The extent to which basal ganglia disorders of postural controlare associated with abnormal central processing of somatosensory information for an internal representation of body position and motion (kinesthesia) is unknown. This project seeks to determine how kinesthetic information is used for postural control in healthy elderly subjects and subjects with Parkinson's disease (PD), a basal ganglia disorder. Both subjective measures (psychophysical) and objective measures (surface reactive forces, kinematic body CoM displacement, and muscle activation) will be used to quantify disorders of kinesthetic integration for postural control in subjects with PD compared to age-matched control subjects. Standing and sitting postural control will be examined because of stance and axial postural problems associated with PD. All studies will test subjects with PD in the ON and OFF states to examine the effects of levodopa replacement on kinesthetic control of posture.
The specific aims address 3 roles of kinesthetic information for the control of posture:
Aim I. Determine how PD affects perception of distal and proximal joint position sense and perception of postural verticality. Exp. 1 will test the hypothesis that the basal ganglia are important for conscious ankle and torso kinesthesia in stance posture. Exp. 2 will test the hypothesis that the basal ganglia integrate vestibular and somatosensory information to provide an internal representation of postural vertical.
Aim I 1. Determine whether PD impairs use of somatosensory graviception as a postural reference. Exps. 3 and 4 will test the hypothesis that PD is associated with impaired use of slow, graviceptive somatosensory information, which normally provides a reference or 'set'point for postural orientation to vertical.
Aim II 1. Define how PD impairs movement-related kinesthetic information for compensatory stepping. Exp 5 and 6 will test the hypothesis that impaired kinesthesia from the legs and falling body results in increased dependence on vision for accurate compensatory stepping to recover equilbrium. Effective rehabilitation of balance disorders requires a better understanding of how kinesthetic information is used for joint alignment, postural verticality, postural orientation, and control of postural equilibrium responses.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
5R37AG006457-28
Application #
8448665
Study Section
Special Emphasis Panel (NSS)
Program Officer
Chen, Wen G
Project Start
1989-09-30
Project End
2014-03-31
Budget Start
2013-05-15
Budget End
2014-03-31
Support Year
28
Fiscal Year
2013
Total Cost
$390,222
Indirect Cost
$135,029
Name
Oregon Health and Science University
Department
Neurology
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Smulders, Katrijn; Dale, Marian L; Carlson-Kuhta, Patricia et al. (2016) Pharmacological treatment in Parkinson's disease: Effects on gait. Parkinsonism Relat Disord 31:3-13
Curtze, Carolin; Nutt, John G; Carlson-Kuhta, Patricia et al. (2016) Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease. Phys Ther 96:1734-1743
Horak, Fay B; Mancini, Martina; Carlson-Kuhta, Patricia et al. (2016) Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease. Phys Ther 96:1364-71
Gera, G; Freeman, D L; Blackinton, M T et al. (2016) Identification of Balance Deficits in People with Parkinson Disease; is the Sensory Organization Test Enough? Int J Phys Med Rehabil 4:
Paquette, Caroline; Franzén, Erika; Horak, Fay B (2016) More Falls in Cerebellar Ataxia When Standing on a Slow Up-Moving Tilt of the Support Surface. Cerebellum 15:336-42
Smith, Beth A; Carlson-Kuhta, Patricia; Horak, Fay B (2016) Consistency in Administration and Response for the Backward Push and Release Test: A Clinical Assessment of Postural Responses. Physiother Res Int 21:36-46
Peterson, Daniel S; Fling, Brett W; Mancini, Martina et al. (2015) Dual-task interference and brain structural connectivity in people with Parkinson's disease who freeze. J Neurol Neurosurg Psychiatry 86:786-92
Curtze, Carolin; Nutt, John G; Carlson-Kuhta, Patricia et al. (2015) Levodopa Is a Double-Edged Sword for Balance and Gait in People With Parkinson's Disease. Mov Disord 30:1361-70
Horak, Fay; King, Laurie; Mancini, Martina (2015) Role of body-worn movement monitor technology for balance and gait rehabilitation. Phys Ther 95:461-70
Cohen, Rajal G; Gurfinkel, Victor S; Kwak, Elizabeth et al. (2015) Lighten Up: Specific Postural Instructions Affect Axial Rigidity and Step Initiation in Patients With Parkinson's Disease. Neurorehabil Neural Repair 29:878-88

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