Effect of medication and STN-DBS on postural control in subjects with Parkinson’s disease

Nantel, Julie; McDonald, Jaime; Brontë‐Stewart, Helen

doi:10.1016/j.parkreldis.2011.11.005

Cited by 69 publications

(76 citation statements)

References 27 publications

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“…Also, we could not identify any significant diseaserelated differences in the first part of the LOS task. In the literature, some other authors did not find disease-related deficiencies in ML postural control in patients with PD at an early stage of their disease (Frenklach et al 2009) while others did (Mancini et al 2012;Nantel et al 2012). We agree that more and more evidence shows that patients with PD at an early stage of the disease are unstable in quiet stance, but this is not systematically the case.…”

Section: Disease-related Impairments In Quiet Stancementioning

confidence: 52%

“…These disease-related effects should be detected because the LOS and RWS tasks are very challenging. On the other hand, we were not sure to find disease-related impairment in ML postural stability in quiet stance because the patients with PD were at a low stage of their disease and because of the conflicting results in the literature (Frenklach et al 2009;Mancini et al 2012;Nantel et al 2012;Termoz et al 2008). …”

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confidence: 93%

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Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control

Bonnet

Delval

Defebvre

2014

Journal of Neurophysiology

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Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease.

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Section: Disease-related Impairments In Quiet Stancementioning

confidence: 52%

mentioning

confidence: 93%

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control

Bonnet

Delval

Defebvre

2014

Journal of Neurophysiology

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“…It is also possible that cholinergic innervation affects both executive function and balance in parallel and both factors influence fall risk. Perhaps the fall reduction seen in the study of Chung et al could be attributable to improvements in both balance and executive function since an increase in mediolateral postural sway has been associated with falls [20,21] and cognitive impairments have been associated with falls [14]. Increased postural sway has been associated with thalamic cholinergic denervation in subjects with PD [22].…”

Section: Resultsmentioning

confidence: 99%

Are Cholinesterase Inhibitors Effective in Improving Balance in ParkinsonÃ¢ÂÂs Disease?

ALP¹,

Jg²

2016

J Neurol Disord

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BackgroundMost falls in Parkinson's disease (PD) appear to be due to a primary balance dysfunction rather than an environmental factor [1]. Accumulating evidence suggests that balance dysfunction cannot only be attributed to changes in the dopaminergic system that seems to be responsible for most of the other motor symptoms in PD [1]. The interventions often helpful in improving other PD symptoms, dopaminergic medications and deep brain stimulation, do not consistently improve balance and falls [2,3]. Degeneration in other brain areas, such as cholinergic cortex, the adrenergic locus coeruleus or the cholinergic/glutaminergic pedunculopontine nucleus may be the origin of the balance problems associated with PD [4].Cholinesterase inhibitors have a positive impact on global assessments, cognitive function, behavioral disturbances, and activities of daily living in persons with PD with Dementia, Lewy Body Dementia, and PD with Cognitive impairment but without dementia (CIND) [5]. A pooled estimate of therapeutic benefit of cholinesterase inhibitors on cognitive function was found with a standard mean difference (SMD) of -0.34 (95% CI -0.46 to -0.23, p<0.00001) versus placebo. A study enrolling 23 subjects in a cross-over design, showed a reduction in falls in persons with PD without dementia when taking donepezil for six weeks. Fall frequency per day decreased from 0.25 ± 0.08 on placebo to 0.13 ± 0.03 on donepezil (p<0.05) [6].It is not clear the exact role cholinergic function plays in gait, balance, and falls. It is clear that functional walking without falls requires executive function, such as the ability to switch attention quickly [7]. The relationship between cholinergic function and falls has been demonstrated with PET imaging [8]. The cholinergic system, specifically the pendunculopontine nucleus (PPN), may have direct effects on gait and balance. Loss of PPN cells is correlated with balance performance and may affect attention [9][10][11]. There are also extensive cholinergic projections to the cerebral cortex with the nucleus basalis of Meyert that suplies the marjority of input to the frontoparietal attention Abstract Background: Cholinesterase inhibitors have been reported to reduce falls in a double blind pilot study. The mechanism by which cholinesterase inhibitors reduce falls is unknown.

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“…In fact, there are 2 main approaches regarding stability analysis during quiet standing, linear and nonlinear approaches. Most of the studies done so far have evaluated the stability by use of the linear method including the use of some parameters such as COP excursion, path length, and velocity [13][14][15]. However, it has been suggested that nonlinear measures of postural sway such as approximate entropy (ApEn) may better reflect changes in the complex, multi component interactions that take place in the postural control system.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of the Effect of Vision on Standing Stability in the Early Stage of Parkinson’s Disease

2018

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Background: Postural instability is a common disorder in Parkinson’s disease (PD). The aim of this study was to evaluate stance stability of the subjects at the early stage of PD with both linear and nonlinear approaches. Moreover, this study aimed to find the effect of visual control on quiet stance postural control in these patients. Method: Seventeen PD patients (Hoehn/Yahr scale: 1) and 17 healthy control subjects were instructed to maintain quiet postural stance in 2 conditions (opened eyes and closed eyes). Four linear (excursion, path length, velocity, root mean square) and 1 nonlinear (approximate entropy) center of pressure (COP) parameters were calculated. A 2 × 2 mixed ANOVA was used for the final analysis. Results: Although there was no difference between the stability of PD patients and healthy control subjects based on excursion of COP in both mediolateral (ML) and anteroposterior (AP) directions, other linear parameters (path length of COP sways, velocity of COP sways, and root mean square in both ML and AP planes) showed that PD patients were significantly unstable compared to normal subjects (p value < 0.05). Vision influenced the stability of both groups significantly. The interaction of vision and group was not significant based on linear and nonlinear stability parameters. Conclusion: Although patients in the early stage of PD seem to be unstable based on COP linear measures, their postural control system is still flexible to adapt to environmental perturbations in quiet stance and they are not more visually dependent than healthy subjects to control stability in this position.

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Effect of medication and STN-DBS on postural control in subjects with Parkinson’s disease

Cited by 69 publications

References 27 publications

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control

Are Cholinesterase Inhibitors Effective in Improving Balance in ParkinsonÃ¢ÂÂs Disease?

An Evaluation of the Effect of Vision on Standing Stability in the Early Stage of Parkinson’s Disease

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Effect of medication and STN-DBS on postural control in subjects with Parkinson’s disease

Cited by 69 publications

References 27 publications

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control

Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control

Are Cholinesterase Inhibitors Effective in Improving Balance in ParkinsonÃ¢ÂÂs Disease?

An Evaluation of the Effect of Vision on Standing Stability in the Early Stage of Parkinson’s Disease

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Are Cholinesterase Inhibitors Effective in Improving Balance in ParkinsonÃ¢ÂÂs Disease?