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Perception of longitudinal body axis in patients with stroke: a pilot study

¹ Laboratoire de Psychologie et NeuroCognition, Université Pierre Mendès France, Grenoble, CNRS, UMR 5015, France
² Unité de Rééducation Neurologique, Département de Médecine Physique et Réadaptation du CHU de Nîmes, Le Grau du Roi, France
³ Division of Neuroscience & Mental Health, Imperial College London, London, UK
⁴ Service de Rééducation Neurologique-CHU, INSERM Motricité-Plasticité ERM207, Dijon, France

Correspondence to:
Correspondence to:
D Pérennou
Service de Rééducation Neurologique-CHU Centre de Médecine Physique et Réadaptation, INSERM Motricité-Plasticité ERM207, 23 rue Gaffarel, 21079 Dijon, France; dominic.perennou{at}chu-dijon.fr

Background and aims: To investigate the hypothesis that patients with a hemisphere stroke may perceive their longitudinal body axis (LBA) rotated in the frontal plane. This error in an egocentric frame of reference could be detrimental to posture, as tilted LBA would imply an unequal distribution of body mass about the true vertical.

Method: 26 healthy subjects matched in age with 18 patients living with stroke participated in the study. The 18 patients were tested on average 80 days after a first left (n = 8) or right (n = 10) hemisphere stroke. Participants perceived their LBA by adjustments of the orientation of a luminous rod pivoting around a dorsonavel axis to the subjective direction of LBA. Participants were studied in the supine position to dissociate somaesthetic cues from graviceptive cues.

Results: Patients with stroke perceived their LBA rotated to the contralesional side in comparison with controls (p = 0.004). For all controls and 10 patients with stroke, the perceived LBA was very close to true LBA (mean (SD) 0.24° (1.31°)). For eight patients with stroke (six right stroke, two left stroke), the perceived LBA was rotated from true body orientation in the direction opposite to the lesioned side (range 3–9.5°, mean 5.2°). These eight patients provided similar estimates by tactile manipulation of the rod (without vision). The rotation of perceived LBA was more pronounced for right-hemisphere strokes. The magnitudes of perceptual rotations correlated with sensory loss, signs of spatial neglect and the degree of postural and gait disability.

Conclusion: This is the first study showing that certain patients with a hemisphere stroke perceive their LBA rotated to the contralesional side. The consequences for perceptuomotor coordination have implications for their postural disorders.

Abbreviations: LBA, longitudinal body axis

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