular disease (BVD), 12 had central dizziness (CD), 7 had vestibular schwannoma (VS), and 4 had psychogenic dizziness (PD). We determined the reference values of the absolute HU-SVV (<2.5°) and HTPG (0.80-1.25) for the sitting position and used these for calculating the HU-SVV and HT-SVV abnormality rates in each type of vertigo/dizziness. RESULTS Among the 357 patients, 111 had abnormal HU-SVV results (31.1%), 132 had abnormal HT-SVV results (37.0%), and 185 had abnormal HU-SVV and/or HT-SVV results (51.8%). The modified HT-SVV test in combination with the original HU-SVV test could detect gravity perception disturbance in patients with vertigo/dizziness significantly better than the original test alone (chi-square: p=0.00019). The HU-SVV, HT-SVV, and HU-SVV and/or HT-SVV abnormality rates were significantly higher in patients with peripheral vestibular diseases, i.e., MD, UVD, BPPV, and BVD than in those with other types of vertigo/dizziness, i.e., VM, OD, CD, VS, and PD (chi-square: p=0.010, p=0.020, and p=0.0025, respectively). CONCLUSION These findings suggest that the combined HT-SVV and HU-SVV test could be a powerful neuro-otologic examination for detecting pathologies in the vestibular otolithic pathway.
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Piscicelli C, Castrioto A, Jaeger M, Fraix V, Chabardes S, Moro E, Krack P, Debû B, Pérennou D. Contribution of Basal Ganglia to the Sense of Upright: A Double-Blind Within-Person Randomized Trial of Subthalamic Stimulation in Parkinson's Disease with Pisa Syndrome. JOURNAL OF PARKINSONS DISEASE 2021; 11:1393-1408. [PMID: 33896847 DOI: 10.3233/jpd-202388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Verticality perception is frequently altered in Parkinson's disease (PD) with Pisa syndrome (PS). Is it the cause or the consequence of the PS? OBJECTIVE We tested the hypothesis that both scenarios coexist. METHODS We performed a double-blind within-person randomized trial (NCT02704910) in 18 individuals (median age 63.5 years) with PD evolving for a median of 17.5 years and PS for 2.5 years and treated with bilateral stimulation of the subthalamus nuclei (STN-DBS) for 6.5 years. We analyzed whether head and trunk orientations were congruent with the visual (VV) and postural (PV) vertical, and whether switching on one or both sides of the STN-DBS could modulate trunk orientation via verticality representation. RESULTS The tilted verticality perception could explain the PS in 6/18 (33%) patients, overall in three right-handers (17%) who showed net and congruent leftward trunk and PV tilts. Two of the 18 (11%) had an outstanding clinical picture associating leftward: predominant parkinsonian symptoms, whole-body tilt (head -11°, trunk -8°) and transmodal tilt in verticality perception (PV -10°, VV -8.9°). Trunk orientation or VV were not modulated by STN-DBS, whereas PV tilts were attenuated by unilateral or bilateral stimulations if it was applied on the opposite STN. CONCLUSION In most cases of PS, verticality perception is altered by the body deformity. In some cases, PS seems secondary to a biased internal model of verticality, and DBS on the side of the most denervated STN attenuated PV tilts with a quasi-immediate effect. This is an interesting track for further clinical studies.
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Affiliation(s)
- Céline Piscicelli
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
| | - Anna Castrioto
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Marie Jaeger
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France
| | - Valerie Fraix
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble-Alpes University Hospital, Grenoble, France
| | - Elena Moro
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Bettina Debû
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Dominic Pérennou
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
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12
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Brugger F, Walch J, Hägele-Link S, Abela E, Galovic M, Kägi G. Decreased grey matter in the postural control network is associated with lateral flexion of the trunk in Parkinson's disease. Neuroimage Clin 2021; 28:102469. [PMID: 33395964 PMCID: PMC7645287 DOI: 10.1016/j.nicl.2020.102469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/12/2020] [Accepted: 10/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Disruption of central networks, particularly of those responsible for integrating multimodal afferents in a spatial reference frame, were proposed in the pathophysiology of lateral trunk flexion in Parkinson's disease (PD). Knowledge about the underlying neuroanatomical structures is limited. OBJECTIVE To investigate if decreased focal grey matter (GM) is associated with trunk flexion to the side and if the revealed GM clusters correlate with a disturbed perception of verticality in PD. METHODS 37 PD patients with and without lateral trunk flexion were recruited. Standardized photos were taken from each patient and trunk orientation was measured by a blinded rater. Voxel-based morphometry (VBM) was used to detect associated clusters of decreased GM. The subjective visual vertical (SVV) was assessed as a marker for perception of verticality and SVV estimates were correlated with GM clusters. RESULTS VBM revealed clusters of decreased GM in the right posterior parietal cortex and in the right thalamus were associated with lateral trunk flexion. The SVV correlated with the extent of trunk flexion, and the side of the SVV tilt correlated with the side of trunk flexion. GM values from the thalamus correlated with the SVV estimates. CONCLUSIONS We report an association between neurodegenerative changes within the posterior parietal cortex and the thalamus and lateral trunk flexion in PD. These brain structures are part of a network proposed to be engaged in postural control and spatial self-perception. Disturbed perception of verticality points to a shifted egocentric spatial reference as an important pathophysiological feature.
