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

Please always quote using this URN: urn:nbn:de:bvb:20-opus-200801
  • 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),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.show moreshow less

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Author: Chiara Palmisano, Gregor Brandt, Matteo Vissani, Nicoló G. Pozzi, Andrea Canessa, Joachim Brumberg, Giorgio Marotta, Jens Volkmann, Alberto Mazzoni, Gianni Pezzoli, Carlo A. Frigo, Ioannis U. Isaias
URN:urn:nbn:de:bvb:20-opus-200801
Document Type:Journal article
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Nuklearmedizin
Medizinische Fakultät / Neurologische Klinik und Poliklinik
Language:English
Parent Title (English):Frontiers in Bioengineering and Biotechnology
ISSN:2296-4185
Year of Completion:2020
Volume:8
Article Number:137
Source:Frontiers in Bioengineering and Biotechnology (2020) 8:137. doi: 10.3389/fbioe.2020.00137
DOI:https://doi.org/10.3389/fbioe.2020.00137
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:Parkinson’s disease; anthropometric measurements; basal ganglia; base of support; dopamine; gait initiation
Release Date:2021/03/02
Date of first Publication:2020/03/06
Open-Access-Publikationsfonds / Förderzeitraum 2020
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International