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Hall KJ, Van Ooteghem K, McIlroy WE. Emotional state as a modulator of autonomic and somatic nervous system activity in postural control: a review. Front Neurol 2023; 14:1188799. [PMID: 37719760 PMCID: PMC10500443 DOI: 10.3389/fneur.2023.1188799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/07/2023] [Indexed: 09/19/2023] Open
Abstract
Advances in our understanding of postural control have highlighted the need to examine the influence of higher brain centers in the modulation of this complex function. There is strong evidence of a link between emotional state, autonomic nervous system (ANS) activity and somatic nervous system (somatic NS) activity in postural control. For example, relationships have been demonstrated between postural threat, anxiety, fear of falling, balance confidence, and physiological arousal. Behaviorally, increased arousal has been associated with changes in velocity and amplitude of postural sway during quiet standing. The potential links between ANS and somatic NS, observed in control of posture, are associated with shared neuroanatomical connections within the central nervous system (CNS). The influence of emotional state on postural control likely reflects the important influence the limbic system has on these ANS/somatic NS control networks. This narrative review will highlight several examples of behaviors which routinely require coordination between the ANS and somatic NS, highlighting the importance of the neurofunctional link between these systems. Furthermore, we will extend beyond the more historical focus on threat models and examine how disordered/altered emotional state and ANS processing may influence postural control and assessment. Finally, this paper will discuss studies that have been important in uncovering the modulatory effect of emotional state on postural control including links that may inform our understanding of disordered control, such as that observed in individuals living with Parkinson's disease and discuss methodological tools that have the potential to advance understanding of this complex relationship.
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Affiliation(s)
- Karlee J. Hall
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Elkjær E, Mikkelsen MB, Michalak J, Mennin DS, O'Toole MS. Motor alterations in depression and anxiety disorders: A systematic review and meta-analysis. J Affect Disord 2022; 317:373-387. [PMID: 36037990 DOI: 10.1016/j.jad.2022.08.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 05/19/2022] [Accepted: 08/21/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Psychomotor retardation has long been recognized as a major feature of depression, and anxiety disorders have been linked with freeze and flight motor responses. This systematic review and meta-analysis aimed a) to synthesize available evidence of motor alterations comparing individuals with depression and anxiety disorders to healthy individuals and b) to evaluate the effect of experimental manipulations of motor displays within these clinical groups. METHOD The databases PubMed and PsycINFO were searched for studies either assessing motor differences between clinical and healthy control groups or manipulating the motor system within a clinical group. RESULTS The literature search yielded 87 relevant papers, comprising 82 studies comparing a clinical group to a healthy group and 5 studies investigating motor manipulations within a clinical sample. The results of the meta-analysis (K = 71) indicated a statistically significant combined estimate of differences between healthy and clinical groups (g = 0.38 [0.31, 0.45], adjusted for publication bias g = 0.26 [0.19, 0.33]) of a small size. This effect did not vary according to type of disorder (anxiety vs. depression, p = .468). From a narrative review of experimental studies within clinical groups, four out of five studies reported statistically significant effects of manipulating the motor system on affective outcomes. DISCUSSION This synthesis adds to the accumulating empirical evidence of motor alterations in depression and anxiety disorders. Future research will need to investigate how individuals suffering from depression or anxiety disorders could benefit from psychological, behavioral, and physical interventions directly aimed at the motor system.
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Affiliation(s)
- Emma Elkjær
- Department for Psychology and Behavioral Sciences, Aarhus University, Denmark.
| | - Mai B Mikkelsen
- Department for Psychology and Behavioral Sciences, Aarhus University, Denmark
| | - Johannes Michalak
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Germany
| | - Douglas S Mennin
- Department of Psychology, Teachers College, Columbia University, New York, NY, United States of America
| | - Mia S O'Toole
- Department for Psychology and Behavioral Sciences, Aarhus University, Denmark.
