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Paramento M, Passarotto E, Maccarone MC, Agostini M, Contessa P, Rubega M, Formaggio E, Masiero S. Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review. PLoS One 2024; 19:e0303086. [PMID: 38776317 PMCID: PMC11111046 DOI: 10.1371/journal.pone.0303086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately 4% of the world's population. Several hypotheses regarding the etiology of AIS have been investigated. In the last decades, impaired visual-spatial perception, alterations in spatial body orientation and sensory integration deficits have been documented. OBJECTIVE We aimed to summarize the neurophysiological, balance, and motion evidence related to AIS published in the last fifteen years, between January 2008 and April 2023. Both observational and interventional studies were considered. Only studies using quantitative assessment methods, such as electroencephalography (EEG), electromyography (EMG), magnetic resonance imaging (MRI), somatosensory evoked potentials, force platform, or motion capture, were included. METHODS 1250 eligible records identified from online database searching were filtered by duplicate removal, title and abstract screening, and qualitative analysis. 61 articles met the inclusion criteria (i.e., Cobb range 10°-35°, age range 10-18 years) and were summarized. RESULTS We found significant evidence of impaired standing balance in individuals with AIS who greatly rely on visual and proprioceptive information to stay upright. EMG studies frequently reported an increased activity on the convex side of the intrinsic spinae muscles. EEG data show increased delta and theta power, higher alpha peak frequencies, and significant suppression in the alpha and beta bands in subjects with AIS during standing tasks. MRI studies report changes in white matter structures, differences in the vestibular system, and abnormal cortical activations over motor-related areas in subjects with AIS. Bracing appears to be an effective treatment for AIS, leading to improvements in static balance and gait. Methodological issues prevent reliable conclusions about the effects of other treatment options. CONCLUSIONS This review underscores the importance of quantitative assessment methods to explore the etiology and pathophysiology of AIS. Further research is needed to measure the impact of physical therapy and orthotic treatments on the neurophysiological mechanisms of the disease.
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Affiliation(s)
- Matilde Paramento
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Edoardo Passarotto
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Maria Chiara Maccarone
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Michela Agostini
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Paola Contessa
- Orthopedic Rehabilitation Unit, Padova University Hospital, Padova, Italy
| | - Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Ospedale Riabilitativo di Alta Specializzazione di Motta di Livenza, Motta di Livenza, Treviso, Italy
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McCallum-Loudeac J, Moody E, Williams J, Johnstone G, Sircombe KJ, Clarkson AN, Wilson MJ. Deletion of a conserved genomic region associated with adolescent idiopathic scoliosis leads to vertebral rotation in mice. Hum Mol Genet 2024; 33:787-801. [PMID: 38280229 PMCID: PMC11031364 DOI: 10.1093/hmg/ddae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/15/2023] [Accepted: 01/12/2024] [Indexed: 01/29/2024] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis, in which spinal curvature develops in adolescence, and 90% of patients are female. Scoliosis is a debilitating disease that often requires bracing or surgery in severe cases. AIS affects 2%-5.2% of the population; however, the biological origin of the disease remains poorly understood. In this study, we aimed to determine the function of a highly conserved genomic region previously linked to AIS using a mouse model generated by CRISPR-CAS9 gene editing to knockout this area of the genome to understand better its contribution to AIS, which we named AIS_CRMΔ. We also investigated the upstream factors that regulate the activity of this enhancer in vivo, whether the spatial expression of the LBX1 protein would change with the loss of AIS-CRM function, and whether any phenotype would arise after deletion of this region. We found a significant increase in mRNA expression in the developing neural tube at E10.5, and E12.5, for not only Lbx1 but also other neighboring genes. Adult knockout mice showed vertebral rotation and proprioceptive deficits, also observed in human AIS patients. In conclusion, our study sheds light on the elusive biological origins of AIS, by targeting and investigating a highly conserved genomic region linked to AIS in humans. These findings provide valuable insights into the function of the investigated region and contribute to our understanding of the underlying causes of this debilitating disease.
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Affiliation(s)
- Jeremy McCallum-Loudeac
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Edward Moody
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Jack Williams
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Georgia Johnstone
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Kathleen J Sircombe
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Andrew N Clarkson
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Megan J Wilson
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
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Langlais T, Vergari C, Rougereau G, Gaume M, Gajny L, Abelin-Genevois K, Bernard JC, Hu Z, Cheng JCY, Chu WCW, Assi A, Karam M, Ghanem I, Bassani T, Galbusera F, Sconfienza LM, Brayda-Bruno M, Courtois I, Ebermeyer E, Vialle R, Dubousset J, Skalli W. Assessment of malalignment at early stage in adolescent idiopathic scoliosis: a longitudinal cohort study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:1665-1674. [PMID: 38407613 DOI: 10.1007/s00586-024-08178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION Our objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between progressive and stable adolescent idiopathic scoliosis (AIS) at early stage. MATERIALS AND METHODS All patients (non-scoliotic and AIS) underwent a biplanar X-ray between 2013 and 2020. In AIS, inclusion criteria were Cobb angle between 10° and 25°; Risser sign lower than 3; age higher than 10 years; and no previous treatment. A 3D spine reconstruction was performed, and the OD-HA was computed automatically. A reference corridor for OD-HA values in non-scoliotic subjects was calculated as the range [5th-95th percentiles]. A severity index, helping to distinguish stable and progressive AIS, was calculated and weighted according to the OD-HA value. RESULTS Eighty-three non-scoliotic and 205 AIS were included. The mean coronal and sagittal OD-HA angles in the non-scoliotic group were 0.2° and -2.5°, whereas in AIS values were 0.3° and -0.8°, respectively. For coronal and sagittal OD-HA, 27.5% and 26.8% of AIS were outside the reference corridor compared with 10.8% in non-scoliotic (OR = 3.1 and 3). Adding to the severity index a weighting factor based on coronal OD-HA, for thoracic scoliosis, improved the positive predictive value by 9% and the specificity by 13%. CONCLUSION Analysis of OD-HA suggests that AIS patients are almost three times more likely to have malalignment compared with a non-scoliotic population. Furthermore, analysis of coronal OD-HA is promising to help the clinician distinguish between stable and progressive thoracic scoliosis.
