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Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease
Early features of Parkinson's disease (PD) include both motor and cognitive changes, suggesting shared common pathways. A common motor dysfunction is postural instability, a known predictor of falls, which have a major impact on quality of life. Understanding mechanisms of postural dynamics in...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290334/ https://www.ncbi.nlm.nih.gov/pubmed/30568629 http://dx.doi.org/10.3389/fneur.2018.01044 |
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author | Pantall, Annette Suresparan, Piriya Kapa, Leanne Morris, Rosie Yarnall, Alison Del Din, Silvia Rochester, Lynn |
author_facet | Pantall, Annette Suresparan, Piriya Kapa, Leanne Morris, Rosie Yarnall, Alison Del Din, Silvia Rochester, Lynn |
author_sort | Pantall, Annette |
collection | PubMed |
description | Early features of Parkinson's disease (PD) include both motor and cognitive changes, suggesting shared common pathways. A common motor dysfunction is postural instability, a known predictor of falls, which have a major impact on quality of life. Understanding mechanisms of postural dynamics in PD and specifically how they relate to cognitive changes is essential for developing effective interventions. The aims of this study were to examine the changes that occur in postural metrics over time and explore the relationship between postural and cognitive dysfunction. The study group consisted of 35 people (66 ± 8years, 12 female, UPDRS III: 22.5 ± 9.6) diagnosed with PD who were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation—PD Gait (ICICLE-GAIT) study. Postural and cognitive assessments were performed at 18, 36, and 54 months after enrolment. Participants stood still for 120 s, eyes open and arms by their side. Postural dynamics were measured using metrics derived from a single tri-axial accelerometer (Axivity AX3, York, UK) on the lower back. Accelerometry metrics included jerk (derivative of acceleration), root mean square, frequency, and ellipsis (acceleration area). Cognition was evaluated by neuropsychological tests including the Montreal Cognitive Assessment (MoCA) and digit span. There was a significant decrease in accelerometry parameters, greater in the anteroposterior direction, and a decline in cognitive function over time. Accelerometry metrics were positively correlated with lower cognitive function and increased geriatric depression score and negatively associated with a qualitative measure of balance confidence. In conclusion, people with PD showed reduced postural dynamics that may represent a postural safety strategy. Associations with cognitive function and depression, both symptoms that may pre-empt motor symptoms, suggest shared neural pathways. Further studies, involving neuroimaging, may determine how these postural parameters relate to underlying neural and clinical correlates. |
format | Online Article Text |
id | pubmed-6290334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62903342018-12-19 Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease Pantall, Annette Suresparan, Piriya Kapa, Leanne Morris, Rosie Yarnall, Alison Del Din, Silvia Rochester, Lynn Front Neurol Neurology Early features of Parkinson's disease (PD) include both motor and cognitive changes, suggesting shared common pathways. A common motor dysfunction is postural instability, a known predictor of falls, which have a major impact on quality of life. Understanding mechanisms of postural dynamics in PD and specifically how they relate to cognitive changes is essential for developing effective interventions. The aims of this study were to examine the changes that occur in postural metrics over time and explore the relationship between postural and cognitive dysfunction. The study group consisted of 35 people (66 ± 8years, 12 female, UPDRS III: 22.5 ± 9.6) diagnosed with PD who were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation—PD Gait (ICICLE-GAIT) study. Postural and cognitive assessments were performed at 18, 36, and 54 months after enrolment. Participants stood still for 120 s, eyes open and arms by their side. Postural dynamics were measured using metrics derived from a single tri-axial accelerometer (Axivity AX3, York, UK) on the lower back. Accelerometry metrics included jerk (derivative of acceleration), root mean square, frequency, and ellipsis (acceleration area). Cognition was evaluated by neuropsychological tests including the Montreal Cognitive Assessment (MoCA) and digit span. There was a significant decrease in accelerometry parameters, greater in the anteroposterior direction, and a decline in cognitive function over time. Accelerometry metrics were positively correlated with lower cognitive function and increased geriatric depression score and negatively associated with a qualitative measure of balance confidence. In conclusion, people with PD showed reduced postural dynamics that may represent a postural safety strategy. Associations with cognitive function and depression, both symptoms that may pre-empt motor symptoms, suggest shared neural pathways. Further studies, involving neuroimaging, may determine how these postural parameters relate to underlying neural and clinical correlates. Frontiers Media S.A. 2018-12-05 /pmc/articles/PMC6290334/ /pubmed/30568629 http://dx.doi.org/10.3389/fneur.2018.01044 Text en Copyright © 2018 Pantall, Suresparan, Kapa, Morris, Yarnall, Del Din and Rochester. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Pantall, Annette Suresparan, Piriya Kapa, Leanne Morris, Rosie Yarnall, Alison Del Din, Silvia Rochester, Lynn Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease |
title | Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease |
title_full | Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease |
title_fullStr | Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease |
title_full_unstemmed | Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease |
title_short | Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease |
title_sort | postural dynamics are associated with cognitive decline in parkinson's disease |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290334/ https://www.ncbi.nlm.nih.gov/pubmed/30568629 http://dx.doi.org/10.3389/fneur.2018.01044 |
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