Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted

Müller, Julia A.; Bockisch, Christopher J.; Tarnutzer, Alexander A.

doi:10.1016/j.clinph.2016.07.010

Cited by 18 publications

(18 citation statements)

References 54 publications

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“…Such distinct patterns of sensory contributions to perception of upright are supported by the findings in patients with vestibular and proprioceptive loss ( 25 , 78 – 87 ). Patients with vestibular loss tend to have no E-effect at small tilt angles and more pronounced A-effects at larger tilt angles, consistent with reduced weight of head position signals and consequently relative underestimation of upright orientation ( 25 , 80 – 82 , 84 , 86 , 87 ). Patients with proprioceptive loss, on the other hand, have decreased A-effect consistent with reduced weight of body proprioception, and consequently relative overestimation of upright orientation ( 25 , 88 , 89 ).…”

Section: Neurobehavioral Aspects Of Upright Perceptionmentioning

confidence: 66%

Perception of Upright: Multisensory Convergence and the Role of Temporo-Parietal Cortex

Kheradmand

Winnick

2017

Front. Neurol.

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We inherently maintain a stable perception of the world despite frequent changes in the head, eye, and body positions. Such "orientation constancy" is a prerequisite for coherent spatial perception and sensorimotor planning. As a multimodal sensory reference, perception of upright represents neural processes that subserve orientation constancy through integration of sensory information encoding the eye, head, and body positions. Although perception of upright is distinct from perception of body orientation, they share similar neural substrates within the cerebral cortical networks involved in perception of spatial orientation. These cortical networks, mainly within the temporo-parietal junction, are crucial for multisensory processing and integration that generate sensory reference frames for coherent perception of self-position and extrapersonal space transformations. In this review, we focus on these neural mechanisms and discuss (i) neurobehavioral aspects of orientation constancy, (ii) sensory models that address the neurophysiology underlying perception of upright, and (iii) the current evidence for the role of cerebral cortex in perception of upright and orientation constancy, including findings from the neurological disorders that affect cortical function.

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Section: Neurobehavioral Aspects Of Upright Perceptionmentioning

confidence: 66%

Perception of Upright: Multisensory Convergence and the Role of Temporo-Parietal Cortex

Kheradmand

Winnick

2017

Front. Neurol.

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“…The SVV primarily reflects asymmetry of utricular inputs between the sides of the vestibular system ( 12 ). The utricle responds to roll tilts and side-to-side translation of the head ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Another study described an enhanced A-effect during lateral body tilt in patients with bilaterally absent vestibular function and also ascribed it to somatosensory inputs ( 11 ). Meanwhile, patients with chronic unilateral peripheral vestibular hypofunction showed that adjustment errors of the SVV were pronounced during an ipsilesional tilt, more so in those with ipsilesionally absent ocular vestibular-evoked myogenic potentials (VEMPs) ( 12 ). These data support a dominant role of the utricle in perception of verticality during head tilts.…”

Section: Introductionmentioning

confidence: 99%

Effects of Head Position on Perception of Gravity in Vestibular Neuritis and Lateral Medullary Infarction

Kim

2018

Front. Neurol.

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ObjectiveInternal representation of gravity can be quantified by measuring the subjective visual vertical (SVV). Modulation of verticality perception during head tilts may be perturbed in vestibular disorders causing SVV tilts in the upright head position. This study aimed to determine the influence of head tilts on the estimation of SVV in acute vestibular disorders.MethodsWe measured the SVV in 37 patients with acute vestibular symptoms due to unilateral vestibular neuritis (VN) (n = 28) and lateral medullary infarction (LMI) (n = 9). Measurements of the SVV were performed under head upright, head tilt 30° and 60° in each direction. Seventeen normal subjects served as the control.ResultsIn controls, head tilt of 30° produced a contraversive shift of the SVV (the E-effect), and head tilt of 60° generated an ipsiversive shift (the A-effect). Patients with VN showed only the A-effect irrespective of the direction and amplitude of head tilt. Patients with LMI could estimate earth verticality accurately during head tilts. Patients with VN during the recovery phase showed the patterns of SVV modulation similar to those observed in the controls either with head upright or tilted.ConclusionGiven the absence of the E-effect in acute VN, the peripheral otolithic inputs appear to be essential in the perception of earth vertical during small static head tilts.

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“…Traditionally, the effect of unilateral peripheral vestibular lesions on SVV was attributed to a tone imbalance of the otolith system (98). Use of a neural network model focusing on the direction of SVV tilts in the roll plane in upright and tilted body positions allowed comparison of the data from model simulations with clinical data (Figure 8).…”

Section: Methods Of Verticality Perceptionmentioning

confidence: 99%

Perception of Verticality and Vestibular Disorders of Balance and Falls

2019

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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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Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted

Cited by 18 publications

References 54 publications

Perception of Upright: Multisensory Convergence and the Role of Temporo-Parietal Cortex

Perception of Upright: Multisensory Convergence and the Role of Temporo-Parietal Cortex

Effects of Head Position on Perception of Gravity in Vestibular Neuritis and Lateral Medullary Infarction

Perception of Verticality and Vestibular Disorders of Balance and Falls

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