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Automated methods for diagnosis of Parkinson’s disease and predicting severity level. Neural Comput Appl 2022. [DOI: 10.1007/s00521-021-06626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Paterna M, Dvir Z, De Benedictis C, Maffiodo D, Franco W, Ferraresi C, Roatta S. Center of pressure displacement due to graded controlled perturbations to the trunk in standing subjects: the force-impulse paradigm. Eur J Appl Physiol 2021; 122:425-435. [PMID: 34797437 DOI: 10.1007/s00421-021-04844-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Many studies have investigated postural reactions (PR) to body-delivered perturbations. However, attention has been focused on the descriptive variables of the PR rather than on the characterization of the perturbation. This study aimed to test the hypothesis that the impulse rather than the force magnitude of the perturbation mostly affects the PR in terms of displacement of the center of foot pressure (ΔCoP). METHODS Fourteen healthy young adults (7 males and 7 females) received 2 series of 20 perturbations, delivered to the back in the anterior direction, at mid-scapular level, while standing on a force platform. In one series, the perturbations had the same force magnitude (40 N) but different impulse (range: 2-10 Ns). In the other series, the perturbations had the same impulse (5 Ns) but different force magnitude (20-100 N). A simple model of postural control restricted to the sagittal plane was also developed. RESULTS The results showed that ΔCoP and impulse were highly correlated (on average: r = 0.96), while the correlation ΔCoP-force magnitude was poor (r = 0.48) and not statistically significant in most subjects. The normalized response, ΔCoPn = ΔCoP/I, was independent of the perturbation magnitude in a wide range of force amplitude and impulse and exhibited good repeatability across different sets of stimuli (on average: ICC = 0.88). These results were confirmed by simulations. CONCLUSION The present findings support the concept that the magnitude of the applied force alone is a poor descriptor of trunk-delivered perturbations and suggest that the impulse should be considered instead.
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Affiliation(s)
- Maria Paterna
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Zeevi Dvir
- Department of Physical Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Carlo De Benedictis
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Daniela Maffiodo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Walter Franco
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Carlo Ferraresi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Silvestro Roatta
- Department of Neuroscience, University of Torino, c.so Raffaello 30, 10125, Turin, Italy.
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Pasman EP, McKeown MJ, Garg S, Cleworth TW, Bloem BR, Inglis JT, Carpenter MG. Brain connectivity during simulated balance in older adults with and without Parkinson's disease. Neuroimage Clin 2021; 30:102676. [PMID: 34215147 PMCID: PMC8102637 DOI: 10.1016/j.nicl.2021.102676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/02/2021] [Accepted: 04/10/2021] [Indexed: 11/07/2022]
Abstract
Individuals with Parkinson's disease often experience postural instability, a debilitating and largely treatment-resistant symptom. A better understanding of the neural substrates contributing to postural instability could lead to more effective treatments. Constraints of current functional neuroimaging techniques, such as the horizontal orientation of most MRI scanners (forcing participants to lie supine), complicates investigating cortical and subcortical activation patterns and connectivity networks involved in healthy and parkinsonian balance control. In this cross-sectional study, we utilized a newly-validated MRI-compatible balance simulator (based on an inverted pendulum) that enabled participants to perform balance-relevant tasks while supine in the scanner. We utilized functional MRI to explore effective connectivity underlying static and dynamic balance control in healthy older adults (n = 17) and individuals with Parkinson's disease while on medication (n = 17). Participants performed four tasks within the scanner with eyes closed: resting, proprioceptive tracking of passive ankle movement, static balancing of the simulator, and dynamic responses to random perturbations of the simulator. All analyses were done in the participant's native space without spatial transformation to a common template. Effective connectivity between 57 regions of interest was computed using a Bayesian Network learning approach with false discovery rate set to 5%. The first 12 principal components of the connection weights, binomial logistic regression, and cross-validation were used to create 4 separate models: contrasting static balancing vs {rest, proprioception} and dynamic balancing vs {rest, proprioception} for both controls and individuals with Parkinson's disease. In order to directly compare relevant connections between controls and individuals with Parkinson's disease, we used connections relevant for predicting a task in either controls or individuals with Parkinson's disease in logistic regression with Least Absolute Shrinkage and Selection Operator regularization. During dynamic balancing, we observed decreased connectivity between different motor areas and increased connectivity from the brainstem to several cortical and subcortical areas in controls, while individuals with Parkinson's disease showed increased connectivity associated with motor and parietal areas, and decreased connectivity from brainstem to other subcortical areas. No significant models were found for static balancing in either group. Our results support the notion that dynamic balance control in individuals with Parkinson's disease relies more on cortical motor areas compared to healthy older adults, who show a preference of subcortical control during dynamic balancing.
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Affiliation(s)
- Elizabeth P Pasman
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | | | - Saurabh Garg
- Pacific Parkinson's Research Centre, Vancouver, BC, Canada
| | - Taylor W Cleworth
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - J Timothy Inglis
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
| | - Mark G Carpenter
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada.
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Dvir Z, Paterna M, Quargnenti M, De Benedictis C, Maffiodo D, Franco W, Ferraresi C, Manca A, Deriu F, Roatta S. Linearity and repeatability of postural responses in relation to peak force and impulse of manually delivered perturbations: a preliminary study. Eur J Appl Physiol 2020; 120:1319-1330. [PMID: 32297004 DOI: 10.1007/s00421-020-04364-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/01/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Postural reactions (PR) of standing subjects have been mostly investigated in response to platform displacements or body perturbations of fixed magnitude. The objective of this study was to investigate the relationship between PR and the peak force and impulse of the perturbation. METHODS In ten healthy young men, standing balance was challenged by anteriorly directed perturbations (peak force: 20-60 N) delivered to the back, at the lumbar (L) or inter-scapular (IS) level, by means of a manual perturbator equipped with a force sensor. Postural reactions as expressed by the displacement of the center of pressure (CoP) were recorded using a force platform. Two sets of 20 randomly ordered perturbations (10 to each site) were delivered in two separate testing sessions. RESULTS The magnitude of CoP response (∆CoP) was better correlated with the impulse (I) than with the peak force of the perturbation. The normalized response, ∆CoPn = ∆CoP/I, exhibited good reliability (ICCs of 0.93 for IS and 0.82 for L), was higher with IS than with L perturbations (p < 0.01), and was significantly correlated with the latency of CoP response: r = 0.69 and 0.71 for IS and L, respectively. CONCLUSION These preliminary findings support the concept that manually delivered perturbations can be used to reliably assess individual PR and that ∆CoPn may effectively express a relevant aspect of postural control.
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Affiliation(s)
- Zeevi Dvir
- Department of Physical Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maria Paterna
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Martina Quargnenti
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Carlo De Benedictis
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Daniela Maffiodo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Walter Franco
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Carlo Ferraresi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Silvestro Roatta
- Department of Neuroscience, University of Torino, c.so Raffaello 30, 10125, Turin, Italy.
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