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Cerebral Cortex Advance Access originally published online on October 12, 2005
Cerebral Cortex 2006 16(8):1077-1086; doi:10.1093/cercor/bhj048
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© The Author 2005. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.

Effect of Vision, Touch and Stance on Cerebellar Vermian-related Sway and Tremor: A Quantitative Physiological and MRI Study

Edith V. Sullivan1, Jessica Rose2 and Adolf Pfefferbaum1,3

1 Department of Psychiatry and Behavioral Sciences and Neuroscience Program, Stanford University School of Medicine, Stanford, CA 94305, USA, 2 Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA and 3 Neuroscience Program, SRI International, Menlo Park, CA, USA

Address correspondence to Edith V. Sullivan, Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305-5723, USA. Email: edie{at}stanford.edu.

Postural balance is impaired in individuals with pathology of the anterior superior vermis of the cerebellum. Chronic alcoholism, with its known vermian pathology, provides a viable model for studying the relationship between cerebellar pathology and postural stability. Decades of separate study of recovering alcoholics and post-mortem neuroanatomical analysis have demonstrated vermian pathology but few studies have used quantitative posturography, acquired concurrently with quantitative neuroimaging, to establish whether this brain structure–function relationship is selective in vivo. Here, 30 healthy men and 39 chronic alcoholic men, abstinent from alcohol for several months, underwent MRI for volumetric quantitation of the cerebellar vermis and three comparison brain regions, the cerebellar hemispheres, supratentorial cortex and corpus callosum. All subjects also participated in an experiment involving a force platform that measured sway path length and tremor during static standing balance under four sensory conditions and two stance conditions. Three novel findings emerged: (i) sway path length, a physiological index of postural control, was selectively related to volume of the cerebellar vermis and not to any comparison brain region in the alcoholics; (ii) spectral analysis revealed sway prominence in the 2–5 Hz band, another physiological sign of vermian lesions and also selectively related to vermian volume in the alcoholics; and (iii) despite substantial postural sway in the patients, they successfully used vision, touch and stance to normalize sway and reduce tremor. The selective relationship of sway path to vermian but not lateral cerebellar volume provides correlational evidence for functional differentiation of these cerebellar regions. Improvement to virtual normal levels in balance and reduction in sway and tremor with changes in vision, touch and stance provide evidence that adaptive mechanisms recruiting sensorimotor integration can be invoked to compensate for underlying cerebellar vermian-related dysfunction.

Key Words: alcoholism • cerebellum • MRI • postural control • posturography • tremor • vermis


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A. Pfefferbaum, M. J. Rosenbloom, E. Adalsteinsson, and E. V. Sullivan
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[Abstract] [Full Text] [PDF]


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