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Staring WHA, Zandvliet S, de Kam D, Solis-Escalante T, Geurts ACH, Weerdesteyn V. Age-related changes in muscle coordination patterns of stepping responses to recover from loss of balance. Exp Gerontol 2024; 191:112424. [PMID: 38604252 DOI: 10.1016/j.exger.2024.112424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Reactive stepping capacity to recover from a loss of balance declines with aging, which increases the risk of falling. To gain insight into the underlying mechanisms, we investigated whether muscle coordination patterns of reactive stepping differed between healthy young and older individuals. METHODS We performed a cross-sectional study between 15 healthy young and 14 healthy older adults. They recovered from 200 multidirectional platform translations that evoked reactive stepping responses. We determined spatiotemporal step variables and used muscle synergy analysis to characterize stance- and swing-leg muscle coordination patterns from the start of perturbation until foot landing. RESULTS We observed delayed step onsets in older individuals, without further spatiotemporal differences. Muscle synergy structure was not different between young and older individuals, but age-related differences were observed in the time-varying synergy activation patterns. In anterior-posterior directions, the older individuals demonstrated significantly enhanced early swing-leg synergy activation consistent with non-stepping behavior. In addition, around step onset they demonstrated increased levels of synergy coactivation (mainly around the ankle) in lateral and anterior directions, which did not appear to hamper foot clearance. CONCLUSION Although synergy structure was not affected by age, the delayed step onsets and the enhanced early synergy recruitment point at a relative bias towards non-stepping behavior in older adults. They may need more time for accumulating information on the direction of perturbation and making the corresponding sensorimotor transformations before initiating the step. Future work may investigate whether perturbation-based training improves these age-related deficits.
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Affiliation(s)
- Wouter H A Staring
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Sarah Zandvliet
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Digna de Kam
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Teodoro Solis-Escalante
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Alexander C H Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Vivian Weerdesteyn
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
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Mirdamadi JL, Ting LH, Borich MR. Distinct Cortical Correlates of Perception and Motor Function in Balance Control. J Neurosci 2024; 44:e1520232024. [PMID: 38413231 PMCID: PMC11007305 DOI: 10.1523/jneurosci.1520-23.2024] [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: 08/08/2023] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 02/29/2024] Open
Abstract
Fluctuations in brain activity alter how we perceive our body and generate movements but have not been investigated in functional whole-body behaviors. During reactive balance, we recently showed that evoked brain activity is associated with the balance ability in young individuals. Furthermore, in PD, impaired whole-body motion perception in reactive balance is associated with impaired balance. Here, we investigated the brain activity during the whole-body motion perception in reactive balance in young adults (9 female, 10 male). We hypothesized that both ongoing and evoked cortical activity influences the efficiency of information processing for successful perception and movement during whole-body behaviors. We characterized two cortical signals using electroencephalography localized to the SMA: (1) the "N1," a perturbation-evoked potential that decreases in amplitude with expectancy and is larger in individuals with lower balance function, and (2) preperturbation β power, a transient rhythm that favors maintenance of the current sensorimotor state and is inversely associated with tactile perception. In a two-alternative forced choice task, participants judged whether pairs of backward support surface perturbations during standing were in the "same" or "different" direction. As expected, lower whole-body perception was associated with lower balance ability. Within a perturbation pair, N1 attenuation was larger on correctly perceived trials and associated with better balance, but not perception. In contrast, preperturbation β power was higher on incorrectly perceived trials and associated with poorer perception, but not balance. Together, ongoing and evoked cortical activity have unique roles in information processing that give rise to distinct associations with perceptual and balance ability.
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Affiliation(s)
- Jasmine L Mirdamadi
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Lena H Ting
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia 30322
- The Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia 30322
| | - Michael R Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia 30322
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Mirdamadi JL, Ting LH, Borich MR. Distinct cortical correlates of perception and motor function in balance control. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.22.554282. [PMID: 37662247 PMCID: PMC10473579 DOI: 10.1101/2023.08.22.554282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Fluctuations in brain state alter how we perceive our body and generate movements but have not been investigated in functional whole-body behaviors. During reactive balance control, we recently showed that evoked brain activity is associated with balance ability in healthy young individuals. Further, in individuals with Parkinson's disease, impairments in whole-body motion perception in reactive balance are associated with clinical balance impairment. Here we investigated brain activity during whole-body motion perception in reactive balance in healthy young adults. We hypothesized that flexibility in brain states underlies successful perception and movement during whole-body movement. We characterized two cortical sensorimotor signals using electroencephalography localized to the supplementary motor area: 1) the "N1 response", a perturbation-evoked potential that decreases in amplitude with expectancy and is larger in individuals with lower balance function; and 2) pre-perturbation beta oscillatory activity, a rhythm that favors maintenance of the current sensorimotor state and is inversely associated with perception in seated somatosensory perceptual tasks. In a two-alternative forced choice task, participants judged whether pairs of backward support-surface perturbations during standing were in the "same" or "different" direction. As expected, lower whole-body perception was associated with lower balance ability. Within a perturbation pair, N1 attenuation was larger on correctly perceived trials and associated with better balance, but not perception. In contrast, pre-perturbation beta power was higher on incorrectly perceived trials and associated with poorer perception, but not balance. Taken together, flexibility in different cortical processes influences perceptual accuracy but have distinct associations with balance and perceptual ability.
