title: Medio-lateral postural instability in subjects with tinnitus.
abstract: BACKGROUND
  Many patients show modulation of tinnitus by gaze, jaw or neck movements, reflecting abnormal sensorimotor integration, and interaction between various inputs. Postural control is based on multi-sensory integration (visual, vestibular, somatosensory, and oculomotor) and indeed there is now evidence that posture can also be influenced by sound. Perhaps tinnitus influences posture similarly to external sound. This study examines the quality of postural performance in quiet stance in patients with modulated tinnitus.
  
  
  METHODS
  Twenty-three patients with highly modulated tinnitus were selected in the ENT service. Twelve reported exclusively or predominately left tinnitus, eight right, and three bilateral. Eighteen control subjects were also tested. Subjects were asked to fixate a target at 40 cm for 51 s; posturography was performed with the platform (Technoconcept, 40 Hz) for both the eyes open and eyes closed conditions.
  
  
  RESULTS
  For both conditions, tinnitus subjects showed abnormally high lateral body sway (SDx). This was corroborated by fast Fourrier Transformation (FFTx) and wavelet analysis. For patients with left tinnitus only, medio-lateral sway increased significantly when looking away from the center.
  
  
  CONCLUSIONS
  Similarly to external sound stimulation, tinnitus could influence lateral sway by activating attention shift, and perhaps vestibular responses. Poor integration of sensorimotor signals is another possibility. Such abnormalities would be accentuated in left tinnitus because of the importance of the right cerebral cortex in processing both auditory-tinnitus eye position and attention.
authors.affiliation: IRIS Group, UMR 8194, CNRS, Service d'Ophtalmologie, Assistance Publique Hôpitaux de Paris Paris, France.
authors.forename: Zoi
authors.initials: Z
authors.lastname: Kapoula
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.forename: Thanh-Thuan
authors.initials: TT
authors.lastname: Lê
authors.forename: Marine
authors.initials: M
authors.lastname: Vernet
authors.forename: Nolwenn
authors.initials: N
authors.lastname: Berbey
authors.forename: Christophe
authors.initials: C
authors.lastname: Orssaud
authors.forename: Alain
authors.initials: A
authors.lastname: Londero
authors.forename: Pierre
authors.initials: P
authors.lastname: Bonfils