title: The association between impaired perception of verticality and cerebral white matter lesions in the elderly patients with orthostatic hypotension.
abstract: BACKGROUND
  The morbidity of orthostatic hypotension (OH) increases with aging and the elderly often complain of dizziness associated with OH, which is implicated in white matter lesions (WMLs) on MRI. However little is known how WMLs are contributed to the development of dizziness in elderly patients.
  
  
  OBJECTIVE
  We evaluated the involvement of cerebral WMLs in the vertical perception in the elderly with OH.
  
  
  METHODS
  This study consisted of 71 dizzy patients who underwent the examinations including the Schellong orthostatic test and subjective visual vertical (SVV) test.
  
  
  RESULTS
  The male patients aged <65 years with OH (1.9 ± 0.9°) showed a significantly higher magnitude of variance of SVV, which reflects an impaired vertical perception, in comparison with the male patients aged <65 years without OH and the male patients aged < 65 years with OH (1.0 ± 0.4°, 0.9 ± 0.4°, p < 0.05). The variance of SVV significantly correlated with the volume of WMLs in both sides on MRI in the male, but not female patients (p < 0.01).
  
  
  CONCLUSIONS
  Our results suggest that severe WMLs in the elderly with OH are involved in impaired perception of verticality, resulting in inducing subjective dizziness.
authors.affiliation: Department of Otolaryngology, Gifu University Graduate School of Medicine, Gifu, Japan. aoki@gifu-u.ac.jp
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Aoki
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Takanori
authors.initials: T
authors.lastname: Wakaoka
authors.forename: Bunya
authors.initials: B
authors.lastname: Kuze
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Mizuta
authors.forename: Yatsuji
authors.initials: Y
authors.lastname: Ito
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D004244:Dizziness / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011187:Posture; D013028:Space Perception / Q000502:physiology*