Associations between white matter microstructure of cerebellar connections and balance performance in people with multiple sclerosis
Date
2020
Authors
Odom, Arianna D., author
Fling, Brett W., advisor
MaƱago, Mark, committee member
Schmid, Arlene, committee member
Journal Title
Journal ISSN
Volume Title
Abstract
Sensory reweighting, the ability to change the relative contribution of visual, vestibular and proprioceptive systems to balance in response to a changing environment, is critical to balance maintenance. The cerebellum contributes to sensory re-weighting through its white matter connections to the brainstem, the cerebellar peduncles. People with multiple sclerosis (PwMS) have impairments in both sensory reweighting and white matter microstructure of the cerebellar peduncles. The purpose of this study was to examine associations between the white matter microstructure of the cerebellar peduncles and balance performance during sensory-manipulated conditions to elucidate the extent of cerebellar-regulated balance in PwMS. We assessed cerebellar peduncle white matter microstructure with radial diffusivity and fractional anisotropy and standing balance performance with center of pressure-derived measures of path length, sway velocity and root mean square of sway during each sensory-manipulated condition of the Clinical Test of Sensory Integration on Balance in 24 PwMS and 21 neurotypical participants (HC). PwMS exhibited worse balance performance across all sensory-manipulated conditions and worse cerebellar peduncle white matter microstructure compared to HC. Notably, PwMS displayed differentially worse vestibular-based balance performance than HC which was associated with worse cerebellar peduncle white matter microstructure. In addition, PwMS demonstrated unique associations between cerebellar peduncle white matter microstructure and visual-based and proprioceptive-based balance performance that were not found in HC. Our findings suggest that PwMS may place a greater reliance on cerebellar-regulated proprioceptive- and visual-based balance control and demonstrate worse vestibular-based balance than HC, augmenting previous work indicating abnormal vestibular-based balance and a contribution of the ICP to proprioceptive-based balance performance in PwMS.