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Affiliation(s)
- Jasmine L. Mirdamadi
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Lena H. Ting
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA 30322, USA
- The Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA 30322, USA
| | - Michael R. Borich
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA 30322, USA
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Liss DJ, Carey HD, Yakovenko S, Allen JL. Young adults perceive small disturbances to their walking balance even when distracted. Gait Posture 2022; 91:198-204. [PMID: 34740056 PMCID: PMC8671331 DOI: 10.1016/j.gaitpost.2021.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The ability to perceive disturbances to ongoing locomotion (e.g., slips and trips) may play an important role in walking balance control. However, how well young adults can perceive such disturbances is unknown. RESEARCH QUESTION The purpose of this study was to identify the perception threshold in young adults to subtle slip-like locomotor disturbances. METHODS Subjects (n = 12) walked on a split-belt treadmill performing a perturbation discrimination task at their preferred walking speed while randomly experiencing locomotor balance disturbances every 8-12 strides. Balance disturbances were imposed through a short-duration decrease in velocity of a single treadmill belt triggered at heel-strike. The treadmill belt returned to the subject's preferred walking speed during the subsequent swing phase. Locomotor disturbances were given with eight different velocity changes ranging from 0 to 0.4 m/s and were randomized and repeated 5 times. Subjects were prompted to respond when asked if they perceived each disturbance. Using a psychophysical approach, we determined the perception thresholds of slip-like locomotor disturbances (i.e., just noticeable difference). The perturbation discrimination task was repeated with subjects performing a secondary cognitive distraction (counting backward by threes). RESULTS Subjects perceived small locomotor disturbances during both normal walking (dominant: 0.07 ± 0.03 m/s, non-dominant: 0.08 ± 0.03 m/s) and while performing the secondary cognitive task (dominant: 0.08 ± 0.01 m/s, non-dominant: 0.09 ± 0.02 m/s). There was no significant difference between legs (p = 0.466), with the addition of the cognitive task (p = 0.08), or interaction between leg and task (p = 0.994). SIGNIFICANCE The ability to perceive subtle slip-like locomotor disturbances was maintained even when performing a cognitively distracting task, suggesting that young adults can perceive very small locomotor disturbances.
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Affiliation(s)
- Daniel J Liss
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV, USA
| | - Hannah D Carey
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV, USA
| | - Sergiy Yakovenko
- Department of Exercise Physiology, West Virginia University, Morgantown, WV, USA
| | - Jessica L Allen
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV, USA.
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Abnormal center of mass feedback responses during balance: A potential biomarker of falls in Parkinson's disease. PLoS One 2021; 16:e0252119. [PMID: 34043678 PMCID: PMC8158870 DOI: 10.1371/journal.pone.0252119] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/10/2021] [Indexed: 02/01/2023] Open
Abstract
Although Parkinson disease (PD) causes profound balance impairments, we know very little about how PD impacts the sensorimotor networks we rely on for automatically maintaining balance control. In young healthy people and animals, muscles are activated in a precise temporal and spatial organization when the center of body mass (CoM) is unexpectedly moved that is largely automatic and determined by feedback of CoM motion. Here, we show that PD alters the sensitivity of the sensorimotor feedback transformation. Importantly, sensorimotor feedback transformations for balance in PD remain temporally precise, but become spatially diffuse by recruiting additional muscle activity in antagonist muscles during balance responses. The abnormal antagonist muscle activity remains precisely time-locked to sensorimotor feedback signals encoding undesirable motion of the body in space. Further, among people with PD, the sensitivity of abnormal antagonist muscle activity to CoM motion varies directly with the number of recent falls. Our work shows that in people with PD, sensorimotor feedback transformations for balance are intact but disinhibited in antagonist muscles, likely contributing to balance deficits and falls.
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Abraham A, Duncan RP, Earhart GM. The Role of Mental Imagery in Parkinson's Disease Rehabilitation. Brain Sci 2021; 11:brainsci11020185. [PMID: 33540883 PMCID: PMC7913152 DOI: 10.3390/brainsci11020185] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
Parkinson’s disease (PD) is a disabling neurodegenerative disease whose manifestations span motor, sensorimotor, and sensory domains. While current therapies for PD include pharmacological, invasive, and physical interventions, there is a constant need for developing additional approaches for optimizing rehabilitation gains. Mental imagery is an emerging field in neurorehabilitation and has the potential to serve as an adjunct therapy to enhance patient function. Yet, the literature on this topic is sparse. The current paper reviews the motor, sensorimotor, and sensory domains impacted by PD using gait, balance, and pain as examples, respectively. Then, mental imagery and its potential for PD motor and non-motor rehabilitation is discussed, with an emphasis on its suitability for addressing gait, balance, and pain deficits in people with PD. Lastly, future research directions are suggested.
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Affiliation(s)
- Amit Abraham
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel 4077625, Israel
- Navigation and Accessibility Research Center of Ariel University (NARCA), Ariel University, Ariel 4077625, Israel
- Correspondence:
| | - Ryan P. Duncan
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO 63108, USA; (R.P.D.); (G.M.E.)
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Gammon M. Earhart
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO 63108, USA; (R.P.D.); (G.M.E.)
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
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Halperin O, Israeli‐Korn S, Yakubovich S, Hassin‐Baer S, Zaidel A. Self‐motion perception in Parkinson's disease. Eur J Neurosci 2020; 53:2376-2387. [DOI: 10.1111/ejn.14716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Orly Halperin
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
| | - Simon Israeli‐Korn
- Department of Neurology Movement Disorders Institute Sheba Medical Center Ramat Gan Israel
- The Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Sol Yakubovich
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
| | - Sharon Hassin‐Baer
- Department of Neurology Movement Disorders Institute Sheba Medical Center Ramat Gan Israel
- The Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Adam Zaidel
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
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