Postural instability and gait disability: related but separable manifestations of Parkinson*s disease

Postural instability and gait disability: related but separable manifestations of Parkinson*s disease - Postural instability versus Gait disability in PD

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

NL-OMON

Registry ID

NL-OMON40055

Enrollment

Registered

2013-01-10

Start date

2013-05-02

Completion date

Unknown

Last updated

2024-06-11

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Movement disorders, Parkinson's disease, postural instability and gait disorders Parkinson's Disease

Interventions

None listed

Eligibility

Age

18 Years to 99 Years

Inclusion criteria

Inclusion criteria: Parkinson's disease patients • Men/women of age > 18 years. • written informed consent • idiopathic PD, according to the UK Brain Bank Criteria. • disease severity 2.5, 3 or 4 on the Hoehn & Yahr scale (gait and/or balance disorders but still able to walk/stand independently.;Controls • right-handed men/women of age > 18 years • written informed consent

Exclusion criteria

Exclusion criteria: Parkinson disease patients • patients with levodopa*induced gait or balance disorders (e.g., levodopa*induced freezing of gait). We will therefore exclude patients who score greater on levodopa than off levodopa on the gait, balance or freezing items of the UPDRS. • failure to lay still for 90 minutes in the scanner (for example due to head tremor or medication-induced excessive movement) • failure to stand/walk independently • other causes of clinically relevant gait difficulties (eg, orthopedic or vestibular disorders) • contra*indications for MR scanning (eg, clautrophobia) • other neurological disorders such as stroke in history or a psychiatric disease • depression • cognitive impairment (MMSE

Design outcomes

Primary

Measure	Time frame
To avoid confounding influences of actual movements, subjects are instructed to mentally simulate the act of swaying and walking, but without actually performing it (motor imagery). To characterize the neural circuit underlying gait control in PD, we use a validated motor imagery protocol. To characterize the neural circuit underlying postural control, we extend this approach and apply a newly developed protocol for motor imagery of balance that closely matches the protocol used for gait. Specifically, we will use a dynamic balance task (imagining to sway on a balance board), because this is clinically more relevant than static balance. By asking subjects to alternately imagine walking or sway, we can directly contrast and isolate the neural substrates of gait and postural control. Finding differences in neural substrate between gait and balance would have great fundamental and clinical implications. First, this would imply that gait impairment and postural instability result from different pathologies in the brain. Second, this would help to create a model for designing specific therapeutic approaches that are required to combat each of these symptoms.	—

Measure

Time frame

To avoid confounding influences of actual movements, subjects are instructed to mentally simulate the act of swaying and walking, but without actually performing it (*motor imagery*). To characterize the neural circuit underlying gait control in PD, we use a validated motor imagery protocol. To characterize the neural circuit underlying postural control, we extend this approach and apply a newly developed protocol for motor imagery of balance that closely matches the protocol used for gait. Specifically, we will use a dynamic balance task (imagining to sway on a balance board), because this is clinically more relevant than static balance. By asking subjects to alternately imagine walking or sway, we can directly contrast and isolate the neural substrates of gait and postural control. Finding differences in neural substrate between gait and balance would have great fundamental and clinical implications. First, this would imply that gait impairment and postural instability result from different pathologies in the brain. Second, this would help to create a model for designing specific therapeutic approaches that are required to combat each of these symptoms.

—

Secondary

Measure	Time frame
Secondary parameters include: - Comparing the brain activity of PD patients with balance impairments and a group of healthy subjects while they mentally imagine swaying - Using clinical and objective assessments of gait and balance as covariates in the analyses.	—

Countries

Netherlands

Outcome results