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Affiliation(s)
- Tristan Langlais
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France.
- Service Orthopédie et Traumatologie, Hôpital des Enfants, Purpan, Toulouse Université, Toulouse, France.
| | - Claudio Vergari
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France
| | - Gregoire Rougereau
- Service Orthopédie et Traumatologie, Hôpital Pitié-Salpêtrière, Sorbonne Université, APHP, Paris, France
| | - Mathilde Gaume
- Service Orthopédie et Traumatologie, Hôpital Necker Enfants Malades, Paris cité Université, APHP, Paris, France
| | - Laurent Gajny
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France
| | - Kariman Abelin-Genevois
- Department of Orthopaedic Surgery and Children Conservative Treatment, Croix-Rouge Française. Centre Médico-Chirurgical Et de Réadaptation Des Massues, Lyon, France
| | - Jean Claude Bernard
- Department of Orthopaedic Surgery and Children Conservative Treatment, Croix-Rouge Française. Centre Médico-Chirurgical Et de Réadaptation Des Massues, Lyon, France
| | - Zongshan Hu
- SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jack Chun Yiu Cheng
- SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Winnie Chiu Wing Chu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ayman Assi
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Joseph University of Beirut, SaintBeirut, Lebanon
| | - Mohamad Karam
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Joseph University of Beirut, SaintBeirut, Lebanon
| | - Ismat Ghanem
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Joseph University of Beirut, SaintBeirut, Lebanon
- Department of Orthopedic Surgery, Hotel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università Degli Studi di Milano, Milan, Italy
| | | | | | - Eric Ebermeyer
- Unite Rachis, CHU - Hopital Bellevue, Saint-Etienne, France
| | - Raphael Vialle
- Sorbonne Université, Service Orthopédie et Traumatologie, Hôpital A. Trousseau, APHP, Paris, France
| | - Jean Dubousset
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France
| | - Wafa Skalli
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, HESAM Université, Paris, France
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Qi X, Peng C, Fu P, Zhu A, Jiao W. Correlation between physical activity and adolescent idiopathic scoliosis: a systematic review. BMC Musculoskelet Disord 2023; 24:978. [PMID: 38115016 PMCID: PMC10729348 DOI: 10.1186/s12891-023-07114-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The multifactorial aetiology of scoliosis is well known. Physical activity is considered both a treatment and causative factor for idiopathic scoliosis; however, evidence for a causal relationship between physical activity levels and idiopathic scoliosis in adolescents is conflicting. Therefore, we aimed to summarise the current evidence regarding the association between adolescent idiopathic scoliosis and physical activity and further to assess whether the relationship is dose dependent. METHODS PubMed, Cochrane, Scopus, and Web of Science databases were searched from 1991 to July 2022 using the following main keywords: adolescent idiopathic scoliosis, physical activity, and risk factors, supplemented with manual searches, secondary citations, and reference searches. The quality of the included literature was evaluated using the Scale for Reporting Observational Studies in Enhanced Epidemiology guidelines. RESULTS Eight studies were included in this review, of which six reported an association between adolescent idiopathic scoliosis and physical activity levels and two reported no association. One British study reported reduced physical function early in life as a new risk factor for scoliosis onset. CONCLUSIONS Physical activity is strongly associated with adolescent idiopathic scoliosis. Physical activity should be encouraged as it plays an important role in the prevention of adolescent idiopathic scoliosis. Further research is needed to determine the dose-dependent relationship between physical activity and prevention of adolescent idiopathic scoliosis.
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Affiliation(s)
- Xiang Qi
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
- School of Physical Education, Taizhou University, Taizhou, China
| | - Chao Peng
- Department of Rehabilitation, The First Affliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Pinting Fu
- Department of Rehabilitation, Shanxi Acupuncture Hospital, Taiyuan, China
| | - Aiyuan Zhu
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Wei Jiao
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
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Paramento M, Rubega M, Di Marco R, Contessa P, Agostini M, Cantele F, Masiero S, Formaggio E. Experimental protocol to investigate cortical, muscular and body representation alterations in adolescents with idiopathic scoliosis. PLoS One 2023; 18:e0292864. [PMID: 37824513 PMCID: PMC10569634 DOI: 10.1371/journal.pone.0292864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. AIS is a three-dimensional morphological spinal deformity that affects approximately 1-3% of adolescents. Not all factors related to the etiology of AIS have yet been identified. OBJECTIVE The primary aim of this experimental protocol is to quantitatively investigate alterations in body representation in AIS, and to quantitatively and objectively track the changes in body sensorimotor representation due to treatment. METHODS Adolescent girls with a confirmed diagnosis of mild (Cobb angle: 10°-20°) or moderate (21°-35°) scoliosis as well as age and sex-matched controls will be recruited. Participants will be asked to perform a 6-min upright standing and two tasks-named target reaching and forearm bisection task. Eventually, subjects will fill in a self-report questionnaire and a computer-based test to assess body image. This evaluation will be repeated after 6 and 12 months of treatment (i.e., partial or full-time brace and physiotherapy corrective postural exercises). RESULTS We expect that theta brain rhythm in the central brain areas, alpha brain rhythm lateralization and body representation will change over time depending on treatment and scoliosis progression as a compensatory strategy to overcome a sensorimotor dysfunction. We also expect asymmetric activation of the trunk muscle during reaching tasks and decreased postural stability in AIS. CONCLUSIONS Quantitatively assess the body representation at different time points during AIS treatment may provide new insights on the pathophysiology and etiology of scoliosis.
