Primary Graviceptive System and Astasia: A Case Report and Literature Review
Astasia refers to the inability to maintain upright posture during standing, despite having full motor strength. Impairment of the vestibulocerebellar pathway, graviceptive system, and cingulate motor area have been proposed to be related to astasia. However, the responsible neural pathways remain u...
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MDPI AG
2023-09-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/13/10/1371 |
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| author | Ko-Ting Chen Sheng-Yao Huang Yi-Jye Chen Ying-Yun Chen |
| author_facet | Ko-Ting Chen Sheng-Yao Huang Yi-Jye Chen Ying-Yun Chen |
| author_sort | Ko-Ting Chen |
| collection | DOAJ |
| description | Astasia refers to the inability to maintain upright posture during standing, despite having full motor strength. Impairment of the vestibulocerebellar pathway, graviceptive system, and cingulate motor area have been proposed to be related to astasia. However, the responsible neural pathways remain unclear. We hypothesize that there is a common neural network behind astasia. To test the hypothesis, we reviewed all reported cases with astasia, including ours, and focused on the correlation between anatomical destruction and symptom presentation. A total of 26, including ours, non-psychogenic astasia patients were identified in the English literature. Seventy-three percent of them were associated with other neurologic symptoms and sixty-two percent of reported lesions were on the right side. Contralateral lateropulsion was very common, followed by retropulsion, when describing astasia. Infarction (54%) was the most reported cause. The thalamus (65%) was the most reported location. Infarctions were the fastest to recover (mean: 10.6 days), while lesions at the brainstem needed a longer time (mean: 61.6 days). By combining the character of lateropulsion in astasia and the presentation of an interrupted graviceptive system, we concluded that the primary graviceptive system may be the common neural network behind astasia. Future studies on astasia should focus on the pathological changes in the perception of verticality in the visual world and the body. |
| first_indexed | 2024-03-10T21:23:12Z |
| format | Article |
| id | doaj.art-1302c6aa634c455c81590251ddb0619c |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T21:23:12Z |
| publishDate | 2023-09-01 |
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| spelling | doaj.art-1302c6aa634c455c81590251ddb0619c2023-11-19T15:51:59ZengMDPI AGBrain Sciences2076-34252023-09-011310137110.3390/brainsci13101371Primary Graviceptive System and Astasia: A Case Report and Literature ReviewKo-Ting Chen0Sheng-Yao Huang1Yi-Jye Chen2Ying-Yun Chen3Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, TaiwanMolecular Medicine Research Center, Chang Gung University, Taoyuan 333, TaiwanDepartment of Ophthalmology, China Medical University Hospital, Taichung 402, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Keelung, Keelung 204, TaiwanAstasia refers to the inability to maintain upright posture during standing, despite having full motor strength. Impairment of the vestibulocerebellar pathway, graviceptive system, and cingulate motor area have been proposed to be related to astasia. However, the responsible neural pathways remain unclear. We hypothesize that there is a common neural network behind astasia. To test the hypothesis, we reviewed all reported cases with astasia, including ours, and focused on the correlation between anatomical destruction and symptom presentation. A total of 26, including ours, non-psychogenic astasia patients were identified in the English literature. Seventy-three percent of them were associated with other neurologic symptoms and sixty-two percent of reported lesions were on the right side. Contralateral lateropulsion was very common, followed by retropulsion, when describing astasia. Infarction (54%) was the most reported cause. The thalamus (65%) was the most reported location. Infarctions were the fastest to recover (mean: 10.6 days), while lesions at the brainstem needed a longer time (mean: 61.6 days). By combining the character of lateropulsion in astasia and the presentation of an interrupted graviceptive system, we concluded that the primary graviceptive system may be the common neural network behind astasia. Future studies on astasia should focus on the pathological changes in the perception of verticality in the visual world and the body.https://www.mdpi.com/2076-3425/13/10/1371astasiagraviceptive systemsubjective visual verticalsubjective posture verticalthalamo-cortical projectionsvestibule-thalamic pathway |
| spellingShingle | Ko-Ting Chen Sheng-Yao Huang Yi-Jye Chen Ying-Yun Chen Primary Graviceptive System and Astasia: A Case Report and Literature Review Brain Sciences astasia graviceptive system subjective visual vertical subjective posture vertical thalamo-cortical projections vestibule-thalamic pathway |
| title | Primary Graviceptive System and Astasia: A Case Report and Literature Review |
| title_full | Primary Graviceptive System and Astasia: A Case Report and Literature Review |
| title_fullStr | Primary Graviceptive System and Astasia: A Case Report and Literature Review |
| title_full_unstemmed | Primary Graviceptive System and Astasia: A Case Report and Literature Review |
| title_short | Primary Graviceptive System and Astasia: A Case Report and Literature Review |
| title_sort | primary graviceptive system and astasia a case report and literature review |
| topic | astasia graviceptive system subjective visual vertical subjective posture vertical thalamo-cortical projections vestibule-thalamic pathway |
| url | https://www.mdpi.com/2076-3425/13/10/1371 |
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