Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?
Postural instability is a frequent symptom of patients with idiopathic normal pressure hydrocephalus (iNPH), and might be due to the misperception of body verticality. The objective of this study was to assess the usefulness of the subjective body vertical (SBV) as a potential tool for diagnosing iN...
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| Veröffentlicht in: | Journal of neurology 2016-09, Vol.263 (9), p.1819-1827 |
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| creator | Selge, C. Schoeberl, F. Bergmann, J. Kreuzpointner, A. Bardins, S. Schepermann, A. Schniepp, R. Koenig, E. Mueller, F. Brandt, T. Dieterich, M. Zwergal, A. Jahn, K. |
| description | Postural instability is a frequent symptom of patients with idiopathic normal pressure hydrocephalus (iNPH), and might be due to the misperception of body verticality. The objective of this study was to assess the usefulness of the subjective body vertical (SBV) as a potential tool for diagnosing iNPH. Twenty patients with iNPH underwent tests of SBV in the pitch and roll planes before and after cerebrospinal fluid (CSF) drainage. Ten patients with other central gait disorders served as controls and also underwent tests for SBV. Before CSF drainage, patients with iNPH showed an impaired verticality perception in the pitch plane with a significant backward deviation of the SBV as compared to the control group (iNPH: mean ± SD −3.7 ± 3.6°; control group: −0.8 ± 2.2°;
t
value = −2.30,
p
t
-test
= 0.03). After CSF drainage, the SBV of the iNPH patients normalized for the pitch plane (−0.9 ± 1.9°). There was a correlation between the backward deviation of the SBV and the ventricular enlargement of the frontal horns (Evan’s index;
r
= −0.52;
p
Pearson
= 0.02). An even stronger correlation was found with the enlargement of the third ventricle (Thalamus index;
r
= −0.64;
p
Pearson
= 0.002). The new and clinically relevant finding of this study is that verticality perception of patients with iNPH is primarily impaired the pitch plane, and it improves after CSF drainage. This disturbance in pitch might be due to a bilateral central vestibular dysfunction of the thalamus. Determination of the SBV in pitch promises to increase diagnostic accuracy in the cases of suspected iNPH. |
| doi_str_mv | 10.1007/s00415-016-8186-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1827910037</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1817053026</sourcerecordid><originalsourceid>FETCH-LOGICAL-c471t-27751d564bf4b6634e10388e4188534c0dc4c4872e9322a66b8aa1711d3e4d8f3</originalsourceid><addsrcrecordid>eNqNkUFrGzEQhUVpaFy3P6CXIuill01mJK0k51JCaJtAIIckZ6GVZFtmvXKl3YD_fWWclhIo5CTQ--bpjR4hnxDOEECdFwCBbQMoG41aNvCGzFBw1qBoF2_JDLiApuWtOCXvS9kAgK7CO3LKFOdiAXJGuvup2wQ3xqdAu-T39CnkMTrbX1BLdzltY4nDivpoV0MqVaFjSj2NA40-pp0d1_VqSHlr-4qHUqYc6Hrvc3Jht7b9VL59ICdL25fw8fmck8cf3x-urpvbu583V5e3jRMKx4Yp1aJvpeiWopOSi4DAtQ4CtW65cOCdcEIrFhacMStlp61Fheh5EF4v-Zx8PfrW2L-mUEZTw7vQ93YIaSoGNVOL-m9cvQJFBS0HJiv65QW6SVMe6iIHSgoGrOacEzxSLqdScliaXY5bm_cGwRy6MseuTO3KHLoyh5nPz85Ttw3-78SfcirAjkCp0rAK-Z-n_-v6G5LqndE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1816420210</pqid></control><display><type>article</type><title>Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Selge, C. ; Schoeberl, F. ; Bergmann, J. ; Kreuzpointner, A. ; Bardins, S. ; Schepermann, A. ; Schniepp, R. ; Koenig, E. ; Mueller, F. ; Brandt, T. ; Dieterich, M. ; Zwergal, A. ; Jahn, K.</creator><creatorcontrib>Selge, C. ; Schoeberl, F. ; Bergmann, J. ; Kreuzpointner, A. ; Bardins, S. ; Schepermann, A. ; Schniepp, R. ; Koenig, E. ; Mueller, F. ; Brandt, T. ; Dieterich, M. ; Zwergal, A. ; Jahn, K.</creatorcontrib><description>Postural instability is a frequent symptom of patients with idiopathic normal pressure hydrocephalus (iNPH), and might be due to the misperception of body verticality. The objective of this study was to assess the usefulness of the subjective body vertical (SBV) as a potential tool for diagnosing iNPH. Twenty patients with iNPH underwent tests of SBV in the pitch and roll planes before and after cerebrospinal fluid (CSF) drainage. Ten patients with other central gait disorders served as controls and also underwent tests for SBV. Before CSF drainage, patients with iNPH showed an impaired verticality perception in the pitch plane with a significant backward deviation of the SBV as compared to the control group (iNPH: mean ± SD −3.7 ± 3.6°; control group: −0.8 ± 2.2°;
t
value = −2.30,
p
t
-test