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Amiaz R, Kimel Naor S, Caspi A, Czerniak E, Noy S, Pelc T, Mintz M, Plotnik M. Responses to balance challenges in persons with panic disorder: A pilot study of computerized static and dynamic balance measurements. Brain Behav 2022; 12:e2411. [PMID: 34843172 PMCID: PMC8785611 DOI: 10.1002/brb3.2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/22/2021] [Accepted: 09/05/2021] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Several studies have shown an association between panic disorder (PD) and reduced balance abilities, mainly based on functional balance scales. This pilot study aims to demonstrate the feasibility of studying balance abilities of persons with PD (PwPD) using computerized static and, for the first time, dynamic balance measurements in order to characterize balance control strategies employed by PwPD. METHODS Twelve PwPD and 11 healthy controls were recruited. PD diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and the severity of symptoms was evaluated using the Hamilton Anxiety Scale (HAM-A), PD Severity Scales (PDSS), and Panic and Agoraphobia Scale (PAS). Balance was clinically assessed using the Activities-Specific Balance Confidence (ABC) scale and physically by the Mini-Balance Evaluation Systems Test (Mini-BESTest). Dizziness was evaluated using the Dizziness Handicap Inventory (DHI) scale. Postural control was evaluated statically by measuring body sway and dynamically by measuring body responses to rapid unexpected physical perturbations. RESULTS PwPD had higher scores on the HAM-A (17.6 ± 10.3 vs. 3.0 ± 2.9; p < .001), PDSS (11.3 ± 5.1 vs. 0; p < .001), and PAS (20.3 ± 8.7 vs. 0; p < .001) questionnaires and lower scores on the balance scales compared to the controls (ABC scale: 156.2 ± 5.9 vs. 160 ± 0.0, p = .016; Mini-BESTest: 29.4 ± 2.1 vs. 31.4 ± 0.9, p = .014; DHI: 5.3 ± 4.4 vs. 0.09 ± 0.3, p < .001). In the static balance tests, PwPD showed a not-significantly smaller ellipse area of center of pressure trajectory (p = .36) and higher body sway velocity (p = .46), whereas in the dynamic balance tests, PwPD had shorter recovery time from physical perturbations in comparison to controls (2.1 ± 1.2s vs. 1.6 ± 0.9 s, p = .018). CONCLUSION The computerized balance tests results point to an adoption of a ''postural rigidity'' strategy by the PwPD, that is, reduced dynamic adaptations in the face of postural challenges. This may reflect a nonsecure compensatory behavior. Further research is needed to delineate this strategy.
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Affiliation(s)
- Revital Amiaz
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shani Kimel Naor
- The Center of Advanced Technologies in Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Asaf Caspi
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efrat Czerniak
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Noy
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tatiana Pelc
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Matti Mintz
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Meir Plotnik
- The Center of Advanced Technologies in Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Linares IMP, Nardi AE, Guimarães FS, Arrais KC, Chagas MH, Osório FL, Hallak JE, Zuardi AW, Coimbra NC, Crippa JA. Increased body sway in phobic patients exposed to images of spiders. Braz J Psychiatry 2020; 43:477-483. [PMID: 33331404 PMCID: PMC8555649 DOI: 10.1590/1516-4446-2020-1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
Objective: The aim of the present study was to analyze the body sway response in specific phobia (SP) patients and healthy controls while viewing neutral, phobic, and disgusting images. Methods: The participants’ heart rate (HR) and skin conductance were also recorded during the procedure. Nineteen patients with arachnophobia and 19 healthy volunteers matched by age, gender, and years of education underwent a postural control test on a stabilometric platform. Results: The platform recorded increased body sway in the SP group when exposed to spider images (SPI). The SP group presented increases in most parameters (SD, velocity, frequency, area, p ≤ 0.05) when viewing pictures of the SPI category. Psychometric measures of subjective anxiety (State-Trait Anxiety Inventory, STAI) and physiological states (HR; skin conductance responses; spontaneous fluctuations in skin conductance) showed increased anxiety (p ≤ 0.05) in the SP group compared to healthy volunteers. High anxiety levels were observed throughout the assessment, including the task of exposure to SPI (p ≤ 0.05). No significant effect or correlation was found between skin conductance and body sway measures (p > 0.05). Conclusions: The results of the postural control test suggest the occurrence of a defensive escape response in SP, in agreement with previous evidence.