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Affiliation(s)
- Matilde Paramento
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Roberto Di Marco
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Paola Contessa
- Orthopedic Rehabilitation Unit, Padova University Hospital, Padova, Italy
| | - Michela Agostini
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Francesca Cantele
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Orthopedic Rehabilitation Unit, Padova University Hospital, Padova, Italy
- Ospedale Riabilitativo di Alta Specializzazione di Motta di Livenza, Motta di Livenza, Treviso, Italy
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
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Wilczyński J, Habik Tatarowska N, Mierzwa Molenda M. Deficits of Sensory Integration and Balance as Well as Scoliotic Changes in Young Schoolgirls. SENSORS (BASEL, SWITZERLAND) 2023; 23:1172. [PMID: 36772216 PMCID: PMC9919114 DOI: 10.3390/s23031172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/06/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to assess the relationship between sensory integration and balance deficits as well as scoliotic changes in young schoolgirls. The study comprised 54 girls aged 11 years with scoliotic changes. The Clinical Test of Sensory Integration and Balance of the Biodex Balance System platform were used to analyze the deficits in sensory integration and balance. Scoliotic changes were assessed using the Diers Formetric III 4D optoelectronic method. In the present study, there was a significant relationship between sensory integration and balance deficits as well as spine curvature angle (°) (p = 0.01), vertebral surface rotation (°) (p = 0.03), pelvic tilt (°) (p = 0.02), and lateral deviation (mm) (p = 0.04). The integration of the sensory systems has a positive effect on the structure of the intended and controlled movement as well as body posture and the development of the spine. In the treatment of scoliotic changes, one should also consider exercises that improve sensory integration as well as position and balance reactions.
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Gómez Cristancho DC, Jovel Trujillo G, Manrique IF, Pérez Rodríguez JC, Díaz Orduz RC, Berbeo Calderón ME. Neurological mechanisms involved in idiopathic scoliosis. Systematic review of the literature. NEUROCIRUGIA (ENGLISH EDITION) 2023; 34:1-11. [PMID: 35256329 DOI: 10.1016/j.neucie.2022.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 02/01/2023]
Abstract
The literature that explains the neurological mechanisms underlying the development or compensation of idiopathic scoliosis is limited. The objective of the article is to describe and integrate the mechanisms and nerve pathways through which idiopathic scoliosis is compensated and/or developed. A narrative systematic review in different databases of the studies published between January 1, 1967 and April 1, 2021 was performed, using the following terms: "scoliosis", "vision", "eye", "vestibule", "labyrinth" "posture", "balance", "eye movements", "cerebellum", "proprioception", and "physiological adaptation". In the search, 1112 references were identified, of which 50 were finally included: 46 observational analytical clinical studies-descriptive (between cohorts, report and series of cases) and 4 experimental studies. In the neurological response to idiopathic scoliosis, the sensory-cortical integration of the afferences in the visual-oculomotor-vestibular-proprioceptive systems, allows modifications at the postural level in order to achieve an initial compensation on the sagittal balance and the centre of body mass; however, over time these compensation mechanisms may be exhausted causing progression of the initial deformity.
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Affiliation(s)
- David Camilo Gómez Cristancho
- Médico General, Miembro Semillero Neurología y Neurocirugía, Pontificia Universidad Javeriana-Hospital Universitario San Ignacio, Bogotá, Colombia.
| | - Gabriela Jovel Trujillo
- Estudiante de Medicina, Miembro Semillero Neurología y Neurocirugía, Pontificia Universidad Javeriana-Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Iván Felipe Manrique
- Estudiante de Medicina, Miembro Semillero Neurología y Neurocirugía, Pontificia Universidad Javeriana-Hospital Universitario San Ignacio, Bogotá, Colombia
| | | | - Roberto Carlos Díaz Orduz
- Médico Neurocirujano, Pontificia Universidad Javeriana-Hospital Universitario San Ignacio, Bogotá, Colombia
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Simoneau M, Pialasse JP, Mercier P, Blouin JS. Adolescents with idiopathic scoliosis show decreased intermuscular coherence in lumbar paraspinal muscles: a new pathophysiological perspective. Clin Neurophysiol 2022; 138:38-51. [DOI: 10.1016/j.clinph.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/18/2022] [Accepted: 03/02/2022] [Indexed: 11/03/2022]
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Mecanismos neurológicos involucrados en la escoliosis idiopática. Revisión sistemática de la literatura. Neurocirugia (Astur) 2022. [DOI: 10.1016/j.neucir.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Desgagnés A, Desmons M, Cyr JP, Simoneau M, Massé-Alarie H. Motor Responses of Lumbar Erector Spinae Induced by Electrical Vestibular Stimulation in Seated Participants. Front Hum Neurosci 2021; 15:690433. [PMID: 34366814 PMCID: PMC8339290 DOI: 10.3389/fnhum.2021.690433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The study of motor responses induced by electrical vestibular stimulation (EVS) may help clarify the role of the vestibular system in postural control. Although back muscles have an important role in postural control, their EVS-induced motor responses were rarely studied. Moreover, the effects of EVS parameters, head position, and vision on EVS-induced back muscles responses remain little explored. Objectives: To explore the effects of EVS parameters, head position, and vision on lumbar erector spinae muscles EVS-induced responses. Design: Exploratory, cross-sectional study. Materials and Methods: Ten healthy participants were recruited. Three head positions (right, left and no head rotation), 4 intensities (2, 3, 4, 5 mA), and 4 EVS durations (5, 20, 100, 200 ms) were tested in sitting position with eyes open or closed. EVS usually induced a body sway toward the anode (placed on the right mastoid). EMG activity of the right lumbar erector spinae was recorded. Variables of interest were amplitude, occurrence, and latency of the EVS-induced modulation of the EMG activity. Results: The short-latency response was inhibitory and the medium-latency response was excitatory. Increased EVS current intensity augmented the occurrence and the amplitude of the short- and medium-latency responses (more inhibition and more excitation, respectively). EVS duration influenced the medium-latency response differently depending on the position of the head. Right head rotation produced larger responses amplitude and occurrence than left head rotation. Opposite head rotation (left vs. right) did not induce a reversal of the short- and medium-latency responses (i.e., the inhibition did not become an excitation), as typically reported in lower legs muscles. The eyes open condition did not modulate muscle responses. Conclusion: Modulation of EVS parameters (current intensity and duration of EVS) affects the amplitude and occurrence of the lumbar erector spinae responses. In contrast, vision did not influence the responses, suggesting its minimal contribution to vestibulomotor control in sitting. The lack of response reversal in sagittal plane may reflect the biomechanical role of lumbar erector spinae to fine-tune the lumbar lordosis during the induced body sway. This hypothesis remains to be further tested.
