TY - JOUR T1 - Visual sensorial preference delays balance control compensation after vestibular schwannoma surgery JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 1287 LP - 1294 DO - 10.1136/jnnp.2007.135913 VL - 79 IS - 11 AU - C Parietti-Winkler AU - G C Gauchard AU - C Simon AU - Ph P Perrin Y1 - 2008/11/01 UR - http://jnnp.bmj.com/content/79/11/1287.abstract N2 - Background: Balance control performance after vestibular schwannoma surgical removal follows a course that is characterised by a deterioration in postural performance immediately after unilateral vestibular deafferentation (uVD) and a recovery process (vestibular compensation). However, sensory strategies for balance vary during tumoral growth, which could lead to differences in the preferential use of sensory afferences. This longitudinal study aimed to assess the post-operative sensorimotor strategies of postural regulation according to sensory preference of balance control before surgery.Methods: Twenty-two patients with vestibular schwannoma (11 relying less on vision (G1), 11 relying more on vision (G2), to control balance before surgery), underwent vestibular, subjective visual vertical (SVV), static posturography and sensory organisation (SOT) tests, before and 8 days, 1 and 3 months after surgery.Results: In G1 patients, little static posturographic and SOT performance deterioration after uVD was observed, despite vestibular test and SVV modifications. In G2 patients, uVD-related modifications followed a time-course characterised by a degradation in posturographic and SOT, vestibular and SVV performances immediately after uVD and a progressive restoration and even improvement 1 month and particularly 3 months after surgery.Conclusions: High preference for vision before surgery intervenes in postural degradation immediately after surgery, thus delaying the short-term effects of vestibular compensation on postural control. Long-term performance being similar whatever the visual status before surgery, the time-dependent implementation of the central adaptive mechanisms due to neuroplasticity leads to a modification of neurosensory information hierarchy, allowing reliance on appropriate information, the gain varying according to the postural task to be performed. ER -