@article{ref1,
title="Why do patients with PSP fall? Evidence for abnormal otolith responses",
journal="Neurology",
year="2008",
author="Leigh, R. J. and Strupp, M. and Walker, Michaela F. and Estrovich, I. and Joshi, A. and Wagner, J. and Liao, K.",
volume="70",
number="10",
pages="802-809",
abstract="BACKGROUND: Patients with progressive supranuclear palsy (PSP) fall frequently, beginning early in the course of their disease. Abnormal vestibulospinal reflexes are suspected, but the angular vestibulo-ocular reflex, which is mediated by the labyrinthine semicircular canals, survives late into the course of the disease. OBJECTIVE: To test the hypothesis that otolithic-mediated reflexes are abnormal in PSP. METHODS: We tested otolith-ocular reflexes (the translational vestibulo-ocular reflex tVOR.) during combined rotation-translation in nine patients with PSP and nine age-matched control subjects; subjects viewed far and near targets. We also tested click-induced otolith-spinal reflexes (vestibular-evoked myogenic potentials VEMPs.) in 10 patients with PSP and 30 age-matched controls. RESULTS: All patients with PSP had small tVOR responses during near viewing that were, on average, only 12% of those of control subjects (p = 0.001). Patients with PSP also showed a reduction of the amplitude of VEMPs compared to control subjects (median range.: 54.3 16.8 to 214. vs 149 11.6 to 466., p = 0.001). CONCLUSIONS: Taken together, these results indicate that abnormal otolith-mediated reflexes may be at least partly responsible for frequent falls in progressive supranuclear palsy, and deserve further study.<p /> <p>Language: en</p>",
language="en",
issn="0028-3878",
doi="10.1212/01.wnl.0000304134.33380.1e",
url="http://dx.doi.org/10.1212/01.wnl.0000304134.33380.1e"
}