Visual deprivation elicits subclinical postural inflexibilities in early Parkinson's disease

Abstract

Background: Postural instability is often experienced in the late stages of PD and is a marker of disease progression. Little information is available on the role of visual inputs as an adaptive strategy to compensate for postural instability in PD. The purpose of this study was to determine visual dependency for postural control in early PD.

Methods: Thirty early PD subjects without postural complaints and 30 matched controls were evaluated for subtle postural instability using static posturography under eyes opened and eyes closed conditions.

Results: No significant differences between groups were observed under eyes opened condition. In eyes closed condition, there was significantly greater mean sway in the mediolateral direction (p=0.01), mean sway velocity (p=0.03), lateral sway velocity (p=0.04), and sway area (p=0.04) in PD than in the control subjects. 95% confidence ellipse of mean sway was largest in PD patients with eyes closed. A strong and significant correlation was observed between disease duration and mean mediolateral sway, sway area, mean sway and lateral sway velocity, and a moderate correlation was shown between Hoehn & Yahr stage and mean mediolateral sway, and sway area.

Conclusion: Our findings suggest that visual dependency exists in early PD and visual deprivation task can help identify subclinical postural instability.

Keywords: Mediolateral sway; Parkinson's disease; Postural inflexibility; Postural instability; Visual dependency; Visual deprivation.