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Affiliation(s)
- Amélie Desgagnés
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Laval University, Quebec City, QC, Canada
| | - Mikaël Desmons
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Laval University, Quebec City, QC, Canada
| | - Jean-Philippe Cyr
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Laval University, Quebec City, QC, Canada
| | - Martin Simoneau
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Laval University, Quebec City, QC, Canada.,Kinesiology Department, Laval University, Quebec City, QC, Canada
| | - Hugo Massé-Alarie
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Laval University, Quebec City, QC, Canada.,Rehabilitation Department, Laval University, Quebec City, QC, Canada
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Szczygieł E, Gigoń A, Chudyba IC, Joanna G, Edward G. Evaluation attempt of own body sensing amongst persons with and without scoliosis. J Back Musculoskelet Rehabil 2021; 34:425-430. [PMID: 33459696 DOI: 10.3233/bmr-191761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a common structural spine deformity affecting 2%-4% of adolescents. Due to the unknown cause of idiopathic scoliosis, its therapy is a long-term and often unsatisfactory process. In the literature, it is often suggested that problems related to the feeling of one's own body are caused by AIS. OBJECTIVE The aim of this study was to assess the feeling of one's own body among children with and without scoliosis on the example of feeling the head position, pelvis shape and balance. METHOD The research included 62 children: 30 with scoliosis and 25 without diagnosed scoliosis with an age range between 11 to 19 years. The minimum scoliosis value was 7∘ and the maximum was 53∘. The average value was 25∘. During the study, three functional tests were used: Cervical Joint Position Error Test (CJPET), Clinical Test of Sensory Integration on Balance (CTSIB) and Body proportion demonstration test (BPDT). RESULTS The results of the tests showed statistically significant differences (CJPET p= 3.54*10-14, CTSIB p= 0.0376, BPDT p= 0.0127). However, none of the studies showed a correlation between the results of people with scoliosis and the value of their Cobb angles.
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Affiliation(s)
- Elżbieta Szczygieł
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | - Agata Gigoń
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | | | - Golec Joanna
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | - Golec Edward
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
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Whole Exome Sequencing of 23 Multigeneration Idiopathic Scoliosis Families Reveals Enrichments in Cytoskeletal Variants, Suggests Highly Polygenic Disease. Genes (Basel) 2021; 12:genes12060922. [PMID: 34208743 PMCID: PMC8235452 DOI: 10.3390/genes12060922] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/04/2021] [Accepted: 06/10/2021] [Indexed: 12/26/2022] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a lateral spinal curvature >10° with rotation that affects 2–3% of healthy children across populations. AIS is known to have a significant genetic component, and despite a handful of risk loci identified in unrelated individuals by GWAS and next-generation sequencing methods, the underlying etiology of the condition remains largely unknown. In this study, we performed exome sequencing of affected individuals within 23 multigenerational families, with the hypothesis that the occurrence of rare, low frequency, disease-causing variants will co-occur in distantly related, affected individuals. Bioinformatic filtering of uncommon, potentially damaging variants shared by all sequenced family members revealed 1448 variants in 1160 genes across the 23 families, with 132 genes shared by two or more families. Ten genes were shared by >4 families, and no genes were shared by all. Gene enrichment analysis showed an enrichment of variants in cytoskeletal and extracellular matrix related processes. These data support a model that AIS is a highly polygenic disease, with few variant-containing genes shared between affected individuals across different family lineages. This work presents a novel resource for further exploration in familial AIS genetic research.