= 0.03). After CSF drainage, the SBV of the iNPH patients normalized for the pitch plane (−0.9 ± 1.9°). There was a correlation between the backward deviation of the SBV and the ventricular enlargement of the frontal horns (Evan’s index;
r
= −0.52;
p
Pearson
= 0.02). An even stronger correlation was found with the enlargement of the third ventricle (Thalamus index;
r
= −0.64;
p
Pearson
= 0.002). The new and clinically relevant finding of this study is that verticality perception of patients with iNPH is primarily impaired the pitch plane, and it improves after CSF drainage. This disturbance in pitch might be due to a bilateral central vestibular dysfunction of the thalamus. Determination of the SBV in pitch promises to increase diagnostic accuracy in the cases of suspected iNPH.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-016-8186-0</identifier><identifier>PMID: 27334906</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Accidental Falls ; Aged ; Balance ; Biomechanical Phenomena ; Catheters ; Cerebrospinal Fluid Shunts ; Cognitive ability ; Diagnostic tests ; Drainage ; Female ; Gait ; Gait Disorders, Neurologic - diagnosis ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure - diagnosis ; Hydrocephalus, Normal Pressure - diagnostic imaging ; Hydrocephalus, Normal Pressure - therapy ; Male ; Medicine ; Medicine & Public Health ; Neurologic Examination - methods ; Neurology ; Neuropsychological Tests ; Neuroradiology ; Neurosciences ; Original Communication ; Patients ; Perception ; Postural Balance ; Posture ; Proprioception ; Severity of Illness Index ; Surgery ; Third Ventricle - diagnostic imaging</subject><ispartof>Journal of neurology, 2016-09, Vol.263 (9), p.1819-1827</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-27751d564bf4b6634e10388e4188534c0dc4c4872e9322a66b8aa1711d3e4d8f3</citedby><cites>FETCH-LOGICAL-c471t-27751d564bf4b6634e10388e4188534c0dc4c4872e9322a66b8aa1711d3e4d8f3</cites><orcidid>0000-0001-5896-1363</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-016-8186-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-016-8186-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27334906$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Selge, C.</creatorcontrib><creatorcontrib>Schoeberl, F.</creatorcontrib><creatorcontrib>Bergmann, J.</creatorcontrib><creatorcontrib>Kreuzpointner, A.</creatorcontrib><creatorcontrib>Bardins, S.</creatorcontrib><creatorcontrib>Schepermann, A.</creatorcontrib><creatorcontrib>Schniepp, R.</creatorcontrib><creatorcontrib>Koenig, E.</creatorcontrib><creatorcontrib>Mueller, F.</creatorcontrib><creatorcontrib>Brandt, T.</creatorcontrib><creatorcontrib>Dieterich, M.</creatorcontrib><creatorcontrib>Zwergal, A.</creatorcontrib><creatorcontrib>Jahn, K.</creatorcontrib><title>Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Postural instability is a frequent symptom of patients with idiopathic normal pressure hydrocephalus (iNPH), and might be due to the misperception of body verticality. The objective of this study was to assess the usefulness of the subjective body vertical (SBV) as a potential tool for diagnosing iNPH. Twenty patients with iNPH underwent tests of SBV in the pitch and roll planes before and after cerebrospinal fluid (CSF) drainage. Ten patients with other central gait disorders served as controls and also underwent tests for SBV. Before CSF drainage, patients with iNPH showed an impaired verticality perception in the pitch plane with a significant backward deviation of the SBV as compared to the control group (iNPH: mean ± SD −3.7 ± 3.6°; control group: −0.8 ± 2.2°;
t
value = −2.30,
p
t
-test
= 0.03). After CSF drainage, the SBV of the iNPH patients normalized for the pitch plane (−0.9 ± 1.9°). There was a correlation between the backward deviation of the SBV and the ventricular enlargement of the frontal horns (Evan’s index;
r
= −0.52;
p
Pearson
= 0.02). An even stronger correlation was found with the enlargement of the third ventricle (Thalamus index;
r
= −0.64;
p
Pearson
