White Matter Microstructure of the Cerebellar Peduncles Is Associated with Balance Performance during Sensory Re-Weighti
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ORIGINAL ARTICLE
White Matter Microstructure of the Cerebellar Peduncles Is Associated with Balance Performance during Sensory Re-Weighting in People with Multiple Sclerosis Arianna D. Odom 1
&
Sutton B. Richmond 1 & Brett W. Fling 1,2
Accepted: 7 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract People with multiple sclerosis (PwMS) exhibit impaired balance during different sensory environments and poor cerebellar peduncle microstructure. We aimed to examine associations between microstructures of the superior, middle and inferior cerebellar peduncles (CP) with visual, vestibular, and proprioceptive-based balance in PwMS. Twenty-seven PwMS and twenty-nine healthy controls (HC) underwent MRI and balance assessments. We assessed CP microstructure with radial diffusivity (RD) and fractional anisotropy (FA) and balance with center of pressure-derived measures of path length and root mean square of sway during proprioceptive (C2), visual (C3), and vestibular (C4) balance conditions of the modified clinical test of sensory integration on balance (mCTSIB). PwMS exhibited significantly lower FA (p < 0.001) and greater RD (p < 0.001) across all CP and greater path length (p < 0.05) in the mCTSIB compared with HC. In PwMS, significant associations were detected between inferior CP white matter microstructure and proprioceptive-based balance control (rho = −0.43, p < 0.05) and middle CP white matter microstructure and visual-based balance control (rho = 0.39, p < 0.05). PwMS may rely more on cerebellarregulated proprioceptive- and visual-based balance control than HC. Keywords Balance . Cerebellum . Multiple sclerosis . MRI . Sensory . Proprioception
Introduction Multiple sclerosis (MS) is a chronic, autoimmune disease affecting the central nervous system (CNS) characterized by both demyelination and axonal damage [1]. Nearly twothirds of PwMS report lack of postural control as a primary contributor to decreased mobility in daily living [2], an impairment detectable early in disease progression, even when clinically assessed disability is negligible [3] and ranked of highest priority among factors affecting quality of life [4]. It is thought that MS-induced damage to white matter Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12311-020-01190-y) contains supplementary material, which is available to authorized users. * Brett W. Fling [email protected] 1
Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80526, USA
2
Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO 80526, USA
connections of posture-related brain regions underlie postural control impairments in PwMS, although the specific neural connections responsible for these impairments remain unclear. PwMS exhibit substantial impairments in postural control that manifest as both increased quantity and variability of postural sway during standing balance [5]. Postural control is
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