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Scheyerer MJ, Rohde A, Stuermer KJ, Kluenter HD, Bredow J, Oikonomidis S, Klußmann JP, Eysel P, Eysel-Gosepath K. Impact of the Vestibular System on the Formation and Progression to Idiopathic Scoliosis: A Review of Literature. Asian Spine J 2020; 15:701-707. [PMID: 33189104 PMCID: PMC8561148 DOI: 10.31616/asj.2020.0308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022] Open
Abstract
The physiopathogenesis of adolescent idiopathic scoliosis remains unknown. However, a multifactorial pathogenesis is being assumed. Besides biomechanical, biochemical, and genetic factors, some studies have focused on congenital or acquired abnormalities in the vestibular organ with consecutive development of scoliosis. This study aims to analyze a possible correlation between any vestibular organ congenital or acquired pathologies and scoliosis based on the current literature. Therefore, we conducted a literature search in three databases, with search terms such as “scoliosis,” “organ of balance,” “idiopathic scoliosis,” “vestibular organ,” “spine,” and “balance.” Fifteen studies were selected and used for research. The relationship between scoliosis and vestibular organ abnormalities was recorded from all included works. Seven studies demonstrated a direct correlation between vestibular organ anatomical abnormalities and the form of the scoliotic spine. Another study confirmed the influence of the pathology of the vestibular organ on scoliosis but questioned whether it had an impact on the formation or the progression of the curvature. Others demonstrated a temporal overlap of the embryonic development of the vestibular organ and the beginning of pre-scoliotic characteristics, but their relationship remained questionable. In three studies, the correlation remained unclear, and any context has been denied. It seems unlikely that an isolated vestibular disorder can trigger structural scoliosis. However, the vestibular system pathologies may certainly occur in the multifactorial genesis of idiopathic scoliosis. Whether the correlation refers to the expression or the progression of scoliosis or may even have an influence on both remains unclear. New treatment options could be derived from these findings with a positive influence on the course of the deformity.
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Affiliation(s)
- Max Joseph Scheyerer
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Axel Rohde
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Konrad Johannes Stuermer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Heinz-Dieter Kluenter
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jan Bredow
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Stavros Oikonomidis
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Peer Eysel
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kathrin Eysel-Gosepath
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, Duesseldorf University Hospital, Duesseldorf, Germany
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Dąbrowska A, Olszewska-Karaban MA, Permoda-Białozorczyk AK, Szalewska DA. The Postural Control Indexes during Unipodal Support in Patients with Idiopathic Scoliosis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7936095. [PMID: 32714985 PMCID: PMC7355347 DOI: 10.1155/2020/7936095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/30/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023]
Abstract
Proper posture provides the best balance and body stability at minimal muscular effort. It is constantly controlled by the central nervous system, which integrates the stimuli from the proprioceptors (deep feeling sensors), vision receptors, and balance receptors through the subcortical structures. The main purpose of the study was to describe single stance stability and its correlation with the degree of scoliosis and trunk rotation among patients suffering from idiopathic scoliosis and in the control group without scoliosis. The study included 80 patients (69 girls and 11 boys) and 40 healthy children without scoliosis (21 girls and 19 boys). The Cobb angle technique was used to determine the magnitude of the deformity. All subjects were divided into three subgroups according to Bogdanov's classification. Single stance stability with eyes open and eyes closed was assessed with an electronic postural station-Delos Postural Proprioceptive System (DPPS). In case of multiple group comparisons for variables with normal distribution ANOVA with Scheffe, post hoc test was used or Kruskal-Wallis test was used as the nonparametric equivalent. The relationship between the two continuous variables was investigated using either Pearson product-moment correlation or Spearman's rank correlation. In all these calculations, the statistical significance level was set to p < 0.05. The single stance test showed a significant difference between the stability index with eyes open and stability index with eyes closed in study and control groups. The character of these alterations is influenced by the degree of trunk rotation. The degree of scoliosis according to Bogdanov classification does not determine the decrease in stability indexes. In summary, significantly lower values of the stability index during one-leg standing with eyes closed indicated balance impairment, which is mainly connected with inadequate functioning of the proprioceptive system.
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Affiliation(s)
- Aneta Dąbrowska
- Department of Rehabilitation Medicine, Medical University of Gdansk, Al. Zwycięstwa 30, 80-219 Gdansk, Poland
- Gdansk College of Health, Pelplińska 7, 80-335 Gdansk, Poland
| | - Marzena A. Olszewska-Karaban
- Department of Rehabilitation Medicine, Medical University of Gdansk, Al. Zwycięstwa 30, 80-219 Gdansk, Poland
- Biomed Rehabilitation Center, Dębinki 7d, 80-294 Gdansk, Poland
| | - Anna K. Permoda-Białozorczyk
- Biomed Rehabilitation Center, Dębinki 7d, 80-294 Gdansk, Poland
- Department of Health and Natural Science, Gdansk University of Physical Education and Sport, Kazimierza Górskiego 1, 80-336 Gdańsk, Poland
| | - Dominika A. Szalewska
- Department of Rehabilitation Medicine, Medical University of Gdansk, Al. Zwycięstwa 30, 80-219 Gdansk, Poland
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Assessment of Static Plantar Pressure, Stabilometry, Vitamin D and Bone Mineral Density in Female Adolescents with Moderate Idiopathic Scoliosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062167. [PMID: 32214036 PMCID: PMC7143889 DOI: 10.3390/ijerph17062167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 12/11/2022]
Abstract
(1) Background: Adolescent idiopathic scoliosis (AIS) can be associated with vitamin D deficiency and osteopenia. Plantar pressure and stabilometry offer important information about posture. The objectives of our study were to compare static plantar pressure and stabilometric parameters, serum 25-OH-vitamin D3 and calcium levels, and bone mineral densitometry expressed as z-score in patients with moderate AIS and healthy subjects. (2) Methods: 32 female adolescents (idiopathic S shaped moderate scoliosis, main lumbar curve) and 32 gender and age-matched controls performed: static plantar pressure, stabilometry, serum 25-OH-vitamin D3 and calcium levels, and dual X-ray absorptiometry scans of the spine. (3) Results: In scoliosis patients, significant differences were recorded between right and left foot for total foot, first and fifth metatarsal, and heel loadings. Stabilometry showed a poorer postural control when compared to healthy subjects (p < 0.001). Patients had significantly lower vitamin D, calcium levels, and z-scores. Lumbar Cobb angle was significantly correlated with the z-score (r = −0.39, p = 0.02), with right foot fifth metatarsal load (r = −0.35, p = 0.04), center of pressure CoPx (r = −0.42, p = 0.01), CoP displacement (r = 0.35, p = 0.04) and 90% confidence ellipse area (r = −0.38, p = 0.03). (4) Conclusions: In our study including female adolescents with idiopathic S shaped moderate scoliosis, plantar pressure and stabilometric parameters were influenced by the main scoliotic curve.
