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Postural instability differences between idiopathic normal pressure hydrocephalus and Parkinson's disease
Yasutaka Nikaido1, Toshihiro Akisue2, Yoshinaga Kajimoto3
1Clinical Department of Rehabilitation, Osaka Medical College Hospital, Osaka, Japan; Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Clinical Neurology and Neurosurgery
|January 15, 2018
Summary
Idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD) show distinct postural control deficits. iNPH patients exhibit wider impairments, especially during lateral leaning, indicating a higher fall risk.
Area of Science:
- Neurology
- Biomechanics
- Geriatrics
Background:
- Postural instability is a common disabling symptom in both idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD).
- Understanding the specific characteristics of postural control deficits can help differentiate these conditions and inform treatment strategies.
Purpose of the Study:
- To investigate and compare the postural control disability between iNPH patients and PD patients.
- To identify potential pathophysiological differences reflected in postural instability.
Main Methods:
- A cohort of 27 iNPH patients, 20 PD patients, and 20 healthy controls (HCs) were assessed.
- Evaluations included the Timed Up and Go (TUG) test and force platform analysis of center of pressure (COP) trajectory during quiet standing and multidirectional leaning tasks.
Main Results:
- Postural control was impaired in PD patients during forward and backward leaning.
- iNPH patients demonstrated impaired postural control in all directions, with significantly worse performance during right and left leaning compared to PD patients.
- No significant differences were found between iNPH and PD patients in TUG performance or postural sway during quiet standing.
Conclusions:
- The distinct patterns of impaired voluntary COP control suggest underlying pathophysiological differences in postural instability between iNPH and PD.
- The pronounced postural instability during lateral leaning in iNPH patients may contribute to wider steps and an increased risk of falls.