Multiple Sclerosis: White and Gray Matter Damage Associated with Balance Deficit Detected at Static Posturography

Abstract

Imbalance due to MS appears to be related to the disconnection between the spinal cord, cerebellum, and cerebral cortex, which in turn produces atrophy of the sensory motor cerebellar regions that are functionally connected with specific cortical areas.

Association of Postural Sway with Disability Status and Cerebellar Dysfunction in People with Multiple Sclerosis

“…A recent study involving in vivo magnetic resonance imaging has shown an association of sway with EO with cerebellar atrophy, and sway with EC was associated with spinal cord atrophy. 33 We found no significant correlations between the EDSS pyramidal subscores (which consisted of upperand lower-limb reflexes, muscle strength, functional tests, and spasticity measures) or lower-limb spasticity and postural sway. In contrast, a previous cluster analysis of high/low spasticity as measured by the H-reflex in people with MS found that those with higher spasticity had increased velocity, area, and mediolateral range of postural sway.…”

“…30 Demyelination in the cerebellum is prominent in people with MS, 31 and lesions in the brainstem and cerebellum have been shown to be associated with increased sway and number of falls over a 6-month period. 32 Standing sway measures have previously been shown to be positively correlated with gray and white matter lesions in the cerebellum and its connections as measured using magnetic resonance imaging in people with MS. 33 Sway with EO has also been shown to be associated with cerebellar atrophy in people with MS. 34 These studies confirm that cerebellar dysfunction plays a major role in the observed increase in EO and EC postural sway in people with MS, with the present study indicating that cerebellar dysfunction is likely to have a major influence on the relationship between increased postural sway and total EDSS scores.…”

The “butterfly diagram”: A gait marker for neurological and cerebellar impairment in people with multiple sclerosis

“…Previous studies have demonstrated that CoP trajectory measurements during walking and standing relate to the clinical and radiological aspects of MS. In a series of papers published by Prosperini et al [12][13][14], elevated trajectories of CoP during standing, were associated with falls, atrophy of the spinal cord, supratentorial associative white matter bundles and gray matter atrophy of the cerebellum in PwMS.…”

Comparison of upright balance in stroke, Parkinson and multiple sclerosis

“…Falls are consistently associated with balance disorders (4)(5)(6), and stabilometric platforms have been used to quantitatively assess balance abnormalities in subjects with neurological disorders (SwND) (7)(8)(9).…”