Vestibular impairment and adaptive postural imbalance in parkinsonian patients with lateral trunk flexion
Identifieur interne : 002223 ( Main/Corpus ); précédent : 002222; suivant : 002224Vestibular impairment and adaptive postural imbalance in parkinsonian patients with lateral trunk flexion
Auteurs : Carmine Vitale ; Vincenzo Marcelli ; Teresa Furia ; Gabriella Santangelo ; Autilia Cozzolino ; Katia Longo ; Roberto Allocca ; Marianna Amboni ; Elio Marciano ; Paolo BaroneSource :
- Movement Disorders [ 0885-3185 ] ; 2011-07.
English descriptors
Abstract
Lateral trunk flexion is a very common clinical observation in patients affected by Parkinson's disease. Postural control is known to depend on vestibular, visual, and somatosensory information. The aim of this study was to investigate whether impairment of vestibular function can account for the postural alterations observed in parkinsonian patients with lateral trunk flexion. We evaluated vestibular function in 11 parkinsonian patients with lateral trunk flexion and in 11 age‐, sex‐, and disease duration–matched patients without lateral trunk flexion. The following vestibular tests were performed: infrared videonystagmography including fast and slow ocular movements, spontaneous‐positional and evoked nystagmus search with and without visual fixation, fast positioning maneuvers, the bithermal caloric test, and the vibration test. A peripheral, unilateral vestibular hypofunction was identified in all patients with lateral trunk flexion. The vestibular hypofunction was ipsilateral to the leaning side and contralateral to the most affected parkinsonian side in all patients. In the control group, 7 subjects had no vestibular signs; 4 subjects had unilateral vestibular hypofunction without clinically evident lateral trunk flexion. Two of the latter patients subsequently developed lateral trunk flexion ipsilateral to the vestibular deficit and contralateral to the side most affected by Parkinson's disease. The processing of vestibular information was impaired in parkinsonian patients affected by lateral trunk flexion. The impairment was at least in part responsible for the patients' postural abnormality. We propose that the acronym PISA (Postural Imbalance Syndrome with vestibular Alterations) be used to describe the specific postural change observed in parkinsonian patients affected by a vestibular defect and lateral trunk flexion. © 2011 Movement Disorder Society
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DOI: 10.1002/mds.23657
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patients with lateral trunk flexion</title><author><name sortKey="Vitale, Carmine" sort="Vitale, Carmine" uniqKey="Vitale C" first="Carmine" last="Vitale">Carmine Vitale</name><affiliation><mods:affiliation>Università degli studi di Napoli “Parthenope,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</mods:affiliation></affiliation></author><author><name sortKey="Marcelli, Vincenzo" sort="Marcelli, Vincenzo" uniqKey="Marcelli V" first="Vincenzo" last="Marcelli">Vincenzo Marcelli</name><affiliation><mods:affiliation>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Servizio di Audiologia e Vestibologia, ASL NA‐1 Centro, DSB 50, Naples, Italy</mods:affiliation></affiliation></author><author><name sortKey="Furia, Teresa" sort="Furia, Teresa" uniqKey="Furia T" first="Teresa" last="Furia">Teresa Furia</name><affiliation><mods:affiliation>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</mods:affiliation></affiliation></author><author><name sortKey="Santangelo, Gabriella" sort="Santangelo, Gabriella" uniqKey="Santangelo G" first="Gabriella" last="Santangelo">Gabriella Santangelo</name><affiliation><mods:affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Dipartimento di Psicologia, Facoltà di Psicologia, Seconda Università degli studi di Napoli, Caserta, Italy</mods:affiliation></affiliation></author><author><name 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sortKey="Amboni, Marianna" sort="Amboni, Marianna" uniqKey="Amboni M" first="Marianna" last="Amboni">Marianna Amboni</name><affiliation><mods:affiliation>Università degli studi di Napoli “Parthenope,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</mods:affiliation></affiliation></author><author><name sortKey="Marciano, Elio" sort="Marciano, Elio" uniqKey="Marciano E" first="Elio" last="Marciano">Elio Marciano</name><affiliation><mods:affiliation>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</mods:affiliation></affiliation></author><author><name sortKey="Barone, Paolo" sort="Barone, Paolo" uniqKey="Barone P" first="Paolo" last="Barone">Paolo Barone</name><affiliation><mods:affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-07">2011-07</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1458">1458</biblScope><biblScope unit="page" to="1463">1463</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">9B3BDA0FF736B57A46C9EAEA8286BEFD5DB5C98D</idno><idno type="DOI">10.1002/mds.23657</idno><idno type="ArticleID">MDS23657</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>lateral trunk flexion</term><term>vestibular hypofunction</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Lateral trunk flexion is a very common