{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:16:47Z","timestamp":1783505807619,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Downbeat nystagmus varies with head position, a phenomenon termed gravity\u2010dependent modulation. We aimed to clarify its mechanism using a velocity\u2010storage model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 10 patients with downbeat nystagmus due to cerebellar disorders, we recorded eye movements at different pitch\u2010 and roll\u2010axis head positions. Sine\u2010wave fitting of the nystagmus intensity as a function of head position decomposed the slow\u2010phase velocity of nystagmus into a gravity\u2010dependent component\u2014the amplitude and phase shift of the sine\u2010wave term\u2014and a gravity\u2010independent constant offset. To probe mechanisms, we applied a velocity\u2010storage model simulating the estimation of rotational velocity, gravity orientation, and inertial acceleration, and incorporated a gravity\u2010estimator lesion that produced a gravity\u2010estimation bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The gravity\u2010dependent component during pitch\u2010axis modulation had a median amplitude of 3.8\u00b0\/s (interquartile range [IQR]\u2009=\u20092.6) and a phase shift of 158.5\u00b0 (57.9). During roll\u2010axis modulation, it had an amplitude of 2.1\u00b0\/s (1.5) and a phase shift of \u22120.9\u00b0 (147.6), with two subgroups showing phase shifts near \u00b190\u00b0. The amplitude was significantly larger during pitch\u2010 than roll\u2010axis modulation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The lesion model generated persistent rotational cues that modulated downbeat nystagmus intensity as observed in the patients and additionally explained the interindividual variation in phase shifts and the weaker modulation of downbeat nystagmus during head roll.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>These findings refine our understanding of cerebellar vestibular processing and provide a computational framework for positional modulation of downbeat nystagmus. The concept of a biased gravity estimate may further account for several clinical phenomena, including atypical patterns of positional nystagmus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70476","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T09:38:42Z","timestamp":1783503522000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gravity\u2010Dependent Modulation of Downbeat Nystagmus: Insights From Velocity\u2010Storage Dysfunction"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9405-5904","authenticated-orcid":false,"given":"Ji\u2010Hyung","family":"Park","sequence":"first","affiliation":[{"name":"Department of Neurology, Severance Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun\u2010Hyuk","family":"Choi","sequence":"additional","affiliation":[{"name":"Dizziness Center, Clinical Neuroscience Center, Department of Neurology Seoul National University Bundang Hospital  Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Otero\u2010Millan","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Optometry and Vision Science University of California  Berkeley USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Zee","sequence":"additional","affiliation":[{"name":"Department of Neurology The Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong\u2010Yoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Dizziness Center, Clinical Neuroscience Center, Department of Neurology Seoul National University Bundang Hospital  Seongnam Korea"},{"name":"Department of Neurology Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1508-2024","authenticated-orcid":false,"given":"Ji\u2010Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Dizziness Center, Clinical Neuroscience Center, Department of Neurology Seoul National University Bundang Hospital  Seongnam Korea"},{"name":"Department of Neurology Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2024.1394859","article-title":"Downbeat Nystagmus: A Clinical and Pathophysiological Review","volume":"15","author":"Marcelli V.","year":"2024","journal-title":"Frontiers in Neurology"},{"issue":"6","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1093\/brain\/awh532","article-title":"Vertical Nystagmus: Clinical Facts and Hypotheses","volume":"128","author":"Pierrot\u2010Deseilligny C.","year":"2005","journal-title":"Brain"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2024.1326879","article-title":"Analysis of Etiology and Clinical Features of Spontaneous Downbeat Nystagmus: A Retrospective Study","volume":"15","author":"Zhang S.","year":"2024","journal-title":"Frontiers in Neurology"},{"issue":"6","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1002\/ana.10370","article-title":"Gravity Dependence of Ocular Drift in Patients With Cerebellar Downbeat Nystagmus","volume":"52","author":"Marti S.","year":"2002","journal-title":"Annals of Neurology"},{"issue":"4","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s00221-008-1396-7","article-title":"A Model\u2010Based Theory on the Origin of Downbeat Nystagmus","volume":"188","author":"Marti S.","year":"2008","journal-title":"Experimental Brain Research"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/bs.pbr.2019.04.012","article-title":"Central Positional Nystagmus: Characteristics and Model\u2010Based Explanations","volume":"249","author":"Choi J. 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