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Affiliation(s)
- Florian Brugger
- Department of Neurology, Kantonsspital St. Gallen, Rorschacherstrasse 95, St. Gallen, Switzerland.
| | - Julia Walch
- Department of Neurology, Kantonsspital St. Gallen, Rorschacherstrasse 95, St. Gallen, Switzerland
| | - Stefan Hägele-Link
- Department of Neurology, Kantonsspital St. Gallen, Rorschacherstrasse 95, St. Gallen, Switzerland
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Marian Galovic
- Department of Neurology, Kantonsspital St. Gallen, Rorschacherstrasse 95, St. Gallen, Switzerland; Clinical and Experimental Epilepsy, Institute of Neurology, University College of London, United Kingdom
| | - Georg Kägi
- Department of Neurology, Kantonsspital St. Gallen, Rorschacherstrasse 95, St. Gallen, Switzerland
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13
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Totilienė M, Uloza V, Lesauskaitė V, Damulevičienė G, Kregždytė R, Kaski D, Ulozienė I. Impaired Subjective Visual Vertical and Increased Visual Dependence in Older Adults With Falls. Front Aging Neurosci 2021; 13:667608. [PMID: 34177553 PMCID: PMC8232053 DOI: 10.3389/fnagi.2021.667608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/11/2021] [Indexed: 12/15/2022] Open
Abstract
Aging affects the vestibular system and may disturb the perception of verticality and lead to increased visual dependence (VD). Studies have identified that abnormal upright perception influences the risk of falling. The aim of our study was to evaluate subjective visual vertical (SVV) and VD using a mobile virtual reality-based system for SVV assessment (VIRVEST) in older adults with falls and evaluate its relationship with clinical balance assessment tools, dizziness, mental state, and depression level. This study included 37 adults >65 years who experienced falls and 40 non-faller age-matched controls. Three tests were performed using the VIRVEST system: a static SVV, dynamic SVV with clockwise and counter-clockwise background stimulus motion. VD was calculated as the mean of absolute values of the rod tilt from each trial of dynamic SVV minus the mean static SVV rod tilt. Older adults who experienced falls manifested significantly larger biases in static SVV (p = 0.012), dynamic SVV (p < 0.001), and VD (p = 0.014) than controls. The increase in static SVV (odds ratio = 1.365, p = 0.023), dynamic SVV (odds ratio = 1.623, p < 0.001) and VD (odds ratio = 1.460, p = 0.010) tilt by one degree significantly related to falls risk in the faller group. Fallers who had a high risk of falling according to the Tinetti test exhibited significantly higher tilts of dynamic SVV than those who had a low or medium risk (p = 0.037). In the faller group, the increase of the dynamic SVV tilt by one degree was significantly related to falls risk according to the Tinetti test (odds ratio = 1.356, p = 0.049). SVV errors, particularly with the dynamic SVV test (i.e., greater VD) were associated with an increased risk of falling in the faller group. The VIRVEST system may be applicable in clinical settings for SVV testing and predicting falls in older adults.
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Affiliation(s)
- Milda Totilienė
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Virgilijus Uloza
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vita Lesauskaitė
- Department of Geriatrics, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gytė Damulevičienė
- Department of Geriatrics, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rima Kregždytė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Diego Kaski
- Department of Clinical and Movement Neurosciences, University College London, London, United Kingdom
| | - Ingrida Ulozienė
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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14
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Dai S, Piscicelli C, Clarac E, Baciu M, Hommel M, Pérennou D. Lateropulsion After Hemispheric Stroke: A Form of Spatial Neglect Involving Graviception. Neurology 2021; 96:e2160-e2171. [PMID: 33722996 DOI: 10.1212/wnl.0000000000011826] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 01/28/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the hypothesis that lateropulsion is an entity expressing an impaired body orientation with respect to gravity in relation to a biased graviception and spatial neglect. METHODS Data from the DOBRAS cohort (ClinicalTrials.gov: NCT03203109) were collected 30 days after a first hemisphere stroke. Lateral body tilt, pushing, and resistance were assessed with the Scale for Contraversive Pushing. RESULTS Among 220 individuals, 72% were upright and 28% showed lateropulsion (tilters [14%] less severe than pushers [14%]). The 3 signs had very high factor loadings (>0.90) on a same dimension, demonstrating that lateropulsion was effectively an entity comprising body tilt (cardinal sign), pushing, and resistance. The factorial analyses also showed that lateropulsion was inseparable from the visual vertical (VV), a criterion referring to vertical orientation (graviception). Contralesional VV biases were frequent (44%), with a magnitude related to lateropulsion severity: upright -0.6° (-2.9; 2.4), tilters -2.9° (-7; 0.8), and pushers -12.3° (-15.4; -8.5). Ipsilesional VV biases were less frequent and milder (p < 0.001). They did not deal with graviception, 84% being found in upright individuals. Multivariate, factorial, contingency, and prediction analyses congruently showed strong similarities between lateropulsion and spatial neglect, the latter encompassing the former. CONCLUSIONS Lateropulsion (pusher syndrome) is a trinity constituted by body tilt, pushing, and resistance. It is a way to adjust the body orientation in the roll plane to a wrong reference of verticality. Referring to straight above, lateropulsion might correspond to a form of spatial neglect (referring to straight ahead), which would advocate for 3D maps in the human brain involving the internal model of verticality.