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Affiliation(s)
- Ila M P Linares
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Institutos Nacionais de Ciência e Tecnologia, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Antonio E Nardi
- Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Francisco S Guimarães
- Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Katia C Arrais
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Institutos Nacionais de Ciência e Tecnologia, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Marcos H Chagas
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Institutos Nacionais de Ciência e Tecnologia, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Flavia L Osório
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Institutos Nacionais de Ciência e Tecnologia, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Jaime E Hallak
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Institutos Nacionais de Ciência e Tecnologia, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Antonio W Zuardi
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Institutos Nacionais de Ciência e Tecnologia, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Norberto C Coimbra
- Laboratório de Neuroanatomia e Neuropsicobiologia, Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil.,Núcleo de Pesquisa em Neurobiologia das Emoções, Núcleos de Apoio à Pesquisa, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - José A Crippa
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Institutos Nacionais de Ciência e Tecnologia, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
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Rodríguez-Rubio PR, Bagur-Calafat C, López-de-Celis C, Bueno-Gracía E, Cabanas-Valdés R, Herrera-Pedroviejo E, Girabent-Farrés M. Validity and Reliability of the Satel 40 Hz Stabilometric Force Platform for Measuring Quiet Stance and Dynamic Standing Balance in Healthy Subjects. Int J Environ Res Public Health 2020; 17:ijerph17217733. [PMID: 33105835 PMCID: PMC7660083 DOI: 10.3390/ijerph17217733] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND A force platform must have validity and reliability for optimal use. The objective of this study was to analyze the validity and the reliability of the Satel 40 Hz stabilometric force platform. METHODS A study of instrumental validity and reliability, involving a cross-sectional correlational and comparative analysis was performed. To determine the validity, four certified weights located on three axes were used and the ability of the stabilometric force platform to detect changes in the position of the different axes was observed. A test-retest was performed to analyze the reliability. Forty-two symptom-free volunteers participated in the study. Assessments were taken in a standing static position and in a dynamic position, with the eyes open and closed. Three measurements were taken and the intra-class correlation coefficient (ICC) was calculated. RESULTS The validity increased as the weight increased for all the variables measured in the stabilometric parameters (p < 0.05). The reliability was shown to be good to excellent for the two visual conditions. The positional variables obtained a higher ICC. The variable with the best ICC was the Y mean in OE (ICC 0.874 and a p < 0.001). All the values showed an increase in a dynamic situation. CONCLUSION The findings support the reliability and validity of the Satel 40 Hz stabilometric force platform. The platform could be recommended to evaluate static and dynamic standing balance in healthy adult individuals. Guidelines for treatment and the level of quality of stabilometry could be obtained from its use.
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Affiliation(s)
- Pere Ramón Rodríguez-Rubio
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
| | - Caritat Bagur-Calafat
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
| | - Carlos López-de-Celis
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Elena Bueno-Gracía
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Rosa Cabanas-Valdés
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
- Correspondence:
| | - Ernesto Herrera-Pedroviejo
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
- Department of Physiotherapy, Blanquerna School of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain
| | - Montserrat Girabent-Farrés
- Department of Physiotherapy, School of health Sciencies, Tecnocampus-pompeu Fabra University, Mataró, 08302 Barcelona, Spain;
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de Souza NS, Martins ACG, Alexandre DJA, Orsini M, Bastos VHDV, Leite MAA, Teixeira S, Velasques B, Ribeiro P, Bittencourt J, Matta APDC, Filho PM. The Influence of Fear of Falling on Orthostatic Postural Control: A Systematic Review. Neurol Int 2015; 7:6057. [PMID: 26788265 PMCID: PMC4704471 DOI: 10.4081/ni.2015.6057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 08/02/2015] [Accepted: 11/12/2015] [Indexed: 01/08/2023] Open
Abstract
Posture is a complex sensory-motor behavior that can be influenced by the fear of falling (FoF) during environmental changes. The aim of this paper is to investigate the influence of FoF on orthostatic postural control in healthy individuals by a systematic review. Thirteen articles were selected. Some other articles (31 references) were used to contextualize and discuss the topic. Studies in the environment made changes on the environment, in which participants were positioned in high hydraulic platforms at different heights, showed a decrease in the center of pressure in the anteroposterior oscillation where the platform was higher. This change in postural control strategy and the FoF are correlated. It can modulate the activity of the muscle spindle (H-reflex) and probably induce postural freezing phenomenon (anticipated postural anxiety). We can conclude that further studies are needed to understand the physiological echanisms involved in FoF and its relation to changes in postural control strategy.
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Affiliation(s)
- Nélio Silva de Souza
- University Center Serra dos Órgãos, Teresópolis; Science of Rehabilitation, Centro Universitário Augusto Motta, Rio de Janeiro
| | - Ana Carolina Gomes Martins
- University Center Serra dos Órgãos, Teresópolis; Integrated Health of Women and Children, Fluminense Federal University, Niterói
| | | | - Marco Orsini
- Science of Rehabilitation, Centro Universitário Augusto Motta, Rio de Janeiro; Severino Sombra University Center, Medicine Department, Vassouras, Rio de Janeiro
| | - Victor Hugo do Vale Bastos
- Science of Rehabilitation, Centro Universitário Augusto Motta, Rio de Janeiro; Department of Neurology, Antônio Pedro University Hospital, Fluminense Federal University, Niterói; Biomedical Sciences stricto sensu, Federal University of Piauí
| | - Marco Antônio A Leite
- Fluminense Federal University Medical School, Niterói; Movement Disorders Unit, Antônio Pedro University Hospital, Fluminense Federal University, Niterói
| | | | - Bruna Velasques
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro; Institute of Applied Neuroscience, Rio de Janeiro, Brazil
| | - Pedro Ribeiro
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro; Institute of Applied Neuroscience, Rio de Janeiro, Brazil
| | - Juliana Bittencourt
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro
| | | | - Pedro Moreira Filho
- Department of Neurology, Antônio Pedro University Hospital, Fluminense Federal University , Niterói
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