The polymodal sensory cortex is crucial for controlling lateral postural stability: evidence from stroke patients

Pérennou, D.; Leblond, C.; Amblard, B.; Micallef, Jean‐Paul; Rouget, Emmanuelle; Pélissier, J.

doi:10.1016/s0361-9230(00)00360-9

Cited by 103 publications

(96 citation statements)

References 22 publications

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“…Abe et al [39] found significantly higher prevalence for pushing behavior, a disorder of the upright body orientation with respect to gravity [39,40], in patients with acute right hemispheric lesions as compared to left and thereby poorer postural control. We have only found two studies on hemispheric asymmetry related specifically to trunk control in stroke, and these demonstrated poorer postural stability in sitting in patients with right hemispheric lesions as compared to left [15,16]. Previous studies therefore suggest a differentiation between the right and left hemisphere in the regulation of postural and trunk control, which is supported by the results of our study.…”

Section: Discussionsupporting

confidence: 88%

“…However, limited research has been undertaken to explore a possible impact of lesion location on trunk control in patients post stroke, possibly because the trunk seemsto be bilaterally innervated [10], and therefore assumed to cause less functional impairment as compared to the affected extremities [11]. Although the trunk has been found to be impaired in several studies [11][12][13][14], we only found two studies that explored hemispheric asymmetry related to trunk control in stroke [15,16], To the best of our knowledge, no studies have explored the possible relationship between trunk control and specific lesion locations, and there is therefore a need for more research in this area. Knowledge of such a relationship could give additional understanding of factors underlying functional problems seen in stroke and highlight a possible need to prioritize trunk retraining for certain patients early post stroke when the potential for recovery is greatest.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trunk Control and Lesion Locations According to Alberta Stroke Program Early CT Score in Acute Stroke: A Cross-Sectional Study

Gjelsvik

Strand²,

Næss³

et al. 2014

Int J Phys Med Rehabil

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Trunk Control and Lesion Locations According to Alberta Stroke Program Early CT Score in Acute Stroke: A Cross-Sectional Study

Gjelsvik

Strand²,

Næss³

et al. 2014

Int J Phys Med Rehabil

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“…Eight brain locations (frontal, Rolando's, parietal and temporal cortices, corona radiata, internal capsule, striatum, and thalamus) were examined using the atlas of Talairach and Tournoux 19 and noted as 0 if no lesion was present or 1 if there was a lesion. 20 The mean lesion size, ranging from 0 to 8 was 4.0Ϯ2.2. This corresponded to a lesion of intermediate size, affecting on average 4 brain areas.…”

Section: Subjectsmentioning

confidence: 97%

Contribution of Each Lower Limb to Upright Standing in Stroke Patients

Genthon

Rougier

Gissot

et al. 2008

Stroke

203

122

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Background and Purpose-To analyze the postural behavior of standing stroke patients: (1) To differentiate between postural impairment attributable to the neurological condition (deficits attributable to the cerebral lesion) and postural impairment attributable to new mechanical constraints caused by body weight asymmetry; (2) To assess the involvement of each limb in the postural impairment; (3) To better understand which clinical deficits underlie the postural impairment. Methods-The posturographic characteristics of each limb in 41 stroke patients (first hemispheric stroke: 16 left, 25 right cerebral lesions) required to stand in their preferred posture were compared to those in 40 matched healthy individuals required to stand asymmetrically. Results-Compared to normal individuals in a similar asymmetrical posture, stroke patients were more unstable. The weight bearing asymmetry and the lateral postural instability were mainly related to spatial neglect. The paretic limb was unable to bring into play a normal longitudinal pattern of the center of pressure, which reflects an impaired stabilization control. Overall postural instability occurred when the strong limb was unable to compensate for the postural impairment of the paretic limb. Conclusions-The weight bearing asymmetry of standing stroke patients is not the primary cause of their postural imbalance, which is rather the consequence of impaired control of postural stabilization involving both limbs. Weight bearing asymmetry may not be the principle target of rehabilitation programs aiming at restoring standing balance after stroke. Instead it is suggested that more account should be taken of the compensatory role of the strong limb. (Stroke.

