Department of Physical Therapy & Rehabilitation Science, University of California, San Francisco, USA; Department of Neurological Surgery, University of California, San Francisco, USA.
Department of Neurological Surgery, University of California, San Francisco, USA.
Neurotherapeutics. 2024 Apr;21(3):e00354. doi: 10.1016/j.neurot.2024.e00354. Epub 2024 Apr 4.
Postural instability is a detrimental and often treatment-refractory symptom of Parkinson's disease. While many existing studies quantify the biomechanical deficits among various postural domains (static, anticipatory, and reactive) in this population, less is known regarding the neural network dysfunctions underlying these phenomena. This review will summarize current studies on the cortical and subcortical neural activities during postural responses in healthy subjects and those with Parkinson's disease. We will also review the effects of current therapies, including neuromodulation and feedback-based wearable devices, on postural instability symptoms. With recent advances in implantable devices that allow chronic, ambulatory neural data collection from patients with Parkinson's disease, combined with sensors that can quantify biomechanical measurements of postural responses, future work using these devices will enable better understanding of the neural mechanisms of postural control. Bridging this knowledge gap will be the critical first step towards developing novel neuromodulatory interventions to enhance the treatment of postural instability in Parkinson's disease.
姿势不稳是帕金森病的一种有害且常难以治疗的症状。虽然许多现有的研究已经量化了该人群在各种姿势领域（静态、预期和反应性）中的生物力学缺陷，但对于这些现象背后的神经网络功能障碍知之甚少。本综述将总结目前关于健康受试者和帕金森病患者在姿势反应过程中的皮质和皮质下神经活动的研究。我们还将回顾当前疗法的效果，包括神经调节和基于反馈的可穿戴设备，这些疗法对姿势不稳症状的影响。随着允许从帕金森病患者中进行慢性、可移动神经数据收集的植入设备的最新进展，以及可以量化姿势反应生物力学测量的传感器的发展，未来使用这些设备的工作将使我们能够更好地理解姿势控制的神经机制。弥合这一知识差距将是开发新型神经调节干预措施以增强帕金森病患者姿势不稳治疗的关键第一步。
