Objective: This study aimed to investigate the effect of stochastic resonance (SR) stimulation on balance control during visually perturbed walking in people with Parkinson disease (PwPD).

Background: Loss of balance is a major problem in PwPD. Although Parkinson disease is mostly characterized by motor impairments, stability issues are affected by sensory deficits, especially in proprioception. [1 – 4] The SR technique has shown promising results in overcoming sensory deficits and enhancing sensory processing for fall prevention. SR is a sub-sensory noise that increases the sensitivity of a sensory system to detect signals, increasing the likelihood of weaker stimuli reaching detection threshold. [5,6] However, it is not known whether SR can improve balance in PwPD during walking.

Method: Fourteen subjects with PD, Hoehn & Yahr stages I – III, completed the study. We determined the sensory thresholds to SR for each subject at six stimuli sites in the lower limbs and determined the optimal SR intensity. Then, subjects walked on a self-paced treadmill in a virtual environment with and without visual perturbations. SR was administered in half of these trials, in a randomized order. From these trials, Area Under the Curve (AUC) of CoM excursion, its peak amplitude, and the time to reach the peak amplitude were calculated. These outcome variables were analyzed using repeated-measures ANOVA, considering lateralization effect.

Results: No significant differences were found in the AUC between the trials with SR stimulation and those without stimulation (p = 0.134 and 0.639 for the more and less affected sides, respectively). Similarly, no significant changes were found in the peaks time on both sides. However, the peak amplitude for the AUC was significantly higher with SR compared to no-SR condition at the more affected side (p = 0.027) and insignificant on the less-affected side.

Conclusion: Using SR stimulation to enhance balance control in PwPD showed insignificant effects in reducing medio-lateral sway in response to visual perturbation while walking. In fact, SR caused more sway in the more affected side, invalidating our hypothesis. Based on previous studies, SR improves sensory feedback. [5 – 7] The inconsistent results seen with our participants could be due to increased sensory input given via SR, which PwPD may not need.

References: 1. Corrà M, Vila-Chã N, Sardoeira A, et al. Peripheral neuropathy in Parkinson’s disease: prevalence and 2 functional impact on gait and balance. Brain. 2022:awac026. https://doi.org/10.1093/brain/awac026
2. Kelemen A, Hala´sz L, Erőss L, et al. Factors affecting postural instability after more than one year bilateral subthalamic stimulation in Parkinson’s disease: A cross-sectional study. PLoS ONE. 2022; 17(2):e0264114. https://doi.org/10.1371/ journal.pone.0264114
3. Bernardinis M, Atashzar SF, Patel RV, et al. Abnormal vision-based displacement perception in Parkinson’s disease. Frontiers in Neuroscience. 2021. doi:http://dx.doi.org/10.3389/fnins.2021.676469
4. Halperin O, Israeli-Korn S, Yakubovich S, et al. Self-motion perception in Parkinson’s disease. Eur J Neurosci. 2021;53:2376– 2387. https://doi-org.udel.idm.oclc.org/10.1111/ejn.14716
5. Zandiyeh P, Küpper J, Mohtadi N, et al. Effect of stochastic resonance on proprioception and kinesthesia in anterior cruciate ligament reconstructed patients. Journal of Biomechanics. 2019;84:52-57.
6. White O, Babic J, Trenado C, et al. The Promise of Stochastic Resonance in Falls Prevention. Front. Physiol. 2019;9:1865. doi: 10.3389/fphys.2018.01865.
7. Sansare A, Arcodia M, Lee S.C.K., et al. Immediate application of low-intensity electrical noise reduced responses to visual perturbations during walking in individuals with cerebral palsy. J NeuroEngineering Rehabil. 2024;21(14). https://doi.org/10.1186/s12984-023-01299-1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effect-of-stochastic-resonance-stimulation-in-neural-control-of-balance-during-walking-in-parkinson-disease/