Abnormal resonance behavior of the postural control loop in Parkinson's disease
Abnormal resonance behavior of the postural control loop in Parkinson's disease
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DOI：
10.1007/s00221-004-1852-y
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发表时间：
2004-08-01
影响因子：
2
通讯作者：
Peterka, RJ
中科院分区：
文献类型：
--
作者：
Maurer, C;Mergner, T;Peterka, RJ
人类对直立站立的姿势控制偶尔会表现出振荡行为。基于以前的工作，我们评估了这种振荡的异常趋势是否可能导致基底神经节功能障碍如帕金森病（PD）患者的运动障碍。我们研究了正常对照组和PD患者在无干扰站立时的姿势控制，重点是足部压力中心（COP）偏移的稳定图扩散分析（SDA）和摇摆幅度和速度的常规测量。我们发现异常1 Hz的身体摇摆振荡的SDA曲线的PD患者，显着不同的身体摇摆通常观察到的对照组受试者在安静的立场。1 Hz的身体摇摆振荡与停止治疗的患者中异常大而快的摇摆相关。在使用左旋多巴、“脑深部刺激”（丘脑底核）以及联合治疗的情况下，SDA曲线的振荡消失，摇摆变慢。摆动消失和摆动速度降低与患者临床运动评估评分的改善高度相关。然而，摇摆幅度与患者的运动评估评分无关，患者报告治疗后临床改善，即使摇摆幅度平均增加。一个简单的反馈模型的姿势控制系统异常大的内部噪声可以预测实验措施和关闭治疗。关闭治疗条件与反馈回路中的高电机增益一致，而打开治疗条件与降低的电机增益一致。
Human postural control of upright stance sporadically can show an oscillatory behavior. Based on previous work, we assessed whether an abnormal tendency for such oscillations might contribute to the motor impairments in patients with basal ganglia dysfunction such as Parkinson's disease (PD). We investigated postural control during unperturbed stance in normal control subjects and in PD patients off and under treatment, focusing on stabilogram diffusion analysis (SDA) of the foot center of pressure (COP) excursions and conventional measures of the sway amplitude and velocity. We found abnormal 1 Hz body sway oscillation in the SDA curves of PD patients that differed significantly from the body sway typically observed in control subjects during quiet stance. The 1 Hz body sway oscillation was associated with abnormally large and fast sway in the patients off treatment. Under treatment with levodopa, with 'deep brain stimulation' (subthalamic nucleus) and even more so with combined treatment, the oscillations in the SDA curves vanished and the sway became slower. The loss of oscillation and reduction of sway velocity were highly correlated with the improvements of patients' clinical motor assessment score. However, sway amplitude was not correlated with the patients' motor assessment score and patients reported clinical improvement under therapy even though sway amplitude increased on average. A simple feedback model of the postural control system with abnormally large internal noise could predict experimental measures both on and off treatment. The off treatment condition was consistent with a high motor gain in the feedback loop, and the on treatment condition with a reduced motor gain.