scholarly journals Cortical and Cerebellar Oscillatory Responses to Postural Instability in Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Taylor J. Bosch ◽  
Stefan Kammermeier ◽  
Christopher Groth ◽  
Matt Leedom ◽  
Elizabeth K. Hanson ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Spectral Power ◽  
Postural Instability ◽  
Oscillatory Activity ◽  
Control Task ◽  
Theta Power ◽  
Balance Task ◽  
Beta Power

Introduction: Posture and balance dysfunctions critically impair activities of daily living of patients with progressing Parkinson's disease (PD). However, the neural mechanisms underlying postural instability in PD are poorly understood, and specific therapies are lacking. Previous electrophysiological studies have shown distinct cortical oscillations with a significant contribution of the cerebellum during postural control tasks in healthy individuals.Methods: We investigated cortical and mid-cerebellar oscillatory activity via electroencephalography (EEG) during a postural control task in 10 PD patients with postural instability (PDPI+), 11 PD patients without postural instability (PDPI–), and 15 age-matched healthy control participants. Relative spectral power was analyzed in the theta (4–7 Hz) and beta (13–30 Hz) frequency bands.Results: Time-dependent postural measurements computed by accelerometer signals showed poor performance in PDPI+ participants. EEG results revealed that theta power was profoundly lower in mid-frontal and mid-cerebellar regions during the postural control task in PDPI+, compared to PDPI– and control participants. In addition, theta power was correlated with postural control performance in PD subjects. No significant changes in beta power were observed. Additionally, oscillatory changes during the postural control task differed from the resting state.Conclusion: This study underlines the involvement of mid-frontal and mid-cerebellar regions in postural stability during a balance task and emphasizes the important role of theta oscillations therein for postural control in PD.

Is Cortical Activation During Walking Different Between Parkinson’s Disease Motor Subtypes?

2020 ◽  
Author(s):  
Diego Orcioli-Silva ◽  
Rodrigo Vitório ◽  
Victor Spiandor Beretta ◽  
Núbia Ribeiro da Conceição ◽  
Priscila Nóbrega-Sousa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Obstacle Avoidance ◽  
Primary Motor Cortex ◽  
Cortical Activity ◽  
Postural Instability ◽  
Cortical Activation ◽  
Motor Area ◽  
Gait Disorder ◽  
Beta Power

Abstract Parkinson’s disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different between PD subtypes, which leads to differences in motor behavior. However, the influence of PD subtype on cortical activity during walking remains poorly understood. Therefore, we aimed to investigate the influence of PD motor subtypes on cortical activity during unobstructed walking and obstacle avoidance. Seventeen PIGD and 19 TD patients performed unobstructed walking and obstacle avoidance conditions. Brain activity was measured using a mobile functional near-infrared spectroscopy–electroencephalography (EEG) systems, and gait parameters were analyzed using an electronic carpet. Concentrations of oxygenated hemoglobin (HbO2) of the prefrontal cortex (PFC) and EEG absolute power from alpha, beta, and gamma bands in FCz, Cz, CPz, and Oz channels were calculated. These EEG channels correspond to supplementary motor area, primary motor cortex, posterior parietal cortex, and visual cortex, respectively. Postural instability gait disorder patients presented higher PFC activity than TD patients, regardless of the walking condition. Tremor dominant patients presented reduced beta power in the Cz channel during obstacle avoidance compared to unobstructed walking. Both TD and PIGD patients decreased alpha and beta power in the FCz and CPz channels. In conclusion, PIGD patients need to recruit additional cognitive resources from the PFC for walking. Both TD and PIGD patients presented changes in the activation of brain areas related to motor/sensorimotor areas in order to maintain balance control during obstacle avoidance, being that TD patients presented further changes in the motor area (Cz channel) to avoid obstacles.

Beta Oscillatory Activity in the Subthalamic Nucleus and Its Relation to Dopaminergic Response in Parkinson's Disease

2006 ◽  
Vol 96 (6) ◽  
pp. 3248-3256 ◽  
Author(s):  
Moran Weinberger ◽  
Neil Mahant ◽  
William D. Hutchison ◽  
Andres M. Lozano ◽  
Elena Moro ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Subthalamic Nucleus ◽  
Field Potential ◽  
Neuronal Population ◽  
Oscillatory Activity ◽  
Motor Deficits ◽  
Beta Activity ◽  
Beta Power ◽  
Dorsal Portion

