Postural instability differences between idiopathic normal pressure hydrocephalus and Parkinson’s disease

• Published in: Clinical neurology and neurosurgery 2018-02, Vol.165, p.103-107
• Main Authors: Nikaido, Yasutaka, Akisue, Toshihiro, Kajimoto, Yoshinaga, Tucker, Adam, Kawami, Yuki, Urakami, Hideyuki, Iwai, Yuka, Sato, Hisatomo, Nishiguchi, Tadayuki, Hinoshita, Tetsuya, Kuroda, Kenji, Ohno, Hiroshi, Saura, Ryuichi
• Format: Article
• Language: English
• Subjects: Balance disturbance; Center of pressure; Disease; Force platform; Hydrocephalus; Idiopathic normal pressure hydrocephalus; Movement disorders; Neurology; Parkinson's disease; Postural instability; Posture; Walking
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2018.01.012

•Postural sway control may be decreased in both PD and iNPH.•Postural stability during quiescent standing is similar in PD and iNPH.•Balance disturbances in PD and iNPH have unique characteristics and differences. We investigated the differences in postural control disability between idiopathic normal pressure hydrocephalus (iNPH) and Parkinson’s disease (PD). Twenty-seven iNPH patients, 20 PD patients, and 20 healthy controls (HCs) were examined using the Timed Up and Go test (TUG) and a force platform for recording the center of pressure (COP) trajectory during quiescent standing and voluntary multidirectional leaning (forward, backward, right, and left for 10 s each). In the leaning task, postural control in PD patients was impaired during forward and backward leaning, whereas postural control in iNPH patients was impaired in all directions. In particular, postural control during right and left leaning was significantly worse in iNPH patients than in PD patients. No significant difference was observed between iNPH and PD patients in TUG and postural sway during quiescent standing. Our results showed that the characteristics of impaired voluntary COP control in iNPH and PD patients might reflect pathophysiological differences in postural instability for each disease. In particular, postural instability during right and left leaning in iNPH patients may be responsible for wider steps and a higher risk of falling.