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The Transverse Gravitational Deviation Index, a Novel Gravity Line-Related Spinal Parameter, Relates to Balance Control and Health-Related Quality of Life in Adults With Spinal Deformity. Spine (Phila Pa 1976) 2020; 45:E25-E36. [PMID: 31842109 DOI: 10.1097/brs.0000000000003301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective cross-sectional case-control study design. OBJECTIVE This study aims to analyze the relation between balance control as well as health-related quality of life (HRQOL) in patients with adult spinal deformity (ASD), with a novel gravity line (GL)-related 3D spinal alignment parameter, the transverse gravitational deviation index (TGDI), defined to quantify the transverse plane position of any vertebra with respect to the GL. SUMMARY OF BACKGROUND DATA Demographic data and balance control have both been identified as important determinants of HRQOL in ASD patients during a preoperative setting. Therefore, a better understanding of the relation between spinal alignment and balance is required. METHODS After informed consent, 15 asymptomatic healthy volunteers (mean age 60.1 ± 11.6 years old) and 55 ASD patients (mean age 63.5 ± 10.1 years old) were included. Relation between performance on BESTest as well as core outcome measures index (COMI) with spinopelvic alignment was explored using General Linear Modeling (GLM). A P-value ≤0.05 was considered statistically significant. RESULTS The L3 TGDI was identified to relate to balance control in the total ASD population after correction for confounding demographic factors (P = 0.001; adjusted R = 0.500) and explained 19% of the observed variance in balance performance. In addition, COMI is related to L3 TGDI in a subgroup of ASD patients with combined coronal and sagittal malalignment of L3 (P = 0.027; slope B = 0.047), despite significant influence of age (P = 0.020). CONCLUSION In ASD patients with a combined coronal and sagittal malalignment of the L3 vertebra, both the level of balance impairment as well as HRQOL are related to the distance component of the L3 TGDI, that is, the offset between the center of the L3 vertebral body and the GL in the transverse plane. LEVEL OF EVIDENCE 2.
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Woo EJ, Siegmund GP, Reilly CW, Blouin JS. Asymmetric Unilateral Vestibular Perception in Adolescents With Idiopathic Scoliosis. Front Neurol 2019; 10:1270. [PMID: 31849828 PMCID: PMC6903771 DOI: 10.3389/fneur.2019.01270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/18/2019] [Indexed: 11/13/2022] Open
Abstract
The cause of Adolescent Idiopathic Scoliosis (AIS) remains unclear, but one proposed cause of AIS is asymmetric vestibular function and the related descending drive to the spine musculature. The objective of this study was to determine if asymmetric vestibular function is present in individuals with AIS. Ten individuals with AIS (8F, 2M) and 10 healthy age- and sex-matched controls were exposed to 10s-long virtual rotations induced by monaural or binaural electrical vestibular stimulation (EVS), and 10s-long real rotations delivered by a rotating chair. Using a forced-choice paradigm, participants indicated their perceived rotation direction (right or left) to stimuli of varying intensity. A Bayesian adaptive algorithm adjusted the stimulus intensity and direction to identify a stimulus level, which we called the direction recognition threshold, at which participants correctly identified the rotation direction 69% of the time. For unilateral vestibular stimuli (monaural EVS), the direction recognition thresholds were more asymmetric in all participants with AIS compared to control participants [(0.22-1.00 mA) vs. (0.01-0.21 mA); p < 0.001]. For bilateral vestibular stimuli, however, the direction recognition thresholds did not differ between groups for either the real or virtual rotations (multiple p > 0.05). Previous reports of semicircular canal orientation asymmetry in individuals with AIS could not explain the magnitude of the vestibular function asymmetry we observed, suggesting a functional cause to the observed vestibular asymmetry. Thus, the present results suggest that a unilateral vestibular dysfunction is linked to AIS, potentially revealing a new path for the screening and monitoring of scoliosis in adolescents.
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Affiliation(s)
- Emma J Woo
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Gunter P Siegmund
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.,MEA Forensic Engineers & Scientists, Richmond, BC, Canada
| | - Christopher W Reilly
- British Columbia Children's Hospital, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jean-Sébastien Blouin
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Institute for Computing, Information, and Cognitive System, University of British Columbia, Vancouver, BC, Canada
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18
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Hatzilazaridis I, Hatzitaki V, Antoniadou N, Samoladas E. Postural and muscle responses to galvanic vestibular stimulation reveal a vestibular deficit in adolescents with idiopathic scoliosis. Eur J Neurosci 2019; 50:3614-3626. [PMID: 31336391 DOI: 10.1111/ejn.14525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 05/14/2019] [Accepted: 06/10/2019] [Indexed: 11/27/2022]
Abstract
One of the most appealing hypotheses around the aetiopathogenesis of adolescent idiopathic scoliosis attributes the development of the spine deformity to an imbalance in the descending vestibulospinal drive to the muscles resulting in a differential mechanical pull on the spine during the early life stages. In this study, we explored this hypothesis by examining postural and muscle responses to binaural bipolar galvanic vestibular stimulation (GVS) of randomly alternating polarity. Adolescents diagnosed with idiopathic scoliosis (n = 12) and healthy age-matched controls (n = 12) stood quietly with feet together (stance duration 66-102 s), eyes closed and facing forward, while 10 short (2s), transmastoidal, bipolar square wave GVS pulses (0.3-2.0 mA) of randomly alternating polarity were delivered at varying time intervals. Responses depicted in the electromyographic (EMG) activity of bilateral axial and appendicular muscles, vertical reaction forces and segment kinematics were recorded and analysed. Scoliotic patients demonstrated smaller ankle muscle responses and a delayed postural shift to the right relative to controls during anode right/cathode left GVS. When GVS polarity was reversed, patients had a greater soleus short-latency response on the left anodal side, while the rest of the muscle and postural responses were similar between groups. Vestibular stimulation also evoked greater head and upper trunk sway in scoliotic compared with healthy adolescents irrespective of stimulus polarity. Results provide new preliminary evidence for a vestibular imbalance in adolescents with idiopathic scoliosis that is compensated by somatosensory, load-related afferent feedback from the lower limbs during the latter part of the response.