clinical observation in patients affected by Parkinson's disease. Postural control is known to depend on vestibular, visual, and somatosensory information. The aim of this study was to investigate whether impairment of vestibular function can account for the postural alterations observed in parkinsonian patients with lateral trunk flexion. We evaluated vestibular function in 11 parkinsonian patients with lateral trunk flexion and in 11 age‐, sex‐, and disease duration–matched patients without lateral trunk flexion. The following vestibular tests were performed: infrared videonystagmography including fast and slow ocular movements, spontaneous‐positional and evoked nystagmus search with and without visual fixation, fast positioning maneuvers, the bithermal caloric test, and the vibration test. A peripheral, unilateral vestibular hypofunction was identified in all patients with lateral trunk flexion. The vestibular hypofunction was ipsilateral to the leaning side and contralateral to the most affected parkinsonian side in all patients. In the control group, 7 subjects had no vestibular signs; 4 subjects had unilateral vestibular hypofunction without clinically evident lateral trunk flexion. Two of the latter patients subsequently developed lateral trunk flexion ipsilateral to the vestibular deficit and contralateral to the side most affected by Parkinson's disease. The processing of vestibular information was impaired in parkinsonian patients affected by lateral trunk flexion. The impairment was at least in part responsible for the patients' postural abnormality. We propose that the acronym PISA (Postural Imbalance Syndrome with vestibular Alterations) be used to describe the specific postural change observed in parkinsonian patients affected by a vestibular defect and lateral trunk flexion. © 2011 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Carmine Vitale MD, PhD</name><affiliations><json:string>Università degli studi di Napoli “Parthenope,” Naples, Italy</json:string><json:string>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</json:string><json:string>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</json:string></affiliations></json:item><json:item><name>Vincenzo Marcelli MD</name><affiliations><json:string>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</json:string><json:string>Servizio di Audiologia e Vestibologia, ASL NA‐1 Centro, DSB 50, Naples, Italy</json:string></affiliations></json:item><json:item><name>Teresa Furia MD</name><affiliations><json:string>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</json:string></affiliations></json:item><json:item><name>Gabriella Santangelo PhD</name><affiliations><json:string>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</json:string><json:string>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</json:string><json:string>Dipartimento di Psicologia, Facoltà di Psicologia, Seconda Università degli studi di Napoli, Caserta, Italy</json:string></affiliations></json:item><json:item><name>Autilia Cozzolino MD</name><affiliations><json:string>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</json:string></affiliations></json:item><json:item><name>Katia Longo MD</name><affiliations><json:string>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</json:string><json:string>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</json:string></affiliations></json:item><json:item><name>Roberto Allocca MD</name><affiliations><json:string>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</json:string></affiliations></json:item><json:item><name>Marianna Amboni MD</name><affiliations><json:string>Università degli studi di Napoli “Parthenope,” Naples, Italy</json:string><json:string>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</json:string><json:string>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</json:string></affiliations></json:item><json:item><name>Elio Marciano MD</name><affiliations><json:string>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</json:string></affiliations></json:item><json:item><name>Paolo Barone MD, PhD</name><affiliations><json:string>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</json:string><json:string>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>vestibular hypofunction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>lateral trunk flexion</value></json:item></subject><articleId><json:string>MDS23657</json:string></articleId><language><json:string>eng</json:string></language><abstract>Lateral trunk flexion is a very common clinical observation in patients affected by Parkinson's disease. Postural control is known to depend on vestibular, visual, and somatosensory information. The aim of this study was to investigate whether impairment of vestibular function can account for the postural alterations observed in parkinsonian patients with lateral trunk flexion. We evaluated vestibular function in 11 parkinsonian patients with lateral trunk flexion and in 11 age‐, sex‐, and disease duration–matched patients without lateral trunk flexion. The following vestibular tests were performed: infrared videonystagmography including fast and slow ocular movements, spontaneous‐positional and evoked nystagmus search