Recent studies suggest that beta (15–30 Hz) oscillatory activity in the subthalamic nucleus (STN) is dramatically increased in Parkinson's disease (PD) and may interfere with movement execution. Dopaminergic medications decrease beta activity and deep brain stimulation (DBS) in the STN may alleviate PD symptoms by disrupting this oscillatory activity. Depth recordings from PD patients have demonstrated beta oscillatory neuronal and local field potential (LFP) activity in STN, although its prevalence and relationship to neuronal activity are unclear. In this study, we recorded both LFP and neuronal spike activity from the STN in 14 PD patients during functional neurosurgery. Of 200 single- and multiunit recordings 56 showed significant oscillatory activity at about 26 Hz and 89% of these were coherent with the simultaneously recorded LFP. The incidence of neuronal beta oscillatory activity was significantly higher in the dorsal STN ( P = 0.01) and corresponds to the significantly increased LFP beta power recorded in the same region. Of particular interest was a significant positive correlation between the incidence of oscillatory neurons and the patient's benefit from dopaminergic medications, but not with baseline motor deficits off medication. These findings suggest that the degree of neuronal beta oscillatory activity is related to the magnitude of the response of the basal ganglia to dopaminergic agents rather than directly to the motor symptoms of PD. The study also suggests that LFP beta oscillatory activity is generated largely within the dorsal portion of the STN and can produce synchronous oscillatory activity of the local neuronal population.

scholarly journals The Impact of Parkinson’s Disease on Postural Control in Older People and How Sex can Mediate These Results: A Systematic Review

Geriatrics ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. 105
Author(s):  
Mathieu Dallaire ◽  
Guillaume Gagnon ◽  
Émilie Fortin ◽  
Josée Nepton ◽  
Anne-France Severn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Older People ◽  
Postural Control ◽  
Elderly People ◽  
Postural Instability ◽  
Current Evidence ◽  
Men And Women ◽  
Significant Difference ◽  
The Impact

Introduction: Parkinson’s disease is most prevalent among elderly people, 65 years and over, and leads to an alteration in motor control associated with postural instability. Current evidence shows that postural control decreases with the aging process. In addition, postural control is more altered in healthy aged men than in women. Until today, few studies have evaluated the combined impact of Parkinson’s disease and sex on postural control. This review has allowed to evaluate the impact of Parkinson’s disease and sex on postural control measurements in elderly people. Methodology: Studies have been selected from two main databases: PubMed and EBSCO using the keywords “Parkinson”, “postural control OR balance” and “sex”. Articles related to the evaluation of postural control, including men and women with Parkinson’s aged over 65 years old, regardless of stage, were included (n = 179). Articles were excluded if not written in French or English or not presenting original content. Results: Ten (10) studies out of 179 that fulfilled inclusion and exclusion criteria were reported in the final analysis, which cumulates a total of 944 individuals with Parkinson’s (410 women). In general, results show greater postural instability among people with Parkinson’s compared to healthy subjects, and this according to different objective measurements using stabilographic parameters from force platforms. Only two studies out of ten evaluated postural control while briefly considering distinctions between sex, but without showing a significant difference between men and women with Parkinson’s. Parkinson’s severity, length of time of Parkinson’s disease and cognitive state of the person are the three variables with a negative impact on postural control. Conclusion: Older people with Parkinson’s disease have greater postural instability. Sex does not seem to influence the postural control of elderly people with Parkinson’s, although more studies are necessary.

scholarly journals Pupillary Response to Postural Demand in Parkinson’s Disease

2021 ◽  
Vol 9 ◽  
Author(s):  
Melike Kahya ◽  
Kelly E. Lyons ◽  
Rajesh Pahwa ◽  
Abiodun E. Akinwuntan ◽  
Jianghua He ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Dual Task ◽  
Pupillary Response ◽  
Cognitive Workload ◽  
Healthy Controls ◽  
Balance Task ◽  
Eyes Open ◽  
Post Hoc

Background: Individuals with Parkinson’s disease (PD) may need to spend more mental and physical effort (i.e., cognitive workload) to maintain postural control. Pupillary response reflects cognitive workload during postural control tasks in healthy controls but has not been investigated as a measure of postural demand in PD.Objectives: To compare pupillary response during increased postural demand using vision occlusion and dual tasking between individuals with PD and healthy controls.Methods: Thirty-three individuals with PD and thirty-five healthy controls were recruited. The four conditions lasted 60 s and involved single balance task with eyes open; single balance task with eyes occluded; dual task with eyes open; dual task with eyes occluded. The dual task comprised the Auditory Stroop test. Pupillary response was recorded using an eye tracker. The balance was assessed by using a force plate. Two-way Repeated Measures ANOVA and LSD post-hoc tests were employed to compare pupillary response and Center of Pressure (CoP) displacement across the four conditions and between individuals with PD and healthy controls.Results: Pupillary response was higher in individuals with PD compared to healthy controls (p = 0.009) and increased with more challenging postural conditions in both groups (p < 0.001). The post-hoc analysis demonstrated increased pupillary response in the single balance eyes occluded (p < 0.001), dual task eyes open (p = 0.01), and dual task eyes occluded (p < 0.001) conditions compared to single task eyes open condition.Conclusion: Overall, the PD group had increased pupillary response with increased postural demand compared to the healthy controls. In the future, pupillary response can be a potential tool to understand the neurophysiological underpinnings of falls risk in the PD population.

