Subjective visual vertical in pitch and roll in right hemispheric stroke

Background and Purpose-Patients with right hemispheric stroke usually present an anticlockwise deviation of the subjective visual vertical (SVV) in the frontal (roll) plane. However, the occurrence of a similar disorder in the sagittal (pitch) plane has never been assessed. We investigated the subjective visual vertical in both planes in those patients. Methods-Eight patients, 4 with spatial neglect (N=) and 4 without neglect (N-), were compared with 4 healthy participants (C). They sat facing a luminous bar adjustable in rotation, either in the roll or in the pitch plane, and had to orient it in a vertical position, in the dark. Results-Compared with N- (-0.1degrees) and C (+1.1degrees) groups, N+ patients presented with a significant backward deviation (-4.5degrees) of the SVV in pitch. In accordance with other studies, they also showed a significant anticlockwise deviation (-8.8degrees) of the SVV in roll, as compared with N- (-1.9degrees) and C (+0.4degrees) subjects. This was associated with an opposite trunk deviation in both planes. Conclusions-While confirming the anticlockwise deviation already reported in the frontal plane, we showed for the first time to our knowledge a backward deviation of the SVV in neglect patients, which has to be put in relation with their balance disorders.