Impaired perception of surface tilt in progressive supranuclear palsy

Marian Dale, Fay Horak, W. Geoffrey Wright, Bernadette M. Schoneburg, John Nutt, Martina Mancini

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction Progressive supranuclear palsy (PSP) is characterized by early postural instability and backward falls. The mechanisms underlying backward postural instability in PSP are not understood. The aim of this study was to test the hypothesis that postural instability in PSP is a result of dysfunction in the perception of postural verticality. Methods We gathered posturography data on 12 subjects with PSP to compare with 12 subjects with idiopathic Parkinson's Disease (PD) and 12 healthy subjects. Objective tests of postural impairment included: dynamic sensory perception tests of gravity and of surface oscillations, postural responses to surface perturbations, the sensory organization test of postural sway under altered sensory conditions and limits of stability in stance. Results Perception of toes up (but not toes down) surface tilt was reduced in subjects with PSP compared to both control subjects (p≤0.001 standing, p≤0.007 seated) and subjects with PD (p≤0.03 standing, p≤0.04 seated). Subjects with PSP, PD and normal controls accurately perceived the direction of gravity when standing on a tilting surface. Unlike PD and control subjects, subjects with PSP exerted less postural corrective torque in response to toes up surface tilts. Discussion Difficulty perceiving backward tilt of the surface or body may account for backward falls and postural impairments in patients with PSP. These observations suggest that abnormal central integration of sensory inputs for perception of body and surface orientation contributes to the pathophysiology of postural instability in PSP.

Original languageEnglish (US)
Article numbere0173351
JournalPLoS One
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2017

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Progressive Supranuclear Palsy
paralysis
Parkinson disease
Parkinson Disease
Toes
Gravitation
gravity
Gravity Sensing
testing
torque
Torque
pathophysiology
oscillation
Healthy Volunteers

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Impaired perception of surface tilt in progressive supranuclear palsy. / Dale, Marian; Horak, Fay; Wright, W. Geoffrey; Schoneburg, Bernadette M.; Nutt, John; Mancini, Martina.

In: PLoS One, Vol. 12, No. 3, e0173351, 01.03.2017.

Research output: Contribution to journalArticle

Dale, Marian ; Horak, Fay ; Wright, W. Geoffrey ; Schoneburg, Bernadette M. ; Nutt, John ; Mancini, Martina. / Impaired perception of surface tilt in progressive supranuclear palsy. In: PLoS One. 2017 ; Vol. 12, No. 3.
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