Person: Castro, Patricia
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Publication Visuospatial orientation: Differential effects of head and body positions(2022) Castro, Patricia; Hussaina, Shahvaiz; Mohameda, Omer G.; Kaskia, Diego; Arshada, Qadeer; Bronsteina, Adolfo M.; Kheradmand, AmirTo orientate in space, the brain must integrate sensory information that encodes the position of the body with the visual cues from the surrounding environment. In this process, the extent of reliance on visual information is known as the visual dependence. Here, we asked whether the relative positions of the head and body can modulate such visual dependence (VD). We used the effect of optokinetic stimulation (30ā¦/s) on subjective visual vertical (SVV) to quantify VD as the average optokinetic-induced SVV bias in clockwise and counter-clockwise directions. The VD bias was measured in eight subjects with a head-on-body tilt (HBT) where only the head was tilted on the body, and also with a whole-body tilt (WBT) where the head and body were tilted together. The VD bias with HBT of 20ā¦was in the same direction of the head tilt position (left tilt VD 1.35 Ā±0.1.2ā¦; right VD 1.60 Ā±0.9ā¦), whereas the VD bias with WBT of 20ā¦was in a direction away from the body tilt position (left tilt VD 2.5 Ā±1.1ā¦; right tilt VD 2.1 Ā±0.9ā¦). These findings show differential effects of relative head and body positions on visual cue integration, a process which could facilitate optimal interaction with the surrounding environment for spatial orientation.Publication Vestibular loss disrupts visual reactivity in the alpha EEG rhythm(2023) Ibitoye, Richard; Castro, Patricia; Ellmers, Toby; Kaski, Diego; Bronstein, AdolfoThe alpha rhythm is a dominant electroencephalographic oscillation relevant to sensory-motor and cognitive function. Alpha oscillations are reactive, being for example enhanced by eye closure, and suppressed following eye opening. The determinants of inter-individual variability in reactivity in the alpha rhythm (e.g. changes with amplitude following eye closure) are not fully understood despite the physiological and clinical applicability of this phenomenon, as indicated by the fact that ageing and neurodegeneration reduce reactivity. Strong interactions between visual and vestibular systems raise the theoretical possibility that the vestibular system plays a role in alpha reactivity. To test this hypothesis, we applied electroencephalography in sitting and standing postures in 15 participants with reduced vestibular function (bilateral vestibulopathy, median age = 70 years, interquartile range = 51-77 years) and 15 age-matched controls. We found participants with reduced vestibular function showed less enhancement of alpha electroencephalography power on eye closure in frontoparietal areas, compared to controls. In participants with reduced vestibular function, video head impulse test gain - as a measure of residual vestibulo-ocular reflex function - correlated with reactivity in alpha power across most of the head. Greater reliance on visual input for spatial orientation ('visual dependence', measured with the rod-and-disc test) correlated with less alpha enhancement on eye closure only in participants with reduced vestibular function, and this was partially moderated by video head impulse test gain. Our results demonstrate for the first time that vestibular function influences alpha reactivity. The results are partly explained by the lack of ascending peripheral vestibular input but also by central reorganisation of processing relevant to visuo-vestibular judgements.Publication Towards an explanation for 'unexplained' dizziness in older people(2024) Castro, Patricia; Ibitoye, Richard; Ellmers, Toby; Kaski, Diego; Arshad, Qadeer; Bronstein, Adolfo M.Background: Subjective unsteadiness or dizziness, usually without increase in body sway, is common in older people. The absence of mechanistic understanding of such symptoms renders clinical management difficult. Here, we explore the mechanisms behind such idiopathic dizziness (ID), focusing on postural control abnormalities. Methods: Thirty patients with ID and 30 age-matched controls stood on a moving platform. Platform oscillations were randomly delivered at different velocities (from 0 to 0.2 m/s). Markers of postural control, including objective sway (trunk sway path, recorded via a sensor attached to vertebrae C7), stepping responses, subjective instability and anxiety ratings were obtained. MRI scans were available for correlations with levels of cerebral small vessel disease in 28 patients and 24 controls. Results: We observed a significant relationship between objective and subjective instability in all groups. The slope of this fit was significantly steeper for patients than controls, indicating greater perceived instability for the same body sway. Stepwise linear regression showed that the slopes of this objectiveāsubjective instability relationship were best explained by concerns about falling (Falls Efficacy Scale-International), clinical physical functioning (Short Physical Performance Battery) and, to some degree, by neuroimaging markers of cerebral small vessel disease. In addition, patients had a reduced stepping threshold, suggesting an overly cautious postural response. Conclusion: The distorted perception of instability and subtle impairments in balance control, including abnormal and overly cautious stepping responses, underlies the emergence of ID. It appears to relate to changes in postural performance, psychological functioning and disruption of postural brain networks associated with cerebral small vessel disease.Publication Priming overconfidence in belief systems reveals negative return on postural control mechanisms(2022) Castro, Patricia; Papoutselou, Efstratia; Mahmoud, Sami; Hussain, Shahvaiz; Fuentealba Bassaletti, Constanza; Kaski, Diego; Bronstein, Adolfo; Arshad, QadeerBackground: Modulation of postural control strategies and heightened perceptual ratings of instability when exposed to postural threats, illustrates the association between anxiety and postural control. Research question: Here we test whether modulating prior expectations can engender postural-related anxiety which, in turn, may impair postural control and dissociate the well-established relationship between sway and subjective instability. Methods: We modulated expectations of the difficulty posed by an upcoming postural task via priming. In the visual priming condition, participants watched a video of an actor performing the task with either a stable or unstable performance, before themselves proceeding with the postural task. In the verbal priming paradigm, participants were given erroneous verbal information regarding the amplitude of the forthcoming platform movement, or no prior information. Results: Following the visual priming, the normal relationship between trunk sway and subjective instability was preserved only in those individuals that viewed the stable but not the unstable actor. In the verbal priming experiment we observed an increase in subjective instability and anxiety during task performance in individuals who were erroneously primed that sled amplitude would increase, when in fact it did not. Significance: Our findings show that people's subjective experiences of instability and anxiety during a balancing task are powerfully modulated by priming. The contextual provision of erroneous cognitive priors dissociates the normally 'hard wired' relationship between objective measures and subjective ratings of sway. Our findings have potential clinical significance for the development of enhanced cognitive retraining in patients with balance disorders, e.g. via modifying expectations.