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“…8,[10][11][12][13] Recent studies, however, have also indicated that the complex motor control system can compensate for impairment to one or more elements of the system by placing increased reliance on remaining intact elements.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7][8][9] More specifically, lesions within the right middle cerebral artery (MCA) territory are particularly disturbing to both the sense of postural verticality and the ability to stabilize the body in the frontal plane. 8,[10][11][12][13] Recent studies, however, have also indicated that the complex motor control system can compensate for impairment to one or more elements of the system by placing increased reliance on remaining intact elements.…”

mentioning

confidence: 99%

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

Chen

Novak

Manor³

2014

Neurology

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Objective: Brain damage within the right middle cerebral artery (MCA) territory is particularly disruptive to mediolateral postural stabilization. The objective of this cross-sectional study was to test the hypothesis that chronic right MCA infarcts (as compared to left) are associated with slower and more bilaterally asymmetrical gait. We further hypothesized that in those with chronic right MCA infarct, locomotor performance is more dependent on gray matter (GM) volumes within noninfarcted regions of the brain that are involved in motor control yet lie outside of the MCA territory.Methods: Gait speed was assessed in 19 subjects with right MCA infarct, 20 with left MCA infarct, and 108 controls. Bilateral plantar pressure and temporal symmetry ratios were calculated in a subset of the cohort. GM volumes within 5 regions outside of the MCA territory (superior parietal lobe, precuneus, caudate, putamen, and cerebellum) were quantified from anatomic MRIs.Results: Right and left infarct groups had similar poststroke duration (7.6 6 6.0 years), infarct size, and functional independence. The right infarct group demonstrated slower gait speed and greater asymmetry compared to the left infarct group and controls (p , 0.05). In the right infarct group only, those with larger GM volumes within the cerebellum (r 2 5 0.32, p 5 0.02) and caudate (r 2 5 0.56, p , 0.001) exhibited faster gait speed.Conclusion: Individuals with chronic lesions within the right MCA territory, as compared to the left MCA territory, exhibit slower, more asymmetrical gait. For these individuals, larger GM volumes within regions outside of the infarcted vascular territory may help preserve locomotor control. Although approximately two-thirds of stroke survivors regain the ability to walk, 1 many present with diminished locomotor performance characterized by slow walking speed and bilaterally asymmetrical walking patterns. 2,3 Lesions within the right hemisphere of the brain, as compared to the left, appear to be more disruptive to both gait and postural control.4-9 More specifically, lesions within the right middle cerebral artery (MCA) territory are particularly disturbing to both the sense of postural verticality and the ability to stabilize the body in the frontal plane. 8,[10][11][12][13] Recent studies, however, have also indicated that the complex motor control system can compensate for impairment to one or more elements of the system by placing increased reliance on remaining intact elements.14 As such, the extent of residual gait abnormality following an infarct may be dependent on not only infarct hemisphere but also on the integrity of noninfarcted brain regions.The objectives of the study were to investigate the effects of infarct hemisphere, as well as gray matter (GM) volumes within regions outside of the infarcted vascular territory, on locomotor performance in individuals with chronic MCA infarcts. We hypothesized that individuals with

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The polymodal sensory cortex is crucial for controlling lateral postural stability: evidence from stroke patients

Cited by 103 publications

References 22 publications

Trunk Control and Lesion Locations According to Alberta Stroke Program Early CT Score in Acute Stroke: A Cross-Sectional Study

Trunk Control and Lesion Locations According to Alberta Stroke Program Early CT Score in Acute Stroke: A Cross-Sectional Study

Contribution of Each Lower Limb to Upright Standing in Stroke Patients

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

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