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Affiliation(s)
- Ioannis Hatzilazaridis
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilia Hatzitaki
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikoleta Antoniadou
- Laboratory of Motor Behavior and Adapted Physical Activity, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Samoladas
- Orthopeadics Division of Genimatas Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Fortin C, Pialasse JP, Knoth IS, Lippé S, Duclos C, Simoneau M. Cortical dynamics of sensorimotor information processing associated with balance control in adolescents with and without idiopathic scoliosis. Clin Neurophysiol 2019; 130:1752-1761. [PMID: 31401484 DOI: 10.1016/j.clinph.2019.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aims at examining the cortical dynamics of sensorimotor information processing related to balance control in participants with adolescent idiopathic scoliosis (AIS) and in age-matched controls (CTL). METHODS Cortical dynamics during standing balance control were assessed in 13 girls with AIS and 13 age-matched controls using electroencephalography. Time-frequency analysis were used to determine frequency power during ankle proprioception alteration (ankle tendons co-vibration interval) or reintegration of ankle proprioception (post-vibration interval) with or without vision. RESULTS Balance control did not differ between groups. In the co-vibration interval, a significant suppression in alpha (8-12 Hz) and beta (13-30 Hz) band power and a significant increase in theta (4-7 Hz) band power were found respectively in the vision and non-vision condition in the AIS group compared to the CTL group. In the post-vibration interval, significant suppressions in beta (13-30 Hz) and gamma (30-50 Hz) band power were observed in the AIS group in the non-vision condition. CONCLUSION Participants with AIS showed brain oscillations differences compared to CTL in the sensorimotor cortex while controlling their balance in various sensory conditions. SIGNIFICANCE Future study using evaluation of cortical dynamics could serve documenting whether rehabilitation programs have an effect on sensorimotor function in AIS.
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Affiliation(s)
- Carole Fortin
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada; Centre de recherche, CHU Sainte-Justine, Montréal, Québec, Canada.
| | - Jean-Philippe Pialasse
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada; Centre de recherche, CHU Sainte-Justine, Montréal, Québec, Canada
| | | | - Sarah Lippé
- Centre de recherche, CHU Sainte-Justine, Montréal, Québec, Canada; Département de psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Cyril Duclos
- École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada; Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Institut de Réadaptation Gingras-Lindsay-de-Montréal, Montréal, Québec, Canada
| | - Martin Simoneau
- Département de kinésiologie, Faculté de médecine, Université Laval, Québec, Québec, Canada; Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Québec, Canada
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Ng SY, Bettany-Saltikov J, Cheung IYK, Chan KKY. The Role of Vitamin D in the Pathogenesis of Adolescent Idiopathic Scoliosis. Asian Spine J 2018; 12:1127-1145. [PMID: 30322242 PMCID: PMC6284127 DOI: 10.31616/asj.2018.12.6.1127] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/22/2018] [Indexed: 12/20/2022] Open
Abstract
Several theories have been proposed to explain the etiology of adolescent idiopathic scoliosis (AIS) until present. However, limited data are available regarding the impact of vitamin D insufficiency or deficiency on scoliosis. Previous studies have shown that vitamin D deficiency and insufficiency are prevalent in adolescents, including AIS patients. A series of studies conducted in Hong Kong have shown that as many as 30% of these patients have osteopenia. The 25-hydroxyvitamin D3 level has been found to positively correlate with bone mineral density (BMD) in healthy adolescents and negatively with Cobb angle in AIS patients; therefore, vitamin D deficiency is believed to play a role in AIS pathogenesis. This study attempts to review the relevant literature on AIS etiology to examine the association of vitamin D and various current theories. Our review suggested that vitamin D deficiency is associated with several current etiological theories of AIS. We postulate that vitamin D deficiency and/or insufficiency affects AIS development by its effect on the regulation of fibrosis, postural control, and BMD. Subclinical deficiency of vitamin K2, a fat-soluble vitamin, is also prevalent in adolescents; therefore, it is possible that the high prevalence of vitamin D deficiency is related to decreased fat intake. Further studies are required to elucidate the possible role of vitamin D in the pathogenesis and clinical management of AIS.
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Idiopathic Scoliosis Families Highlight Actin-Based and Microtubule-Based Cellular Projections and Extracellular Matrix in Disease Etiology. G3-GENES GENOMES GENETICS 2018; 8:2663-2672. [PMID: 29930198 PMCID: PMC6071588 DOI: 10.1534/g3.118.200290] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Idiopathic scoliosis (IS) is a structural lateral spinal curvature of ≥10° that affects up to 3% of otherwise healthy children and can lead to life-long problems in severe cases. It is well-established that IS is a genetic disorder. Previous studies have identified genes that may contribute to the IS phenotype, but the overall genetic etiology of IS is not well understood. We used exome sequencing to study five multigenerational families with IS. Bioinformatic analyses identified unique and low frequency variants (minor allele frequency ≤5%) that were present in all sequenced members of the family. Across the five families, we identified a total of 270 variants with predicted functional consequences in 246 genes, and found that eight genes were shared by two families. We performed GO term enrichment analyses, with the hypothesis that certain functional annotations or pathways would be enriched in the 246 genes identified in our IS families. Using three complementary programs to complete these analyses, we identified enriched categories that include stereocilia and other actin-based cellular projections, cilia and other microtubule-based cellular projections, and the extracellular matrix (ECM). Our results suggest that there are multiple paths to IS and provide a foundation for future studies of IS pathogenesis.
