Evolution characteristics of dynamic balance disorder over the course of PD and relationship with dopamine depletion

Frontiers in Aging Neuroscience

Aging Neuroscience

Na Wu¹  Jing Gan¹  Jiahao Zhao¹  Ying Wan¹  Lu Song¹  Hui Wang²  Zhenguo Liu²  Yafu Yin²  Xiaodong Wu² 

[1] Department of Neurology, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China;Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China;

关键词: Parkinson's disease;    dynamic balance;    dopamine transporter (DAT);    dopaminergic depletion;    white matter hyperintensities (WMHs);   

DOI  :  10.3389/fnagi.2022.1075572

 received in 2022-10-20, accepted in 2022-12-29,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveThis study aimed to assess the evolution of dynamic balance impairment during the course of Parkinson's disease (PD) and to clarify the contribution of striatal dopaminergic innervation to poor dynamic balance.MethodsIn our study, 89 patients with PD (divided into 2 groups according to the H-Y stage) and 39 controls were included. Kinematic data were recorded by a portable inertial measurement unit system. Dopaminergic loss in the striatal subregion was verified through the 11C-CFT PET examination. The severity of white matter hyperintensities (WMHs) was assessed by the Scheltens scale. The correlation between dynamic kinematic parameters and dopamine transporter availability was analyzed by multivariate regression analysis.ResultsPatients with early PD presented with imbalance featured by smaller three-dimensional trunk ROM with reduced trunk coronal angular velocity during walking and with reduced trunk sagittal angular velocity during the stand-to-sit task (all p < 0.05). These abnormalities were not more severe at a later stage. The ROM in the coronal and transverse planes during walking correlated with caudate DAT uptake (β = 0.832, p = 0.006, Q = 0.030, and β = 0.890, p = 0.003, Q = 0.030) after controlling for age, gender, and WMHs. As the disease progressed, the trunk sagittal and transverse angular velocities during walking and trunk sagittal angular velocity when turning and sitting-to-standing were slower, which was accompanied by reduced gait velocity gradually (all p < 0.05). These parameters related to disease progression have no association with striatal DAT uptake (all p > 0.05).ConclusionThe dynamic balance in PD was impaired from the early stages, and the characteristics of the impairment changed differently as the disease progressed. Dopaminergic denervation has a lower contribution to dynamic balance disorders throughout PD.

【 授权许可】

Unknown   
Copyright © 2023 Gan, Wu, Wan, Zhao, Song, Wu, Wang, Yin and Liu.