Gait Initiation in Parkinson's Disease: Impact of Dopamine Depletion and Initial Stance Condition.

Parkinson’s disease anthropometric measurements basal ganglia base of support dopamine gait initiation

Journal

Frontiers in bioengineering and biotechnology
ISSN: 2296-4185
Titre abrégé: Front Bioeng Biotechnol
Pays: Switzerland
ID NLM: 101632513

Informations de publication

Date de publication:
2020
Historique:
received: 07 10 2019
accepted: 11 02 2020
entrez: 27 3 2020
pubmed: 27 3 2020
medline: 27 3 2020
Statut: epublish

Résumé

Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson's disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment.

Identifiants

pubmed: 32211390
doi: 10.3389/fbioe.2020.00137
pmc: PMC7068722
doi:

Types de publication

Journal Article

Langues

eng

Pagination

137

Informations de copyright

Copyright © 2020 Palmisano, Brandt, Vissani, Pozzi, Canessa, Brumberg, Marotta, Volkmann, Mazzoni, Pezzoli, Frigo and Isaias.

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Auteurs

Chiara Palmisano (C)

Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany.
MBMC Lab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.

Gregor Brandt (G)

Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany.

Matteo Vissani (M)

Translational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.

Nicoló G Pozzi (NG)

Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany.

Andrea Canessa (A)

Fondazione Europea di Ricerca Biomedica (FERB Onlus), Cernusco s/N (Milan), Italy.

Joachim Brumberg (J)

Department of Nuclear Medicine, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany.

Giorgio Marotta (G)

Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.

Jens Volkmann (J)

Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany.

Alberto Mazzoni (A)

Translational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.

Gianni Pezzoli (G)

Centro Parkinson, ASST G. Pini-CTO, Milan, Italy.

Carlo A Frigo (CA)

MBMC Lab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.

Ioannis U Isaias (IU)

Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, Germany.

Classifications MeSH