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Affiliation(s)
- Shenhao Dai
- From the Neurorehabilitation Department, Institute of Rehabilitation (S.D., C.P., E.C., M.B., D.P.), Grenoble Alpes University Hospital; and Lab Psychology and NeuroCognition (S.D., C.P., M.B., D.P.) and AGEIS EA 7407 (M.H.), Université Grenoble Alpes, Grenoble, France
| | - Céline Piscicelli
- From the Neurorehabilitation Department, Institute of Rehabilitation (S.D., C.P., E.C., M.B., D.P.), Grenoble Alpes University Hospital; and Lab Psychology and NeuroCognition (S.D., C.P., M.B., D.P.) and AGEIS EA 7407 (M.H.), Université Grenoble Alpes, Grenoble, France
| | - Emmanuelle Clarac
- From the Neurorehabilitation Department, Institute of Rehabilitation (S.D., C.P., E.C., M.B., D.P.), Grenoble Alpes University Hospital; and Lab Psychology and NeuroCognition (S.D., C.P., M.B., D.P.) and AGEIS EA 7407 (M.H.), Université Grenoble Alpes, Grenoble, France
| | - Monica Baciu
- From the Neurorehabilitation Department, Institute of Rehabilitation (S.D., C.P., E.C., M.B., D.P.), Grenoble Alpes University Hospital; and Lab Psychology and NeuroCognition (S.D., C.P., M.B., D.P.) and AGEIS EA 7407 (M.H.), Université Grenoble Alpes, Grenoble, France
| | - Marc Hommel
- From the Neurorehabilitation Department, Institute of Rehabilitation (S.D., C.P., E.C., M.B., D.P.), Grenoble Alpes University Hospital; and Lab Psychology and NeuroCognition (S.D., C.P., M.B., D.P.) and AGEIS EA 7407 (M.H.), Université Grenoble Alpes, Grenoble, France
| | - Dominic Pérennou
- From the Neurorehabilitation Department, Institute of Rehabilitation (S.D., C.P., E.C., M.B., D.P.), Grenoble Alpes University Hospital; and Lab Psychology and NeuroCognition (S.D., C.P., M.B., D.P.) and AGEIS EA 7407 (M.H.), Université Grenoble Alpes, Grenoble, France.
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15
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Conrad J, Habs M, Ruehl M, Boegle R, Ertl M, Kirsch V, Eren O, Becker-Bense S, Stephan T, Wollenweber F, Duering M, Dieterich M, Eulenburg PZ. Structural reorganization of the cerebral cortex after vestibulo-cerebellar stroke. Neuroimage Clin 2021; 30:102603. [PMID: 33676164 PMCID: PMC7933782 DOI: 10.1016/j.nicl.2021.102603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Structural reorganization following cerebellar infarcts is not yet known. This study aimed to demonstrate structural volumetric changes over time in the cortical vestibular and multisensory areas (i.e., brain plasticity) after acute cerebellar infarcts with vestibular and ocular motor symptoms. Additionally, we evaluated whether structural reorganization in the patients topographically correlates with cerebello-cortical connectivity that can be observed in healthy participants. METHODS We obtained high-resolution structural imaging in seven patients with midline cerebellar infarcts at two time points. These data were compared to structural imaging of a group of healthy age-matched controls using voxel-based morphometry (2×2 ANOVA approach). The maximum overlap of the infarcts was used as a seed region for a separate resting-state functional connectivity analysis in healthy volunteers. RESULTS Volumetric changes were detected in the multisensory cortical vestibular areas around the parieto-opercular and (retro-) insular cortex. Furthermore, structural reorganization was evident in parts of the frontal, temporal, parietal, limbic, and occipital lobes and reflected functional connections between the main infarct regions in the cerebellum and the cerebral cortex in healthy individuals. CONCLUSIONS This study demonstrates structural reorganization in the parieto-opercular insular vestibular cortex after acute vestibulo-cerebellar infarcts. Additionally, the widely distributed structural reorganization after midline cerebellar infarcts provides additional in vivo evidence for the multifaceted contribution of cerebellar processing to cortical functions that extend beyond vestibular or ocular motor function.
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Affiliation(s)
- Julian Conrad
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany.
