Affiliations: Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri
Note: [*] Reprint address: Gary D. Paige, University of Rochester Medical Center, Department of Neurology, 601 Elmwood Avenue, Box 673, Rochester, NY 14642.
Abstract: Effective interpretation of vestibular inputs to postural control requires that orientation of head on body is known. Postural stability might deteriorate when vestibular information and neck information are not properly coupled, as might occur with vestibular pathology. Postural sway was assessed in unilateral vestibulopathic patients before and acutely, 1,4, and 18+ months after unilateral vestibular ablation (UVA) as well as in normal subjects. Postural equilibrium with eyes closed was quantified as scaled pk-pk sway during 20 s trials in which the support surface was modulated proportionally with sway. Subjects were tested with the head upright and facing forward, turned 45∘ right, and 45∘ left. Equilibrium was uninfluenced by head orientation in normal subjects. In contrast, patients after UV A showed both a general reduction in stability and a right/left head orientation-dependent asymmetry. These abnormalities adaptively recovered with time. It is concluded that vestibular inputs to postural control are interpreted within a sensory-motor context of head-on-body orientation.
