Bisdorff A R, Anastasopoulos D, Bronstein A M, Gresty M A
MRC Human Movement and Balance Unit, National Hospital for Neurology and Neurosurgery, London, England.
Acta Otolaryngol Suppl. 1995;520 Pt 1:68-71. doi: 10.3109/00016489509125193.
The perception of subjective postural vertical was assessed in normals and patients with peripheral and central vestibular disorders and spasmodic torticollis. The subjects were seated in a motorized gimbal with the head and torso restrained and their eyes closed. The gimbal executed 7-10 cycles of tilt around the vertical at 1.5 degrees/s in either pitch or roll. Subjects indicated when they began to feel upright and again when they began to feel tilted by an analogous 3-position joystick. Normal subjects felt upright within a sector of 5-6 degrees around vertical in pitch and roll. Five patients with absent vestibular function, 25 torticollis patients and 3 patients with acute unilateral peripheral vestibular lesions showed a significant increase of the sector in pitch and roll, but only the latter had a mild directional bias. Two patients with long standing complete unilateral vestibular deficit and 8 patients with up or downbeat nystagmus in the vicinity of upright had abnormally large sectors within which they felt to be upright. The results suggest that vestibular function is important for the accurate perception of the postural vertical and that a directional asymmetry in vestibulo-ocular function or a head tilt does not necessarily correlate with a directional bias of subjective verticality.
在正常人和患有外周及中枢前庭疾病以及痉挛性斜颈的患者中评估了主观姿势垂直感知。受试者坐在一个电动万向节上，头部和躯干受到限制且双眼闭合。万向节以1.5度/秒的速度围绕垂直轴在俯仰或横滚方向上执行7 - 10个倾斜周期。受试者通过一个类似的三位操纵杆指示他们何时开始感觉直立，以及何时开始感觉倾斜。正常受试者在俯仰和横滚方向上围绕垂直轴的5 - 6度扇形范围内感觉直立。5名前庭功能缺失的患者、25名斜颈患者和3名急性单侧外周前庭病变患者在俯仰和横滚方向上的扇形范围显著增加，但只有后者有轻微的方向偏差。2名长期存在完全单侧前庭功能缺失的患者以及8名在直立附近有上跳或下跳性眼球震颤的患者，他们感觉直立的扇形范围异常大。结果表明，前庭功能对于姿势垂直的准确感知很重要，并且前庭眼功能的方向不对称或头部倾斜不一定与主观垂直性的方向偏差相关。
