Perception of postural verticality in roll and pitch while sitting and standing in healthy subjects

Assessment of verticality perception is increasingly used in patients with disorders of upright body orientation, e.g. in pusher behavior after hemispheric stroke or in retropulsion in neurovascular or degenerative diseases. The subjective postural vertical (SPV) assesses the individual's perceived upright body orientation in space and can be determined in a sitting or a standing position. As somatosensory input differs between sitting and standing, we suppose a different representation of verticality. Thus, the aim of this study was to compare the SPV while sitting and while standing, and to determine the influence of proprioceptive and visual stimulations on the SPV in both positions. Twenty healthy subjects (18-40 years, 9 female) participated in two experiments. In experiment 1 the SPV was assessed in the pitch and roll planes while sitting and standing. In experiment 2 we additionally applied somatosensory Achilles tendon vibration and visual optokinetic stimulation. Results of experiment 1 revealed no difference of the SPV error between sitting and standing. Though, we found an increased SPV variability while sitting. Experiment 2 showed no effect of sensory manipulation in the pitch plane, but an effect of optokinetic stimulation in the roll plane. The tilt in direction of the visual stimuli was more pronounced while sitting. Optokinetic stimulation also resulted in a larger SPV variability in roll, indicating larger insecurity in verticality estimation during stimulation. In conclusion, even though the SPV assessment while sitting and standing resulted in similar mean values, the larger variability and the higher sensitivity to visual stimuli while sitting suggest different strategies for verticality estimation while sitting and while standing.