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(Stroke. 2005;36:2203.)
© 2005 American Heart Association, Inc.

Original Contributions

Effect of Posture on the Perception of Verticality in Neglect Patients

From the Service de Rééducation Neurologique and EA 2691, Hôpital Swynghedauw (A.S., J.D., M.R.), CHRU de Lille; Neurosciences Fonctionnelles et Pathologies (A.S., J.H., J.D.), FRE2726 CNRS, Université de Lille 2, CHRU de Lille; and URECA (A.S., Y.C.), Université de Lille 3, France.

Correspondence to A. Saj, Laboratoire de Neurosciences Fonctionnelles et Pathologies, CNRS FRE 2726, Service E. F. Vision, CHRU-Hôpital Roger Salengro, 59037 Lille Cedex, France. E-mail a-saj{at}chru-lille.fr

Background and Purpose— The anticlockwise (ACW) deviation of the visual and visuohaptic subjective verticals (SVs), known to occur in patients with right hemisphere lesion, is amplified by spatial neglect (N). These patients have only been assessed when sitting. We investigated the hypothesis that postural changes modulate visuohaptic SV deviation.

Methods— Eight patients presenting with a right hemisphere lesion and spatial N were compared with 6 matched control subjects (C). In the dark, they had to rotate a luminous rod to put it at the vertical in 4 conditions: (1) sitting with plantar sole support; (2) sitting without plantar sole support; (3) sitting with legs extended on a support; and (4) supine position.

Results— N patients showed a significant ACW deviation (–4.5°) of the SV compared with C subjects (+0.01°). The effect of body position depended on the group (P=0.022) because changes had definite effects in the N but not in the C group. In fact, the former showed a reduction of the ACW deviation, from the first to the fourth condition.

Conclusions— Although the possible role of plantar and leg somaesthetic inputs remains to be thoroughly investigated, the modulation of gravitational inputs at trunk or vestibular level influences the SV deviation in N patients. This has to be put in relation with the modulation of N signs reported by other authors when passing from the sitting to the supine position.

Key Words: hemispatial • neglect • posture • stroke • visual vertical

This article has been cited by other articles:

				A Saj, J Honore, C Richard, T Bernati, and M Rousseaux Reducing rightward bias of subjective straight ahead in neglect patients by changes in body orientation J. Neurol. Neurosurg. Psychiatry, September 1, 2008; 79(9): 991 - 996. [Abstract] [Full Text] [PDF]