Supraspinal control of automatic postural responses in people with multiple sclerosis

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

doi:10.1016/j.gaitpost.2016.02.023

Supraspinal control of automatic postural responses in people with multiple sclerosis

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

Physical Therapy

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

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 language	English
Pages (from-to)	92-95
Number of pages	4
Journal	Gait and Posture
Volume	47
DOIs	https://doi.org/10.1016/j.gaitpost.2016.02.023
State	Published - 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.

Keywords

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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10.1016/j.gaitpost.2016.02.023

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title = "Supraspinal control of automatic postural responses in people with multiple sclerosis",

abstract = "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.",

keywords = "Multiple sclerosis, Muscle onset latency, Pedunculopontine nucleus, Postural responses, Radial diffusivity",

author = "Peterson, {D. S.} and G. Gera and Horak, {F. B.} and Fling, {B. W.}",

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: {\textcopyright} 2016.",

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AU - Horak, F. B.

AU - Fling, B. W.

N1 - 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.

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N2 - 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.

AB - 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.

KW - Multiple sclerosis

KW - Muscle onset latency

KW - Pedunculopontine nucleus

KW - Postural responses

KW - Radial diffusivity

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Supraspinal control of automatic postural responses in people with multiple sclerosis

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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