Asymmetric vestibular stimulation reveals persistent disruption of motion perception in unilateral vestibular lesions

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Title: Asymmetric vestibular stimulation reveals persistent disruption of motion perception in unilateral vestibular lesions
Author(s): Bronstein, AM
Panichi, R
Faralli, M
Bruni, R
Kiriakarely, A
Occhigrossi, C
Ferraresi, A
Item Type: Journal Article
Abstract: Self-motion perception was studied in patients with unilateral vestibular lesions (UVL) due to acute vestibular neuritis at 1 week, 4, 8 and 12 months after the acute episode. We assessed vestibularly-mediated self-motion perception by measuring the error in reproducing the position of a remembered visual target at the end of 4 cycles of asymmetric whole-body rotation. The oscillatory stimulus consists of a slow (0.09Hz) and a fast (0.38Hz) half cycle. A large error was present in UVL patients when the slow half cycle was delivered towards the lesion side, but minimal towards the healthy side. This asymmetry diminished over time, but it remained abnormally large at 12 months. In contrast, vestibulo-ocular reflex responses showed a large direction-dependent error only initially, then they normalized. Normalization also occurred for conventional reflex vestibular measures (caloric tests, subjective visual vertical and head shaking nystagmus) and for perceptual function during symmetric rotation. Vestibular-related handicap, measured with the Dizziness Handicap Inventory (DHI) at 12 months, correlated with self-motion perception asymmetry but not with abnormalities in vestibulo-ocular function. We conclude that 1) a persistent self-motion perceptual bias is revealed by asymmetric rotation in UVLs despite vestibulo-ocular function becoming symmetric over time 2) this dissociation is caused by differential perceptual-reflex adaptation to high and low frequency rotations when these are combined as with our asymmetric stimulus 3) the findings imply differential central compensation for vestibulo-perceptual and vestibulo-ocular reflex functions 4) self-motion perception disruption may mediate long-term vestibular-related handicap in UVL patients.
Publication Date: 16-Aug-2017
Date of Acceptance: 15-Aug-2017
URI: http://hdl.handle.net/10044/1/50441
DOI: https://dx.doi.org/10.1152/jn.00674.2016
ISSN: 0002-9513
Publisher: American Physiological Society
Start Page: 2819
End Page: 2832
Journal / Book Title: American Journal of Physiology
Volume: 118
Issue: 5
Sponsor/Funder: Medical Research Council (MRC)
Funder's Grant Number: MR/J004685/1
Copyright Statement: Copyright © 2017 by the American Physiological Society. Licensed under Creative Commons Attribution CC-BY 4.0 https://creativecommons.org/licenses/by/4.0/deed.en_US
Keywords: asymmetric rotation
dizziness
motion perception
unilateral vestibular lesion
vestibular neuritis
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Neurology & Neurosurgery
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine



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