Postural instability in people with Parkinson's disease and freezing of gait: behavioral and neural correlates

Postural instability is a key feature of Parkinson's disease (PD) frequently leading to falls inevitably with devastating consequences. Despite its importance, the neural aspects contributing to this deficit are largely unknown in PD. Therefore, in the current project, we will investigate behavioral as well as neural aspects of postural control in PD. As freezing of gait, defined as an involuntary interruption of walking, is known to be one of the main triggers of falls, postural instability will be investigated in subgroups of patients with and without freezing who are matched for disease severity. In the first stage, we will study the motor, cognitive and proprioceptive aspects of balance. Next, the neural background of postural instability will be investigated by means of diffusion tensor imaging and resting state and functional magnetic resonance imaging. We expect that patients with PD will have more proprioception-related brain activity changes and that the most salient markers of postural instability will be related to specific degeneration of white matter integrity and functional connectivity involving the pedunculopontine nucleus, the basal ganglia and parietal and frontal cortical regions. We also predict that proprioceptive deficits and related postural instability and brain activity changes will be more pronounced in freezers. These behavioral and neural insights will form the basis for individualized rehabilitation interventions for postural instability in PD.

Publication year:2021

Accessibility:Closed