Advanced characterization of static postural control dysfunction in persons with multiple sclerosis and associated neural mechanisms |
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| Institution: | 1. Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD;2. Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD;3. Department of Health Care Sciences, Wayne State University, Detroit, MI;4. Department of Neurology, Wayne State University, Detroit, MI;5. Translational Neuroscience Program, Wayne State University, Detroit, MI;6. School of Information and Electronics, Beijing Institute of Technology, Beijing, China;7. Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD;8. School of Medicine, Tulane University, New Orleans, LA;9. Department of Neurology, Johns Hopkins University, Baltimore, MD;10. Department of Neuroscience, Johns Hopkins University, Baltimore, MD;1. Faculty of Medicine and Health, University of New South Wales, UNSW Sydney, Sydney, NSW 2052, Australia;2. Falls, Balance, and Injury Research Centre, Neuroscience Research, 139 Barker Street, Randwick, NSW 2031, Australia;3. Worcester Polytechnic Institute, 100 Institute Rd, Worcester, MA 01609, United States |
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| Abstract: | BackgroundMultiple sclerosis (MS) is an autoimmune-based chronic inflammatory disease characterized by the neurodegeneration of the central nervous system and produces postural dysfunction. Quiet or static standing is a complex task carried out through afferent sensory inputs and efferent postural corrective outputs. Currently the mechanisms underlying these outputs remain largely unknown.Research questionAssess the relationship between multi-dimensional measures of postural control and microstructural integrity of the cortical sensorimotor pathway (CSP) in persons with MS (PwMS) and neurotypical adults.MethodsPostural control performance was assessed by both overall and directional time-to-boundary measures across four manipulated sensory stance conditions (eyes open/closed; stance firm/foam) in twenty-nine neurotypical and twenty-seven PwMS. These postural outcomes were evaluated with mixed-model repeated measures analysis of variance across group (MS and control) and stance condition. Postural performance was also correlated with magnetic resonance imaging diffusion tensor-derived measures of microstructural integrity of the CSP.ResultsPwMS displayed significantly (p = 0.026) worse anterior-posterior postural control compared to their neurotypical counterparts across sensory testing conditions and poorer CSP microstructural integrity in comparison to neurotypical adults (p = 0.008). Additionally, PwMS displayed a significant association (2D (rho = -0.384, p = 0.048), AP (rho = -0.355, p = 0.035), and ML (rho = -0.365, p = 0.030) between integrity of the CSP and postural control performance during proprioceptive-based balance, such that those with worse cortical structure had poorer balance control.SignificanceThis is the first study to establish connections between the microstructural integrity of the CSP and multi-dimensional postural control performance. Results indicate that a reduction in the CSP microstructural integrity is associated with poorer postural control in PwMS. These outcomes identify neural underpinnings of postural control dysfunction in PwMS and provide new avenues for evaluating the efficacy of postural rehabilitation strategies in PwMS that express proprioceptive-based postural deficits. |
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| Keywords: | Balance Postural control Time-to-boundary Cortical sensorimotor pathway Diffusion tensor imaging |
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