| | - Maximilian Habs
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Maxine Ruehl
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Rainer Boegle
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany; Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Germany
| | - Matthias Ertl
- Department of Psychology, University of Bern, Switzerland
| | - Valerie Kirsch
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Ozan Eren
- Department of Neurology, University Hospital, LMU Munich, Germany
| | - Sandra Becker-Bense
- German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany
| | - Thomas Stephan
- Department of Neurology, University Hospital, LMU Munich, Germany
| | - Frank Wollenweber
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany; Department of Neurology, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Marianne Dieterich
- Department of Neurology, University Hospital, LMU Munich, Germany; German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Peter Zu Eulenburg
- German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Germany; Institute for Neuroradiology, University Hospital, LMU Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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16
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Wada Y, Yamanaka T, Kitahara T, Kurata J. Effect of head roll-tilt on the subjective visual vertical in healthy participants: Towards better clinical measurement of gravity perception. Laryngoscope Investig Otolaryngol 2020; 5:941-949. [PMID: 33134543 PMCID: PMC7585259 DOI: 10.1002/lio2.461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/27/2020] [Accepted: 09/12/2020] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Gravity perception is an essential function for spatial orientation and postural stability; however, its assessment is not easy. We evaluated the head-tilt perception gain (HTPG, that is, mean perceptual gain [perceived/actual tilt angle] during left or right head roll-tilt conditions) and head-upright subjective visual vertical (SVV) using a simple method developed by us to investigate the characteristics of gravity perception in healthy participants. METHODS We measured the SVV and head roll-tilt angle during head roll-tilt within ±30° of vertical in the sitting and standing positions while the participant maintained an upright trunk (sitting, 434 participants; standing, 263 participants). We evaluated the head-upright SVV, HTPG, and laterality of the HTPG. RESULTS We determined the reference ranges of the absolute head-upright SVV (<2.5°), HTPG (0.80-1.25), and HTPG laterality (<10%) for the sitting position. The head-upright SVV and HTPG laterality were not influenced by sex or age. However, the HTPG was significantly greater in women than in men and in middle-aged (30-64 years) and elderly (65-88 years) participants than in young participants (18-29 years). The HTPG, but not the head-upright SVV or HTPG laterality, was significantly higher in the standing vs sitting position. CONCLUSION The HTPG is a novel parameter of gravity perception involving functions of the peripheral otolith and neck somatosensory systems to the central nervous system. The HTPG in healthy participants is influenced by age and sex in the sitting position and immediately increases after standing to reinforce the righting reflex for unstable posture, which was not seen in the head-upright SVV, previously considered the only parameter. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Yoshiro Wada
- Department of Otolaryngology, Head and Neck SurgeryNara Medical UniversityNaraJapan
- Wada ENT ClinicOsakaJapan
| | - Toshiaki Yamanaka
- Department of Otolaryngology, Head and Neck SurgeryNara Medical UniversityNaraJapan
| | - Tadashi Kitahara
- Department of Otolaryngology, Head and Neck SurgeryNara Medical UniversityNaraJapan
| | - Junichi Kurata
- Department of Mechanical Systems EngineeringKansai UniversityOsakaJapan
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Ulozienė I, Totilienė M, Balnytė R, Kuzminienė A, Kregždytė R, Paulauskas A, Blažauskas T, Marozas V, Uloza V, Kaski D. Subjective visual vertical and visual dependency in patients with multiple sclerosis. Mult Scler Relat Disord 2020; 44:102255. [DOI: 10.1016/j.msard.2020.102255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/05/2020] [Accepted: 05/31/2020] [Indexed: 01/19/2023]
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18
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Conrad J, Habs M, Boegle R, Ertl M, Kirsch V, Stefanova-Brostek I, Eren O, Becker-Bense S, Stephan T, Wollenweber F, Duering M, Zu Eulenburg P, Dieterich M. Global multisensory reorganization after vestibular brain stem stroke. Ann Clin Transl Neurol 2020; 7:1788-1801. [PMID: 32856758 PMCID: PMC7545594 DOI: 10.1002/acn3.51161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Patients with acute central vestibular syndrome suffer from vertigo, spontaneous nystagmus, postural instability with lateral falls, and tilts of visual vertical. Usually, these symptoms compensate within months. The mechanisms of compensation in vestibular infarcts are yet unclear. This study focused on structural changes in gray and white matter volume that accompany clinical compensation. METHODS We studied patients with acute unilateral brain stem infarcts prospectively over 6 months. Structural changes were compared between the acute phase and follow-up with a group of healthy controls using voxel-based morphometry. RESULTS Restitution of vestibular function following brain stem infarcts was accompanied by downstream structural changes in multisensory cortical areas. The changes depended on the location of the infarct along the vestibular pathways in patients with pathological tilts of the SVV and on the quality of the vestibular percept (rotatory vs graviceptive) in patients with pontomedullary infarcts. Patients with pontomedullary infarcts with vertigo or spontaneous nystagmus showed volumetric increases in vestibular parietal opercular multisensory and (retro-) insular areas with right-sided preference. Compensation of graviceptive deficits was accompanied by adaptive changes in multiple multisensory vestibular areas in both hemispheres in lower brain stem infarcts and by additional changes in the motor system in upper brain stem infarcts. INTERPRETATION This study demonstrates multisensory neuroplasticity in both hemispheres along with the clinical compensation of vestibular deficits following unilateral brain stem infarcts. The data further solidify the concept of a right-hemispheric specialization for core vestibular processing. The identification of cortical structures involved in central compensation could serve as a platform to launch novel rehabilitative treatments such as transcranial stimulations.
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Affiliation(s)
- Julian Conrad
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, Germany
| | - Maximilian Habs
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, Germany
| | - Rainer Boegle
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Munich, Germany
| | - Matthias Ertl
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany.,Department of Psychology, University of Bern, Bern, Switzerland
| | - Valerie Kirsch
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Munich, Germany
| | | | - Ozan Eren
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Sandra Becker-Bense
- German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, Germany
| | - Thomas Stephan
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Frank Wollenweber
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.,Department of Neurology, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Peter Zu Eulenburg
- German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Munich, Germany.,Institute for Neuroradiology, University Hospital, LMU Munich, Munich, Germany
| | - Marianne Dieterich
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany.,German Center for Vertigo and Balance Disorders (DSGZ), University Hospital, LMU Munich, Munich, Germany.,Graduate School of Systemic Neurosciences - GSN-LMU, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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19
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Time Course of Sensory Substitution for Gravity Sensing in Visual Vertical Orientation Perception following Complete Vestibular Loss. eNeuro 2020; 7:ENEURO.0021-20.2020. [PMID: 32561572 PMCID: PMC7358335 DOI: 10.1523/eneuro.0021-20.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/24/2020] [Accepted: 03/30/2020] [Indexed: 01/06/2023] Open
Abstract
Loss of vestibular function causes severe acute symptoms of dizziness and disorientation, yet the brain can adapt and regain near to normal locomotor and orientation function through sensory substitution. Animal studies quantifying functional recovery have yet been limited to reflexive eye movements. Here, we studied the interplay between vestibular and proprioceptive graviception in macaque monkeys trained in an earth-vertical visual orientation (subjective visual vertical; SVV) task and measured the time course of sensory substitution for gravity perception following complete bilateral vestibular loss (BVL). Graviceptive gain, defined as the ratio of perceived versus actual tilt angle, decreased to 20% immediately following labyrinthectomy, and recovered to nearly prelesion levels with a time constant of approximately three weeks of postsurgery testing. We conclude that proprioception accounts for up to 20% of gravity sensing in normal animals, and is re-weighted to substitute completely perceptual graviception after vestibular loss. We show that these results can be accounted for by an optimal sensory fusion model.
