Dataset Information

Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment.

ABSTRACT:

Background

In addition to motor deficits, Parkinson's disease (PD) may cause perceptual impairments. The role of perceptual impairments in sensorimotor function is unclear, and has typically been studied in single-joint motions.

Research question

We hypothesized that perception of whole-body motion is impaired in PD and contributes to balance impairments. We tested (1) whether directional acuity to whole body perturbations during standing was worse in people with PD compared to neurotypical older adults (NOA), and (2) whether balance ability, as assessed by the MiniBESTest, was associated with poor directional acuity in either group.

Methods

Participants were exposed to pairs of support-surface translation perturbations in a two-alternative forced choice testing paradigm developed previously in a young healthy population. The first perturbation of each pair that was to be judged by participants was directly backward, and the second perturbation deviated from the left or right from the backward direction by 1°-44°. Participants reported whether the perturbations in each pair were in the "same" or "different" direction. Judgements from 24 to 67 perturbation pairs were used to calculate directional acuity thresholds corresponding to "just-noticeable differences" in perturbation direction. Linear mixed models determined associations between directional thresholds and clinical variables including MDS-UPDRS-III score, age, and MiniBESTest score.

Results

20 PD (64?±?7 y, 12 male, ?12?h since last intake of antiparkinsonian medications) and 12 NOA (64?±?8, 6 male) were assessed. Directional thresholds were higher (worse) among PD participants (17.6?±?5.9° vs. 12.8?±?3.3°, P?SignificancePerception of whole-body motion is impaired in PD and may contribute to impaired balance and falls.

SUBMITTER: Bong SM

PROVIDER: S-EPMC7015810 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment.

Bong Sistania M SM McKay J Lucas JL Factor Stewart A SA Ting Lena H LH

Gait & posture 20191104

<h4>Background</h4>In addition to motor deficits, Parkinson's disease (PD) may cause perceptual impairments. The role of perceptual impairments in sensorimotor function is unclear, and has typically been studied in single-joint motions.<h4>Research question</h4>We hypothesized that perception of whole-body motion is impaired in PD and contributes to balance impairments. We tested (1) whether directional acuity to whole body perturbations during standing was worse in people with PD compared to ne ...[more]

PMID: 31731133

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Project description:Parkinson's disease is prototypically a movement disorder. Although perceptual and motor functions are highly interdependent, much less is known about perceptual deficits in Parkinson's disease, which are less observable by nature, and might go unnoticed if not tested directly. It is therefore imperative to seek and identify these, to fully understand the challenges facing patients with Parkinson's disease. Also, perceptual deficits may be related to motor symptoms. Posture, gait and balance, affected in Parkinson's disease, rely on veridical perception of one's own motion (self-motion) in space. Yet it is not known whether self-motion perception is impaired in Parkinson's disease. Using a well-established multisensory paradigm of heading discrimination (that has not been previously applied to Parkinson's disease), we tested unisensory visual and vestibular self-motion perception, as well as multisensory integration of visual and vestibular cues, in 19 Parkinson's disease, 23 healthy age-matched and 20 healthy young-adult participants. After experiencing vestibular (on a motion platform), visual (optic flow) or multisensory (combined visual-vestibular) self-motion stimuli at various headings, participants reported whether their perceived heading was to the right or left of straight ahead. Parkinson's disease participants and age-matched controls were tested twice (Parkinson's disease participants on and off medication). Parkinson's disease participants demonstrated significantly impaired visual self-motion perception compared with age-matched controls on both visits, irrespective of medication status. Young controls performed slightly (but not significantly) better than age-matched controls and significantly better than the Parkinson's disease group. The visual self-motion perception impairment in Parkinson's disease correlated significantly with clinical disease severity. By contrast, vestibular performance was unimpaired in Parkinson's disease. Remarkably, despite impaired visual self-motion perception, Parkinson's disease participants significantly overweighted the visual cues during multisensory (visual-vestibular ) integration (compared with Bayesian predictions of optimal integration) and significantly more than controls. These findings indicate that self-motion perception in Parkinson's disease is affected by impaired visual cues and by suboptimal visual-vestibular integration (overweighting of visual cues). Notably, vestibular self-motion perception was unimpaired. Thus, visual self-motion perception is specifically impaired in early-stage Parkinson's disease. This can impact Parkinson's disease diagnosis and subtyping. Overweighting of visual cues could reflect a general multisensory integration deficit in Parkinson's disease, or specific overestimation of visual cue reliability. Finally, impaired self-motion perception in Parkinson's disease may contribute to impaired balance and gait control. Future investigation into this connection might open up new avenues of alternative therapies to better treat these difficult symptoms.

Dataset Information

Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment.

Background

Research question

Methods

Results

Publications

Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment.

Similar Datasets

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