Topology of brainstem lesions associated with subjective visual vertical tilt
Topology of brainstem lesions associated with subjective visual vertical tilt
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与主观视觉垂直倾斜相关的脑干病变的拓扑结构
DOI：
10.1212/wnl.0000000000000480
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发表时间：
2014
期刊：
影响因子：
9.9
通讯作者：
Seul
中科院分区：
文献类型：
--
作者：
Tae;Sun;K. Kwak;Jongmin Lee;Byoung;Seul
目的：我们的目的是确定脑干垂直知觉的解剖通路的拓扑结构。方法：对82例急性单侧脑干梗死患者进行主观视觉垂直（SVV）检查。负责病理SVV倾斜脑干病变的拓扑结构确定使用基于MRI的体素病变行为映射，从概率病变地图构建。结果如下：急性单侧脑干梗死患者中50%（41/82）有SVV倾斜异常，其中76%（31/41）为同侧倾斜，24%（10/41）为反侧倾斜。SVV反向倾斜的患者表现出前庭内侧核的吻侧、内侧纵束、吻侧间质内侧纵束和Cajal间质核的重叠病变。与此相反，与同侧SVV倾斜和眼功能障碍的患者表现出病变的内侧和下前庭核在延髓尾侧，而那些孤立的垂直知觉变化的内侧丘系的内侧损伤。结论：我们的研究结果提供了一个途径传递同侧耳石信号的证据，该途径绕过内侧丘系内侧的眼神经系统，称为同侧前庭丘脑束。
Objective: We aimed to determine the topology of anatomical pathways for verticality perception in the brainstem. Methods: We measured the subjective visual vertical (SVV) in 82 patients with acute unilateral infarction of the brainstem alone. The topology of the brainstem lesions responsible for pathologic SVV tilt were determined using MRI-based voxel-wise lesion-behavior mapping, from which probabilistic lesion maps were constructed. Results: Fifty percent of patients (41/82) with acute unilateral brainstem infarcts had abnormal SVV tilt, of which 76% (31/41) had ipsiversive tilt and 24% (10/41) had contraversive tilt. Patients with contraversive SVV tilt exhibited overlapping lesions of the rostral medial vestibular nucleus, medial longitudinal fasciculus, rostral interstitial medial longitudinal fasciculus, and interstitial nucleus of Cajal. In contrast, patients with ipsiversive SVV tilt and oculomotor disturbances exhibited lesions of the medial and inferior vestibular nuclei in the caudal medulla, while those with isolated vertical perceptual changes had injury to the medial side of the medial lemniscus. Conclusions: Our findings provide evidence of a pathway transmitting ipsiversive otolithic signals that bypass the oculomotor system at the medial side of the medial lemniscus, called the ipsilateral vestibulothalamic tract.
影响因子：
9.9
作者：
Zwergal, A.;Cnyrim, C.;Strupp, M.
通讯作者：
Strupp, M.