The Influence of Unilateral Labyrinthectomy on Orientation in Space

Friedmann, G

doi:10.3109/00016487109125366

Cited by 67 publications

(29 citation statements)

References 22 publications

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“…In the literature, acutely after UVH a strong bias of the SVV and the subjective visual horizontal (SVH) towards the lesioned side (up to 25° (Friedmann, 1971, Curthoys et al , 1991, Bergenius et al , 1996, Anastasopoulos et al , 1997, Lopez et al , 2008) has been described consistently. While this bias slowly decreases, not all patients reach normal values after months to years (Friedmann, 1970, Curthoys et al , 1991, Böhmer et al , 1995, Tribukait et al , 1998, Hafström et al , 2004, Hafstrom et al , 2006, Lopez et al , 2008, Toupet et al , 2014, with adjustment errors between -2.0° and 11.7°.…”

Section: Discussionmentioning

confidence: 97%

“…The SVV thereby shifts towards the lesioned side when upright (Friedmann, 1971, Curthoys et al , 1991, Bergenius et al , 1996, Anastasopoulos et al , 1997, Lopez et al , 2008. Healthy humans show a distinct pattern of roll-angle dependent SVV errors: while roll over-compensation occurs at small (<60°) and very large (>120-135°) (Tarnutzer et al , 2009a) angles (E-effect) (Mueller, 1916), roll undercompensation is found for medium-sized (60-135°) angles (A-effect) (Aubert, 1861).…”

Section: Introductionmentioning

confidence: 99%

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

Müller

Bockisch

Tarnutzer

2016

Clinical Neurophysiology

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OBJECTIVE Acute unilateral peripheral-vestibular hypofunction (UVH) shifts the subjective visual vertical (SVV) ipsilesionally, triggering central compensation that usually eliminates shifts when upright. We hypothesized that compensation is worse when roll-tilted. METHODS We quantified SVV errors and variability in different roll-tilted positions (0°, ±45°, ±90°) in patients with chronic UVH affecting the superior branch (SVN; n=4) or the entire (CVN; n=9) vestibular nerve. RESULTS Errors in SVN and CVN were not different. When roll-tilted ipsilesionally 45°(9.6±5.4°vs. -0.2±6.4°, patients vs. controls, p<0.001) and 90°(23.5±5.7°vs. 16.8±8.8°, p=0.003), the patient's SVV was shifted significantly towards the lesioned ear. When upright, only a trend was noted (3.6±2.2°vs. 0.0±1.2°, p=0.099); for contralesional roll-tilts shifts were not different from controls. Variability was larger for CVN than SVN (p=0.046). With increasing disease-duration, adjustment errors decayed for ipsilesional roll-tilt and upright (p0.025). CONCLUSIONS The reason verticality perception was distorted for ipsilesional roll-tilts, may be the insufficient integration of contralesional otolith-input. Similar errors in SVN and CVN suggest a dominant utricular role in verticality perception, albeit the sacculus may improve precision of SVV estimates. SIGNIFICANCE With deficiencies in central compensation being roll-angle dependent, extending SVV-testing to roll-tilted positions may improve identifying patients with chronic UVH. Highlights:• Visual vertical (VV) was measured in 13 patients with chronic unilateral vestibular hypofunction.• VV shifts in the patients were significant only when rolled ipsilesionally.• Thus VV testing in roll-tilted positions is recommended to identify more subtle vestibular deficits. 3 AbstractObjective: Acute unilateral peripheral-vestibular hypofunction (UVH) shifts the subjective visual vertical (SVV) ipsilesionally, triggering central compensation that usually eliminates shifts when upright. We hypothesized that compensation is worse when roll-tilted. Methods

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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

Müller

Bockisch

Tarnutzer

2016

Clinical Neurophysiology

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“…It should be noted that many other projections are activated either directly or indirectly by vestibular afferent input and these other pathways are not shown in this very simplified illustration [for references, see Wilson and Melvill Jones, 1979;Highstein and McCrea, 1988;Nakao et al, 1982;Shimazu andPrecht, 1965, 1966;Shimazu, 1983;Precht et al, 1966;Precht and Shimazu, 1965;Ried et al, 1984;Smith and Curthoys, 1988a, b;Newlands and Perachio, 1990a, b;Ris et al, 1995Ris et al, , 1997Markham et al, 1977Markham et al, , 1978 in reduced viewing conditions. A short visible line in an otherwise darkened room appears to be rotated down on the affected side by the extent of the ocular torsion [Curthoys et al, 1991;Friedmann, 1970Friedmann, , 1971. So if the person has had a right vestibular loss it appears to them that a truly horizontal line is rotated right-side down (clockwise from the observer's point of view).…”

Section: Ocular Tilt Reactionmentioning

confidence: 99%

Vestibular Compensation

Curthoys¹,

Halmagyi²

1998

Advances in Oto-Rhino-Laryngology

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“…measurements of horizontal, vertical and torsional eye movements during off-vertical, eccentric wholebody rotations, and linear body accelerations, as well as psychophysical settings, such as tilt estimation, in response to the linear accelerations produced by swings, sleds, centrifuges, tilt chairs and barbeque spit rotations [Curthoys et al, 1991b;Friedmann, 1970Friedmann, , 1971Furman et al, 1992;Halmagyi and Curthoys, 1999]. While these tests have provided important information on the interaction between otolith and semicircular canal system, their main disadvantages as a clinical test are cost and practicability.…”

Section: Introductionmentioning

confidence: 99%

Otolith Function Assessed with the Subjective Postural Horizontal and Standardised Stance and Gait Tasks

Beule

Allum

2006

Audiol Neurotol

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If otolith function is essential to maintain upright standing while moving along slanted or uneven surfaces, subjects with an otolith deficit should have difficulty judging whether the inclination of the surface on which they are standing is tilted or not. We tested this judgement and compared it with the ability to control trunk sway during standardised stance and gait tests. Thirteen patients with unilateral vestibular nerve neurectomy at least 6 months prior to testing and 39 age-matched controls were asked to move a dynamic posturography platform on which they were standing back to their subjective ‘horizontal’ position after the platform had been slowly tilted at 0.4°/s to 5° in 8 different directions. Normal subjects left the platform deviated in pitch (forwards-backwards) at about 0.7° on describing the platform as levelled off for all directions of tilt. Patients showed larger deviations of about 1.3° in pitch with significant differences for forward right tilt (1.58 ± 0.73° compared to 0.73 ± 0.11° for normals; mean and SEM) and for forward left. Roll (lateral) deviations were about 0.4° for normals and 0.5° larger for the patients (for example, for backward left, 1.13 ± 0.24° compared to 0.4 ± 0.07° in normals). Except for a tendency towards greater deviations to the lesion side of patients with eyes closed, no differences were noted between tests under eyes open and closed conditions. However, for backward and roll tilts patients needed to steady themselves first by grasping a handrail when tested with eyes closed. Stance tests on foam showed increases in roll and pitch trunk sway with respect to controls. Patients had significantly larger trunk roll sway deviations during 1-legged stance tests and during gait trials. For stance trials, the patients lost their balance control prior to the end of the standard 20-second recording time. We conclude that a unilateral loss of otolith inputs due to nerve resection permanently impairs the ability to judge whether the support surface is horizontal, and leads to excessive trunk sway when standing on a compliant surface as well as excessive trunk roll sway during gait.

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The Influence of Unilateral Labyrinthectomy on Orientation in Space

Cited by 67 publications

References 22 publications

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

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

Vestibular Compensation

Otolith Function Assessed with the Subjective Postural Horizontal and Standardised Stance and Gait Tasks

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