Abstract
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.
Highlights
Posture and balance dysfunctions critically impair activities of daily living of patients with progressing Parkinson’s disease (PD)
PDPI+ participants were selected on the basis of the following criteria: (a) their clinical balance score was greater or equal to five (CBS; sum of mUPDRS items # Leg Agility, # Arising from Chair, # Posture, and # Postural Stability); (b) PDPI+ status was clinically verified by a movement disorders specialist; (c) for subjective confirmation of PDPI+, an unassisted balance task was performed immediately prior to the study trials
There was a prominent decrease of theta oscillation power in the mid-frontal Cz and mid-cerebellar Cbz regions during the postural control task in PDPI+ participants, indicating a negative correlation between theta oscillations and postural control behavioral outcomes among PD patients
Summary
Posture and balance dysfunctions critically impair activities of daily living of patients with progressing Parkinson’s disease (PD). Motor symptoms of Parkinson’s disease (PD) include full body motor dysfunctions in balance, posture, and gait. These are prevalent in advanced stages as well as in older PD patients [1,2,3,4,5]. Postural instability is a common and disabling full body motor feature of PD, which is likely to affect more than 80% of PD patients in the disease progress [6]. Non-motor symptoms, cognitive deficits worsening with disease progression, add to overall disability and increase the risk of postural control disturbances [8,9,10]. The postural control system integrates visual, proprioceptive, and vestibular sensory information; studies indicate that this integration of relevant sensory information may be critically disrupted in PD [11, 12]
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