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The indirect motor or extrapyramidal pathways originate in the brainstem, the lower portion of the brain that connects it to the spinal cord. They consist of several distinct tracts, each with specialized functions. The four main tracts of the indirect motor pathways are the vestibulospinal tract, the reticulospinal tract, the tectospinal tract, and the rubrospinal tract.
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Related Experiment Video

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Experimental Methods to Study Human Postural Control
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Multisensory integration in balance control.

A M Bronstein1

  • 1Neuro-otology Unit, Imperial College London, Charing Cross Hospital and National Hospital for Neurology and Neurosurgery, London, United Kingdom.

Handbook of Clinical Neurology
|September 18, 2016
PubMed
Summary
This summary is machine-generated.

Multisensory integration is key for balance control, with visual-vestibular interaction crucial for suppressing the vestibulo-ocular reflex (VOR). Understanding VOR suppression aids in diagnosing central balance disorders and treating visual vertigo.

Keywords:
VOR suppressiondizzinessoscillopsiavisual vertigovisuo–vestibular interaction

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Area of Science:

  • Neuroscience
  • Biomechanics
  • Ophthalmology

Background:

  • Multisensory integration, particularly visuo-vestibular interaction, is fundamental for maintaining balance in both healthy individuals and those with diseases.
  • The vestibulo-ocular reflex (VOR) suppression, an ability of the visual system to modulate the VOR, is a key area of study.
  • Impairment in VOR suppression is indicative of central nervous system lesions, making its assessment clinically valuable.

Purpose of the Study:

  • To introduce the concept of multisensory integration in balance control, encompassing visual, somatosensory, and vestibular inputs.
  • To explore the clinical relevance of vestibulo-ocular reflex (VOR) suppression in diagnosing central versus peripheral balance disorders.
  • To present the principles of rehabilitation for visual vertigo, a condition characterized by dizziness triggered by visual stimuli.

Main Methods:

  • Review of experimental findings on visually-evoked postural responses, highlighting the visual system's potential to initially dominate other sensory inputs.
  • Analysis of the syndrome of visual vertigo, including its triggers and patient-reported symptoms like dizziness in visually stimulating environments.
  • Presentation of a diagnostic algorithm for oscillopsia and differentiation from visual vertigo.

Main Results:

  • Visual stimuli can generate postural responses that temporarily override vestibular and proprioceptive signals.
  • VOR suppression is impaired by central lesions, offering a diagnostic marker distinct from peripheral vestibular dysfunction.
  • Visual vertigo patients experience dizziness in response to optokinetic stimuli or visually complex environments.

Conclusions:

  • Multisensory integration is critical for effective balance control, with visuo-vestibular interactions playing a significant role.
  • Assessment of VOR suppression is a valuable clinical tool for identifying central neurological deficits affecting balance.
  • Rehabilitation strategies involving repeated exposure to visual motion can effectively treat visual vertigo.