Background

Multiple sclerosis (MS) is an autoimmune-based chronic inflammatory disease characterized by the neurodegeneration of the central nervous system and produces postural dysfunction. Quiet or static standing is a complex task carried out through afferent sensory inputs and efferent postural corrective outputs. Currently the mechanisms underlying these outputs remain largely unknown.

Research question

Assess the relationship between multi-dimensional measures of postural control and microstructural integrity of the cortical sensorimotor pathway (CSP) in persons with MS (PwMS) and neurotypical adults.

Methods

Postural control performance was assessed by both overall and directional time-to-boundary measures across four manipulated sensory stance conditions (eyes open/closed; stance firm/foam) in twenty-nine neurotypical and twenty-seven PwMS. These postural outcomes were evaluated with mixed-model repeated measures analysis of variance across group (MS and control) and stance condition. Postural performance was also correlated with magnetic resonance imaging diffusion tensor-derived measures of microstructural integrity of the CSP.

Results

PwMS displayed significantly (p = 0.026) worse anterior-posterior postural control compared to their neurotypical counterparts across sensory testing conditions and poorer CSP microstructural integrity in comparison to neurotypical adults (p = 0.008). Additionally, PwMS displayed a significant association (2D (rho = -0.384, p = 0.048), AP (rho = -0.355, p = 0.035), and ML (rho = -0.365, p = 0.030) between integrity of the CSP and postural control performance during proprioceptive-based balance, such that those with worse cortical structure had poorer balance control.

Significance

This is the first study to establish connections between the microstructural integrity of the CSP and multi-dimensional postural control performance. Results indicate that a reduction in the CSP microstructural integrity is associated with poorer postural control in PwMS. These outcomes identify neural underpinnings of postural control dysfunction in PwMS and provide new avenues for evaluating the efficacy of postural rehabilitation strategies in PwMS that express proprioceptive-based postural deficits.

中文翻译：

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多发性硬化症患者静态姿势控制功能障碍及其相关神经机制的高级表征

背景

多发性硬化症（MS）是一种基于自身免疫的慢性炎症性疾病，其特征在于中枢神经系统的神经变性并产生姿势功能障碍。安静或静止站立是通过传入的感觉输入和传入的姿势矫正输出执行的复杂任务。目前，这些产出所依据的机制在很大程度上仍然未知。

研究问题

评估姿势控制的多维量度与MS（PwMS）和典型成人的皮质感觉运动通路（CSP）的微结构完整性之间的关系。

方法

通过在29种神经典型和27种PwMS中对四种操纵的感觉姿势条件（睁眼/闭眼；姿势坚定/泡沫）进行总体和定向到边界的时间评估姿势控制性能。这些姿势结果通过混合模型重复测量分析评估了各组之间的差异（MS和对照）和姿势状况。姿势表现还与CSP的显微结构完整性的磁共振成像扩散张量得出的测量值相关。

结果

 在感觉测试条件下，与神经典型患者相比，PwMS表现出明显的前-后姿势控制（p = 0.026），与神经典型成年人相比，pwMS的CSP微结构完整性较差（p  = 0.008）。此外，PwMS 在CSP完整性和（CSP）完整性之间显示出显着关联（2D（rho = -0.384，p  = 0.048），AP（rho = -0.355，p  = 0.035）和ML（rho = -0.365，p = 0.030）。在基于本体感受的平衡过程中的姿势控制性能，使得那些皮质结构较差的人的平衡控制能力较差。

意义

这是第一个建立CSP的微结构完整性与多维姿势控制性能之间关系的研究。结果表明，Cw微结构完整性的降低与PwMS中较差的姿势控制有关。这些结果确定了PwMS中姿势控制功能障碍的神经基础，并为评估基于本体感受性姿势缺陷的PwMS中姿势康复策略的有效性提供了新途径。