Bove Marco, Marinelli Lucio, Avanzino Laura, Marchese Roberta, Abbruzzese Giovanni
Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy.
Mov Disord. 2006 Feb;21(2):192-8. doi: 10.1002/mds.20696.
Essential tremor (ET) is a common movement disorder causing an important functional disability. ET is generally regarded as a monosymptomatic disorder, but additional signs may be present. We analyzed postural sway in 19 patients with classic ET and in 19 sex- and age-matched normal controls (NC) to uncover possible abnormalities of balance control. Static posturography was performed with eyes open (EO) and closed during quiet stance and during performance of mental calculation or motor sequence of thumb opposition to the other fingers. No significant differences of center of foot pressure (COP) parameters were observed between patients and controls during quiet standing. Visual deprivation induced a similar worsening of postural sway in both groups. Concomitant performance of a cognitive or motor task did not affect COP area, whereas COP path was significantly modified by the cognitive task in both groups. In all EO conditions, the COP path was significantly lower in NC than in ET, but such offset was related only to the group of ET patients with head tremor. This study demonstrates that balance control is only minimally affected in ET, although patients with head involvement and longer disease duration tend to present a reduced postural stability. The "dual-task effect" is less important in ET than in Parkinson's disease patients.
特发性震颤(ET)是一种常见的运动障碍,会导致严重的功能残疾。ET通常被视为单症状疾病,但可能存在其他体征。我们分析了19例典型ET患者以及19例性别和年龄匹配的正常对照(NC)的姿势摆动情况,以发现平衡控制可能存在的异常。在安静站立以及进行心算或拇指与其他手指对指的运动序列时,分别在睁眼(EO)和闭眼状态下进行静态姿势描记法。在安静站立时,患者和对照组之间未观察到足压力中心(COP)参数的显著差异。视觉剥夺在两组中均导致姿势摆动出现类似程度的恶化。认知或运动任务的同时执行并未影响COP面积,而两组中的认知任务均显著改变了COP路径。在所有EO条件下,NC组的COP路径均显著低于ET组,但这种差异仅与伴有头部震颤的ET患者组有关。本研究表明,ET患者的平衡控制仅受到轻微影响,尽管伴有头部受累和病程较长的患者往往表现出姿势稳定性降低。“双任务效应”在ET患者中比在帕金森病患者中影响更小。