The Subjective Visual Vertical and the Subjective Haptic Vertical Access Different Gravity Estimates

The subjective visual vertical (SVV) and the subjective haptic vertical (SHV) both claim to probe the underlying perception of gravity. However, when the body is roll tilted these two measures evoke different patterns of errors with SVV generally becoming biased towards the body (A-effect, named for its discoverer, Hermann Rudolph Aubert) and SHV remaining accurate or becoming biased away from the body (E-effect, short for Entgegengesetzt-effect, meaning “opposite”, i.e., opposite to the A-effect). We compared the two methods in a series of five experiments and provide evidence that the two measures access two different but related estimates of gravitational vertical. Experiment 1 compared SVV and SHV across three levels of whole-body tilt and found that SVV showed an A-effect at larger tilts while SHV was accurate. Experiment 2 found that tilting either the head or the trunk independently produced an A-effect in SVV while SHV remained accurate when the head was tilted on an upright body but showed an A-effect when the body was tilted below an upright head. Experiment 3 repeated these head/body configurations in the presence of vestibular noise induced by using disruptive galvanic vestibular stimulation (dGVS). dGVS abolished both SVV and SHV A-effects while evoking a massive E-effect in the SHV head tilt condition. Experiments 4 and 5 show that SVV and SHV do not combine in an optimally statistical fashion, but when vibration is applied to the dorsal neck muscles, integration becomes optimal. Overall our results suggest that SVV and SHV access distinct underlying gravity percepts based primarily on head and body position information respectively, consistent with a model proposed by Clemens and colleagues.     

Adaptive Visual Re-Weighting in Children’s Postural Control

This study investigated how children’s postural control adapts to changes in the visual environment and whether they use previous experience to adjust postural responses to following expositions. Four-, eight-, and twelve-year-old children (10 in each group) and 10 young adults stood upright inside of a moving room during eight trials each lasting one-minute. In the first trial, the room was stationary. In the following seven trials, the room oscillated at 0.2 Hz, amplitude of 0.5 cm, with the exception of the fifth trial, in which the room oscillated with amplitude of 3.2 cm. Body sway responses of young adults and older children down-weighted more to the increased visual stimulus amplitude when compared to younger children. In addition, four- and eight-year-old children quickly up-weighted body responses to visual stimulus in the subsequent two trials after the high amplitude trial. Sway variability decreased with age and was greatest during the high-amplitude trial. These results indicate that four year olds have already developed the adaptive capability to quickly down-weight visual influences. However, the increased gain values and residual variability observed for the younger children suggest that they have not fully calibrated their adaptive response to that of the young adults tested. Moreover, younger children do not carry over their previous experience from the sensorial environment to adapt to future changes.     

Differential Effects of Visual Feedback on Subjective Visual Vertical Accuracy and Precision

The brain constructs an internal estimate of the gravitational vertical by integrating multiple sensory signals. In darkness, systematic head-roll dependent errors in verticality estimates, as measured by the subjective visual vertical (SVV), occur. We hypothesized that visual feedback after each trial results in increased accuracy, as physiological adjustment errors (A−/E-effect) are likely based on central computational mechanisms and investigated whether such improvements were related to adaptational shifts of perceived vertical or to a higher cognitive strategy. We asked 12 healthy human subjects to adjust a luminous arrow to vertical in various head-roll positions (0 to 120deg right-ear down, 15deg steps). After each adjustment visual feedback was provided (lights on, display of previous adjustment and of an earth-vertical cross). Control trials consisted of SVV adjustments without feedback. At head-roll angles with the largest A-effect (90, 105, and 120deg), errors were reduced significantly (p<0.001) by visual feedback, i.e. roll under-compensation decreased, while precision of SVV was not significantly (p>0.05) influenced. In seven subjects an additional session with two consecutive blocks (first with, then without visual feedback) was completed at 90, 105 and 120deg head-roll. In these positions the error-reduction by the previous visual feedback block remained significant over the consecutive 18–24 min (post-feedback block), i.e., was still significantly (p<0.002) different from the control trials. Eleven out of 12 subjects reported having consciously added a bias to their perceived vertical based on visual feedback in order to minimize errors. We conclude that improvements of SVV accuracy by visual feedback, which remained effective after removal of feedback for ≥18 min, rather resulted from a cognitive strategy than by adapting the internal estimate of the gravitational vertical. The mechanisms behind the SVV therefore, remained stable, which is also supported by the fact that SVV precision – depending mostly on otolith input - was not affected by visual feedback.     

