Detailed Information

Cited 0 time in webofscience Cited 0 time in scopus
Metadata Downloads

Characteristics and mechanism of apogeotropic central positional nystagmus

Authors
Choi, Jeong-YoonGlasauer, StefanKim, Ji HyunZee, David S.Kim, Ji-Soo
Issue Date
3월-2018
Publisher
OXFORD UNIV PRESS
Keywords
vertigo; nystagmus; positional nystagmus; velocity-storage mechanism; nodulus
Citation
BRAIN, v.141, pp.762 - 775
Indexed
SCIE
SCOPUS
Journal Title
BRAIN
Volume
141
Start Page
762
End Page
775
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/76800
DOI
10.1093/brain/awx381
ISSN
0006-8950
Abstract
Here we characterize persistent apogeotropic type of central positional nystagmus, and compare it with the apogeotropic nystagmus of benign paroxysmal positional vertigo involving the lateral canal. Nystagmus was recorded in 27 patients with apogeotropic type of central positional nystagmus (22 with unilateral and five with diffuse cerebellar lesions) and 20 patients with apogeotropic nystagmus of benign paroxysmal positional vertigo. They were tested while sitting, while supine with the head straight back, and in the right and left ear-down positions. The intensity of spontaneous nystagmus was similar while sitting and supine in apogeotropic type of central positional nystagmus, but greater when supine in apogeotropic nystagmus of benign paroxysmal positional vertigo. In central positional nystagmus, when due to a focal pathology, the lesions mostly overlapped in the vestibulocerebellum (nodulus, uvula, and tonsil). We suggest a mechanism for apogeotropic type of central positional nystagmus based on the location of lesions and a model that uses the velocity-storage mechanism. During both tilt and translation, the otolith organs can relay the same gravito-inertial acceleration signal. This inherent ambiguity can be resolved by a ` tilt-estimator circuit' in which information from the semicircular canals about head rotation is combined with otolith information about linear acceleration through the velocity-storage mechanism. An example of how this mechanism works in normal subjects is the sustained horizontal nystagmus that is produced when a normal subject is rotated at a constant speed around an axis that is tilted away from the true vertical (off-vertical axis rotation). We propose that when the tilt-estimator circuit malfunctions, for example, with lesions in the vestibulocerebellum, the estimate of the direction of gravity is erroneously biased away from true vertical. If the bias is toward the nose, when the head is turned to the side while supine, there will be sustained, unwanted, horizontal positional nystagmus (apogeotropic type of central positional nystagmus) because of an inappropriate feedback signal indicating that the head is rotating when it is not.
Files in This Item
There are no files associated with this item.
Appears in
Collections
College of Medicine > Department of Medical Science > 1. Journal Articles

qrcode

Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.

Related Researcher

Researcher Kim, Ji Hyun photo

Kim, Ji Hyun
의과대학 (의학과)
Read more

Altmetrics

Total Views & Downloads

BROWSE