Impaired tilt perception in Parkinson's disease: a central vestibular integration failure.
Impaired tilt perception in Parkinson's disease: a central vestibular integration failure.
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DOI：
10.1371/journal.pone.0124253
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Palla A
中科院分区：
文献类型：
--
作者：
Bertolini G;Wicki A;Baumann CR;Straumann D;Palla A
平衡控制受损是帕金森病（PD）的一个标志性症状。感觉-运动整合的改变是造成这种缺陷的原因之一。我们的目的是确定受损的前庭信号处理是否增加了疾病。我们让患者（N = 11; 68±6y）和年龄匹配的健康受试者（hS: N = 19; 65±11y）在完全黑暗的运动平台上连续进行两次向前倾斜运动（12个系列；N = 24；总共288次试验），并要求他们指出哪一种倾斜感觉更大。通过将倾斜运动与平移结合起来，我们操纵了前庭感觉输入，以调查假设的损伤是由感觉器官（“单一scc -线索条件”的半圆形通道，“单一t -线索条件”的耳石）本身的缺陷还是感觉整合失败（“多线索条件”）引起的。与hS相比，患者在多线索条件下的倾斜度辨别较差（p = 0.02）。在单线索条件下，两组之间没有发现显著差异。多线索条件与最优观察者理论联合单线索条件预测结果的比较显示，与hS相比，患者（p = 0.04）未能有效地结合SCC和OT信息来改善倾斜感知。我们发现PD患者对前倾的识别不如hS准确，提示前庭知觉受损。此外，与仅激活SCC或OT线索的情况相比，在同时获得SCC和OT信息的情况下，患者的倾斜歧视并没有像hS中那样得到改善。后者提供的证据表明，倾斜误解PD最有可能是前庭信号整合失败的结果。
Impaired balance control is a hallmark symptom in Parkinson’s disease (PD). Altered sensory-motor integration contributes to the deficiency. We aimed to determine whether impaired vestibular signal processing added to the disorder. We exposed patients (N = 11; 68±6y) and age-matched healthy subjects (hS: N = 19; 65±11y) on a motion platform in complete darkness to two consecutive forward tilt movements (12 series; N = 24; overall 288 trials) and asked them to indicate which tilt was perceived larger. By combing tilt movements with translations we manipulated vestibular sensory input in order to investigate whether putative impairment resulted from a deficiency of the sensory organs (semicircular canals in ‘single-SCC-cue-condition’, otoliths in ‘single-OT-cue-condition’) themselves or to a sensory integration failure (‘multi-cue-condition’). Tilt discrimination in the multi-cue-condition was inferior in patients compared to hS (p = 0.02). No significant differences between the two groups were found for both single-cue-conditions. Comparison of multi-cue-condition with a prediction resulting from the combination of both single-cue-conditions by optimal observer theory revealed that patients (p = 0.04), in contrast to hS, failed to efficiently combine SCC and OT information to improve tilt perception. We found that PD patients distinguished forward tilts less precise than hS, suggesting impaired vestibular perception. Tilt discrimination in patients, moreover, did not improve as much as in hS in conditions where both SCC and OT information was available compared to conditions where only SCC or OT cues were activated. The latter provides evidence that tilt misperception in PD most likely results from an integration failure of vestibular signals.
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