The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis.
Identifieur interne : 000C62 ( Main/Corpus ); précédent : 000C61; suivant : 000C63The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis.
Auteurs : Luca Prosperini ; Anna Kouleridou ; Nikolaos Petsas ; Laura Leonardi ; Francesca Tona ; Patrizia Pantano ; Carlo PozzilliSource :
- Journal of the neurological sciences [ 1878-5883 ] ; 2011.
English descriptors
- KwdEn :
- Accidental Falls (prevention & control), Adult (MeSH), Brain Stem (pathology), Cerebellum (pathology), Cross-Sectional Studies (MeSH), Female (MeSH), Humans (MeSH), Magnetic Resonance Imaging (methods), Male (MeSH), Middle Aged (MeSH), Multiple Sclerosis (complications), Multiple Sclerosis (pathology), Postural Balance (physiology), Sensation Disorders (etiology), Sensation Disorders (pathology).
- MESH :
- complications : Multiple Sclerosis.
- etiology : Sensation Disorders.
- methods : Magnetic Resonance Imaging.
- pathology : Brain Stem, Cerebellum, Multiple Sclerosis, Sensation Disorders.
- physiology : Postural Balance.
- prevention & control : Accidental Falls.
- Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged.
Abstract
OBJECTIVE
The role of static posturography and magnetic resonance imaging (MRI) in identifying patients at high risk of falls was investigated. Relationships between static posturography measures and MRI metrics were also investigated.
METHODS
A total of 31 ambulatory MS patients (EDSS ranging from 2.0 to 5.0) with a predominant balance disorder were recruited. Each patient underwent a static posturography with a monoaxial platform and a conventional 1.5 T brain MRI scan. Measurements of T1-hypointense and T2-hyperintense lesion volumes (LVs), focusing on lesions selectively located at infratentorial levels, were performed by two operators unaware of clinical data. The self-reported number of falls in the previous 6 months was considered as the main outcome measure.
RESULTS
Fourteen (45%) patients reported 1 or more falls over the past 6 months. When compared to non-faller patients, they had a higher EDSS score, poorer static standing balance, and greater brainstem and middle cerebellar peduncle (MCP) T2-LVs. A strength correlation between brainstem T2-LV and impaired static standing balance in an open eye condition was also found. In the multivariate analysis, the variables more strictly associated with recurrent falls were greater T2-LV at the MCP (beta: 6.2; p=0.01) and brainstem (beta: 5.8; p=0.001) levels, and a wider displacement of the body center of pressure in the closed eye condition (beta: 0.02; p=0.03).
CONCLUSION
Our data suggests that the damage of specific infratentorial areas negatively affect the static standing balance and may predispose MS patients to accidental falls. These findings might contribute in selecting patients requiring a proper rehabilitation intervention program.
DOI: 10.1016/j.jns.2011.02.014
PubMed: 21402386
Links to Exploration step
pubmed:21402386Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis.</title>
<author><name sortKey="Prosperini, Luca" sort="Prosperini, Luca" uniqKey="Prosperini L" first="Luca" last="Prosperini">Luca Prosperini</name>
<affiliation><nlm:affiliation>Dept. of Neurology and Psychiatry, Sapienza University, Rome, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kouleridou, Anna" sort="Kouleridou, Anna" uniqKey="Kouleridou A" first="Anna" last="Kouleridou">Anna Kouleridou</name>
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<author><name sortKey="Petsas, Nikolaos" sort="Petsas, Nikolaos" uniqKey="Petsas N" first="Nikolaos" last="Petsas">Nikolaos Petsas</name>
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<author><name sortKey="Leonardi, Laura" sort="Leonardi, Laura" uniqKey="Leonardi L" first="Laura" last="Leonardi">Laura Leonardi</name>
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<author><name sortKey="Tona, Francesca" sort="Tona, Francesca" uniqKey="Tona F" first="Francesca" last="Tona">Francesca Tona</name>
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<author><name sortKey="Pantano, Patrizia" sort="Pantano, Patrizia" uniqKey="Pantano P" first="Patrizia" last="Pantano">Patrizia Pantano</name>
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<author><name sortKey="Pozzilli, Carlo" sort="Pozzilli, Carlo" uniqKey="Pozzilli C" first="Carlo" last="Pozzilli">Carlo Pozzilli</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis.</title>
<author><name sortKey="Prosperini, Luca" sort="Prosperini, Luca" uniqKey="Prosperini L" first="Luca" last="Prosperini">Luca Prosperini</name>
<affiliation><nlm:affiliation>Dept. of Neurology and Psychiatry, Sapienza University, Rome, Italy.</nlm:affiliation>
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<author><name sortKey="Kouleridou, Anna" sort="Kouleridou, Anna" uniqKey="Kouleridou A" first="Anna" last="Kouleridou">Anna Kouleridou</name>
</author>
<author><name sortKey="Petsas, Nikolaos" sort="Petsas, Nikolaos" uniqKey="Petsas N" first="Nikolaos" last="Petsas">Nikolaos Petsas</name>
</author>
<author><name sortKey="Leonardi, Laura" sort="Leonardi, Laura" uniqKey="Leonardi L" first="Laura" last="Leonardi">Laura Leonardi</name>
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<author><name sortKey="Tona, Francesca" sort="Tona, Francesca" uniqKey="Tona F" first="Francesca" last="Tona">Francesca Tona</name>
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<author><name sortKey="Pantano, Patrizia" sort="Pantano, Patrizia" uniqKey="Pantano P" first="Patrizia" last="Pantano">Patrizia Pantano</name>
