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Vestibular compensation of otolith graviceptive dysfunction in stroke patients.

Eur J Neurol. 2021 Nov 22. doi: 10.1111/ene.15193. Epub ahead of print. PMID: 34808013.

Authors/Editors: Baier B, Cuvenhaus H, Müller N, Birklein F, Dieterich M.
Publication Date: 2021


Background and purpose: A sensitive and frequent clinical sign of a vestibular tone imbalance is the tilt of the perceived subjective visual vertical (SVV). There are no data yet focusing on lesion location at the cortical level as a factor for predicting compensation from the tilt of the SVV.

Methods: With modern voxelwise lesion behavior mapping analysis, the present study determines whether lesion location in 23 right-hemispheric cortical stroke patients with an otolith dysfunction could predict the compensation of a vestibular tone imbalance in the chronic stage.

Results: Our statistical anatomical lesion analysis revealed that lesions of the posterior insular cortex are involved in vestibular otolith compensation.

Conclusion: The insular cortex appears to be a critical anatomical region for predicting a tilt of the SVV as a chronic disorder in stroke patients.

Keywords: compensation; insular cortex; stroke; subjective visual vertical.

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