Long latency postural reflexes are under supraspinal dopaminergic control

Bloem, Bastiaan R.; Beckley, Dennis J.; Vugt, Jeroen P. P. van; Dijk, J. Gert van; Remler, Michael P.; Langston, J. William; Roos, Raymund A.C.

doi:10.1002/mds.870100509

Cited by 18 publications

(9 citation statements)

References 39 publications

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“…For instance, whereas long latency reflexes (LLR) and somatosensory-evoked potentials (SEP) are largely ab-sent in HD, [32][33][34][35] LLR and SEP are present but abnormal in PD. 9,36,37 Despite these differences, it is interesting to note that both our study and that of Smith and colleagues 31 found the patient groups to be deficient in adaptive control. It is noteworthy that Smith and coworkers 31 did not note this deficit in a group of cerebellar subjects, reinforcing their conclusions of BG involvement.…”

Section: Discussionmentioning

confidence: 51%

Deficits in rapid adjustments of movements according to task constraints in Parkinson's disease

et al. 2004

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The role of the basal ganglia in the adaptive control of movement was investigated by unexpectedly perturbing movements in 8 patients with Parkinson's disease (PD) tested off medication and in 6 aged-matched healthy subjects. Subjects performed two movement components simultaneously and without visual feedback: touching the nose with the finger while leaning the trunk forward. Subjects wore a harness connected to an electromagnet, which was attached to a wall. The trunk movement was mechanically blocked in randomly selected trials by engaging the electromagnet. While healthy subjects performed the task equally well in both conditions, PD subjects' hand movements significantly deteriorated in trunk-perturbed compared to trunk-free trials. Deteriorated hand movements were characterized by segmented hand paths, unsmooth velocity profiles, and prolonged movement times. This finding indicated that the relatively local trunk perturbation had a global effect on the hand movement of PD subjects, necessitating them to reinitiate, after some delay, their arm movement in perturbed trials. Thus, the basal ganglia may be a critical node in brain networks mediating the flexibility of responses to altered motor states.

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Section: Discussionmentioning

confidence: 51%

Deficits in rapid adjustments of movements according to task constraints in Parkinson's disease

et al. 2004

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“…These reflex abnormalities were found to respond only partially to dopaminergic medication and could not be demonstrated in other hypodopaminergic syndromes. This suggests a contribution of non-dopaminergic lesions [6].…”

Section: Introductionmentioning

confidence: 98%

Effect of functional NMDA-antagonist flupirtine on automatic postural responses in Parkinson's disease

Putzki¹,

Maschke²,

Drepper³

et al. 2002

Journal of Neurology

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Animal studies have demonstrated potent antiparkinsonian and other motor effects of the functional NMDA-antagonist flupirtine and suggest a therapeutic use in Parkinson's disease (PD). In healthy subjects flupirtine decreases the functionally destabilizing medium latency (ML) response following toe-up rotations of a moving platform. Because ML responses are known to be increased in PD, this study examined s the effects of flupirtine on postural responses in patients with PD. During 22 days 21 patients with PD took 50 mg, 100 mg flupirtine or placebo following a randomized, double-blind design. Clinical impairment was assessed by means of the Unified Parkinson's Disease Rating Scale (UPDRS). No significant difference between the effect of flupirtine and placebo on ML responses was observed. There was an unspecific improvement of overall UPDRS scores in placebo and flupirtine conditions compared with baseline measures which was more marked in the placebo condition. No improvement in the UPDRS motor subscale was observed. As no beneficial effect on the clinical presentation and no effect on postural responses could be demonstrated, flupirtine does not seem to be a therapeutic option in PD.

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“…Since the LLL are suggested to be under supraspinal control [3,12,13], it may be theorized that pallidotomy alters a central controlling (modulating) subsystem. Brainstem reticular nuclei have been suggested in the control of automated motor movement [14].…”

Section: Postural Physiologymentioning

confidence: 99%

“…These corrective reflexes are thought to be generated by the LLL response. Previous studies have shown that scaling of the LLL is impaired in Parkinson's disease (PD), most likely due to loss of dopaminergic control [3]. The loss of scaling indicates that PD patients cannot modify the 'postural set', the functional requirement of a postural task, causing a fixed gain in the postural reflex.…”

Section: Introductionmentioning

confidence: 99%

“…The loss of scaling indicates that PD patients cannot modify the 'postural set', the functional requirement of a postural task, causing a fixed gain in the postural reflex. In the normal human, the postural set can be scaled appropriately to meet the individual postural need [1,2,3]. Since the PD patient cannot do this well, they lose their balance and fall.…”

Section: Introductionmentioning

confidence: 99%

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Stereotactic Posterioventral Pallidotomy Improves Balance Control as Assessed by Computerized Posturography

Mandybur¹,

King

Moore

1999

Stereotact Funct Neurosurg

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Postural instability is arguably the most debilitating symptom of Parkinson’s disease (PD). Recently, posterioventral pallidotomy/pallidoansotomy (PVP) has been advocated to improve a multitude of symptoms associated with PD. Dyskinesias, rigidity and bradykinesia are the most talked about improved symptoms, but posture and gait are also affected after PVP. To analyze the effect of PVP on postural control, 14 patients with PD were prospectively studied using a computerized dynamic posturography machine. Seven males and 7 females underwent a total of 18 procedures, 6 left PVP, 6 right PVP, 2 bilateral and 2 had Vim thalamotomies in addition to PVP. Data were collected pre- and postoperatively after a 12-hour drug-free interval (‘off’ period) and 1–2 h after medications (‘on’ period). Postoperative analyses were performed between 1 and 3 months postoperatively. As a group, patients’ balance, in the off period, improved after surgery in a dynamic setting. Prior to surgery, patients’ anterior-posterior sway exceeded their stability limits (patient fell) on 31% of the trials. After surgery, the fall rate decreased to 23%. Anterior-posterior sway decreased significantly (p < 0.05) postoperatively when the platform was sway referenced. In comparing the effect of surgery in decreasing sway with that of medication preoperatively, improvement after surgery (off period) was better than the preoperative on period (p < 0.05). Patients also improved in ostoperative off state when compared to preoperative off state with the platform sway referenced (p < 0.05), controlling for improvement in dyskinesia-induced imbalance. In conclusion, PVP improves standing balance performance better than that achieved with medications preoperatively. Since central input parameters were improved, the mechanism of PVP may be centralized.

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Long latency postural reflexes are under supraspinal dopaminergic control

Cited by 18 publications

References 39 publications

Deficits in rapid adjustments of movements according to task constraints in Parkinson's disease

Deficits in rapid adjustments of movements according to task constraints in Parkinson's disease

Effect of functional NMDA-antagonist flupirtine on automatic postural responses in Parkinson's disease

Stereotactic Posterioventral Pallidotomy Improves Balance Control as Assessed by Computerized Posturography

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