Benefit of Bi-Ocular Visual Stimulation for Postural Control in Children with Strabismus

Vision is important for postural control as is shown by the Romberg quotient (RQ): with eyes closed, postural instability increases relative to eyes open (RQ = 2). Yet while fixating at far distance, postural stability is similar with eyes open and eyes closed (RQ = 1). Postural stability can be better with both eyes viewing than one eye, but such effect is not consistent among healthy subjects. The first goal of the study is to test the RQ as a function of distance for children with convergent versus divergent strabismus. The second goal is to test whether vision from two eyes relative to vision from one eye provides better postural stability. Thirteen children with divergent strabismus and eleven with convergent strabismus participated in this study. Posturtography was done with the Techno concept device. Experiment 1, four conditions: fixation at 40 cm and at 200 cm both with eyes open and eyes covered (evaluation of RQ). Experiment 2, six conditions: fixation at 40 cm and at 200 cm, with both eyes viewing or under monocular vision (dominant and non-dominant eye). For convergent strabismus, the groups mean value of RQ was 1.3 at near and 0.94 at far distance; for divergent, it was 1.06 at near and 1.68 at far. For all children, the surface of body sway was significantly smaller under both eyes viewing than monocular viewing (either eye). Increased RQ value at near for convergent and at far for divergent strabismus is attributed to the influence of the default strabismus angle and to better use of ocular motor signals. Vision with the two eyes improves postural control for both viewing distances and for both types of strabismus. Such benefit can be due to complementary mechanisms: larger visual field, better quality of fixation and vergence angle due to the use of visual inputs from both eyes.     

Effects of White Matter Injury on Resting State fMRI Measures in Prematurely Born Infants

The cerebral white matter is vulnerable to injury in very preterm infants (born prior to 30 weeks gestation), resulting in a spectrum of lesions. These range from severe forms, including cystic periventricular leukomalacia and periventricular hemorrhagic infarction, to minor focal punctate lesions. Moderate to severe white matter injury in preterm infants has been shown to predict later neurodevelopmental disability, although outcomes can vary widely in infants with qualitatively comparable lesions. Resting state functional connectivity magnetic resonance imaging has been increasingly utilized in neurodevelopmental investigations and may provide complementary information regarding the impact of white matter injury on the developing brain. We performed resting state functional connectivity magnetic resonance imaging at term equivalent postmenstrual age in fourteen preterm infants with moderate to severe white matter injury secondary to periventricular hemorrhagic infarction. In these subjects, resting state networks were identifiable throughout the brain. Patterns of aberrant functional connectivity were observed and depended upon injury severity. Comparisons were performed against data obtained from prematurely-born infants with mild white matter injury and healthy, term-born infants and demonstrated group differences. These results reveal structural-functional correlates of preterm white matter injury and carry implications for future investigations of neurodevelopmental disability.     

Polarity-Dependent Misperception of Subjective Visual Vertical during and after Transcranial Direct Current Stimulation (tDCS)

Pathologic tilt of subjective visual vertical (SVV) frequently has adverse functional consequences for patients with stroke and vestibular disorders. Repetitive transcranial magnetic stimulation (rTMS) of the supramarginal gyrus can produce a transitory tilt on SVV in healthy subjects. However, the effect of transcranial direct current stimulation (tDCS) on SVV has never been systematically studied. We investigated whether bilateral tDCS over the temporal-parietal region could result in both online and offline SVV misperception in healthy subjects. In a randomized, sham-controlled, single-blind crossover pilot study, thirteen healthy subjects performed tests of SVV before, during and after the tDCS applied over the temporal-parietal region in three conditions used on different days: right anode/left cathode; right cathode/left anode; and sham. Subjects were blind to the tDCS conditions. Montage-specific current flow patterns were investigated using computational models. SVV was significantly displaced towards the anode during both active stimulation conditions when compared to sham condition. Immediately after both active conditions, there were rebound effects. Longer lasting after-effects towards the anode occurred only in the right cathode/left anode condition. Current flow models predicted the stimulation of temporal-parietal regions under the electrodes and deep clusters in the posterior limb of the internal capsule. The present findings indicate that tDCS over the temporal-parietal region can significantly alter human SVV perception. This tDCS approach may be a potential clinical tool for the treatment of SVV misperception in neurological patients.     

Postural Control During Visual and Kinesthetic Motor Imagery

Despite the accumulating evidence supporting an interaction between cognitive functions and postural control, little is known about the selective impact of the mental representation of an action, i.e., motor imagery (MI) on postural control. As postural oscillations are reduced during a cognitive task of backward silent counting, a greater stability is also expected during MI compared to a no-task condition (standing). Twenty participants took part in this experiment, which aimed at providing evidence that MI may improve postural stability. They were requested to mentally imagine a movement while standing on a force-plate. Results showed a decrease in both path length and postural sway variability on the anterior-posterior and lateral axes during all dual-task sessions, as compared to the motionless condition. These postural adjustments might result from both central and peripheral processes, and/or increased muscle stiffness. Conversely, postural oscillation amplitude increased on the vertical axis during MI of three vertical jumps, hence suggesting that postural regulations remain task-related during MI. Finally, our data showed that kinesthetic and visual imagery differentially impacted the postural regulation.     