with and without visual fixation, fast positioning maneuvers, the bithermal caloric test, and the vibration test. A peripheral, unilateral vestibular hypofunction was identified in all patients with lateral trunk flexion. The vestibular hypofunction was ipsilateral to the leaning side and contralateral to the most affected parkinsonian side in all patients. In the control group, 7 subjects had no vestibular signs; 4 subjects had unilateral vestibular hypofunction without clinically evident lateral trunk flexion. Two of the latter patients subsequently developed lateral trunk flexion ipsilateral to the vestibular deficit and contralateral to the side most affected by Parkinson's disease. The processing of vestibular information was impaired in parkinsonian patients affected by lateral trunk flexion. The impairment was at least in part responsible for the patients' postural abnormality. We propose that the acronym PISA (Postural Imbalance Syndrome with vestibular Alterations) be used to describe the specific postural change observed in parkinsonian patients affected by a vestibular defect and lateral trunk flexion. © 2011 Movement Disorder Society</abstract><qualityIndicators><score>6.757</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>1892</abstractCharCount><pdfWordCount>3757</pdfWordCount><pdfCharCount>25259</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>261</abstractWordCount></qualityIndicators><title>Vestibular impairment and adaptive postural imbalance in parkinsonian patients with lateral trunk flexion</title><genre><json:string>article</json:string></genre><host><volume>26</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>6</total><last>1463</last><first>1458</first></pages><issn><json:string>0885-3185</json:string></issn><issue>8</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1002/mds.23657</json:string></doi><id>9B3BDA0FF736B57A46C9EAEA8286BEFD5DB5C98D</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/9B3BDA0FF736B57A46C9EAEA8286BEFD5DB5C98D/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/9B3BDA0FF736B57A46C9EAEA8286BEFD5DB5C98D/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/9B3BDA0FF736B57A46C9EAEA8286BEFD5DB5C98D/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Vestibular impairment and adaptive postural imbalance in parkinsonian patients with lateral trunk flexion</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">*Relevant conflicts of interest/financial disclosures: Nothing to report. 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Pansini 5, 80131 Naples, Italy</p></note><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-07"></date><biblScope unit="volume">26</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1458">1458</biblScope><biblScope unit="page" to="1463">1463</biblScope></imprint></monogr><idno type="istex">9B3BDA0FF736B57A46C9EAEA8286BEFD5DB5C98D</idno><idno type="DOI">10.1002/mds.23657</idno><idno type="ArticleID">MDS23657</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Lateral trunk flexion is a very common clinical observation in patients affected by Parkinson's disease. Postural control is known to depend on vestibular, visual, and somatosensory information. The aim of this study was to investigate whether impairment of vestibular function can account for the postural alterations observed in parkinsonian patients with lateral trunk flexion. We evaluated vestibular function in 11 parkinsonian patients with lateral trunk flexion and in 11 age‐, sex‐, and disease duration–matched patients without lateral trunk flexion. The following vestibular tests were performed: infrared videonystagmography including fast and slow ocular movements, spontaneous‐positional and evoked nystagmus search with and without visual fixation, fast positioning maneuvers, the bithermal caloric test, and the vibration test. A peripheral, unilateral vestibular hypofunction was identified in all patients with lateral trunk flexion. The vestibular hypofunction was ipsilateral to the leaning side and contralateral to the most affected parkinsonian side in all patients. In the control group, 7 subjects had no vestibular signs; 4 subjects had unilateral vestibular hypofunction without clinically evident lateral trunk flexion. Two of the latter patients subsequently developed lateral trunk flexion ipsilateral to the vestibular deficit and contralateral to the side most affected by Parkinson's disease. The processing of vestibular information was impaired in parkinsonian patients affected by lateral trunk flexion. The impairment was at least in part responsible for the patients' postural abnormality. We propose that the acronym PISA (Postural Imbalance Syndrome with vestibular Alterations) be used to describe the specific postural change observed in parkinsonian patients affected by a vestibular defect and lateral trunk flexion. © 2011 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>vestibular hypofunction</term></item><item><term>lateral trunk flexion</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-07-31">Received</change><change when="2010-12-28">Registration</change><change when="2011-07">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/9B3BDA0FF736B57A46C9EAEA8286BEFD5DB5C98D/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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Pansini 5, 80131 Naples, Italy</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23657.