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20
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Reuss S, Siebrecht E, Stier U, Buchholz HG, Bausbacher N, Schabbach N, Kronfeld A, Dieterich M, Schreckenberger M. Modeling Vestibular Compensation: Neural Plasticity Upon Thalamic Lesion. Front Neurol 2020; 11:441. [PMID: 32528401 PMCID: PMC7256190 DOI: 10.3389/fneur.2020.00441] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022] Open
Abstract
The present study in rats was conducted to identify brain regions affected by the interruption of vestibular transmission and to explore selected aspects of their functional connections. We analyzed, by positron emission tomography (PET), the regional cerebral glucose metabolism (rCGM) of cortical, and subcortical cerebral regions processing vestibular signals after an experimental lesion of the left laterodorsal thalamic nucleus, a relay station for vestibular input en route to the cortical circuitry. PET scans upon galvanic vestibular stimulation (GVS) were conducted in each animal prior to lesion and at post-lesion days (PLD) 1, 3, 7, and 20, and voxel-wise statistical analysis of rCGM at each PLD compared to pre-lesion status were performed. After lesion, augmented metabolic activation by GVS was detected in cerebellum, mainly contralateral, and in contralateral subcortical structures such as superior colliculus, while diminished activation was observed in ipsilateral visual, entorhinal, and somatosensory cortices, indicating compensatory processes in the non-affected sensory systems of the unlesioned side. The changes in rCGM observed after lesion resembled alterations observed in patients suffering from unilateral thalamic infarction and may be interpreted as brain plasticity mechanisms associated with vestibular compensation and substitution. The second set of experiments aimed at the connections between cortical and subcortical vestibular regions and their neurotransmitter systems. Neuronal tracers were injected in regions processing vestibular and somatosensory information. Injections into the anterior cingulate cortex (ACC) or the primary somatosensory cortex (S1) retrogradely labeled neuronal somata in ventral posteromedial (VPM), posterolateral (VPL), ventrolateral (VL), posterior (Po), and laterodorsal nucleus, dorsomedial part (LDDM), locus coeruleus, and contralateral S1 area. Injections into the parafascicular nucleus (PaF), VPM/VPL, or LDDM anterogradely labeled terminal fields in S1, ACC, insular cortex, hippocampal CA1 region, and amygdala. Immunohistochemistry showed tracer-labeled terminal fields contacting cortical neurons expressing the μ-opioid receptor. Antibodies to tyrosine hydroxylase, serotonin, substance P, or neuronal nitric oxide-synthase did not label any of the traced structures. These findings provide evidence for opioidergic transmission in thalamo-cortical transduction.
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Affiliation(s)
- Stefan Reuss
- Department of Nuclear Medicine, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Elena Siebrecht
- Department of Anatomy and Cell Biology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Ulla Stier
- Department of Anatomy and Cell Biology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Hans-Georg Buchholz
- Department of Nuclear Medicine, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Nicole Bausbacher
- Department of Nuclear Medicine, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Nadine Schabbach
- Department of Anatomy and Cell Biology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Andrea Kronfeld
- Department of Neuroradiology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
| | - Marianne Dieterich
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians-University München, Munich, Germany.,Cluster of Systems Neurology, SyNergy, München, Germany
| | - Mathias Schreckenberger
- Department of Nuclear Medicine, University Medical Center, Johannes Gutenberg-University, Mainz, Germany
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Dale A, Cullen KE. The Ventral Posterior Lateral Thalamus Preferentially Encodes Externally Applied Versus Active Movement: Implications for Self-Motion Perception. Cereb Cortex 2020; 29:305-318. [PMID: 29190334 DOI: 10.1093/cercor/bhx325] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 11/07/2017] [Indexed: 11/15/2022] Open
Abstract
Successful interaction with our environment requires that voluntary behaviors be precisely coordinated with our perception of self-motion. The vestibular sensors in the inner ear detect self-motion and in turn send projections via the vestibular nuclei to multiple cortical areas through 2 principal thalamocortical pathways, 1 anterior and 1 posterior. While the anterior pathway has been extensively studied, the role of the posterior pathway is not well understood. Accordingly, here we recorded responses from individual neurons in the ventral posterior lateral thalamus of macaque monkeys during externally applied (passive) and actively generated self-motion. The sensory responses of neurons that robustly encoded passive rotations and translations were canceled during comparable voluntary movement (~80% reduction). Moreover, when both passive and active self-motion were experienced simultaneously, neurons selectively encoded the detailed time course of the passive component. To examine the mechanism underlying the selective elimination of vestibular sensitivity to active motion, we experimentally controlled correspondence between intended and actual head movement. We found that suppression only occurred if the actual sensory consequences of motion matched the motor-based expectation. Together, our findings demonstrate that the posterior thalamocortical vestibular pathway selectively encodes unexpected motion, thereby providing a neural correlate for ensuring perceptual stability during active versus externally generated motion.
