System-wise balance evaluation and its association with structural brain changes in Parkinson's disease

Area of Science:

• Neuroscience
• Neurology
• Medical Imaging

Background:

• Balance dysfunction in Parkinson's disease (PD) is complex and not fully captured by traditional tests.
• The Mini Balance Evaluation Systems Test (MiniBESTest) offers a multidimensional and quantitative assessment of balance.
• Existing clinical assessments lack the granularity to fully evaluate balance impairment in PD.

Purpose of the Study:

• To investigate the neural correlates of balance dysfunction in PD.
• To associate MiniBESTest scores with structural brain changes using voxel-based morphometry (VBM).
• To identify specific brain regions related to different aspects of balance control in PD patients.

Main Methods:

• Fifty PD patients underwent MiniBESTest, clinical assessment, and MRI.
• Voxel-based morphometry (VBM) regression analysis was employed.
• Cortical gray matter volumes were analyzed for associations with MiniBESTest scores.

Main Results:

• Significant correlations found between total MiniBESTest scores and gray matter atrophy in the superior temporal gyrus (STG) and insular cortex.
• Subscore II (reactive postural control) linked to left STG atrophy.
• Subscore IV (dynamic gait) associated with atrophy in the precentral cortex and temporoparietal junction.

Conclusions:

• Structural brain changes correlate with multidimensionally assessed balance dysfunction in PD.
• Atrophy in the superior temporal gyrus (STG) is strongly associated with balance deficits in PD.
• The STG plays a crucial role in dynamic postural control and related symptoms in Parkinson's disease.