Influence of sensory loss on the perception of verticality in stroke patients

Saeys, Wim; Vereeck, Luc; Truijen, Steven; Lafosse, Christophe; Wuyts, Floris; Heyning, Paul Van de

doi:10.3109/09638288.2012.671883

Cited by 38 publications

(48 citation statements)

References 25 publications

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“…Less is known regarding the consequences of somatosensory loss on the perception of spatial orientation, although its influence has been extensively studied in the context of motor control (Rothwell et al, 1982 ; Sanes et al, 1984 ; Sainburg et al, 1993 ; Sarlegna et al, 2010 ). Stroke patients suffering single-hemisphere somatosensory lesions exhibit a substantial bias during SVV adjustments toward the hypoesthetic side (Anastasopoulos et al, 1999 ) and adjustments are also more variable (Barra et al, 2010 ; Saeys et al, 2012 ). On the other hand, only severe hemihypoesthesia biases the subjective postural vertical (SPV), that is the alignment of whole-body orientation with the gravitational vertical (Anastasopoulos et al, 1999 ).…”

Section: Introductionmentioning

confidence: 99%

Do Visual and Vestibular Inputs Compensate for Somatosensory Loss in the Perception of Spatial Orientation? Insights from a Deafferented Patient

Bringoux

Cesare

Borel

et al. 2016

Front. Hum. Neurosci.

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The present study aimed at investigating the consequences of a massive loss of somatosensory inputs on the perception of spatial orientation. The occurrence of possible compensatory processes for external (i.e., object) orientation perception and self-orientation perception was examined by manipulating visual and/or vestibular cues. To that aim, we compared perceptual responses of a deafferented patient (GL) with respect to age-matched Controls in two tasks involving gravity-related judgments. In the first task, subjects had to align a visual rod with the gravitational vertical (i.e., Subjective Visual Vertical: SVV) when facing a tilted visual frame in a classic Rod-and-Frame Test. In the second task, subjects had to report whether they felt tilted when facing different visuo-postural conditions which consisted in very slow pitch tilts of the body and/or visual surroundings away from vertical. Results showed that, much more than Controls, the deafferented patient was fully dependent on spatial cues issued from the visual frame when judging the SVV. On the other hand, the deafferented patient did not rely at all on visual cues for self-tilt detection. Moreover, the patient never reported any sensation of tilt up to 18° contrary to Controls, hence showing that she did not rely on vestibular (i.e., otoliths) signals for the detection of very slow body tilts either. Overall, this study demonstrates that a massive somatosensory deficit substantially impairs the perception of spatial orientation, and that the use of the remaining sensory inputs available to a deafferented patient differs regarding whether the judgment concerns external vs. self-orientation.

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Section: Introductionmentioning

confidence: 99%

Do Visual and Vestibular Inputs Compensate for Somatosensory Loss in the Perception of Spatial Orientation? Insights from a Deafferented Patient

Bringoux

Cesare

Borel

et al. 2016

Front. Hum. Neurosci.

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“…In particular, the somatosensory system is supposed to be important for the SPV-for example, to improve the stability of the verticality representation (Barbieri et al, 2010;Barra et al, 2010;Bringoux, Marin, Nougier, Barraud, & Raphel, 2000). Saeys et al (2012) determined the influence of somatosensory loss on the perception of verticality in stroke patients during sitting. They differentiated between skin-related and joint-related somatosensory information and found a stronger relationship between the SPV and skin-related somatosensory input.…”

Section: Age Dependencymentioning

confidence: 99%

The subjective postural vertical in standing: Reliability and normative data for healthy subjects

Bergmann

Kreuzpointner

Krewer

et al. 2014

Atten Percept Psychophys

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Impaired verticality perception can cause falls, or even the inability to stand, due to lateropulsion or retropulsion. The internal estimate of verticality can be assessed through the subjective visual, haptic, or postural vertical (SPV). The SPV reflects impaired upright body orientation, but has primarily been assessed in sitting position. The internal representations of body orientation might be different between sitting and standing, mainly because of differences in somatosensory input for the estimation of SPV. To test the SPV during standing, we set up a paradigm using a device that allows movement in three dimensions (the Spacecurl). This study focused on the test-retest and interrater reliabilities of SPV measurements (n = 25) and provides normative values for the age range 20-79 years (n = 60; 10 healthy subjects per decade). The test-retest and interrater reliabilities for SPV measurements in standing subjects were good. The normality values ranged from -1.7°to 2.3°in the sagittal plane, and from -1.6°to 1.2°in the frontal plane. Minor alterations occurred with aging: SPV shifted backward with increasing age, and the variability of verticality estimates increased. Assessment of SPV in standing can be done with reliable results. SPV should next be used to test patients with an impaired sense of verticality, to determine its diagnostic value in comparison to established tools.

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“…There is often dissociation between the two vertical stimulations [4,16]. Nevertheless, post-stroke patients could have a problem with afferent input or integration disorders of different sensory modalities that may lead to the misperception of verticality [14]. In our study, all subjects had somatosensory loss on the contralesional side.…”

Section: Discussionmentioning

confidence: 75%

“…The correct perception of verticality is formed by integrating adequate visual, vestibular, and somatosensory input [13]. Based on these afferent inputs, internal sensory integration process construct perception of verticality, which is normally parallel to the earth's vertical axis [13,14]. It can be evaluated through different modalities, such as visual, haptic, and postural [13,15].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Visual and Haptic Vertical Stimulation on Standing Balance in Stroke Patients

Hong

Park

2013

Ann Rehabil Med

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ObjectiveTo explore the effect of visual and haptic vertical stimulation on standing balance in post-stroke patients.MethodsTwenty-five post-stroke patients were recruited. We measured left/right standing pressure differences and the center of pressure (COP) parameters for each patient under three different conditions: no stimulation, visual, and haptic stimulated conditions. First, patients stood on a posturography platform with their eyes blindfolded. After a rest period, the patients stood on the same platform with their eyes fixed to a 1.5-m luminous rod, which was placed at a vertical position in front of the patients. After another rest period, the patients again stood touching a vertically placed long rod in their non-hemiplegic hand with their eyes blindfolded. We collected the signals from the feet in each condition and obtained the balance indices.ResultsCompared with the no stimulation condition, significant improvements were observed for most of the COP parameters including COP area, length, and velocity for both the visual and haptic vertical stimulation conditions (p<0.01). Additionally, when we compared visual and haptic vertical stimulation, visual vertical stimulation was superior to haptic stimulation for all COP parameters (p<0.01). Left/right standing pressure differences, increased, although patients bore more weight on their paretic side when vertical stimulation was applied (p>0.01).ConclusionBoth visual and haptic vertical stimulation improved standing steadiness of post-stroke patients. Notably, visual vertical stimulation was more effective than haptic stimulation.

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Influence of sensory loss on the perception of verticality in stroke patients

Cited by 38 publications

References 25 publications

Do Visual and Vestibular Inputs Compensate for Somatosensory Loss in the Perception of Spatial Orientation? Insights from a Deafferented Patient

Do Visual and Vestibular Inputs Compensate for Somatosensory Loss in the Perception of Spatial Orientation? Insights from a Deafferented Patient

The subjective postural vertical in standing: Reliability and normative data for healthy subjects

The Effects of Visual and Haptic Vertical Stimulation on Standing Balance in Stroke Patients

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