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Affiliation(s)
- Alexis Dale
- Department of Physiology, McGill University, Montreal, Quebec, Canada
| | - Kathleen E Cullen
- Department of Physiology, McGill University, Montreal, Quebec, Canada
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22
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Babyar SR, Smeragliuolo A, Albazron FM, Putrino D, Reding M, Boes AD. Lesion Localization of Poststroke Lateropulsion. Stroke 2020; 50:1067-1073. [PMID: 31009350 DOI: 10.1161/strokeaha.118.023445] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Hemispheric stroke studies associating lateropulsion (pusher syndrome) with the location of brain lesions have had mixed results from small, unmatched samples. This study was designed to determine whether lateropulsion localizes to specific brain regions across patients with stroke using a case-control design. Methods- Fifty patients with lateropulsion after stroke were matched with 50 stroke patients without lateropulsion using age, time since onset of stroke, admission motor Functional Independence Measure score, lesion side, and gender. The primary analysis included multivariate lesion symptom mapping using sparse canonical correlations to identify regions most associated with lateropulsion as assessed with the Burke Lateropulsion Scale. Secondary analyses included evaluating paired comparisons for lesion volume, degree of motor impairment, motor and cognitive Functional Independence Measure scores. Results- The lesion symptom mapping analysis of all lesions mapped onto a common hemisphere produced an overall significant model ( P<5×10-5) with a regional peak at the inferior parietal lobe at the junction of the post-central gyrus (Brodmann Area 2) and Brodmann Area 40 as the lesion location most associated with lateropulsion. Lesion volume was larger for patients with lateropulsion. Despite adequate matching, motor performance and total Functional Independence Measure scores differed at a group level between patients with and without lateropulsion. Conclusions- This analysis implicated lesion involvement of the inferior parietal lobe as a key neuroanatomical determinant of developing lateropulsion. A better understanding of the anatomic underpinnings of lateropulsion may improve rehabilitation efforts, including the potential for informing noninvasive neuromodulation approaches.
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Affiliation(s)
- Suzanne R Babyar
- From the Department of Physical Therapy, Hunter College, The City University of New York, NY (S.R.B.).,Neurology, Stroke Unit, Burke Rehabilitation Hospital, White Plains, NY (S.R.B., M.R.)
| | - Anna Smeragliuolo
- Department of Telemedicine and Virtual Rehabilitation, Burke Medical Research Institute, White Plains, NY (A.S., D.P.)
| | - Fatimah M Albazron
- Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, Departments of Pediatrics, Neurology & Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (F.M.A., A.D.B.)
| | - David Putrino
- Department of Telemedicine and Virtual Rehabilitation, Burke Medical Research Institute, White Plains, NY (A.S., D.P.).,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY (D.P.)
| | - Michael Reding
- Neurology, Stroke Unit, Burke Rehabilitation Hospital, White Plains, NY (S.R.B., M.R.)
| | - Aaron D Boes
- Iowa Neuroimaging and Noninvasive Brain Stimulation Laboratory, Departments of Pediatrics, Neurology & Psychiatry, University of Iowa Hospitals and Clinics, Iowa City (F.M.A., A.D.B.)
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23
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Dieterich M, Brandt T. Perception of Verticality and Vestibular Disorders of Balance and Falls. Front Neurol 2019; 10:172. [PMID: 31001184 PMCID: PMC6457206 DOI: 10.3389/fneur.2019.00172] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 02/08/2019] [Indexed: 11/16/2022] Open
Abstract
Objective: To review current knowledge of the perception of verticality, its normal function and disorders. This is based on an integrative graviceptive input from the vertical semicircular canals and the otolith organs. Methods: The special focus is on human psychophysics, neurophysiological and imaging data on the adjustments of subjective visual vertical (SVV) and the subjective postural vertical. Furthermore, examples of mathematical modeling of specific vestibular cell functions for orientation in space in rodents and in patients are briefly presented. Results: Pathological tilts of the SVV in the roll plane are most sensitive and frequent clinical vestibular signs of unilateral lesions extending from the labyrinths via the brainstem and thalamus to the parieto-insular vestibular cortex. Due to crossings of ascending graviceptive fibers, peripheral vestibular and pontomedullary lesions cause ipsilateral tilts of the SVV; ponto-mesencephalic lesions cause contralateral tilts. In contrast, SVV tilts, which are measured in unilateral vestibular lesions at thalamic and cortical levels, have two different characteristic features: (i) they may be ipsi- or contralateral, and (ii) they are smaller than those found in lower brainstem or peripheral lesions. Motor signs such as head tilt and body lateropulsion, components of ocular tilt reaction, are typical for vestibular lesions of the peripheral vestibular organ and the pontomedullary brainstem (vestibular nucleus). They are less frequent in midbrain lesions (interstitial nucleus of Cajal) and rare in cortical lesions. Isolated body lateropulsion is chiefly found in caudal lateral medullary brainstem lesions. Vestibular function in the roll plane and its disorders can be mathematically modeled by an attractor model of angular head velocity cell and head direction cell function. Disorders manifesting with misperception of the body vertical are the pusher syndrome, the progressive supranuclear palsy, or the normal pressure hydrocephalus; they may affect roll and/or pitch plane. Conclusion: Clinical determinations of the SVV are easy and reliable. They indicate acute unilateral vestibular dysfunctions, the causative lesion of which extends from labyrinth to cortex. They allow precise topographical diagnosis of side and level in unilateral brainstem or peripheral vestibular disorders. SVV tilts may coincide with or differ from the perception of body vertical, e.g., in isolated body lateropulsion.
