The most rostral structures for eliciting this misalignment are therefore located in the rostral midbrain (INC) (Brandt et al. 1994). Therefore, the triad of ocular tilt reaction (OT, skew U0126 deviation, HT) is elicited at the infratentorial level as a brainstem sign. Lesions in the ascending pathways from the brainstem to

the vestibular cortex in the insula affect only the perception of verticality – as in our study. Our reanalysis of a possible conjunction of the tilt of SVV and thermal perception indicates that the severity of vestibular and temperature sensory deficits in acute IC stroke might be associated. The simultaneous impairment of temperature perception and tilt of SVV suggests that multisensory input converge in the IC. Our findings support Inhibitors,research,lifescience,medical the notion that the IC – and in particular Inhibitors,research,lifescience,medical its posterior part – is a primary sensory brain region integrating the different sensations. Previous data also support a close interaction between somatosensory signals such as pain and vestibular stimulation (McGeoch et al. 2008, 2009; Ferrè et al. 2012). This might be caused by the activation of posterior IC neurons leading to interdependent suppression of either feeling – finally to maintain homeostasis (Fig. ​(Fig.3).3). These manifold interactions in the IC might be the

basis for the multisensory deficits often observed after IC stroke. Figure 3 Simplified Inhibitors,research,lifescience,medical schematic drawing of central structures involved in the processing of vestibular and thermal information reaching the insular cortex as multisensory Inhibitors,research,lifescience,medical region via the thalamus. Intrainsular connections between vestibular (blue) and somatosensory … Acknowledgments This work was supported by the Deutsche Forschungsgemeinschaft (BA 4097/1-1) to BB. Conflict of Interest None declared.

Macroscopically, the brain has a simple structure, despite its complex functions. Morphologically, brain structures consist mainly of gyri and sulci, with these Inhibitors,research,lifescience,medical structures being quite common in human beings. This simplicity makes it easier to normalize

the brain to an anatomically standardized space and to introduce voxel-based statistical analysis. Histologically, the majority of brain tissue consists of gray matter, white matter, and cerebrospinal fluid space. Gray matter thickness reflects the number of residual neurons. Commonly, brain magnetic resonance imaging (MRI) has been used to derive anatomical and tissue volume information, Resminostat especially in gray and white matter. The voxel-based morphometry (VBM) technique objectively maps gray matter loss on a voxel-by-voxel basis after anatomic standardization. This is one of the simplest methods available to avoid subjectivity and dependence on an a priori hypothesis and to adopt the principle of data-driven analysis (Ashburner and Friston 2000). In patients with Alzheimer’s disease (AD), a significant reduction of gray matter volume in the hippocampal formation and entorhinal cortex has been described (Ohnishi et al. 2001; Hirata et al. 2005).