Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition
Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson’s disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is...
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doaj-d051b5ba9e2d479d84f5905ebb2cb0c02020-11-25T03:36:44ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852020-03-01810.3389/fbioe.2020.00137503252Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance ConditionChiara Palmisano0Chiara Palmisano1Gregor Brandt2Matteo Vissani3Nicoló G. Pozzi4Andrea Canessa5Joachim Brumberg6Giorgio Marotta7Jens Volkmann8Alberto Mazzoni9Gianni Pezzoli10Carlo A. Frigo11Ioannis U. Isaias12Department of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, GermanyMBMC Lab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, ItalyDepartment of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, GermanyTranslational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant’Anna, Pontedera, ItalyDepartment of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, GermanyFondazione Europea di Ricerca Biomedica (FERB Onlus), Cernusco s/N (Milan), ItalyDepartment of Nuclear Medicine, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, GermanyDepartment of Nuclear Medicine, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, GermanyTranslational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant’Anna, Pontedera, ItalyCentro Parkinson, ASST G. Pini-CTO, Milan, ItalyMBMC Lab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, ItalyDepartment of Neurology, University Hospital Würzburg and The Julius Maximilian University of Würzburg, Würzburg, GermanyPostural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson’s disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment.https://www.frontiersin.org/article/10.3389/fbioe.2020.00137/fullgait initiationParkinson’s diseasebasal gangliadopaminebase of supportanthropometric measurements |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chiara Palmisano Chiara Palmisano Gregor Brandt Matteo Vissani Nicoló G. Pozzi Andrea Canessa Joachim Brumberg Giorgio Marotta Jens Volkmann Alberto Mazzoni Gianni Pezzoli Carlo A. Frigo Ioannis U. Isaias |
spellingShingle |
Chiara Palmisano Chiara Palmisano Gregor Brandt Matteo Vissani Nicoló G. Pozzi Andrea Canessa Joachim Brumberg Giorgio Marotta Jens Volkmann Alberto Mazzoni Gianni Pezzoli Carlo A. Frigo Ioannis U. Isaias Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition Frontiers in Bioengineering and Biotechnology gait initiation Parkinson’s disease basal ganglia dopamine base of support anthropometric measurements |
author_facet |
Chiara Palmisano Chiara Palmisano Gregor Brandt Matteo Vissani Nicoló G. Pozzi Andrea Canessa Joachim Brumberg Giorgio Marotta Jens Volkmann Alberto Mazzoni Gianni Pezzoli Carlo A. Frigo Ioannis U. Isaias |
author_sort |
Chiara Palmisano |
title |
Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition |
title_short |
Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition |
title_full |
Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition |
title_fullStr |
Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition |
title_full_unstemmed |
Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition |
title_sort |
gait initiation in parkinson’s disease: impact of dopamine depletion and initial stance condition |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Bioengineering and Biotechnology |
issn |
2296-4185 |
publishDate |
2020-03-01 |
description |
Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson’s disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment. |
topic |
gait initiation Parkinson’s disease basal ganglia dopamine base of support anthropometric measurements |
url |
https://www.frontiersin.org/article/10.3389/fbioe.2020.00137/full |
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