{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T23:15:08Z","timestamp":1783120508036,"version":"3.54.6"},"reference-count":57,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:00:00Z","timestamp":1760832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:00:00Z","timestamp":1760832000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000377","name":"Vivensa Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000320","name":"Alzheimer's Society","doi-asserted-by":"publisher","award":["AS\u2010PG\u201014\u2010022"],"award-info":[{"award-number":["AS\u2010PG\u201014\u2010022"]}],"id":[{"id":"10.13039\/501100000320","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000320","name":"Alzheimer's Society","doi-asserted-by":"publisher","award":["453 (AS\u2010JF\u201018\u2010003)"],"award-info":[{"award-number":["453 (AS\u2010JF\u201018\u2010003)"]}],"id":[{"id":"10.13039\/501100000320","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011199","name":"FP7 Ideas: European Research Council","doi-asserted-by":"publisher","award":["616905"],"award-info":[{"award-number":["616905"]}],"id":[{"id":"10.13039\/100011199","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Abstract<\/jats:title>\n \n We have recently shown that perception of uprightness is disturbed in typical Alzheimer's disease (tAD) and posterior cortical atrophy (PCA; \u2018visual\u2010variant Alzheimer's\u2019); disturbances were attributed to disrupted spatial transformation of graviceptive information. Here, we extend investigations to the vestibular control of uprightness during stance using galvanic vestibular stimulation (GVS) under various proprioceptive and visual conditions. An appropriately directed response to GVS requires spatial transformation of the vestibular signal based on head orientation relative to the feet, while non\u2010vestibular sensory information can modulate the magnitude of response. Balance responses were repeatedly evoked in healthy participants (\n n<\/jats:italic>\n \u00a0=\u00a021) and participants with AD (tAD:\n n<\/jats:italic>\n \u00a0=\u00a018; PCA:\n n<\/jats:italic>\n \u00a0=\u00a018) under conditions evaluating proprioceptive\u2013vestibular integration (head directed right, straight or left without vision), or visuo\u2010vestibular integration (head directed straight with or without vision). Across head directions without vision, GVS\u2010evoked response direction and magnitude were comparable across groups. These comparable responses without vision indicate sparing of vestibulo\u2010motor systems and proprioceptive\u2013vestibular integration predicated on transformations between head, body and leg coordinates. However, the modulating effect of vision on GVS\u2010evoked response magnitude was decreased in PCA relative to control and tAD groups. This relatively decreased effect of vision in PCA was evident through the earliest mechanical indicator of response, consistent with reduced feedforward effects of vision on vestibularly driven balance response. Exaggerated response magnitude with vision was associated with occipito\u2010thalamic volumetric and projection fibre abnormalities in PCA. The findings suggest candidate pathways for visual modulation of vestibular balance control and dissociations between systems responsible for perceiving uprightness\n versus<\/jats:italic>\n rapid sensorimotor balance control.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n Accurate balance control relies on the integration of vestibular, proprioceptive and visual inputs, transformed across spatial reference frames.<\/jats:p>\n <\/jats:list-item>\n \n We examined whole\u2010body balance responses to galvanic vestibular stimulation (GVS) under varying visual and proprioceptive conditions in people with posterior cortical atrophy (PCA), typical Alzheimer's disease (tAD) and controls.<\/jats:p>\n <\/jats:list-item>\n \n Without vision, GVS\u2010evoked balance responses were comparable across groups with the head turned left, right or straight ahead, indicating spared proprioceptive\u2013vestibular integration in patient groups.<\/jats:p>\n <\/jats:list-item>\n \n With vision, visual input had a reduced modulatory effect on GVS responses in PCA relative to tAD and control groups. This was evident at the earliest stage of mechanical response, suggesting reduced feedforward visual influences on balance control in PCA.<\/jats:p>\n <\/jats:list-item>\n \n Our findings implicate disrupted occipito\u2010thalamic pathways in PCA\u2010related balance disturbances. The findings reveal a dissociation between perceived uprightness and sensorimotor balance control, with implications for understanding disturbed spatial orientation and balance in dementia.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1113\/jp288693","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:59:58Z","timestamp":1760921998000},"page":"1255-1271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Visual modulation of vestibular\u2010evoked balance response disturbed by posterior cortical atrophy"],"prefix":"10.1113","volume":"604","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0934-1613","authenticated-orcid":false,"given":"Dilek","family":"Ocal","sequence":"first","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5513-5058","authenticated-orcid":false,"given":"Matt","family":"Bancroft","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7833-616X","authenticated-orcid":false,"given":"David","family":"Cash","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Kaski","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie S.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London London UK"},{"name":"UK Dementia Research Institute, UCL Queen Square Institute of Neurology, University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian J.","family":"Crutch","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9708-3599","authenticated-orcid":false,"given":"Keir X. 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