Stefan Kammermeier1, Kathrin Maierbeck2, Lucia Dietrich3, Annika Plate4, Stefan Lorenzl5, Arun Singh6, Kai Bötzel4, Christoph Maurer7. 1. Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany. Electronic address: stefan.kammermeier@med.uni-muenchen.de. 2. Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Klinik für Anästhesiologie, Marchioninistraße 15, 81377 München, Germany. 3. Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Abteilung für Allgemeinchirurgie, Kliniken Ostallgäu-Kaufbeuren, Dr.-Gutermann-Straße 2, 87600 Kaufbeuren, Germany. 4. Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany. 5. Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Abteilung für Neurologie, Krankenhaus Agatharied, Norbert-Kerkel-Platz, 83734 Hausham, Germany. 6. Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Department of Neurology, University of Iowa, Iowa, IA, United States. 7. Klinik für Neurologie und Neurophysiologie, Universitätsklinikum Freiburg, Breisacher Str. 64, 79106 Freiburg im Breisgau, Germany.
Abstract
OBJECTIVES: We aimed to assess whether postural abnormalities in Progressive Supranuclear Palsy (PSP) and Idiopathic Parkinson's Disease (IPD) are qualitatively different by analysing spontaneous and reactive postural control. METHODS: We assessed postural control upon platform tilts in 17 PSP, 11 IPD patients and 18 healthy control subjects using a systems analysis approach. RESULTS: Spontaneous sway abnormalities in PSP resembled those of IPD patients. Spontaneous sway was smaller, slower and contained lower frequencies in both PSP and IPD as compared to healthy subjects. The amount of angular body excursions as a function of platform angular excursions (GAIN) in PSP was qualitatively different from both IPD and healthy subjects (GAIN cut-off value: 2.9, sensitivity of 94%, specificity of 72%). This effect was pronounced at the upper body level and at low as well as high frequencies. In contrast, IPD patients' stimulus-related body excursions were smaller compared to healthy subjects. Using a systems analysis approach, we were able to allocate these different postural strategies to differences in the use of sensory information as well as to different error correction efforts. CONCLUSIONS: While both PSP and IPD patients show abnormal postural control, the underlying pathology seems to be different. SIGNIFICANCE: The identification of disease-specific postural abnormalities shown here may be helpful for diagnostic as well as therapeutic discriminations of PSP vs. IPD.
OBJECTIVES: We aimed to assess whether postural abnormalities in Progressive Supranuclear Palsy (PSP) and Idiopathic Parkinson's Disease (IPD) are qualitatively different by analysing spontaneous and reactive postural control. METHODS: We assessed postural control upon platform tilts in 17 PSP, 11 IPD patients and 18 healthy control subjects using a systems analysis approach. RESULTS: Spontaneous sway abnormalities in PSP resembled those of IPD patients. Spontaneous sway was smaller, slower and contained lower frequencies in both PSP and IPD as compared to healthy subjects. The amount of angular body excursions as a function of platform angular excursions (GAIN) in PSP was qualitatively different from both IPD and healthy subjects (GAIN cut-off value: 2.9, sensitivity of 94%, specificity of 72%). This effect was pronounced at the upper body level and at low as well as high frequencies. In contrast, IPD patients' stimulus-related body excursions were smaller compared to healthy subjects. Using a systems analysis approach, we were able to allocate these different postural strategies to differences in the use of sensory information as well as to different error correction efforts. CONCLUSIONS: While both PSP and IPD patients show abnormal postural control, the underlying pathology seems to be different. SIGNIFICANCE: The identification of disease-specific postural abnormalities shown here may be helpful for diagnostic as well as therapeutic discriminations of PSP vs. IPD.
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