Journal
ANNALS OF NEUROLOGY
Volume 77, Issue 2, Pages 343-347Publisher
WILEY
DOI: 10.1002/ana.24329
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Funding
- Swiss National Science Foundation, Berne, Switzerland [32003B_130163/1]
- Betty and David Koetser Foundation for Brain Research, Zurich, Switzerland
- Center of Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Bonizzi-Theler Foundation, Zurich, Switzerland
- Swiss National Science Foundation (SNF) [32003B_130163] Funding Source: Swiss National Science Foundation (SNF)
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Current concepts postulate a decisive role of the cerebellar nodulus in the processing of otolith input. We hypothesized that nodular lesions abolish otolith-perceptual integration, predicting alignment of perceived direction of earth vertical with the z-axis of the head and not with gravity. In an 80-year-old patient with acute heminodular infarction, the subjective visual vertical deviated contralesionally by -21.1 degrees when the patient was upright. After subtracting this offset, perceived vertical closely matched the patient's head orientation when the patient was roll-tilted. Otolith-ocular reflexes remained normal. This is the first report on abolished earth verticality perception in heminodular stroke and underlines the importance of the nodulus in spatial orientation. Ann Neurol 2015;77:343-347
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