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Biomedical subjects

Siegbert Krafczyk

Publications and source records attributed to Siegbert Krafczyk.

8 recordsLinked to original sources
PubMed2006

Artificial neural network: a new diagnostic posturographic tool for disorders of stance.

OBJECTIVE: To determine the accuracy of diagnoses made with artificial neural network techniques (ANNW) that identify postural sway patterns typical for balance disorders. METHODS: Body sway was measured by means of posturography during 10 test conditions of increasing difficulty. From a database of 676 subjects 60 training cases (TCs) and 60 validation cases (VCs) were selected in which the following diagnoses had been established clinically: normal subject (NS), postural phobic vertigo (PPV), anterior lobe cerebellar atrophy (CA), primary orthostatic tremor (OT), and acute unilateral vestibular neuritis (VN). A standard 3-layer feed-forward ANNW, using the backpropagation algorithm, was trained with TCs, validated with VCs, and its accuracy tested on 5 new cases. RESULTS: ANNW differentiated the established diagnoses with an overall sensitivity and specificity of 0.93. Sensitivity and specificity were 1 for NS and OT; for PPV, 0.87 and 0.96; for CA, 1 and 0.98; and for VN, 0.8 and 0.98, respectively. New subjects were identified with ANNW output variables of the true diagnoses between 0.73 and 1. CONCLUSIONS: ANNW differentiates postural sway patterns of several distinct clinical balance disorders with high sensitivity and specificity. Once designed and tested ANNW could be considered a black box, which each examiner can apply to predict a specific diagnosis even without a clinical examination. SIGNIFICANCE: A promising diagnostic tool for disorders of upright stance in selected neurological disorders.

Adolescent↗
PubMed2006

Postural reactions to soleus muscle vibration in Parkinson's disease: scaling deteriorates as disease progresses.

Previous research has shown that Parkinson's disease (PD) patients, especially those with postural instability, respond hyperactively to visual, vestibular, and neck proprioceptive sensory manipulation. To determine if this impairment of the sensory information scaling holds true for the lower leg proprioceptive system, we studied postural responses to mechanical vibration (which affects the muscle spindle Ia afferents) applied to the soleus muscles of PD subjects and healthy controls. Early-stage and advanced-stage PD patients as well as age-matched control subjects participated. Each group comprised 11 subjects. Nine pulses of 3-s long vibration were applied randomly to both soleus muscles while subjects kept their eyes closed. Postural responses to these stimuli were measured by static posturography. The effect of dopaminergic medication was established by testing patients in both ON and OFF treatment phases. There was no intergroup difference in the pattern or latencies of responses. However, the amplitudes were significantly larger in advanced PD patients; controls did not differ from early-stage PD patients. Dopaminergic medication had no significant effect on any of the measures. The scaling of postural reactions triggered by lower leg proprioception is disturbed in advanced PD. Neither afferent proprioceptive deficits nor inaccurate timing is involved. This study gives further evidence for the generalized impairment of the scaling of postural responses evoked whenever there is a sudden change of sensory conditions, as occurs with the progression of PD. Such impairment could play a significant role in the pathophysiology of postural instability and falls in PD patients.

Accidental Falls↗
PubMed2006

Postural reactions to neck vibration in Parkinson's disease.

To test the hypothesis that reduced reactions to proprioceptive input signals contribute to postural instability in Parkinson's disease (PD), pulses of mechanical vibration were applied to the neck muscles of PD patients and healthy controls. This stimulus elicits postural reactions in standing subjects. Participating were 13 moderately affected PD patients, 13 severely affected PD patients, and 13 age-matched healthy subjects. Patients were tested on and off medication. Three-second-long pulses of vibration were regularly (10 times) applied to the posterior neck muscles while subjects kept their eyes open or closed. Postural responses to the stimuli were measured by static posturography. No intergroup difference in the pattern and latencies of responses was found. However, the amplitudes of the postural reactions (shift of center of foot pressure) were significantly larger in advanced PD patients; those of moderately affected PD patients did not differ from those of control subjects. Moreover, the size of postural responses in both latter groups decreased across the trial contrary to that of advanced PD patients. Comparison of the measures during on and off testing revealed no significant differences. These results indicate that neither afferent proprioceptive deficits nor central integrative functions but rather scaling and habituation of erroneous proprioceptive information are disturbed in the postural control of advanced PD. Nondopaminergic structures seem to be responsible for this impairment.

Afferent Pathways↗
PubMed2003

Optokinetic stimulation in microgravity: torsional eye movements and subjective visual vertical.