scholarly journals Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Cathy C. Harro ◽  
Amanda Kelch ◽  
Cora Hargis ◽  
Abigail DeWitt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Fall Risk ◽  
Postural Instability ◽  
Healthy Adults ◽  
Force Platform ◽  
Disease Stage ◽  
Balance Performance ◽  
Platform System

Introduction. Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson’s disease (PD). Computerized posturography employing a force platform system provides objective, quantitative assessments of postural control impairments. This study examines balance performance as measured by force platform (FP) tests in persons with PD compared to age-matched healthy adults. Secondarily, we examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population.Methods. Participants—42 individuals with PD (Hoehn and Yahr stage = 2.33 ± 0.77) and 55 age-matched healthy adults—were assessed on three standardized balance measures on a computerized force platform system. Between groups, comparisons of FP performance were analyzed using independentt-test. Within the group, comparisons for the PD cohort were analyzed using ANOVA for comparing disease stage and Mann–WhitneyUtest for PD subtypes.Results. The PD cohort demonstrated significantly greater postural instability on the sensory organization test (SOT) measures (P=0.013, CI-95% = 1.286 to 10.37) and slower movement velocity on the limits of stability (LOS) test (P=0.001, CI-95% = 0.597 to 1.595) than the healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. Within the PD group, the SOT differentiated between H&Y stages 1–3. The motor control test (MCT) detected changes in reactive postural control mainly in later disease stages. All three FP tests distinguished between PD subtypes, with thePosture Gait Instabilitysubtype demonstrating poorer balance performance thanTremor Dominantsubtype.Conclusion. These findings suggest FP measures provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk in persons with PD.

scholarly journals Assessment of postural instability in Parkinson’s disease patients

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohamed Aziz Mohamed Talaat ◽  
Amr Elfatatry ◽  
Nibras Mohamed Ibrahim Mohamed Noor ◽  
Mirhan Eldeeb
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Postural Instability ◽  
Control Group ◽  
Study Group ◽  
Clinical Tool ◽  
Body Movements ◽  
Dynamic Posturography ◽  
Balance Impairment

Abstract Background Parkinson’s disease (PD) is a degenerative, progressive, neurological condition that influences the control of a person’s body movements. Computerized dynamic posturography (CDP) is a clinical tool intended to evaluate the integration of visual, vestibular, and somatosensory inputs to maintain postural gait. Posturography can be used to measure postural instability in PD patients. So, the aim of this study was to evaluate the postural control and elaborate on the pathophysiology of the balance impairment in PD patients in the “on” state. Results All antero-posterior (AP) and medio-lateral (ML) sensory balance scores, except vestibular ones, were significantly lower in the study group compared to the control group. AP and ML sway were generally higher in the study group at all frequencies, with AP being mostly greater compared to ML sway in PD subjects. Global sensory scores were shown to deteriorate with increased durations of the disease and treatment. Conclusions PD patients have higher postural instability in comparison to controls with AP sway being higher compared to ML.

Intraoperative localization of spatially and spectrally distinct resting-state networks in Parkinson’s disease

2020 ◽  
Vol 132 (4) ◽  
pp. 1234-1242 ◽  
Author(s):  
Paolo Belardinelli ◽  
Ramin Azodi-Avval ◽  
Erick Ortiz ◽  
Georgios Naros ◽  
Florian Grimm ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Network Effects ◽  
Brain Activity ◽  
Dynamic Imaging ◽  
Oscillatory Activity ◽  
Network Information ◽  
Novel Approach ◽  
Electrophysiological Recordings ◽  
Intraoperative Localization

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for symptomatic Parkinson’s disease (PD); the clinical benefit may not only mirror modulation of local STN activity but also reflect consecutive network effects on cortical oscillatory activity. Moreover, STN-DBS selectively suppresses spatially and spectrally distinct patterns of synchronous oscillatory activity within cortical-subcortical loops. These STN-cortical circuits have been described in PD patients using magnetoencephalography after surgery. This network information, however, is currently not available during surgery to inform the implantation strategy.The authors recorded spontaneous brain activity in 3 awake patients with PD (mean age 67 ± 14 years; mean disease duration 13 ± 7 years) during implantation of DBS electrodes into the STN after overnight withdrawal of dopaminergic medication. Intraoperative propofol was discontinued at least 30 minutes prior to the electrophysiological recordings. The authors used a novel approach for performing simultaneous recordings of STN local field potentials (LFPs) and multichannel electroencephalography (EEG) at rest. Coherent oscillations between LFP and EEG sensors were computed, and subsequent dynamic imaging of coherent sources was performed.The authors identified coherent activity in the upper beta range (21–35 Hz) between the STN and the ipsilateral mesial (pre)motor area. Coherence in the theta range (4–6 Hz) was detected in the ipsilateral prefrontal area.These findings demonstrate the feasibility of detecting frequency-specific and spatially distinct synchronization between the STN and cortex during DBS surgery. Mapping the STN with this technique may disentangle different functional loops relevant for refined targeting during DBS implantation.

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