Balance in multiple sclerosis: relationship to central brain regions

• Published in: Experimental brain research Vol. 236; no. 10; pp. 2739 - 2750
• Main Authors: Doty, Richard L., MacGillivray, Michael R., Talab, Hussam, Tourbier, Isabelle, Reish, Megan, Davis, Sherrie, Cuzzocreo, Jennifer L., Shepard, Neil T., Pham, Dzung L.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2018; Springer; Springer Nature B.V
• Subjects: Adult; Analysis; Analysis of Variance; Ataxia; Balance; Biomedical and Life Sciences; Biomedicine; Brain; Brain - diagnostic imaging; Brain - physiopathology; Case-Control Studies; Control; Cortex (frontal); Diagnosis; Equilibrium (Physiology); Female; Frontal lobe; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Medical tests; Middle Aged; Motor Activity - physiology; Motor task performance; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - pathology; Muscles; Neurology; Neurosciences; Postural Balance - physiology; Posture; Proprioception; Reaction Time - physiology; Research Article; Sensation Disorders - diagnostic imaging; Sensation Disorders - etiology; Sensory integration; Sex Factors; Skin; Somatosensory cortex; Temporal cortex; Vestibular system; Visual cortex; Multiple sclerosis; Vestibular system; Proprioception; Balance; Vision
• ISSN: 0014-4819; 1432-1106
• DOI: 10.1007/s00221-018-5332-1

Dizziness, postural instability, and ataxia are among the most debilitating symptoms of multiple sclerosis (MS), reflecting, in large part, dysfunctional integration of visual, somatosensory, and vestibular sensory cues. However, the role of MS-related supratentorial lesions in producing such symptoms is poorly understood. In this study, motor control test (MCT) and dynamic sensory organization test (SOT) scores of 58 MS patients were compared to those of 72 healthy controls; correlations were determined between the MS scores of 49 patients and lesion volumes within 26 brain regions. Depending upon platform excursion direction and magnitude, MCT latencies, which were longer in MS patients than controls (
p
 < 0.0001), were correlated with lesion volumes in the cortex, medial frontal lobes, temporal lobes, and parietal opercula (
r
’s ranging from 0.20 to 0.39). SOT test scores were also impacted by MS and correlated with lesions in these same brain regions as well as within the superior frontal lobe (
r
’s ranging from − 0.28 to − 0.40). The strongest and most consistent correlations occurred for the most challenging tasks in which incongruent visual and proprioceptive feedback were given. This study demonstrates that supratentorial lesion volumes are associated with quantitative balance measures in MS, in accord with the concept that balance relies upon highly convergent and multimodal neural pathways involving the skin, muscles, joints, eyes, and vestibular system.