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Affiliation(s)
- Marianne Dieterich
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany.,Department of Neurology, Ludwig-Maximilians University, Munich, Germany.,Munich Cluster for Systems Neurology, Munich, Germany
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Germany.,Clinical Neuroscience, Ludwig-Maximilians University, Munich, Germany
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24
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Glasauer S, Dieterich M, Brandt T. Neuronal network-based mathematical modeling of perceived verticality in acute unilateral vestibular lesions: from nerve to thalamus and cortex. J Neurol 2018; 265:101-112. [PMID: 29845378 DOI: 10.1007/s00415-018-8909-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022]
Abstract
Acute unilateral lesions of vestibular graviceptive pathways from the otolith organs and semicircular canals via vestibular nuclei and the thalamus to the parieto-insular vestibular cortex regularly cause deviations of perceived verticality in the frontal roll plane. These tilts are ipsilateral in peripheral and in ponto-medullary lesions and contralateral in ponto-mesencephalic lesions. Unilateral lesions of the vestibular thalamus or cortex cause smaller tilts of the perceived vertical, which may be either ipsilateral or contralateral. Using a neural network model, we previously explained why unilateral vestibular midbrain lesions rarely manifest with rotational vertigo. We here extend this approach, focussing on the direction-specific deviations of perceived verticality in the roll plane caused by acute unilateral vestibular lesions from the labyrinth to the cortex. Traditionally, the effect of unilateral peripheral lesions on perceived verticality has been attributed to a lesion-based bias of the otolith system. We here suggest, on the basis of a comparison of model simulations with patient data, that perceived visual tilt after peripheral lesions is caused by the effect of a torsional semicircular canal bias on the central gravity estimator. We further argue that the change of gravity coding from a peripheral/brainstem vectorial representation in otolith coordinates to a distributed population coding at thalamic and cortical levels can explain why unilateral thalamic and cortical lesions have a variable effect on perceived verticality. Finally, we propose how the population-coding network for gravity direction might implement the elements required for the well-known perceptual underestimation of the subjective visual vertical in tilted body positions.
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Affiliation(s)
- S Glasauer
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany. .,German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany.
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-University, Munich, Germany.,German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - T Brandt
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany.,Clinical Neuroscience, Ludwig-Maximilians-University, Munich, Germany
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25
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Ulozienė I, Totilienė M, Paulauskas A, Blažauskas T, Marozas V, Kaski D, Ulozas V. Subjective visual vertical assessment with mobile virtual reality system. MEDICINA-LITHUANIA 2018; 53:394-402. [PMID: 29510903 DOI: 10.1016/j.medici.2018.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/18/2018] [Accepted: 02/08/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVE The subjective visual vertical (SVV) is a measure of a subject's perceived verticality, and a sensitive test of vestibular dysfunction. Despite this, and consequent upon technical and logistical limitations, SVV has not entered mainstream clinical practice. The aim of the study was to develop a mobile virtual reality based system for SVV test, evaluate the suitability of different controllers and assess the system's usability in practical settings. MATERIALS AND METHODS In this study, we describe a novel virtual reality based system that has been developed to test SVV using integrated software and hardware, and report normative values across healthy population. Participants wore a mobile virtual reality headset in order to observe a 3D stimulus presented across separate conditions - static, dynamic and an immersive real-world ("boat in the sea") SVV tests. The virtual reality environment was controlled by the tester using a Bluetooth connected controllers. Participants controlled the movement of a vertical arrow using either a gesture control armband or a general-purpose gamepad, to indicate perceived verticality. We wanted to compare 2 different methods for object control in the system, determine normal values and compare them with literature data, to evaluate the developed system with the help of the system usability scale questionnaire and evaluate possible virtually induced dizziness with the help of subjective visual analog scale. RESULTS There were no statistically significant differences in SVV values during static, dynamic and virtual reality stimulus conditions, obtained using the two different controllers and the results are compared to those previously reported in the literature using alternative methodologies. The SUS scores for the system were high, with a median of 82.5 for the Myo controller and of 95.0 for the Gamepad controller, representing a statistically significant difference between the two controllers (P<0.01). The median of virtual reality-induced dizziness for both devices was 0.7. CONCLUSIONS The mobile virtual reality based system for implementation of subjective visual vertical test, is accurate and applicable in the clinical environment. The gamepad-based virtual object control method was preferred by the users. The tests were well tolerated with low dizziness scores in the majority of patients.
