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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2007 September;57(3):121-4
Static posturography in subjects with Down syndrome: preliminary results
Medicina M. C., Dellepiane M., Mora R., Mura A. C.
1 ENT Unit, Galliera Hospital, Genoa
2 ENT Clinic, University of Genoa, Genoa, Italy
Aim.The increased incidence of hearing loss in children with Down’s syndrome (DS) has been well documented, while the characteristics of nystagmus sometimes present in these subjects are discussed. Hypotonia is a common feature in DS and could be responsable of the abnormal motor coordination, especially when associated with vestibular impairment. There are a few studies investigating the vestibular function in DS, perhaps because of the difficulty of obtaining a good collaboration or because of the use of complex examination techniques. The aim of this preliminary study is to evaluate the alteration of postural control, if any, in DS, by static posturography, which measures the postural sway in response to upright standing on a stationary force platform and is a relatively simple thecnique to use.
Methods. Recordings were made by static posturography in 12 subjects with DS with age ranging from 8 to 13 years.
Results. The results showed all parameters increased both in closed eyes (EC) and in open eyes (EO) conditions, but only SWAY (mean velocity of displacement) was significantly increased.
Conclusion. The complex neural connections between the vestibular apparatus and the motor system start during the intrauterine life and continue to interact after birth: in DS the association between postural reactions and motor milestones appear to be similar to normal people. A significantly higher SWAY velocity both in EO and in EC conditions appears to be a characteristic in DS from infancy to adulthood, as well as a relative efficency of visual control. It is possible that the postural control impairment could be related to a sensory organization deficit at higher levels, according to the observed cerebral alterations described by neuroimaging studies. More work is needed to identify which subcomponents (vestibular, proprioceptive and visual) of balance system is specifically involved in the postural deficit of DS and the possible relationship with the hypotonia. Posturography testing has been easily completed in all DS and thus is a reliable diagnostic tool in this people too.