Vestibular Circuits in Stroke survivors

Stroke is a common disorder in the elderly and is one of the main causes of permanent disability and mortality. Regardless of the heterogeneity and high inter-subject variability of the effects of stroke, balance and gait problems are one of the most important post-stroke conflicts which, based on evidence, leads to difficulties in motion ability control and locomotor disability. Postural instability is more prominent in patients with right hemisphere damage and probably related to its spatial role. Human spatial orientation uses from purely objects vertical perception for lateralization to gravity and its disorder is related to balance recovery after stroke. The neuroanatomical basis of visual vertical judgment is a vast cortical network, which is organized bilaterally. This cortical network includes several areas of the occipital, parietal, and temporal lobes in addition to the cerebellum and brainstem. These areas play an important role in vertical perception and also play a role in the processing of vestibular information. To date, changes in cortical networks in stroke patients with abnormal vertical perception have not been addressed. In this article, we examined the changes in this network so that by examining the changes, a way can be provided for the better neurorehabilitation of this group of patients.脑卒中（Stroke）是老年人常见的神经系统病症，亦是引发永久性残疾与死亡的主要诱因之一。尽管脑卒中的病理效应存在显著异质性且个体间差异较大，但平衡与步态障碍仍是卒中后最主要的并发症之一，现有研究证实此类障碍会导致运动控制困难与运动功能残疾。右侧半球损伤患者的姿势不稳症状更为突出，这可能与其空间认知功能的特异性作用相关。人类空间定向能力涵盖从单纯物体垂直感知到重力侧向化的完整范畴，其功能紊乱与卒中后平衡恢复进程密切相关。视觉垂直判断的神经解剖基础是一套双侧构建的广泛皮层网络。该网络除小脑与脑干外，还包含枕叶、顶叶及颞叶的多个功能脑区。这些脑区不仅在垂直感知过程中发挥核心作用，同时参与前庭信息的处理与整合。截至目前，针对垂直感知异常的脑卒中患者的皮层网络变化尚未得到充分研究与阐释。本研究针对该皮层网络的变化展开系统性分析，以期通过揭示此类变化，为该类患者的优化神经康复提供理论依据与实践路径。