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Related Experiment Video

Updated: Apr 29, 2026

Assessment of Static Graviceptive Perception in the Roll-Plane using the Subjective Visual Vertical Paradigm
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Subjective visual vertical in Pisa syndrome.

Darío H Scocco1, Judith N Wagner2, Juan Racosta1

  • 1Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina.

Parkinsonism & Related Disorders
|May 27, 2014
PubMed
Summary

Parkinson's Disease (PD) and Pisa Syndrome (PS) significantly alter the subjective visual vertical (SVV) perception in patients. These changes suggest primary perceptual dysfunction rather than being solely due to body axis deviation.

Keywords:
Lateral trunk flexionPostural controlVestibular diseaseVisual vertical – Parkinson's disease

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Area of Science:

  • Neuroscience
  • Perception Science
  • Movement Disorders

Background:

  • Parkinson's Disease (PD) impacts sensory integration, affecting visual dependency and spatial awareness.
  • Pisa Syndrome (PS), a lateral body deviation in PD, has an unclear origin.
  • Investigating the link between PS, altered subjective visual vertical (SVV), and sensory contributions is crucial.

Purpose of the Study:

  • To determine if Pisa Syndrome (PS) is associated with altered subjective visual vertical (SVV) perception in Parkinson's Disease (PD) patients.
  • To differentiate between SVV alterations secondary to body deviation versus primary perceptual dysfunction.
  • To explore the influence of sensory modalities and dopaminergic medication on these perceptual changes.

Main Methods:

  • Compared SVV perception in 17 PD patients (8 with PS, 9 without PS) and 18 healthy controls.
  • Assessed SVV in seated, lateral horizontal, and manually rectified positions (for PS patients).
  • Evaluated visual dependency using frame and moving stimulus patterns, with and without dopaminergic medication ('on'/'off').

Main Results:

  • PD patients (medicated) and PS patients (medicated and unmedicated) showed significant SVV deviations compared to controls when seated.
  • SVV differences persisted in PS patients (unmedicated) even after manual correction.
  • Increased visual dependency was observed in PD patients (unmedicated) compared to controls when in a lateral position.

Conclusions:

  • Both PD and PS patients exhibit SVV deviations not fully explained by their lateral body posture.
  • These perceptual alterations likely stem from primary sensory dysfunction or modified internal verticality models.
  • Re-weighting of perceptual inputs may underlie these observed changes in PD and PS.