INTRODUCTION: Microgravity provides unique sensory inputs to the vestibular and oculomotor systems. We sought to determine the effects of long-term spaceflight on sensing of spatial orientation. METHODS: Two cosmonauts participated in experiments on human vestibulo-visual interactions during a long-term mission (178 d) in the MIR station in 1995. During circular optokinetic stimulation (OKS) the tonic torsional eye position (torsional beating field, TBF) and the subjective visual vertical (SVV) were recorded on several days of the space mission as well as pre- and post-flight. A reference data set was obtained from healthy subjects on Earth, in whom the TBF was measured in upright and in prone positions. RESULTS: Neither cosmonaut showed changes in the SVV or the TBF values during the first days in microgravity. On flight day 149, cosmonaut A showed an increase of both values, which continued to rise by 4- and 10-fold until the end of the flight (TBF: 8.1 degrees; SVV: 216.8 degrees). This cosmonaut reported that the increase was accompanied by a loss of spatial orientation. In contrast, cosmonaut B's values remained at pre-flight levels (TBF: 1.6 degrees; SVV: 4.4 degrees). Post-flight values of the TBF did not significantly differ from pre-flight values for either cosmonaut. Subjects showed an increase of the TBF by more than a factor of 2 in prone position (range -7.7 degrees to +10.2 degrees) compared with upright position (range -3.7 degrees to +3.4 degrees). CONCLUSIONS: Pre-flight, post-flight and during the first part of the flight, both cosmonauts exhibited values similar to those of normal subjects in an upright position. The increased TBF values of cosmonaut A from flight day 110 on were within the range of the normal subjects in prone (face-down) position, when the gravity vector cannot be used to stabilize the TBF against the rotating stimulus (the axis of rotation is parallel to the gravity vector). The increasing deviations of cosmonaut A's SVV values in-flight suggest the presence of an internal body reference system, which weakened throughout the flight and thus lost its stabilizing effect.

Adaptation, Physiological↗
PubMed2002

Phobic postural vertigo. Body sway during visually induced roll vection.

Patients with phobic postural vertigo (PPV) often report a particularly increased unsteadiness when looking at moving visual scenes. Therefore, the differential effects of large-field visual motion stimulation in roll plane on body sway during upright stance were analyzed in 23 patients with PPV, who had been selected for the integrity of their vestibular and balance systems, and in 17 healthy subjects. Visual motion stimulation induced a sensation of apparent body motion (roll vection) in all patients and normal subjects. Normal subjects showed an increased lateral sway path with a lateral shift of the center of pressure (COP) in stimulus direction (mean 1.67 cm, SD 1.63). The patients also exhibited an increase in sway path during visual motion stimulation; however, their body sway differed from that of normals in that there was no lateral displacement of COP (mean 0.19 cm, SD 0.73). The lateral displacement of COP and the increase in RMS of body sway during visual motion stimulation were significantly greater in normals than in the patients ( p<0.05). The patients' increased body sway without COP deviation does not imply an increased risk of falling. Two explanations are conceivable for this increased body sway without body deviation in patients with PPV: (a) the patients rely more on proprioceptive and vestibular rather than on visual cues to regulate upright stance; or (b) they depend on visual, vestibular, and proprioceptive information, but the threshold at which they initiate a compensatory body sway opposite in direction to a perceived body deviation is lower than in normal subjects. The data support the second explanation.

Adult↗
PubMed2002

Suppression of eye movements improves balance.

The aim of this study was to investigate the possible interaction of vestibulo-ocular and vestibulo-spinal functions. Spontaneous eye movements and anterior-posterior and lateral body sway were recorded simultaneously in 10 patients with vestibular neuritis (Experiment 1) and in 11 healthy subjects (Experiment 2) while all subjects wore a mask that allowed fixation of a head-fixed target. For the healthy subjects, there was no significant difference in postural sway for the conditions of eyes open in darkness and fixation of the head-fixed target. For the patients, the question was whether transient suppression of the spontaneous nystagmus by fixating the target affected excessive body sway or whether modulation of nystagmus and postural sway were largely independent. The mean peak slow-phase velocity of the spontaneous nystagmus decreased from 13.5 +/- 5.6 to 4.3 +/- 2.4 degrees /s during fixation. The suppression of nystagmus also reduced postural sway while standing on foam rubber. Mean value decreased from 25.2 +/- 7.6 to 16.2 +/- 7.7 mm (right-left root mean square values; ANOVA, P = 0.003). Since a head-fixed target was used to suppress spontaneous eye movements, the data cannot be explained by any stabilizing effect of afferent visual cues. Instead, ocular motor efference copy signals or reafferences may have contributed to the postural instability of patients with vestibular neuritis, which would explain the reduction of postural sway during fixation suppression of the nystagmus. Thus, ocular motor signals rather than afferent visual cues about retinal slip are used for visual control of postural sway, at least in this experimental paradigm.

Adult↗