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Verticality perception reveals a vestibular deficit in adolescents with idiopathic scoliosis. Exp Brain Res 2018; 236:1725-1734. [DOI: 10.1007/s00221-018-5256-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/07/2018] [Indexed: 10/17/2022]
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Pialasse JP, Mercier P, Descarreaux M, Simoneau M. A procedure to detect abnormal sensorimotor control in adolescents with idiopathic scoliosis. Gait Posture 2017; 57:124-129. [PMID: 28605674 DOI: 10.1016/j.gaitpost.2017.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 05/25/2017] [Accepted: 05/30/2017] [Indexed: 02/02/2023]
Abstract
This work identifies, among adolescents with idiopathic scoliosis, those demonstrating impaired sensorimotor control through a classification procedure comparing the amplitude of their vestibular-evoked postural responses. The sensorimotor control of healthy adolescents (n=17) and adolescents with idiopathic scoliosis (n=52) with either mild (Cobb angle≥15° and ≤30°) or severe (Cobb angle >30°) spine deformation was assessed through galvanic vestibular stimulation. A classification procedure sorted out adolescents with idiopathic scoliosis whether the amplitude of their vestibular-evoked postural response was dissimilar or similar to controls. Compared to controls, galvanic vestibular stimulation evoked larger postural response in adolescents with idiopathic scoliosis. Nonetheless, the classification procedure revealed that only 42.5% of all patients showed impaired sensorimotor control. Consequently, identifying patients with sensorimotor control impairment would allow to apply personalized treatments, help clinicians to establish prognosis and hopefully improve the condition of patients with adolescent idiopathic scoliosis.
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Affiliation(s)
- Jean-Philippe Pialasse
- Faculté de médecine, Département de kinésiologie, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec, Québec, Canada
| | - Pierre Mercier
- Clinique d'orthopédie infantile de Québec and Département de Chirurgie, Université Laval, Québec, Canada
| | - Martin Descarreaux
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Martin Simoneau
- Faculté de médecine, Département de kinésiologie, Université Laval, Québec, Canada; Centre de recherche du CHU de Québec, Québec, Canada.
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Mello AI, Kanitz AC, Martinez FG. Non-invasive interventions in idiopathic scoliosis: a systematic review. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.s01.ar02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Idiopathic Scoliosis (IS) is an idiopathic curvature of the spine in all three plans, been treated conservatively (non-invasive) or surgicaly (invasive). The effectiveness of noninvasive therapy still remains lacking in a scientific basis to support their evidence-based applicability. Objective: Evaluate the effects of non-invasive interventions in spine lateral inclination in IS through a systematic literature review. Methods: The search of studies in MEDLINE, SCOPUS and COCHRANE databases was performed on 24th March, 2014. The terms used were: Scoliosis, therapeutic exercise, physical therapy. Clinical trials with scoliotic patients undergoing some type of non-invasive intervention were included. The outcome was spine lateral inclination. Results: The research found 941 studies, seven of these were included after a screening performed by two independent reviewers. Six studies (85.7%) have adopted some sort of kinesiotherapeutic technic, and three studies (42.8%) used corrective orthosis. The average intervention time in kinesiotherapeutic technique studies was of 37.6 weeks and 91.6 weeks in the studies of corrective brace. The progression improvement of the spine lateral inclination was reported by 83.3% (5 of 6) of the kinesiotherapeutic technique studies and in 66.6% (2 of 3) of studies with corrective brace. Conclusion: An improvement was found, in general, in the progression of spine lateral inclination in IS subjects of both sexes from 11 to 25 years of age undergoing non-invasive interventions.
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Sensorimotor Control Impairment in Young Adults With Idiopathic Scoliosis Compared With Healthy Controls. J Manipulative Physiol Ther 2016; 39:473-479. [PMID: 27544925 DOI: 10.1016/j.jmpt.2016.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 01/15/2016] [Accepted: 01/18/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE It has been hypothesized that the impaired sensorimotor control observed in adolescents with idiopathic scoliosis (IS) may be related more to the onset of scoliosis than to the maturation of sensory systems or sensorimotor control mechanisms. The objective of this study was to assess sensorimotor control in adults diagnosed with IS in adolescence versus healthy controls. METHODS The study included 20 young adults 20 to 24 years of age (10 healthy controls and 10 diagnosed with adolescent IS but not treated for it). Binaural bipolar galvanic vestibular stimulation (GVS) was delivered to assess sensorimotor control. Vertical forces under each foot and upper body kinematics along the frontal plane were measured before GVS (2-second window), during GVS (2-second window), immediately after the cessation of GVS (1-second window), and during the following 2 seconds. Balance control was assessed by calculating the root mean square values of vertical forces and upper body kinematics. RESULTS Compared with healthy controls, the IS group showed greater body sway upon GVS; the amplitude of this sway was even greater immediately after the cessation of GVS-an outcome requiring sensorimotor control. CONCLUSION Compared with normal controls, adults who had been diagnosed with IS in adolescence showed altered balance control immediately following GVS. This finding suggests that dysfunctional sensorimotor control may be related to the onset of scoliosis rather than to a transient suboptimal development of the sensory systems or sensorimotor control mechanisms.
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