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Affiliation(s)
- Ingrida Ulozienė
- Department of Otorhinolaryngology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Milda Totilienė
- Department of Otorhinolaryngology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Andrius Paulauskas
- Department of Software Systems, Faculty of Informatics, Kaunas University of Technology, Lithuania
| | - Tomas Blažauskas
- Department of Software Systems, Faculty of Informatics, Kaunas University of Technology, Lithuania
| | - Vaidotas Marozas
- Biomedical Engineering Institute, Kaunas University of Technology, Lithuania
| | - Diego Kaski
- Sobell Department for Motor Control, University College London, United Kingdom
| | - Virgilijus Ulozas
- Department of Otorhinolaryngology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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26
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Nakul E, Lopez C. Commentary: Out-of-Body Experience during Awake Craniotomy. Front Hum Neurosci 2017; 11:417. [PMID: 28871221 PMCID: PMC5566977 DOI: 10.3389/fnhum.2017.00417] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 08/04/2017] [Indexed: 11/26/2022] Open
Affiliation(s)
- Estelle Nakul
- Centre National de la Recherhe Scientifique (LNIA, FR3C), Aix-Marseille UniversitéMarseille, France
| | - Christophe Lopez
- Centre National de la Recherhe Scientifique (LNIA, FR3C), Aix-Marseille UniversitéMarseille, France
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27
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Dieterich M, Kirsch V, Brandt T. Right-sided dominance of the bilateral vestibular system in the upper brainstem and thalamus. J Neurol 2017; 264:55-62. [DOI: 10.1007/s00415-017-8453-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/06/2017] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
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28
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Akdal G, Toydemir HE, Tanrıverdizade T, Halmagyi GM. Room tilt illusion: a symptom of both peripheral and central vestibular disorders. Acta Neurol Belg 2017; 117:363-365. [PMID: 27015958 DOI: 10.1007/s13760-016-0628-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 03/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Gülden Akdal
- Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | - Hülya Ertaşoğlu Toydemir
- Department of Neurology, Bakırköy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Tural Tanrıverdizade
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
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29
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30
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Becker-Bense S, Buchholz HG, Baier B, Schreckenberger M, Bartenstein P, Zwergal A, Brandt T, Dieterich M. Functional Plasticity after Unilateral Vestibular Midbrain Infarction in Human Positron Emission Tomography. PLoS One 2016; 11:e0165935. [PMID: 27824897 PMCID: PMC5100888 DOI: 10.1371/journal.pone.0165935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 10/20/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of the study was to uncover mechanisms of central compensation of vestibular function at brainstem, cerebellar, and cortical levels in patients with acute unilateral midbrain infarctions presenting with an acute vestibular tone imbalance. Eight out of 17 patients with unilateral midbrain infarctions were selected on the basis of signs of a vestibular tone imbalance, e.g., graviceptive (tilts of perceived verticality) and oculomotor dysfunction (skew deviation, ocular torsion) in F18-fluordeoxyglucose (FDG)-PET at two time points: A) in the acute stage, and B) after recovery 6 months later. Lesion-behavior mapping analyses with MRI verified the exact structural lesion sites. Group subtraction analyses and comparisons with healthy controls were performed with Statistic Parametric Mapping for the PET data. A comparison of PET A of acute-stage patients with that of healthy controls showed increases in glucose metabolism in the cerebellum, motion-sensitive visual cortex areas, and inferior temporal lobe, but none in vestibular cortex areas. At the supratentorial level bilateral signal decreases dominated in the thalamus, frontal eye fields, and anterior cingulum. These decreases persisted after clinical recovery in contrast to the increases. The transient activations can be attributed to ocular motor and postural recovery (cerebellum) and sensory substitution of vestibular function for motion perception (visual cortex). The persisting deactivation in the thalamic nuclei and frontal eye fields allows alternative functional interpretations of the thalamic nuclei: either a disconnection of ascending sensory input occurs or there is a functional mismatch between expected and actual vestibular activity. Our data support the view that both thalami operate separately for each hemisphere but receive vestibular input from ipsilateral and contralateral midbrain integration centers. Normally they have gatekeeper functions for multisensory input to the cortex and automatic motor output to subserve balance and locomotion, as well as sensorimotor integration.
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Affiliation(s)
- Sandra Becker-Bense
- Department of Neurology, University of Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders-IFB, University of Munich, Munich, Germany
| | - Hans-Georg Buchholz
- Department of Nuclear Medicine, Johannes Gutenberg-University, Mainz, Germany
| | - Bernhard Baier
- Department of Neurology, Johannes Gutenberg-University, Mainz, Germany
| | | | - Peter Bartenstein
- German Center for Vertigo and Balance Disorders-IFB, University of Munich, Munich, Germany
- Department of Nuclear Medicine, University of Munich, Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), University of Munich, Munich, Germany
| | - Andreas Zwergal
- Department of Neurology, University of Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders-IFB, University of Munich, Munich, Germany
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders-IFB, University of Munich, Munich, Germany
- Institute for Clinical Neuroscience, University of Munich, Munich, Germany
| | - Marianne Dieterich
- Department of Neurology, University of Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders-IFB, University of Munich, Munich, Germany
- Munich Cluster of Systems Neurology (SyNergy), University of Munich, Munich, Germany
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31
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Affiliation(s)
- James G Colebatch
- From the Prince of Wales Hospital Clinical School and Neuroscience Research Australia (J.G.C.), University of New South Wales, Randwick; Central Clinical School (G.M.H.), University of Sydney and Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia; and the Department of Neurology and Psychiatry (S.L.), Policlinico Umberto I Hospital, Sapienza University of Rome, Italy.
| | - G Michael Halmagyi
- From the Prince of Wales Hospital Clinical School and Neuroscience Research Australia (J.G.C.), University of New South Wales, Randwick; Central Clinical School (G.M.H.), University of Sydney and Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia; and the Department of Neurology and Psychiatry (S.L.), Policlinico Umberto I Hospital, Sapienza University of Rome, Italy
| | - Svetlana Lorenzano
- From the Prince of Wales Hospital Clinical School and Neuroscience Research Australia (J.G.C.), University of New South Wales, Randwick; Central Clinical School (G.M.H.), University of Sydney and Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia; and the Department of Neurology and Psychiatry (S.L.), Policlinico Umberto I Hospital, Sapienza University of Rome, Italy
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