Asymmetry of the Subjective Visual Vertical in Patients With Unilateral Peripheral Vestibular Deficit
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives: Perception of verticality is clinically assessed using the subjective visual vertical (SVV), a test of the otolith system that consists of aligning a bar on the gravitational vertical in darkness. Patients with acute unilateral vestibulopathy (AUVP) show a systematic SVV bias toward the affected side, whichever the side of line orientation. Whether SVV estimates are symmetrical has not been investigated.Subjects and Methods: This study included 10 patients with AUVP (vestibular neuritis) and 10 with BPPV (posterior semicircular canal). SVV measurements were made at two preset angles of line orientation (15° and 30°) toward the ipsilateral and contralateral sides, relative to the affected side.Results: The results showed asymmetrical SVV estimates in the AUVP group, with significantly greater SVV errors for ipsilateral than contralateral line orientation, as well as for the preset angle of 30° compared to 15°. SVV estimates were significantly lower in patients with BPPV who also exhibited SVV asymmetry. SVV estimates remained unchanged just after the maneuver and were normalized some days later or after supplementary maneuvers.Conclusions: SVV asymmetry should be routinely considered in the clinic. We recommend individually assessing ipsilateral and contralateral SVV and using at least two preset angles. This allows for a better assessment and diagnosis of otolith organ imbalance that can trigger chronic instability and dizziness. The contribution of neck afferents related to head position in space seems to be the main source of SVV asymmetry.
Abstract
Background and Objectives: Perception of verticality is clinically assessed using the subjective visual vertical (SVV), a test of the otolith system that consists of aligning a bar on the gravitational vertical in darkness. Patients with acute unilateral vestibulopathy (AUVP) show a systematic SVV bias toward the affected side, whichever the side of line orientation. Whether SVV estimates are symmetrical has not been investigated.Subjects and Methods: This study included 10 patients with AUVP (vestibular neuritis) and 10 with BPPV (posterior semicircular canal). SVV measurements were made at two preset angles of line orientation (15° and 30°) toward the ipsilateral and contralateral sides, relative to the affected side.Results: The results showed asymmetrical SVV estimates in the AUVP group, with significantly greater SVV errors for ipsilateral than contralateral line orientation, as well as for the preset angle of 30° compared to 15°. SVV estimates were significantly lower in patients with BPPV who also exhibited SVV asymmetry. SVV estimates remained unchanged just after the maneuver and were normalized some days later or after supplementary maneuvers.Conclusions: SVV asymmetry should be routinely considered in the clinic. We recommend individually assessing ipsilateral and contralateral SVV and using at least two preset angles. This allows for a better assessment and diagnosis of otolith organ imbalance that can trigger chronic instability and dizziness. The contribution of neck afferents related to head position in space seems to be the main source of SVV asymmetry.
참고문헌 (45)
- Dakin CJ, "Gravity estimation and verticality perception", Handb Clin Neurol, 159, pp.43~59 (2018)
- Bronstein AM, "The interaction of otolith and proprioceptive information in the perception of verticality. The effects of labyrinthine and CNS disease", Ann N Y Acad Sci, 871, pp.324~333 (1999)
- Iranfar S, "Subjective visual vertical test : the effect of preset angle and visual background", J Rehab Med, 2, pp.47~54 (2013)
- Böhmer A, "The subjective visual vertical as a clinical parameter of vestibular function in peripheral vestibular diseases", J Vestib Res, 5, pp.35~45 (1995)
- Dichgans J, "The role of vision in gravitational orientation", Fortschr Zool, 23, pp.255~263 (1975)
- Mittelstaedt H, "The subjective vertical as a function of visual and extraretinal cues", Acta Psychol(Amst), 63, pp.63~85 (1986)
- Kupferberg A, "Influence of uninformative visual cues on gravity perception", Ann N Y Acad Sci, 1164, pp.403~405 (2009)
- Yelnik AP, "Perception of verticality after recent cerebral hemispheric stroke", Stroke, 33, pp.2247~2253 (2002)
- Guerraz M, "Head orientation involvement in assessment of the subjective vertical during whole body tilt", Percept Mot Skills, 87, pp.643~648 (1998)
- Lopez C, "How body position changes visual vertical perception after unilateral vestibular loss", Neuropsychologia, 46, pp.2435~2440 (2008)
- Kheradmand A, "Perception of upright : multisensory convergence and the role of temporo-parietal cortex", Front Neurol, 8, pp.552~ (2017)
