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Subjective visual vertical in pitch and roll in right hemispheric stroke.

Saj A, Honoré J, Bernati T, Coello Y, Rousseaux M

Service de Rééducation Neurologique, Hôpital Swynghedauw, CHRU de Lille, France.

BACKGROUND AND PURPOSE: Patients with right hemispheric stroke usually present an anticlockwise deviation of the subjective visual vertical (SVV) in the frontal (roll) plane. However, the occurrence of a similar disorder in the sagittal (pitch) plane has never been assessed. We investigated the subjective visual vertical in both planes in those patients. METHODS: Eight patients, 4 with spatial neglect (N+) and 4 without neglect (N-), were compared with 4 healthy participants (C). They sat facing a luminous bar adjustable in rotation, either in the roll or in the pitch plane, and had to orient it in a vertical position, in the dark. RESULTS: Compared with N- (-0.1 degrees) and C (+1.1 degrees) groups, N+ patients presented with a significant backward deviation (-4.5 degrees) of the SVV in pitch. In accordance with other studies, they also showed a significant anticlockwise deviation (-8.8 degrees) of the SVV in roll, as compared with N- (-1.9 degrees) and C (+0.4 degrees) subjects. This was associated with an opposite trunk deviation in both planes. CONCLUSIONS: While confirming the anticlockwise deviation already reported in the frontal plane, we showed for the first time to our knowledge a backward deviation of the SVV in neglect patients, which has to be put in relation with their balance disorders.

Published 1 March 2005 in Stroke, 36(3): 588-91.
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