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Parkinson’s disease (PD) is a progressive neurodegenerative disorder of unclear etiology and pathogenesis. Research results gathered to date support the hypothesis that the motor symptoms of the disease result from the gradual loss of midbrain dopamine neurons residing in the substantia nigra pars compacta (SNpc). Recent discoveries, however, significantly expand this knowledge indicating that the primary source of the PD pathogenesis may be located both in the SNpc as well as in the GABAergic striatum. Newly discovered striatal neurogenesis – normally a lifelong process – determines the efficiency of nigrostriatal interaction. Deficient neurogenesis within the striatum followed by a decline in the GABAergic/dopaminergic interaction results in progressive disconnection of the dopaminergic input, which initiates a ‘vicious circle’ cascade of neuronal damage. Effects of both deficient striatal neurogenesis and age‑related neurodegeneration within the striatum accumulate, resulting in a progressive decline in the control functions of the basal ganglia, loss of dopaminergic neurons, and occurrence of PD clinical symptoms. Functional and pharmacological control of these dynamic relationships may result in treatments that are more effective with fewer side‑effects
In the search of a reliable postural stability index, two sway time series: the center-of-mass (COM) and the center-of-foot pressure (COP) were recorded simultaneously in elderly subjects standing quiet with eyes open and with eyes closed. From a battery of commonly use sway measures, only the anteroposterior COM and the COP path lengths proved their high sensitivity and discriminative power to the imposed vision conditions. Based upon these indices, a new measure – sway ratio (SR) – was computed, as the COP-to-COM path length ratio. The measure can easily distinguish vision vs. no vision in the elderly. The SR can be successfully accessed base upon the COP signal only. In contrast to traditional sway indices, the SR as a relative measure is insensitive to the length of sampled record and to the signal sampling frequency. Its magnitude can be interpreted as an average amount of balance controlling motor activity that coincides with a unit COM displacement. The SR is recommended as a reliable measure that allows for assessment of postural stability.
Directional characteristics of postural sway and their impact on postural stability control (PSC) still need to be clarified. To assess the directional characteristics of PSC, center-of-pressure (COP) while standing quiet was recorded and analyzed in 46 young healthy subjects. The participants completed five 60-s trials with 'eyes open' and five with 'eyes closed'. The control asymmetry was characterized using three standardized COP measures: mean sway velocity (V), sway ratio (SR), and sway directional index (DI). The COP data were low-pass filtered at 10 Hz. In such conditions the V, SR and DI revealed consistent and unique differences in both the anteroposterior (AP) and the mediolateral (ML) controls. Each of the COP measures showed the involvement of different neuromuscular and biomechanical mechanisms in the stabilization of standing posture. The DI documented a very stable proportion between frontal and saggital controls, with roughly 60% of the swaying movements being performed in the AP direction. The AP DI was significantly higher in comparison with the ML value (0.71±0.04 vs. 0.55±0.06). This proportion remained at the same level in both experimental groups and it was only slightly affected by the visual conditions. Analysis of the SR confirmed that to maintain stable stance the neuromuscular system must allocate 50% more effort to control AP stability. The results also documented gender-related differences in postural stability. Generally the female subjects appeared to have lower postural stability as evidenced by higher COM and COP velocities. Consequently the higher SR values observed in the female group indicate a need for higher neuromuscular efforts to maintain stable posture. The introduced here set of COP measures proved to be a valuable standard for static posturography, creating the opportunity for improved and reliable assessment of postural stability.
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