Document Detail


Altered control of postural sway following cerebral infarction: a cross-sectional analysis.
MedLine Citation:
PMID:  20142612     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Balance impairment is common following cerebral infarction. However, the effects of lesion hemisphere on postural control are largely unknown. We examined dependence upon vision and noninfarcted regional brain tissue volumes for postural control in individuals with right and left hemisphere middle cerebral artery (MCA) infarcts.
METHODS: Subjects with right MCA infarct (n = 17, age = 65 +/- 8 years, 7 +/- 6 years poststroke), left MCA infarct (n = 20, age = 65 +/- 8 years, 7 +/- 6 years poststroke), and controls (n = 55, age = 65 +/- 8 years) were studied. Postural control was defined by average velocity and the range and variability of mediolateral (ML) and anteroposterior (AP) sway during eyes-open and eyes-closed standing. Regional brain volumes were quantified using anatomic MRI at 3 Tesla.
RESULTS: Right and left hemisphere stroke groups had similar infarct volumes and outcomes. Subjects with right hemisphere infarcts demonstrated greater sway velocity, ML range, and ML variability with eyes closed compared to eyes open. In this group, smaller occipital lobe volumes were associated with greater eyes-open sway velocity (R = -0.64, p = 0.012) and ML range (R = -0.82, p = 0.001). Smaller cerebellar volumes were associated with greater eyes-closed sway velocity (R = -0.60, p = 0.015), ML range (R = -0.70, p = 0.007), and ML variability (R = -0.85, p < 0.001). These associations were not observed in left hemisphere infarct subjects or controls. AP sway was unaffected by infarct hemisphere or visual condition and did not correlate with regional brain volumes.
CONCLUSIONS: Right hemisphere middle cerebral artery infarcts are associated with increased dependence on vision and noninfarcted brain regions (i.e., occipital lobes, cerebellum) to control postural sway. Strategies emphasizing postural tasks under reduced visual conditions may enhance functional recovery in these individuals.
Authors:
B Manor; K Hu; P Zhao; M Selim; D Alsop; P Novak; L Lipsitz; V Novak
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  74     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-03-05     Revised Date:  2014-09-22    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  458-64     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Biomechanical Phenomena
Cerebral Infarction / physiopathology*
Cross-Sectional Studies
Feedback, Physiological / physiology
Female
Functional Laterality / physiology*
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Photic Stimulation / methods
Postural Balance / physiology*
Posture / physiology*
Residence Characteristics
Visual Perception / physiology
Grant Support
ID/Acronym/Agency:
AG004390/AG/NIA NIH HHS; AG023480/AG/NIA NIH HHS; R01 AG028076/AG/NIA NIH HHS; R01 AG028076-01A2/AG/NIA NIH HHS; R01 NS045745/NS/NINDS NIH HHS; R01 NS045745-01A2/NS/NINDS NIH HHS; R01-NS045745/NS/NINDS NIH HHS; R41 NS053128/NS/NINDS NIH HHS; R41 NS053128-01A2/NS/NINDS NIH HHS; T32 AG023480/AG/NIA NIH HHS; UL 1RR025758/RR/NCRR NIH HHS; UL1 RR025758/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Neurology. 2010 Feb 9;74(6):448-9   [PMID:  20142611 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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