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<author><name sortKey="Pozzilli, Carlo" sort="Pozzilli, Carlo" uniqKey="Pozzilli C" first="Carlo" last="Pozzilli">Carlo Pozzilli</name>
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<series><title level="j">Journal of the neurological sciences</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (prevention & control)</term>
<term>Adult (MeSH)</term>
<term>Brain Stem (pathology)</term>
<term>Cerebellum (pathology)</term>
<term>Cross-Sectional Studies (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Magnetic Resonance Imaging (methods)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Multiple Sclerosis (complications)</term>
<term>Multiple Sclerosis (pathology)</term>
<term>Postural Balance (physiology)</term>
<term>Sensation Disorders (etiology)</term>
<term>Sensation Disorders (pathology)</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Multiple Sclerosis</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Sensation Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Magnetic Resonance Imaging</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain Stem</term>
<term>Cerebellum</term>
<term>Multiple Sclerosis</term>
<term>Sensation Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Postural Balance</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Accidental Falls</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Cross-Sectional Studies</term>
<term>Female</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>The role of static posturography and magnetic resonance imaging (MRI) in identifying patients at high risk of falls was investigated. Relationships between static posturography measures and MRI metrics were also investigated.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>A total of 31 ambulatory MS patients (EDSS ranging from 2.0 to 5.0) with a predominant balance disorder were recruited. Each patient underwent a static posturography with a monoaxial platform and a conventional 1.5 T brain MRI scan. Measurements of T1-hypointense and T2-hyperintense lesion volumes (LVs), focusing on lesions selectively located at infratentorial levels, were performed by two operators unaware of clinical data. The self-reported number of falls in the previous 6 months was considered as the main outcome measure.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Fourteen (45%) patients reported 1 or more falls over the past 6 months. When compared to non-faller patients, they had a higher EDSS score, poorer static standing balance, and greater brainstem and middle cerebellar peduncle (MCP) T2-LVs. A strength correlation between brainstem T2-LV and impaired static standing balance in an open eye condition was also found. In the multivariate analysis, the variables more strictly associated with recurrent falls were greater T2-LV at the MCP (beta: 6.2; p=0.01) and brainstem (beta: 5.8; p=0.001) levels, and a wider displacement of the body center of pressure in the closed eye condition (beta: 0.02; p=0.03).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>Our data suggests that the damage of specific infratentorial areas negatively affect the static standing balance and may predispose MS patients to accidental falls. These findings might contribute in selecting patients requiring a proper rehabilitation intervention program.</p>
</div>
</front>
</TEI>
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<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">The role of static posturography and magnetic resonance imaging (MRI) in identifying patients at high risk of falls was investigated. Relationships between static posturography measures and MRI metrics were also investigated.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">A total of 31 ambulatory MS patients (EDSS ranging from 2.0 to 5.0) with a predominant balance disorder were recruited. Each patient underwent a static posturography with a monoaxial platform and a conventional 1.5 T brain MRI scan. Measurements of T1-hypointense and T2-hyperintense lesion volumes (LVs), focusing on lesions selectively located at infratentorial levels, were performed by two operators unaware of clinical data. The self-reported number of falls in the previous 6 months was considered as the main outcome measure.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Fourteen (45%) patients reported 1 or more falls over the past 6 months. When compared to non-faller patients, they had a higher EDSS score, poorer static standing balance, and greater brainstem and middle cerebellar peduncle (MCP) T2-LVs. A strength correlation between brainstem T2-LV and impaired static standing balance in an open eye condition was also found. In the multivariate analysis, the variables more strictly associated with recurrent falls were greater T2-LV at the MCP (beta: 6.2; p=0.01) and brainstem (beta: 5.8; p=0.001) levels, and a wider displacement of the body center of pressure in the closed eye condition (beta: 0.02; p=0.03).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Our data suggests that the damage of specific infratentorial areas negatively affect the static standing balance and may predispose MS patients to accidental falls. These findings might contribute in selecting patients requiring a proper rehabilitation intervention program.</AbstractText>
<CopyrightInformation>Copyright © 2011 Elsevier B.V. All rights reserved.</CopyrightInformation>
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