Dynamic postural balance indices can help discriminate between patients with multiple system atrophy and Parkinson's disease

Wei Bao; Puyu Li; Ying Yang; Kai Chen; Jun Liu

doi:10.3389/fneur.2022.1089439

Dynamic postural balance indices can help discriminate between patients with multiple system atrophy and Parkinson's disease

Front Neurol. 2023 Jan 9:13:1089439. doi: 10.3389/fneur.2022.1089439. eCollection 2022.

Authors

Wei Bao¹, Puyu Li², Ying Yang¹, Kai Chen¹, Jun Liu²

Affiliations

¹ School of Mechanical Engineering, Hangzhou Dianzi University, Hangzhou, Zhejiang, China.
² Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Background: Patients with Parkinson's disease (PD) and those with multiple system atrophy (MSA) show similar symptoms but have different clinical treatments. It will be helpful to discriminate between these two kinds of patients at an early or middle stage. The purpose of this study is to highlight the differences in posturographic characterization between patients with PD and those with MSA during quiet standing and perturbed standing.

Methods: A total of clinically diagnosed 42 patients with PD and 32 patients with MSA participated in the experiment. Patients were asked to first stand on a static balance force platform and then on a dynamic balance (medial-lateral rocker) force platform to measure the center of pressure (COP) trajectory during an eyes-open (EO) state. The posturographic parameters were obtained under the two standing conditions for statistical analysis.

Results: Four posturographic variables were calculated and analyzed, namely, the standard deviation of COP position (SD), sway path of COP position (SP), an elliptical area covering the 95% COP position trajectory (EA), sway path of COP position (SP), and integral area of the power spectral density at 0-0.5 Hz frequency band (PSD). Except for variable EA, the other three variables are all in the medial-lateral (ML) direction. In the static balance experiment, there were no significant differences between the four variables between patients with PD and those with MSA. However, in the dynamic balance experiment, the obtained four variables all presented significant differences between patients with PD and those with MSA.

Conclusion: The dynamic posturographic variables with significant differences between patients with PD and those with MSA imply that patients with MSA have worse postural control ability in the medial-lateral (ML) direction compared to patients with PD. The obtained dynamic indices may help supplemental clinical evaluation to discriminate between patients with MSA and those with PD.

Keywords: Parkinson's disease (PD); balance control; center of pressure (COP); multiple system atrophy (MSA); posturography.

Associated data

figshare/10.6084/m9.figshare.19633638.v6

Grants and funding

This study was supported by the Key Scientific Research Project of Zhejiang Province, China (Grant Number 2017C03040) and the Fundamental Research Funds for the Provincial Universities of Zhejiang (Grant Number GK229909299001-020). There was no additional external funding received for this study.