- Mittelstaedt H, "A new solution to the problem of the subjective vertical", Naturwissenschaften, 70, pp.272~281 (1983)
- Brandt T, "Vestibular cortex lesions affect the perception of verticality", Ann Neurol, 35, pp.403~412 (1994)
- Lopez C, "The thalamocortical vestibular system in animals and humans", Brain Res Rev, 67, pp.119~146 (2011)
- Baier B, "Posterior insular cortex – a site of vestibular–somatosensory interaction?", Brain Behav, 3, pp.519~524 (2013)
- Bolandi Shirejini M, "The application of subjective visual vertical in balance system disorders", Aud Vestib Res, 27, pp.1~11 (2018)
- Vibert D, "Long-term evolution of subjective visual vertical after vestibular neurectomy and labyrinthectomy", Acta Otolaryngol, 120, pp.620~622 (2000)
- Lopez C, "Changes of visual vertical perception : a long-term sign of unilateral and bilateral vestibular loss", Neuropsychologia, 45, pp.2025~2037 (2007)
- Tarnutzer AA, "Gravity dependence of subjective visual vertical variability", J Neurophysiol, 102, pp.1657~1671 (2009)
- Curthoys IS, "Human ocular torsional position before and after unilateral vestibular neurectomy", Exp Brain Res, 85, pp.218~225 (1991)
- Redon C, "Betahistine treatment improves the recovery of static symptoms in patients with unilateral vestibular loss", J Clin Pharmacol, 51, pp.538~548 (2011)
- Lacour M, "Two conditions to fully recover dynamic canal function in unilateral peripheral vestibular hypofunction patients", J Vestib Res, 31, pp.407~421 (2021)
- Lacour M, "Vestibular rehabilitation improves spontaneous nystagmus normalization in patients with acute unilateral vestibulopathy", Front Rehabil Sci, 4, pp.1122301~ (2023)
- Halmagyi GM, "Ocular tilt reaction with peripheral vestibular lesion", Ann Neurol, 6, pp.80~83 (1979)
- Fetter M, "Assessing vestibular function : which tests, when?", J Neurol, 247, pp.335~342 (2000)
- Clarke AH, "Unilateral examination of utricle and saccule function", J Vestib Res, 13, pp.215~225 (2003)
- Gall RM, "Subjective visual vertical in patients with benign paroxysmal positional vertigo", J Otolaryngol, 28, pp.162~165 (1999)
- Faralli M, "Subjective visual vertical before and after treatment of a BPPV episode", Auris Nasus Larynx, 38, pp.307~311 (2011)
- Toupet M, "Subjective visual vertical tilt attraction to the side of rod presentation : effects of age, sex, and vestibular disorders", Otol Neurotol, 36, pp.1074~1080 (2015)
- Venhovens J, "Static subjective visual vertical in healthy volunteers : the effects of different preset angle deviations and test-retest variability", Neuroophthalmology, 40, pp.113~119 (2016)
- Pagarkar W, "Subjective visual vertical and horizontal : effect of the preset angle", Arch Otolaryngol Head Neck Surg, 134, pp.394~401 (2008)
- Kheradmand A, "Visual perception of upright : head tilt, visual errors and viewing eye", J Vestib Res, 25, pp.201~209 (2016)
- Strupp M, "Acute unilateral vestibulopathy", Neurol Clin, 33, pp.669~685 (2015)
- Wade SW, "The effect of ocular torsional position on perception of the roll-tilt of visual stimuli", Vision Res, 37, pp.1071~1078 (1997)
- Lopez C, "Torsional optokinetic nystagmus after unilateral vestibular loss : asymmetry and compensation", Brain, 128, pp.1511~1524 (2005)
- Yelnik AP, "Perception of verticality after recent cerebral hemispheric stroke", Stroke, 33, pp.2247~2253 (2002)
- Saj A, "Functional neuroanatomy of vertical visual perception in humans", Front Neurol, 10, pp.142~ (2019)
- Tarnutzer AA, "Visually guided adjustments of body posture in the roll plane", Exp Brain Res, 227, pp.111~120 (2013)
- Otero-Millan J, "Upright perception and ocular torsion change independently during head tilt", Front Hum Neurosci, 10, pp.573~ (2016)
- Mezey LE, "Changes in ocular torsion position produced by a single visual line rotating around the line of sight--visual"entrainment"of ocular torsion", Vision Res, 44, pp.397~406 (2004)
- Tarnutzer AA, "Roll-dependent modulation of the subjective visual vertical : contributions of head-and trunkbased signals", J Neurophysiol, 103, pp.934~941 (2010)
- Dieterich M, "Dominance for vestibular cortical function in the non-dominant hemisphere", Cereb Cortex, 13, pp.994~1007 (2003)
- Toupet M, "Influence of body laterality on recovery from subjective visual vertical tilt after vestibular neuritis", Audiol Neurootol, 19, pp.248~255 (2014)
- Habs M, "Primary or secondary chronic functional dizziness: does it make a difference? A DizzyReg study in 356 patients", J Neurol, 267(Suppl 1), pp.212~222 (2020)
- Staab JP, "Diagnostic criteria for persistent postural-perceptual dizziness(PPPD) : consensus document of the committee for the classification of vestibular disorders of the Bárány society", J Vestib Res, 27, pp.191~208 (2017)