Mori Kimihiko, Nakamura Kae, Hashimoto Shingo, Wakida Masanori, Hase Kimitaka
Department of Physical Medicine and Rehabilitation, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan; Department of Physiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan.
Department of Physiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan.
Neurosci Res. 2021 Feb;163:18-25. doi: 10.1016/j.neures.2020.02.005. Epub 2020 Feb 19.
Visual vertical (VV), visually perceived direction of gravity, is widely measured to assess the vestibular function and visuospatial cognition. VV has been assessed by comparing orientation and variability of measured values separately between subject groups. However, changes in orientation and variability often differ in patients with unilateral spatial neglect (USN). Here, we developed a novel classification of VV that combines orientation and variability and characterized the effects of USN on VV. Forty-three subacute stroke patients with or without USN (USN+, n = 17; USN-, n = 26) and 33 age-matched controls were included in the study. In darkness, a luminous line, initially tilted at 30° either to the left or right, gradually rotated towards the vertical. The VV was defined as the deviation of the subjectively-perceived vertical from the true vertical. The new classification demonstrated that, while the majority of USN + patients (14/17) exhibited large variability, nine showed normal orientation and five showed greater contra-lesional deviation of orientation, suggesting different underlying mechanisms for orientation and variability. Further analyses revealed VV deviation to the initial tilt in all groups. However, the deviation in USN + was larger and more variable, indicating attentional disorders. Such characterization would contribute to individually specified clinical rehabilitation.
视觉垂直（VV），即视觉上感知到的重力方向，被广泛用于评估前庭功能和视觉空间认知。通过分别比较不同受试者组测量值的方向和变异性来评估VV。然而，单侧空间忽视（USN）患者的方向和变异性变化往往不同。在此，我们开发了一种结合方向和变异性的VV新分类方法，并描述了USN对VV的影响。本研究纳入了43例有或无USN的亚急性中风患者（USN+组，n = 17；USN-组，n = 26）和33名年龄匹配的对照组。在黑暗中，一条最初向左或向右倾斜30°的发光线逐渐向垂直方向旋转。VV被定义为主观感知的垂直方向与真实垂直方向的偏差。新分类方法表明，虽然大多数USN+患者（14/17）表现出较大变异性，但9例患者方向正常，5例患者的方向向患侧对侧有更大偏差，这表明方向和变异性存在不同的潜在机制。进一步分析发现，所有组中VV均向初始倾斜方向偏移。然而，USN+组的偏移更大且更具变异性，表明存在注意力障碍。这种特征描述将有助于个体化的临床康复。
