Impaired Tilt Suppression of Post-Rotatory Nystagmus and Cross-Coupled Head-Shaking Nystagmus in Cerebellar Lesions: Image Mapping Study

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• 作者：Sun-Uk Lee ; Jeong-Yoon Choi ; Hyo-Jung Kim ; Jeong-Jin Park ; David S. Zee…
• 关键词：Vertigo ; Nystagmus ; Vestibulo ; ocular reflex ; Nodulus ; Uvula
• 刊名：The Cerebellum
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：16
• 期：1
• 页码：95-102
• 全文大小：
• 刊物主题：Neurosciences; Neurology; Neurobiology;
• 出版者：Springer US
• ISSN：1473-4230
• 卷排序：16

文摘

We sought to determine the cerebellar structures responsible for tilt suppression of post-rotatory nystagmus. We investigated ocular motor findings and MRI lesions in 73 patients with isolated cerebellar lesions who underwent recording of the vestibulo-ocular reflex (VOR) using rotatory chair tests. Tilt suppression of post-rotatory nystagmus was diminished in 27 patients (27/73, 37.0 %). The gains of the VOR and the TCs of per- and post-rotatory nystagmus did not differ between the patients with diminished and with normal tilt suppression. The patients with impaired tilt suppression showed perverted (“cross-coupled”) head-shaking nystagmus (pHSN) and central positional nystagmus (CPN) more frequently than those with normal responses. Tilt suppression was impaired in five (71.4 %) of the seven patients with isolated nodulus and uvular infarction. Probabilistic lesion-mapping analysis showed that the nodulus and uvula are responsible for tilt suppression. Impaired tilt suppression may be ascribed to disruption of cerebellar contribution to the vestibular velocity-storage mechanism, which integrates information from the semicircular canals and otolith organs to help derive the brain’s estimate of the head orientation relative to the pull of gravity.