Quantification of postural sway in normals and patients with cerebellar diseases

Diener, Hans-Christoph; Dichgans, J.; Bacher, M.; Gompf, Bruno

doi:10.1016/0013-4694(84)90172-x

Cited by 342 publications

(166 citation statements)

References 12 publications

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“…It is apparent that in the case of the Pts, the increases in TLs are significant. Therefore, the findings are consistent with those obtained by traditional methods, which show significantly greater lengths of CoP path trajectories obtained using a stabilometric platform, or greater angular displacement and velocities obtained using a gyroscope, in the case of patients (Diener, Dichgans, Bacher, & Gompf, 1984;Warrenburg et al, 2005). An interesting finding is that the greatest difference is in the case of measurement of TL of the trunk.…”

Section: Discussionsupporting

confidence: 88%

Trajectory length of pitch vs. roll: Technique for assessment of postural stability

Kutílek¹,

Socha²,

Čakrt³

et al. 2015

Acta Gymnica

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Section: Discussionsupporting

confidence: 88%

Trajectory length of pitch vs. roll: Technique for assessment of postural stability

Kutílek¹,

Socha²,

Čakrt³

et al. 2015

Acta Gymnica

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“…Several physiological studies in monkey and humans have provided evidence that the cerebello-thalamo-cortical circuit is essential for gait and balance (Diener et al, 1984;Itō , 1984;Hallett and Massaquoi, 1993;Armstrong and Marple-Horvat, 1996;Cooper et al, 2000;Ilg et al, 2007;Blangero et al, 2009). Real locomotion FDG PET studies have also confirmed a prominent activation in the vermal and paravermal cerebellum, with extensions into the superior cerebellar peduncle bilaterally (Ishii, 1995;la Fougere et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Progressive gait ataxia following deep brain stimulation for essential tremor: adverse effect or lack of efficacy?

Reich¹,

Brumberg²,

Pozzi³

et al. 2016

Brain

131

132

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*These authors contributed equally to this work.Thalamic deep brain stimulation is a mainstay treatment for severe and drug-refractory essential tremor, but postoperative management may be complicated in some patients by a progressive cerebellar syndrome including gait ataxia, dysmetria, worsening of intention tremor and dysarthria. Typically, this syndrome manifests several months after an initially effective therapy and necessitates frequent adjustments in stimulation parameters. There is an ongoing debate as to whether progressive ataxia reflects a delayed therapeutic failure due to disease progression or an adverse effect related to repeated increases of stimulation intensity. In this study we used a multimodal approach comparing clinical stimulation responses, modelling of volume of tissue activated and metabolic brain maps in essential tremor patients with and without progressive ataxia to disentangle a disease-related from a stimulation-induced aetiology. Ten subjects with stable and effective bilateral thalamic stimulation were stratified according to the presence (five subjects) of severe chronic-progressive gait ataxia. We quantified stimulated brain areas and identified the stimulation-induced brain metabolic changes by multiple 18 F-fluorodeoxyglucose positron emission tomography performed with and without active neurostimulation. Three days after deactivating thalamic stimulation and following an initial rebound of symptom severity, gait ataxia had dramatically improved in all affected patients, while tremor had worsened to the presurgical severity, thus indicating a stimulation rather than disease-related phenomenon. Models of the volume of tissue activated revealed a more ventrocaudal stimulation in the (sub)thalamic area of patients with progressive gait ataxia. Metabolic maps of both patient groups differed by an increased glucose uptake in the cerebellar nodule of patients with gait ataxia. Our data suggest that chronic progressive gait ataxia in essential tremor is a reversible cerebellar syndrome caused by a maladaptive response to neurostimulation of the (sub)thalamic area. The metabolic signature of progressive gait ataxia is an activation of the cerebellar nodule, which may be caused by inadvertent current spread and antidromic stimulation of a cerebellar outflow pathway originating in the vermis. An anatomical candidate could be the ascending limb of the uncinate tract in the subthalamic area. Adjustments in programming and precise placement of the electrode may prevent this adverse effect and help fine-tuning deep brain stimulation to ameliorate tremor without negative cerebellar signs.

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“…Sum of the root 20) . Frequency analysis could be useful in understanding the mechanism of neurotoxicity of occupational and environmental factors, as many clinical studies [31][32][33][34][35][36] have suggested that disorders of the vestibular, spinocerebellar afferent, and cerebellar systems are related to the following changes in specific frequency domains and directions of postural sway.…”

Section: Computerized Static Posturographymentioning

confidence: 99%

Effects of Pesticides on the Peripheral and Central Nervous System in Tobacco Farmers in Malaysia: Studies on Peripheral Nerve Conduction, Brain-Evoked Potentials and Computerized Posturography

et al. 2005

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We examined the effects of pesticides on the central and peripheral nervous system in the setting of a tobacco farm at a developing country. Maximal motor and sensory nerve conduction velocities (MCV and SCV, respectively) in the median, sural and tibial nerves, postural sway, and brain-evoked potentials (auditory event-related and visual-evoked potentials) were measured in 80 male tobacco farmers and age-and sex-matched 40 controls in Kelantan, Malaysia. Median SCV (finger-wrist) in farmers using Delsen (mancozeb, dithiocarbamate fungicide), who showed significant decrease of serum cholinesterase activities, were significantly lower compared with the controls. Sural SCV in farmers using Fastac (α α α α α-cypermethrin, pyrethroid insecticide) and median MCV (elbowwrist) in farmers using Tamex (butralin, dinitroaniline herbicide) were significantly slowed compared with their respective controls. In Delsen (mancozeb, dithiocarbamate) users, the power of postural sway of 0-1 Hz was significantly larger than that in the controls both in the anterior-posterior direction with eyes open and in the right-left direction with eyes closed. The former type of sway was also significantly increased in Tamaron (methamidophos, organophosphorus insecticide) users. In conclusion, nerve conduction velocities and postural sway seem to be sensitive indicators of the effects of pesticides on the central and peripheral nervous system.

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Quantification of postural sway in normals and patients with cerebellar diseases

Cited by 342 publications

References 12 publications

Trajectory length of pitch vs. roll: Technique for assessment of postural stability

Trajectory length of pitch vs. roll: Technique for assessment of postural stability

Progressive gait ataxia following deep brain stimulation for essential tremor: adverse effect or lack of efficacy?

Effects of Pesticides on the Peripheral and Central Nervous System in Tobacco Farmers in Malaysia: Studies on Peripheral Nerve Conduction, Brain-Evoked Potentials and Computerized Posturography

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