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. 2021 Oct 27:15:733684.
doi: 10.3389/fnsys.2021.733684. eCollection 2021.

Representation of Body Orientation in Vestibular-Defective Patients Before and After Unilateral Vestibular Loss

Liliane Borel  1 , Jacques Honoré  2 , Mathilde Bachelard-Serra  3   4 , Jean-Pierre Lavieille  1   3 , Arnaud Saj  5   6   7
Affiliations

Representation of Body Orientation in Vestibular-Defective Patients Before and After Unilateral Vestibular Loss

Liliane Borel et al. Front Syst Neurosci. .

Abstract

Introduction: The unilateral vestibular syndrome results in postural, oculomotor, perceptive, and cognitive symptoms. This study was designed to investigate the role of vestibular signals in body orientation representation, which remains poorly considered in vestibular patients. Methods: The subjective straight ahead (SSA) was investigated using a method disentangling translation and rotation components of error. Participants were required to align a rod with their body midline in the horizontal plane. Patients with right vestibular neurotomy (RVN; n =8) or left vestibular neurotomy (LVN; n = 13) or vestibular schwannoma resection were compared with 12 healthy controls. Patients were tested the day before surgery and during the recovery period, 7 days and 2 months after the surgery. Results: Before and after unilateral vestibular neurotomy, i.e., in the chronic phases, patients showed a rightward translation bias of their SSA, without rotation bias, whatever the side of the vestibular loss. However, the data show that the lower the translation error before neurotomy, the greater its increase 2 months after a total unilateral vestibular loss, therefore leading to a rightward translation of similar amplitude in the two groups of patients. In the early phase after surgery, SSA moved toward the operated side both in translation and in rotation, as typically found for biases occurring after unilateral vestibular loss, such as the subjective visual vertical (SVV) bias. Discussion and Conclusion: This study gives the first description of the immediate consequences and of the recovery time course of body orientation representation after a complete unilateral vestibular loss. The overall evolution differed according to the side of the lesion with more extensive changes over time before and after left vestibular loss. It is noteworthy that representational disturbances of self-orientation were highly unusual in the chronic stage after vestibular loss and similar to those reported after hemispheric lesions causing spatial neglect, while classical ipsilesional biases were reported in the acute stage. This study strongly supports the notion that the vestibular system plays a major role in body representation processes and more broadly in spatial cognition. From a clinical point of view, SSA appeared to be a reliable indicator for the presence of a vestibular disorder.

Keywords: recovery time-course; spatial cognition; spatial orientation; subjective visual straight ahead; unilateral vestibular loss.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Apparatus and participant positioning for assessing the SSA.
Figure 2
Figure 2
SSA deviation in translation and rotation plotted in left-right coordinates. The SSA is reported for patients with LVN (filled squares) and RVN (filled circles), and healthy controls (open circles). Positive signs indicate rightward translation and clockwise (CW) rotation. CCW: counterclockwise. The bars show the standard errors.
Figure 3
Figure 3
SSA deviation in translation and rotation plotted in ipsi-contra coordinates (relative to the operated side). The SSA is reported for patients with LVN (filled squares) and RVN (filled circles). Positive signs indicate contralateral translation and rotation. The bars show the standard errors.
Figure 4
Figure 4
Long-term increase of the right translation bias as a function of the initial bias in right (RVN) and left (LVN) operated patients.
See this image and copyright information in PMC

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