Increased Adiposity in Adults Born Preterm and Their Children

Background

Preterm birth is associated with abnormalities in growth, body composition, and metabolism during childhood, but adult data are scarce and none exist for their offspring. We therefore aimed to examine body composition and cardiovascular risk factors in adults born preterm and their children.

Methods

A cohort of 52 adults (aged 35.7 years, 54% female, 31 born preterm) and their term-born children (n=61, aged 8.0 years, 54% female, 60% from a preterm parent) were studied. Auxology and body composition (whole-body dual-energy X-ray absorptiometry) were measured, and fasting blood samples taken for metabolic and hormonal assessments.

Results

Adults born preterm had greater abdominal adiposity, displaying more truncal fat (p=0.006) and higher android to gynoid fat ratio (p=0.004). Although women born preterm and at term were of similar weight and BMI, men born preterm (n=8) were on average 20 kg heavier (p=0.010) and of greater BMI (34.2 vs 28.4 kg/m²; p=0.021) than men born at term (n=16). Adults born preterm also displayed a less favourable lipid profile, including lower HDL-C concentrations (p=0.007) and greater total cholesterol to HDL-C ratio (p=0.047). Children of parents born preterm tended to have more body fat than the children of parents born at term (21.3 vs 17.6%; p=0.055). Even after adjustment for mean parental BMI, children of parents born preterm had altered fat distribution, with more truncal fat (p=0.048) and greater android to gynoid fat ratio (p=0.009).

Conclusions

Adults born preterm, particularly men, have markedly increased fat mass and altered fat distribution. A similar increase in abdominal adiposity was observed in the term born offspring of parents born preterm, indicating that adverse outcomes associated with preterm birth may extend to the next generation.     

Risk Factors for Postural Tachycardia Syndrome in Children and Adolescents

Background

Postural tachycardia syndrome (POTS) is prevalent in children and adolescents and has a great impact on health. But its risk factors have not been fully understood. This study aimed to explore possible risk factors for children and adolescents with POTS.

Methods and Findings

600 children and adolescents (test group) aged 7–18 (11.9±3.0) years old, 259 males and 341 females, were recruited for identifying its risk factors. Another 197 subjects aged from 7 to 18 (11.3±2.3) years old were enrolled in the validation group. Heart rate (HR) and blood pressure (BP) were monitored during upright test. Risk factors were analyzed and sensitivity and specificity for predicting POTS were tested via receiver operating characteristic curve. Among 600 subjects, 41 were confirmed with POTS patients (6.8%) based on clinical manifestation and upright test. The results showed a significant difference in daily water intake, the daily sleeping hours, supine HR, HR increment and maximum HR during upright test between POTS and the unaffected children (P<0.05). Likelihood of POTS would increase by 1.583 times if supine HR was increased by 10 beats/min (95%CI 1.184 to 2.116, P<0.01), by 3.877 times if a child''s water intake was less than 800 ml/day (95%CI 1.937 to 7.760, P<0.001), or by 5.905 times (95%CI 2.972 to 11.733, P<0.001) if sleeping hours were less than 8 hours/day. Supine HR, daily water intake and sleeping hours showed the capability of predicting POTS in children and adolescents with an AUC of 83.9% (95% CI: 78.6%–89.1%), sensitivity of 80.5% and specificity of 75%. Furthermore, in validation group, predictive sensitivity and specificity were 73.3% and 72.5%.

Conclusion

Faster supine HR, less water intake and shorter sleeping hours were identified as risk factors for POTS.     

Incidence of Neoplasms in Children Born after Influenza Epidemics

Following a recent report that neoplasia of the lymphatic and haematopoietic tissues is commoner than average in children whose mothers have had influenza in pregnancy, the incidence of neoplasms in 1954-68 in children of the Manchester Hospital Region was examined in relation to date of birth. There were no significant differences between cohorts born in different quinquennia. Incidence among children born after six influenza epidemics in 1951-68 was no higher than among other children born in these years. It is concluded that if there is an association between maternal influenza and childhood neoplasia it is probably due to factors such as immunological deficiencies which may predispose independently to both conditions.     

Saccades Improve Postural Control: A Developmental Study in Normal Children

Introduction

Dual-task performance is known to affect postural stability in children. This study focused on the effect of oculomotor tasks like saccadic eye movements on postural stability, studied in a large population of children by recording simultaneously their eye movements and posture.

