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Parkinson’s Disease
Volume 2016, Article ID 7489105, 4 pages
Research Article

Subjective Visual Vertical in PD Patients with Lateral Trunk Flexion

1Movement Disorders Clinic, Strasse nach Fichtenwalde 16, 14547 Beelitz-Heilstätten, Germany
2Department of ENT, Trauma Hospital Berlin, Warener Strasse 7, 12683 Berlin, Germany
3Department of Neurology, Medical University of Innsbruck, Anichstrasse 25, 6020 Innsbruck, Austria

Received 1 October 2015; Revised 12 January 2016; Accepted 23 February 2016

Academic Editor: Ivan Bodis-Wollner

Copyright © 2016 F. Gandor et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Lateral trunk flexion (LTF) is a common phenomenon in patients with Parkinson’s disease (PD) and has recently been associated with peripheral vestibular dysfunction. Since deviation of the subjective visual vertical (SVV) is a well-recognized feature of disorders involving vestibular processing, we analyzed SVV angles in 30 PD patients with and without LTF to assess the possible role of vestibular dysfunction in the pathogenesis of LTF in PD. Quantification of SVV was obtained using a simple bedside test. PD patients with LTF had significantly greater SVV angles as compared to PD patients without LTF (median: 4.3° [range: 0.1–17.7], , versus 0.8° [0.1–1.9], ; ). 14 of 21 patients with LTF showed pathological SVV, while all 9 patients without LTF had normal SVV. Abnormal SVV was more frequent when LTF was reversible in the supine position compared to fixed LTF. In a subgroup of PD patients with LTF, pathological SVV suggests vestibular dysbalance, which might be involved in the pathophysiological mechanisms underlying LTF.