Palakurthi Bhavana, Burugupally Sindhu Preetham
Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA.
Department of Mechanical Engineering, Wichita State University, Wichita, KS 67260, USA.
Brain Sci. 2019 Sep 18;9(9):239. doi: 10.3390/brainsci9090239.
Parkinson's disease (PD) is a heterogeneous progressive neurodegenerative disorder, which typically affects older adults; it is predicted that by 2030 about 3% of the world population above 65 years of age is likely to be affected. At present, the diagnosis of PD is clinical, subjective, nonspecific, and often inadequate. There is a need to quantify the PD factors for an objective disease assessment. Among the various factors, postural instability (PI) is unresponsive to the existing treatment strategies resulting in morbidity. In this work, we review the physiology and pathophysiology of postural balance that is essential to treat PI among PD patients. Specifically, we discuss some of the reported factors for an early PI diagnosis, including age, nervous system lesions, genetic mutations, abnormal proprioception, impaired reflexes, and altered biomechanics. Though the contributing factors to PI have been identified, how their quantification to grade PI severity in a patient can help in treatment is not fully understood. By contextualizing the contributing factors, we aim to assist the future research efforts that underpin posturographical and histopathological studies to measure PI in PD. Once the pathology of PI is established, effective diagnostic tools and treatment strategies could be developed to curtail patient falls.
帕金森病（PD）是一种异质性进行性神经退行性疾病，通常影响老年人；据预测，到2030年，全球65岁以上人口中约3%可能会受到影响。目前，PD的诊断是临床性的、主观的、非特异性的，而且往往不充分。需要对PD相关因素进行量化，以便进行客观的疾病评估。在各种因素中，姿势不稳（PI）对现有治疗策略无反应，会导致发病。在这项工作中，我们回顾了姿势平衡的生理学和病理生理学，这对于治疗PD患者的PI至关重要。具体而言，我们讨论了一些已报道的早期PI诊断因素，包括年龄、神经系统病变、基因突变、本体感觉异常、反射受损和生物力学改变。尽管已经确定了PI的相关因素，但它们如何量化以评估患者PI的严重程度并有助于治疗，目前尚未完全明确。通过将这些相关因素置于具体情境中，我们旨在助力未来的研究工作，这些工作是支撑用于测量PD中PI的姿势描记法和组织病理学研究的基础。一旦确定了PI的病理机制，就可以开发有效的诊断工具和治疗策略，以减少患者跌倒。
