Kammermeier Stefan, Dietrich Lucia, Maierbeck Kathrin, Plate Annika, Lorenzl Stefan, Singh Arun, Bötzel Kai
Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.
Abteilung für Allgemeinchirurgie, Kliniken Ostallgäu-Kaufbeuren, Kaufbeuren, Germany.
Front Neurol. 2017 Dec 20;8:689. doi: 10.3389/fneur.2017.00689. eCollection 2017.
Progressive supranuclear palsy (PSP) and late-stage idiopathic Parkinson's disease (IPD) are neurodegenerative movement disorders resulting in different postural instability and falling symptoms. IPD falls occur usually forward in late stage, whereas PSP falls happen in early stages, mostly backward, unprovoked, and with high morbidity. Postural responses to sensory anteroposterior tilt illusion by bilateral dorsal neck vibration were probed in both groups versus healthy controls on a static recording posture platform. Three distinct anteroposterior body mass excursion peaks (P1-P3) were observed. 18 IPD subjects exhibited well-known excessive response amplitudes, whereas 21 PSP subjects' responses remained unaltered to 22 control subjects. Neither IPD nor PSP showed response latency deficits, despite brainstem degeneration especially in PSP. The observed response patterns suggest that PSP brainstem pathology might spare the involved proprioceptive pathways and implies viability of neck vibration for possible biofeedback and augmentation therapy in PSP postural instability.
进行性核上性麻痹(PSP)和晚期特发性帕金森病(IPD)是神经退行性运动障碍,会导致不同的姿势不稳和跌倒症状。IPD跌倒通常发生在晚期,多向前跌倒,而PSP跌倒发生在早期,多向后跌倒,无明显诱因,且发病率高。在静态记录姿势平台上,对两组患者以及健康对照者进行双侧颈背振动诱发的感觉前后倾斜错觉的姿势反应测试。观察到三个不同的身体前后质量偏移峰值(P1 - P3)。18名IPD受试者表现出众所周知的过度反应幅度,而21名PSP受试者的反应与22名对照受试者相比没有变化。尽管存在脑干变性,尤其是在PSP中,但IPD和PSP均未表现出反应潜伏期缺陷。观察到的反应模式表明,PSP脑干病变可能未累及相关的本体感觉通路,这意味着颈部振动对于PSP姿势不稳可能的生物反馈和增强治疗具有可行性。