= 0.002). The new and clinically relevant finding of this study is that verticality perception of patients with iNPH is primarily impaired the pitch plane, and it improves after CSF drainage. This disturbance in pitch might be due to a bilateral central vestibular dysfunction of the thalamus. Determination of the SBV in pitch promises to increase diagnostic accuracy in the cases of suspected iNPH.</description><subject>Accidental Falls</subject><subject>Aged</subject><subject>Balance</subject><subject>Biomechanical Phenomena</subject><subject>Catheters</subject><subject>Cerebrospinal Fluid Shunts</subject><subject>Cognitive ability</subject><subject>Diagnostic tests</subject><subject>Drainage</subject><subject>Female</subject><subject>Gait</subject><subject>Gait Disorders, Neurologic - diagnosis</subject><subject>Humans</subject><subject>Hydrocephalus</subject><subject>Hydrocephalus, Normal Pressure - diagnosis</subject><subject>Hydrocephalus, Normal Pressure - diagnostic imaging</subject><subject>Hydrocephalus, Normal Pressure - therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurologic Examination - methods</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Patients</subject><subject>Perception</subject><subject>Postural Balance</subject><subject>Posture</subject><subject>Proprioception</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Third Ventricle - diagnostic imaging</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkUFrGzEQhUVpaFy3P6CXIuill01mJK0k51JCaJtAIIckZ6GVZFtmvXKl3YD_fWWclhIo5CTQ--bpjR4hnxDOEECdFwCBbQMoG41aNvCGzFBw1qBoF2_JDLiApuWtOCXvS9kAgK7CO3LKFOdiAXJGuvup2wQ3xqdAu-T39CnkMTrbX1BLdzltY4nDivpoV0MqVaFjSj2NA40-pp0d1_VqSHlr-4qHUqYc6Hrvc3Jht7b9VL59ICdL25fw8fmck8cf3x-urpvbu583V5e3jRMKx4Yp1aJvpeiWopOSi4DAtQ4CtW65cOCdcEIrFhacMStlp61Fheh5EF4v-Zx8PfrW2L-mUEZTw7vQ93YIaSoGNVOL-m9cvQJFBS0HJiv65QW6SVMe6iIHSgoGrOacEzxSLqdScliaXY5bm_cGwRy6MseuTO3KHLoyh5nPz85Ttw3-78SfcirAjkCp0rAK-Z-n_-v6G5LqndE</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Selge, C.</creator><creator>Schoeberl, F.</creator><creator>Bergmann, J.</creator><creator>Kreuzpointner, A.</creator><creator>Bardins, S.</creator><creator>Schepermann, A.</creator><creator>Schniepp, R.</creator><creator>Koenig, E.</creator><creator>Mueller, F.</creator><creator>Brandt, T.</creator><creator>Dieterich, M.</creator><creator>Zwergal, A.</creator><creator>Jahn, K.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5896-1363</orcidid></search><sort><creationdate>20160901</creationdate><title>Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus?</title><author>Selge, C. ; 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The objective of this study was to assess the usefulness of the subjective body vertical (SBV) as a potential tool for diagnosing iNPH. Twenty patients with iNPH underwent tests of SBV in the pitch and roll planes before and after cerebrospinal fluid (CSF) drainage. Ten patients with other central gait disorders served as controls and also underwent tests for SBV. Before CSF drainage, patients with iNPH showed an impaired verticality perception in the pitch plane with a significant backward deviation of the SBV as compared to the control group (iNPH: mean ± SD −3.7 ± 3.6°; control group: −0.8 ± 2.2°;
t
value = −2.30,
p
t
-test
= 0.03). After CSF drainage, the SBV of the iNPH patients normalized for the pitch plane (−0.9 ± 1.9°). There was a correlation between the backward deviation of the SBV and the ventricular enlargement of the frontal horns (Evan’s index;
r
= −0.52;
p
Pearson
= 0.02). An even stronger correlation was found with the enlargement of the third ventricle (Thalamus index;
r
= −0.64;
p
Pearson
= 0.002). The new and clinically relevant finding of this study is that verticality perception of patients with iNPH is primarily impaired the pitch plane, and it improves after CSF drainage. This disturbance in pitch might be due to a bilateral central vestibular dysfunction of the thalamus. Determination of the SBV in pitch promises to increase diagnostic accuracy in the cases of suspected iNPH.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27334906</pmid><doi>10.1007/s00415-016-8186-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5896-1363</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Accidental Falls Aged Balance Biomechanical Phenomena Catheters Cerebrospinal Fluid Shunts Cognitive ability Diagnostic tests Drainage Female Gait Gait Disorders, Neurologic - diagnosis Humans Hydrocephalus Hydrocephalus, Normal Pressure - diagnosis Hydrocephalus, Normal Pressure - diagnostic imaging Hydrocephalus, Normal Pressure - therapy Male Medicine Medicine & Public Health Neurologic Examination - methods Neurology Neuropsychological Tests Neuroradiology Neurosciences Original Communication Patients Perception Postural Balance Posture Proprioception Severity of Illness Index Surgery Third Ventricle - diagnostic imaging |
| title | Subjective body vertical: a promising diagnostic tool in idiopathic normal pressure hydrocephalus? |
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