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="34"></count><count type="wordTotal" number="5088"></count></countGroup><titleGroup><title type="main" xml:lang="en">Vestibular impairment and adaptive postural imbalance in parkinsonian patients with lateral trunk flexion<link href="#fn2"></link></title><title type="short" xml:lang="en">Vestibular Impairment in PD Patients With Ltf</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2 #af3" noteRef="#fn1"><personName><givenNames>Carmine</givenNames><familyName>Vitale</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af4 #af5" noteRef="#fn1"><personName><givenNames>Vincenzo</givenNames><familyName>Marcelli</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Teresa</givenNames><familyName>Furia</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2 #af3 #af6"><personName><givenNames>Gabriella</givenNames><familyName>Santangelo</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Autilia</givenNames><familyName>Cozzolino</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af2 #af3"><personName><givenNames>Katia</givenNames><familyName>Longo</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Roberto</givenNames><familyName>Allocca</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af2 #af3"><personName><givenNames>Marianna</givenNames><familyName>Amboni</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Elio</givenNames><familyName>Marciano</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af2 #af3" corresponding="yes"><personName><givenNames>Paolo</givenNames><familyName>Barone</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>barone@unina.it</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="IT" type="organization"><unparsedAffiliation>Università degli studi di Napoli “Parthenope,” Naples, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="IT" type="organization"><unparsedAffiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="IT" type="organization"><unparsedAffiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="IT" type="organization"><unparsedAffiliation>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="IT" type="organization"><unparsedAffiliation>Servizio di Audiologia e Vestibologia, ASL NA‐1 Centro, DSB 50, Naples, Italy</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="IT" type="organization"><unparsedAffiliation>Dipartimento di Psicologia, Facoltà di Psicologia, Seconda Università degli studi di Napoli, Caserta, Italy</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">vestibular hypofunction</keyword><keyword xml:id="kwd3">lateral trunk flexion</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Lateral trunk flexion is a very common clinical observation in patients affected by Parkinson's disease. Postural control is known to depend on vestibular, visual, and somatosensory information. The aim of this study was to investigate whether impairment of vestibular function can account for the postural alterations observed in parkinsonian patients with lateral trunk flexion. We evaluated vestibular function in 11 parkinsonian patients with lateral trunk flexion and in 11 age‐, sex‐, and disease duration–matched patients without lateral trunk flexion. The following vestibular tests were performed: infrared videonystagmography including fast and slow ocular movements, spontaneous‐positional and evoked nystagmus search with and without visual fixation, fast positioning maneuvers, the bithermal caloric test, and the vibration test. A peripheral, unilateral vestibular hypofunction was identified in all patients with lateral trunk flexion. The vestibular hypofunction was ipsilateral to the leaning side and contralateral to the most affected parkinsonian side in all patients. In the control group, 7 subjects had no vestibular signs; 4 subjects had unilateral vestibular hypofunction without clinically evident lateral trunk flexion. Two of the latter patients subsequently developed lateral trunk flexion ipsilateral to the vestibular deficit and contralateral to the side most affected by Parkinson's disease. The processing of vestibular information was impaired in parkinsonian patients affected by lateral trunk flexion. The impairment was at least in part responsible for the patients' postural abnormality. We propose that the acronym <i>PISA</i> (<i>P</i>ostural <i>I</i>mbalance <i>S</i>yndrome with vestibular <i>A</i>lterations) be used to describe the specific postural change observed in parkinsonian patients affected by a vestibular defect and lateral trunk flexion. © 2011 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn2"><p><b>Relevant conflicts of interest/financial disclosures:</b> Nothing to report. Full financial disclosures and author roles may be found in the online version of this article.</p></note><note xml:id="fn1"><p>Carmine Vitale and Vincenzo Marcelli contributed equally to this article.