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Stance disturbance in multiple sclerosis: brainstem lesions and posturographic assessment

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Author(s): Dario Alpini | Federica Di Berardino | Valentina Mattei | Domenico Caputo | Peter Schalek | Antonio Cesarani

Journal: Audiology Research
ISSN 2039-4330

Volume: 2;
Issue: 1;
Date: 2012;
Original page

Keywords: Multiple Sclerosis | MRI | Posturography | Vestibulo-spinal reflex.

ABSTRACT
Background. Balance disorders are commonly evidenced during the course of multiple sclerosis (MS). The aim of this study is to report characteristics of MS patient stance control disorders, measured by means of posturography and related to the brainstem lesions. Methods. Thirty-eight patients affected by MS, mildly to moderately disable according to Kurtzke’s Expanded Disability Status Scale, underwent a complete clinical neurological and vestibular evaluation and brain MRI scanning. All patients were then tested on a static posturography platform (Tetrax, Israel) in four conditions: eyes open and closed standing on a firm surface and on a foam pad. Results. Clinical and/or MRI evidence of brainstem involvement was observed in 55.3 % of patients. When brainstem lesion was detected, Fourier analysis showed a typical pattern characterized by inversion of the  0- 0.1 Hz and  0.1 - 0.25 Hz. frequency bands. Conclusions. MS leads to pervasive postural disturbances in the majority of subjects, including the visuo-vestibular loops and proprioception involving vestibulo-spinal pathways in at least 55.3 % of patients. Our results may also suggest the presence of Fourier inversion in patients with brainstem lesions.
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