Sullivan Edith V, Sassoon Stephanie A, Pohl Kilian M, Saranathan Manojkumar, Zahr Natalie M, Pfefferbaum Adolf
Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Center for Health Sciences, SRI International, Menlo Park, CA, USA.
Transl Psychiatry. 2025 Sep 1;15(1):338. doi: 10.1038/s41398-025-03552-8.
Postural instability, a concomitant of falls, can persist in people with alcohol use disorder (AUD) even with sustained sobriety. Balance testing using a force plate, which detects micromovements while standing still, can be quantified with spectral analysis and expressed as temporal frequency, an index of truncal (i.e., postural) tremor. Here, we investigated physiological and brain structural factors that may contribute to a mechanistic understanding of postural instability during quiet standing in AUD. This mixed cross-sectional/longitudinal design included 462 observations in 292 participants (age 25-75 years): 120 men and 44 women with DSM-5-determined AUD and 75 control men and 53 control women. All participants completed balance testing on a force plate under two conditions: eyes open and eyes closed, both with feet together. Most participants also underwent two-point discrimination testing on the soles of the feet and structural MRI, typically within the week of balance testing. Linear mixed-effects models revealed greater tremor in all conditions in the AUD than control group with the diagnostic differences attributed to AUD men. Age effects did not differ significantly between AUD and control groups. By contrast, stronger correlations were detected between greater tremor, measured as a 2-5 Hz/0-2 Hz frequency quotient, and smaller regional brain volumes selective to motor centers (frontal supplemental motor cortex, thalamus, pallidum, cerebellar white matter) of the AUD men. The salient signs of postural instability were attributable to AUD men who consumed alcohol exceeding NIAAA guideline limits in the year prior to testing.
姿势不稳是跌倒的一个伴随症状，即使在持续戒酒的情况下，酒精使用障碍（AUD）患者仍可能存在。使用测力台进行平衡测试，该测试可在静止站立时检测微小运动，通过频谱分析可对其进行量化，并表示为时间频率，这是躯干（即姿势）震颤的一个指标。在此，我们研究了可能有助于从机制上理解AUD患者安静站立时姿势不稳的生理和脑结构因素。这种混合的横断面/纵向设计包括对292名参与者（年龄25 - 75岁）的462次观察：120名患有DSM - 5确诊的AUD的男性和44名女性，以及75名对照男性和53名对照女性。所有参与者在两种条件下在测力台上完成平衡测试：双脚并拢睁眼和闭眼。大多数参与者还在平衡测试的一周内进行了足底两点辨别测试和结构MRI检查。线性混合效应模型显示，在所有条件下，AUD组的震颤均大于对照组，诊断差异归因于AUD男性。AUD组和对照组之间的年龄效应无显著差异。相比之下，以2 - 5Hz/0 - 2Hz频率商测量的更大震颤与AUD男性运动中心（额叶辅助运动皮层、丘脑、苍白球、小脑白质）选择性的较小区域脑容量之间存在更强的相关性。姿势不稳的显著体征归因于在测试前一年饮酒量超过美国国立酒精滥用与酒精中毒研究所（NIAAA）指南限制的AUD男性。