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Vestibular impairment and adaptive postural imbalance in parkinsonian patients with lateral trunk flexion</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Vestibular Impairment in PD Patients With Ltf</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Vestibular impairment and adaptive postural imbalance in parkinsonian patients with lateral trunk flexion</title></titleInfo><name type="personal"><namePart type="given">Carmine</namePart><namePart type="family">Vitale</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Università degli studi di Napoli “Parthenope,” Naples, Italy</affiliation><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</affiliation><description>Carmine Vitale and Vincenzo Marcelli contributed equally to this article.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Vincenzo</namePart><namePart type="family">Marcelli</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</affiliation><affiliation>Servizio di Audiologia e Vestibologia, ASL NA‐1 Centro, DSB 50, Naples, Italy</affiliation><description>Carmine Vitale and Vincenzo Marcelli contributed equally to this article.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Teresa</namePart><namePart type="family">Furia</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gabriella</namePart><namePart type="family">Santangelo</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</affiliation><affiliation>Dipartimento di Psicologia, Facoltà di Psicologia, Seconda Università degli studi di Napoli, Caserta, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Autilia</namePart><namePart type="family">Cozzolino</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Katia</namePart><namePart type="family">Longo</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roberto</namePart><namePart type="family">Allocca</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marianna</namePart><namePart type="family">Amboni</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Università degli studi di Napoli “Parthenope,” Naples, Italy</affiliation><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elio</namePart><namePart type="family">Marciano</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Servizio di Audiologia e Vestibologia, Dipartimento di Neuroscienze, Università “Federico II,” Naples, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paolo</namePart><namePart type="family">Barone</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Dipartimento di Scienze Neurologiche, Università “Federico II,” Naples, Italy</affiliation><affiliation>Istituto di Diagnosi e Cura “Hermitage Capodimonte,” Naples, Italy</affiliation><description>Correspondence: Department of Neurological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-07</dateIssued><dateCaptured encoding="w3cdtf">2010-07-31</dateCaptured><dateValid encoding="w3cdtf">2010-12-28</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">2</extent><extent unit="references">34</extent><extent unit="words">5088</extent></physicalDescription><abstract lang="en">Lateral trunk flexion is a very common clinical observation in patients affected by Parkinson's disease. Postural control is known to depend on vestibular, visual, and somatosensory information. The aim of this study was to investigate whether impairment of vestibular function can account for the postural alterations observed in parkinsonian patients with lateral trunk flexion. We evaluated vestibular function in 11 parkinsonian patients with lateral trunk flexion and in 11 age‐, sex‐, and disease duration–matched patients without lateral trunk flexion. The following vestibular tests were performed: infrared videonystagmography including fast and slow ocular movements, spontaneous‐positional and evoked nystagmus search with and without visual fixation, fast positioning maneuvers, the bithermal caloric test, and the vibration test. A peripheral, unilateral vestibular hypofunction was identified in all patients with lateral trunk flexion. The vestibular hypofunction was ipsilateral to the leaning side and contralateral to the most affected parkinsonian side in all patients. In the control group, 7 subjects had no vestibular signs; 4 subjects had unilateral vestibular hypofunction without clinically evident lateral trunk flexion. Two of the latter patients subsequently developed lateral trunk flexion ipsilateral to the vestibular deficit and contralateral to the side most affected by Parkinson's disease. The processing of vestibular information was impaired in parkinsonian patients affected by lateral trunk flexion. The impairment was at least in part responsible for the patients' postural abnormality. We propose that the acronym PISA (Postural Imbalance Syndrome with vestibular Alterations) be used to describe the specific postural change observed in parkinsonian patients affected by a vestibular defect and lateral trunk flexion. © 2011 Movement Disorder Society</abstract><note type="content">*Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author roles may be found in the online version of this article.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>vestibular hypofunction</topic><topic>lateral trunk flexion</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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