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Author Notes:

Correspondence: Lena H. Ting PhD, Wallace H. Coulter Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, 1760 Haygood Drive, Suite W200, Atlanta, Georgia, 30322, USA, lting@emory.edu

Author Contributions: Sistania Bong: Data curation, Formal analysis, Investigation, Software, Validation, Visualization, Writing – original draft, Writing – review & editing. J. Lucas McKay: Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Software, Validation, Visualization, Writing – original draft, Writing – review & editing.

Stewart Factor: Data curation, Funding acquisition, Writing – review & editing. Lena Ting: Conceptualization, Data curation, Formal analysis, Funding acquisition,Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.

Disclosures: Ms. Bong has nothing to disclose. Dr. McKay has received research funding or support from the National Institutes of Health.

Dr. Factor has received research funding or support from the National Institutes of Health, the Michael J. Fox Foundation, Ipsen, Medtronic, Boston Scientific, Teva, US World Meds, Sunovion Therapeutics, Vaccinex, Voyager, Jazz Pharmaceuticals, CHDI Foundation. . Dr. Factor has received honoraria from Lundbeck, Teva, Sunovion, Biogen, Acadia, Neuroderm. Dr. Factor has received royalties from Blackwell Futura, Demos, Springer and Uptodate.

Dr. Ting has received research funding or support from the National Institutes of Health and the National Science Foundation.


Research Funding:

This study was supported in part by National Institutes of Health grants 2R01HD046922

R01 HD090642, K25HD086276, R01 NR016151, and the Sartain Lanier Family Foundation.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Neurosciences
  • Orthopedics
  • Sport Sciences
  • Neurosciences & Neurology
  • Parkinson's disease
  • Perception
  • Posture
  • Balance
  • Automatic postural response
  • Motor
  • Kinesthesia
  • Falls
  • Acceleration
  • Individuals
  • Thresholds
  • Vibration
  • Deficits
  • Acuity

Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment


Journal Title:

Gait & Posture


Volume 76


, Pages 44-50

Type of Work:

Article | Post-print: After Peer Review


Background: In addition to motor deficits, Parkinson's disease (PD) may cause perceptual impairments. The role of perceptual impairments in sensorimotor function is unclear, and has typically been studied in single-joint motions. Research question: We hypothesized that perception of whole-body motion is impaired in PD and contributes to balance impairments. We tested (1) whether directional acuity to whole body perturbations during standing was worse in people with PD compared to neurotypical older adults (NOA), and (2) whether balance ability, as assessed by the MiniBESTest, was associated with poor directional acuity in either group. Methods: Participants were exposed to pairs of support-surface translation perturbations in a two-alternative forced choice testing paradigm developed previously in a young healthy population. The first perturbation of each pair that was to be judged by participants was directly backward, and the second perturbation deviated from the left or right from the backward direction by 1°–44°. Participants reported whether the perturbations in each pair were in the “same” or “different” direction. Judgements from 24 to 67 perturbation pairs were used to calculate directional acuity thresholds corresponding to “just-noticeable differences” in perturbation direction. Linear mixed models determined associations between directional thresholds and clinical variables including MDS-UPDRS-III score, age, and MiniBESTest score. Results: 20 PD (64 ± 7 y, 12 male, ≥12 h since last intake of antiparkinsonian medications) and 12 NOA (64 ± 8, 6 male) were assessed. Directional thresholds were higher (worse) among PD participants (17.6 ± 5.9° vs. 12.8 ± 3.3°, P < 0.01). Linear mixed models further showed that higher thresholds were associated with MDS-UPDRS-III score (P < 0.01), and were associated with poorer balance ability among PD participants (P < 0.01), but not among NOA participants (P = 0.40). Significance: Perception of whole-body motion is impaired in PD and may contribute to impaired balance and falls.

Copyright information:

© 2019 published by Elsevier. This manuscript is made available under the Elsevier user license

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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