Does Impaired Plantar Cutaneous Vibration Perception Contribute to Axial Motor Symptoms in Parkinson’s Disease? Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation

Abstract

Objective: To investigate whether impaired plantar cutaneous vibration perception contributes to axial motor symptoms in Parkinson’s disease (PD) and whether anti-parkinsonian medication and subthalamic nucleus deep brain stimulation (STN-DBS) show different effects. Methods: Three groups were evaluated: PD patients in the medication “on” state (PD-MED), PD patients in the medication “on” state and additionally “on” STN-DBS (PD-MED–DBS), as well as healthy subjects (HS) as reference. Motor performance was analyzed using a pressure distribution platform. Plantar cutaneous vibration perception thresholds (VPT) were investigated using a customized vibration exciter at 30 Hz. Results: Motor performance of PD-MED and PD-MED–DBS was characterized by greater postural sway, smaller limits of stability ranges, and slower gait due to shorter strides, fewer steps per minute, and broader stride widths compared to HS. Comparing patient groups, PD-MED–DBS showed better overall motor performance than PD-MED, particularly for the functional limits of stability and gait. VPTs were significantly higher for PD-MED compared to those of HS, which suggests impaired plantar cutaneous vibration perception in PD. However, PD-MED–DBS showed less impaired cutaneous vibration perception than PD-MED. Conclusions: PD patients suffer from poor motor performance compared to healthy subjects. Anti-parkinsonian medication in tandem with STN-DBS seems to be superior for normalizing axial motor symptoms compared to medication alone. Plantar cutaneous vibration perception is impaired in PD patients, whereas anti-parkinsonian medication together with STN-DBS is superior for normalizing tactile cutaneous perception compared to medication alone. Consequently, based on our results and the findings of the literature, impaired plantar cutaneous vibration perception might contribute to axial motor symptoms in PD.

Anatomical Exploration of the KI1 Acupoint: Implications for Medial and Lateral Plantar Nerve Stimulation

“…This study highlights the neural and muscular structures targeted by acupuncture at the KI1 acupoint, revealing differences between male and female anatomies regarding this stimulation. Recent studies have shown that sensory nerves and connective tissues in the soles, crucial for detecting pressure and vibration, have a direct impact on the central nervous system [20]. This indicates that stimulating plantar nerves can notably improve motor and cognitive functions, presenting significant advantages for therapeutic rehabilitation [21].…”

Immediate Effects of Wearing an Ankle Bandage on Fine Coordination, Proprioception, Balance and Gait in Patients with an Acute Ankle Injury

“…Maintaining balance is usually accomplished by using either the ankle strategy or the hip strategy. The ankle strategy shifts the center of gravity by moving the entire body as a single-segmented inverted pendulum around the ankle joint, whereas the hip strategy involves moving the body as a double-segmented inverted pendulum with counter-phase motions around both the hip and ankle joints [22,68,69,71]. As a result of the injury, the subjects may switch from the typical ankle strategy to the hip strategy, which is less effective for quasi-static balance tasks [69,72,73].…”

“…This includes damage of specialized receptors, which are located in muscles, tendons, ligaments, and the joint capsule, such as Golgi tendon organs, muscle spindles, joint receptors and various mechanoreceptors. As these receptors provide important information about muscle length, muscle contraction speed, muscle 2 tension, and joint position, for planning, adapting and executing movements, any disruption may negatively affect motor control [13][14][15][18][19][20][21][22].…”