Functional disturbance of the locomotor network in progressive supranuclear palsy

Zwergal, Andreas; Fougère, Christian la; Lorenzl, Stefan; Rominger, Axel; Xiong, Guoming; Deutschenbaur, Lorenz; Schöberl, Florian; Linn, Jennifer; Dieterich, Marianne; Brandt, Thomas; Strupp, Michael; Bartenstein, Peter; Jahn, Klaus

doi:10.1212/wnl.0b013e318281cc43

Cited by 65 publications

(64 citation statements)

References 39 publications

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“…This also agrees with a study which demonstrated that the post-erolateral thalamus was involved in resistance to the Aubert effect, i.e., the deviation of visual vertical estimates in the direction of body tilts [20]. Furthermore, an association of postural instability and falls with thalamic dysfunction has been demonstrated in PSP-Richardson phenotype with prominent postural instability [31,40]. In our study, a pronounced backward deviation of the SBV correlated with greater ventricular enlargement.…”

Section: Mechanisms Underlying Postural Instability In the Pitch Plansupporting

confidence: 93%

Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?

et al. 2016

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Postural instability is a frequent symptom of patients with idiopathic normal pressure hydrocephalus (iNPH), and might be due to the misperception of body verticality. The objective of this study was to assess the usefulness of the subjective body vertical (SBV) as a potential tool for diagnosing iNPH. Twenty patients with iNPH underwent tests of SBV in the pitch and roll planes before and after cerebrospinal fluid (CSF) drainage. Ten patients with other central gait disorders served as controls and also underwent tests for SBV. Before CSF drainage, patients with iNPH showed an impaired verticality perception in the pitch plane with a significant backward deviation of the SBV as compared to the control group (iNPH: mean ± SD -3.7 ± 3.6°; control group: -0.8 ± 2.2°; t value = -2.30, p t-test = 0.03). After CSF drainage, the SBV of the iNPH patients normalized for the pitch plane (-0.9 ± 1.9°). There was a correlation between the backward deviation of the SBV and the ventricular enlargement of the frontal horns (Evan's index; r = -0.52; p Pearson = 0.02). An even stronger correlation was found with the enlargement of the third ventricle (Thalamus index; r = -0.64; p Pearson = 0.002). The new and clinically relevant finding of this study is that verticality perception of patients with iNPH is primarily impaired the pitch plane, and it improves after CSF drainage. This disturbance in pitch might be due to a bilateral central vestibular dysfunction of the thalamus. Determination of the SBV in pitch promises to increase diagnostic accuracy in the cases of suspected iNPH.

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Section: Mechanisms Underlying Postural Instability In the Pitch Plansupporting

confidence: 93%

Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?

et al. 2016

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“…The complexity of additional simultaneous cognitive tasks probably has a considerable impact on walking performance and brain activity as indicated by studies summarized in our current review (Beurskens et al, 2014;Hill et al, 2013) as well as in other non-included work (Al-Yahya et al, 2011;Hall et al, 2011;Patel et al, 2014;Srygley et al, 2009). However, patients with neurological pathologies seem to either compensate their structural and/or functional impairments by an augmented activation of brain areas or by recruiting additional brain areas (Cremers et al, 2012;Jahn et al, 2009;Peterson et al, 2014a;Peterson et al, 2014b;Snijders et al, 2011;Wai et al, 2012;Zwergal et al, 2013).…”

Section: Complex Motor Tasks Dual Tasks and Speedmentioning

confidence: 50%

“…primary sensorimotor cortex Ouchi et al (2001) 1. healthy subjects (n= 6 / 65.3 ± 5.9) / Parkinson patients (n = 7 / 66.3 ± 6.6) 2. [ ] -CFT -PET Healthy subjects / Walking (vs rest): significant reduction of marker substance in putamen and caudate (indicate higher brain activity) PD patients / walking (vs. rest): significant reduction of marker substance in orbitofrontal cortex and caudate (indicate higher brain activity) PD patients vs. healthy controls / walking: no significant group differences in gait orbitofrontal [ ] -CFT uptake was inversely correlated with cadence ROI = caudate, putamen, orbitofrontal cortex and cerebellum Zwergal et al (2013) PSP A c c e p t e d M a n u s c r i p 52 Page 54 of 57 A c c e p t e d M a n u s c r i p 54 Table 9: Brain activity during different walking speeds and precision stepping Abbreviations: bil. = bilateral; fNIRS = Functional Near-Infrared Spectroscopy; SMC = primary sensorimotor cortex; lat.…”

Section: Page 34 Of 57mentioning

confidence: 99%

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Brain activity during walking: A systematic review

Hamacher

Herold

Wiegel

et al. 2015

Neuroscience & Biobehavioral Reviews

241

202

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“…Reflexive stabilization of eye and head as well as automatic locomotion at higher speed are mediated by infrathalamic brainstem and cerebellar locomotor centers [64–66]. In contrast, conscious perception of body posture and motion, goal-directed movements, and control of low-speed locomotion are mediated by suprathalamic sensorimotor mechanisms and higher cognitive vestibular functions including spatial orientation and navigation [67,68].…”

Section: Discussionmentioning

confidence: 99%

Functional Plasticity after Unilateral Vestibular Midbrain Infarction in Human Positron Emission Tomography

et al. 2016

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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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Functional disturbance of the locomotor network in progressive supranuclear palsy

Cited by 65 publications

References 39 publications

Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?

Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?

Brain activity during walking: A systematic review

Functional Plasticity after Unilateral Vestibular Midbrain Infarction in Human Positron Emission Tomography

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