Supraspinal control of automatic postural responses in people with multiple sclerosis

D. S. Peterson, G. Gera, F. B. Horak, B. W. Fling

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


The neural underpinnings of delayed automatic postural responses in people with multiple sclerosis (PwMS) are unclear. We assessed whether white matter pathways of two supraspinal regions (the cortical proprioceptive Broadman's Area-3; and the balance/locomotor-related pedunculopontine nucleus) were related to delayed postural muscle response latencies in response to external perturbations. 19 PwMS (48.8 ± 11.4 years; EDSS = 3.5 (range: 2-4)) and 12 healthy adults (51.7 ± 12.2 years) underwent 20 discrete, backward translations of a support surface. Onset latency of agonist (medial-gastrocnemius) and antagonist (tibialis anterior) muscles were assessed. Diffusion tensor imaging assessed white-matter integrity (i.e. radial diffusivity) of cortical proprioceptive and balance/locomotor-related tracts. Latency of the tibialis anterior, but not medial gastrocnemius was larger in PwMS than control subjects (p = 0.012 and 0.071, respectively). Radial diffusivity of balance/locomotor tracts was higher (worse) in PwMS than control subjects (p = 0.004), and was significantly correlated with tibialis (p = 0.002), but not gastrocnemius (p = 0.06) onset latency. Diffusivity of cortical proprioceptive tracts was not correlated with muscle onset. Lesions in supraspinal structures including the pedunculopontine nucleus balance/locomotor network may contribute to delayed onset of postural muscle activity in PwMS, contributing to balance deficits in PwMS.

Original languageEnglish
Pages (from-to)92-95
Number of pages4
JournalGait and Posture
StatePublished - Jun 1 2016

Bibliographical note

Funding Information:
The authors thank Heather Schlueter for assisting in participant recruitment, screening and data collection and Ed King for technical assistance. The experiments were conducted in the Balance Disorders Laboratory at the Oregon Health and Science University. Conflict of interest : Dr. Horak and OHSU have an equity/interest in APDM, a company that may have a commercial interest in the results of the study. This potential conflict of interest has been reviewed and managed by the Research & Development Committee at the Portland VA Medical Center and OHSU. No other authors declare any conflict of interest. Funding : This work was supported by The United States Department of Veteran's Affairs Rehabilitation Research and Development Service , grant numbers #I01BX007080 (Career Development Award-1; Peterson) and E10750R (VA Merit Award; Horak), the National Institutes of Health , grant number R01 AG006457 29 (Horak), the Medical Research Foundation of Oregon , and the National MS Society , grant numbers RG-5273 (Fling), FG 2058-A-1 (Gera) and MB-0027 (Horak). The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

Publisher Copyright:
© 2016.


  • Multiple sclerosis
  • Muscle onset latency
  • Pedunculopontine nucleus
  • Postural responses
  • Radial diffusivity

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


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