Materials and Methods

Ninety-five healthy children from 5.8 to 17.6 years old were examined. All children were free of any vestibular, neurological, ophtalmologic and orthoptic abnormalities. Postural control was measured with a force platform TechnoConcept®, and eye movements with video oculography (MobilEBT®). Children performed two oculomotor tasks: fixation of a stable central target and horizontal saccades. We measured the saccade latency and the number of saccades during fixation as well as the surface, length and mean velocity of the center of pressure.

Results

During postural measurement, we observed a correlation between the age on the one hand and a decrease in saccade latency as well as an improvement in the quality of fixation on the other. Postural sway decreases with age and is reduced in the dual task (saccades) in comparison with a simple task of fixation.

Discussion - Conclusion

These results suggest a maturation of neural circuits controlling posture and eye movements during childhood. This study also shows the presence of an interaction between the oculomotor system and the postural system. Engaging in oculomotor tasks results in a reduction of postural sway.     

Interaction between Visual and Proprioceptive Analyzers in Vertical Posture Control

The CNS can precisely assess the spatial position of the human body only by simultaneously processing and integrating the visual, proprioceptive, and vestibular inputs. Postural stability data make it possible to estimate changes taking place in the function of analyzers involved in the maintenance of the upright posture. The vertical posture stability was assessed in healthy children and children with spastic diplegic cerebral palsy from their postural responses to the presentation of single optokinetic or somatosensory stimuli. The visual analyzer was found to play a significant role in maintaining the upright position under natural gravity conditions in healthy children. A single exposure of the proprioceptive system to variable forces directed with the gravity of the earth (vertical) decreased the contribution of the visual analyzer. Healthy children maintained the upright position relying on the direction of movement of the optokinetic stimuli, which, however, produced no effect on the maintenance of posture in the patients. A hypothesis is proposed that prenatal or early postnatal CNS lesions decrease the contribution of phylogenetically newer brain structures to the regulation of upright posture.     

Postural Sway and Gaze Can Track the Complex Motion of a Visual Target

Variability is an inherent and important feature of human movement. This variability has form exhibiting a chaotic structure. Visual feedback training using regular predictive visual target motions does not take into account this essential characteristic of the human movement, and may result in task specific learning and loss of visuo-motor adaptability. In this study, we asked how well healthy young adults can track visual target cues of varying degree of complexity during whole-body swaying in the Anterior-Posterior (AP) and Medio-Lateral (ML) direction. Participants were asked to track three visual target motions: a complex (Lorenz attractor), a noise (brown) and a periodic (sine) moving target while receiving online visual feedback about their performance. Postural sway, gaze and target motion were synchronously recorded and the degree of force-target and gaze-target coupling was quantified using spectral coherence and Cross-Approximate entropy. Analysis revealed that both force-target and gaze-target coupling was sensitive to the complexity of the visual stimuli motions. Postural sway showed a higher degree of coherence with the Lorenz attractor than the brown noise or sinusoidal stimulus motion. Similarly, gaze was more synchronous with the Lorenz attractor than the brown noise and sinusoidal stimulus motion. These results were similar regardless of whether tracking was performed in the AP or ML direction. Based on the theoretical model of optimal movement variability tracking of a complex signal may provide a better stimulus to improve visuo-motor adaptation and learning in postural control.     

The Effect of a Stroop-like Task on Postural Control in Dyslexic Children

The influence of a secondary task on concurrent postural control was explored in twenty-one dyslexic children (mean age: 10.4±0.3 years). Data were compared with twenty age-matched non-dyslexic children. As a secondary task, a modified Stroop test was used, in which words were replaced with pictures of fruits. The postural control of children was recorded in standard Romberg condition as the children were asked to name the colour of fruits appearing consecutively on a computer screen. Two conditions were tested: a congruent condition, in which the fruit was drawn in its natural ripe colour, and a non-congruent colour condition (NC), in which the fruit was drawn in three abnormal colours. A fixating condition was used as baseline. We analyzed the surface, length and mean speed of the center of pressure and measured the number of correct responses in the Stroop-like tasks. Dyslexic children were seen to be significantly more unstable than non-dyslexic ones. For both groups of children, the secondary task significantly increased postural instability in comparison with the fixating condition. The number of correct responses in the modified Stroop task was significantly higher in the non-dyslexic than in the dyslexic group. The postural instability observed in dyslexic children is in line with the cerebellar hypothesis and supports the idea of a deficit in automatic performance in such children. Furthermore, in accordance with cross domain competition model, our findings show that attentional resources are used to a greater extent by the secondary task than in controlling body stability.