A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's Disease
Background: Postural instability is a debilitating and largely treatment-resistant symptom of Parkinson's disease (PD). A better understanding of the neural substrates contributing to postural instability could lead to new targets for improved pharmacological and neurosurgical interventions. Ho...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00922/full |
| _version_ | 1818911472470720512 |
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| author | Elizabeth P. Pasman Martin J. McKeown Taylor W. Cleworth Taylor W. Cleworth Bastiaan R. Bloem J. Timothy Inglis J. Timothy Inglis J. Timothy Inglis Mark G. Carpenter Mark G. Carpenter Mark G. Carpenter |
| author_facet | Elizabeth P. Pasman Martin J. McKeown Taylor W. Cleworth Taylor W. Cleworth Bastiaan R. Bloem J. Timothy Inglis J. Timothy Inglis J. Timothy Inglis Mark G. Carpenter Mark G. Carpenter Mark G. Carpenter |
| author_sort | Elizabeth P. Pasman |
| collection | DOAJ |
| description | Background: Postural instability is a debilitating and largely treatment-resistant symptom of Parkinson's disease (PD). A better understanding of the neural substrates contributing to postural instability could lead to new targets for improved pharmacological and neurosurgical interventions. However, investigating these neural substrates necessitates the use of functional MRI scanners, which are almost exclusively horizontally-based.Objective: We aimed to develop, and validate the use of, an MRI compatible balance simulator to study static and dynamic balance control in PD patients and elderly controls.Methods: Our MRI compatible balance simulator allowed participants to actively balance an inverted pendulum by activating postural muscles around the ankle joint while supine. Two studies were performed to compare static and dynamic balance performance between upright stance and simulated stance in PD patients and controls. Study 1 (14 PD; 20 controls) required participants to maintain static balance during upright and simulated stance for 120 s with eyes open and closed. In study 2 (20 PD; 22 controls) participants repeated the static balance task (80 s, eyes closed only), and also completed a dynamic balance task which required maintaining balance while experiencing random anterior-posterior perturbations applied to the trunk/pendulum. Postural sway of the body/pendulum was measured using an angular velocity sensor (SwayStarTM, study 1) and Optotrak motion capture (study 2). Outcome measures were amplitude and frequency of center of mass sway for static balance, and peak and time-to-peak of center of mass displacement and velocity for dynamic balance.Results: PD patients had larger sway amplitude during both upright and simulated static balance compared to controls. PD patients had larger peak and time-to-peak sway, and larger time-to-peak sway velocity, during simulated, but not upright, dynamic balance compared to controls.Conclusions: Deficits in static and dynamic balance control can be detected in PD patients using a novel MRI compatible balance simulator. This technique allows for functional neuroimaging to be combined with balance-relevant tasks, and provides a new means to create insights into the neural substrates contributing to postural instability in PD. |
| first_indexed | 2024-12-19T22:59:15Z |
| format | Article |
| id | doaj.art-c850bf51a11f4c809645a22ffeff932e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-19T22:59:15Z |
| publishDate | 2019-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-c850bf51a11f4c809645a22ffeff932e2022-12-21T20:02:34ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-08-011010.3389/fneur.2019.00922466417A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's DiseaseElizabeth P. Pasman0Martin J. McKeown1Taylor W. Cleworth2Taylor W. Cleworth3Bastiaan R. Bloem4J. Timothy Inglis5J. Timothy Inglis6J. Timothy Inglis7Mark G. Carpenter8Mark G. Carpenter9Mark G. Carpenter10School of Kinesiology, University of British Columbia, Vancouver, BC, CanadaPacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, CanadaSchool of Kinesiology, University of British Columbia, Vancouver, BC, CanadaSchool of Kinesiology and Health Science, York University, Toronto, ON, CanadaDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, NetherlandsSchool of Kinesiology, University of British Columbia, Vancouver, BC, CanadaDjavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, CanadaInternational Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, CanadaSchool of Kinesiology, University of British Columbia, Vancouver, BC, CanadaDjavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, CanadaInternational Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, CanadaBackground: Postural instability is a debilitating and largely treatment-resistant symptom of Parkinson's disease (PD). A better understanding of the neural substrates contributing to postural instability could lead to new targets for improved pharmacological and neurosurgical interventions. However, investigating these neural substrates necessitates the use of functional MRI scanners, which are almost exclusively horizontally-based.Objective: We aimed to develop, and validate the use of, an MRI compatible balance simulator to study static and dynamic balance control in PD patients and elderly controls.Methods: Our MRI compatible balance simulator allowed participants to actively balance an inverted pendulum by activating postural muscles around the ankle joint while supine. Two studies were performed to compare static and dynamic balance performance between upright stance and simulated stance in PD patients and controls. Study 1 (14 PD; 20 controls) required participants to maintain static balance during upright and simulated stance for 120 s with eyes open and closed. In study 2 (20 PD; 22 controls) participants repeated the static balance task (80 s, eyes closed only), and also completed a dynamic balance task which required maintaining balance while experiencing random anterior-posterior perturbations applied to the trunk/pendulum. Postural sway of the body/pendulum was measured using an angular velocity sensor (SwayStarTM, study 1) and Optotrak motion capture (study 2). Outcome measures were amplitude and frequency of center of mass sway for static balance, and peak and time-to-peak of center of mass displacement and velocity for dynamic balance.Results: PD patients had larger sway amplitude during both upright and simulated static balance compared to controls. PD patients had larger peak and time-to-peak sway, and larger time-to-peak sway velocity, during simulated, but not upright, dynamic balance compared to controls.Conclusions: Deficits in static and dynamic balance control can be detected in PD patients using a novel MRI compatible balance simulator. This technique allows for functional neuroimaging to be combined with balance-relevant tasks, and provides a new means to create insights into the neural substrates contributing to postural instability in PD.https://www.frontiersin.org/article/10.3389/fneur.2019.00922/fullParkinson's diseasepostural instabilityelderlystatic balancedynamic balancebalance simulator |
| spellingShingle | Elizabeth P. Pasman Martin J. McKeown Taylor W. Cleworth Taylor W. Cleworth Bastiaan R. Bloem J. Timothy Inglis J. Timothy Inglis J. Timothy Inglis Mark G. Carpenter Mark G. Carpenter Mark G. Carpenter A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's Disease Frontiers in Neurology Parkinson's disease postural instability elderly static balance dynamic balance balance simulator |
| title | A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's Disease |
| title_full | A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's Disease |
| title_fullStr | A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's Disease |
| title_full_unstemmed | A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's Disease |
| title_short | A Novel MRI Compatible Balance Simulator to Detect Postural Instability in Parkinson's Disease |
| title_sort | novel mri compatible balance simulator to detect postural instability in parkinson s disease |
| topic | Parkinson's disease postural instability elderly static balance dynamic balance balance simulator |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00922/full |
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