Postural instability and falls in Parkinson's disease

Jacob J. Crouse, Joseph R. Phillips, Marjan Jahanshahi, Ahmed A. Moustafa*

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

28 Citations (Scopus)
10 Downloads (Pure)

Abstract

Postural instability (PI) is one of the most debilitating motor symptoms of Parkinson's disease (PD), as it is associated with an increased risk of falls and subsequent medical complications (e.g. fractures), fear of falling, decreased mobility, self-restricted physical activity, social isolation, and decreased quality of life. The pathophysiological mechanisms underlying PI in PD remain elusive. This short review provides a critical summary of the literature on PI in PD, covering the clinical features, the neural and cognitive substrates, and the effects of dopaminergic medications and deep brain stimulation. The delayed effect of dopaminergic medication combined with the success of extrastriatal deep brain stimulation suggests that PI involves neurotransmitter systems other than dopamine and brain regions extending beyond the basal ganglia, further challenging the traditional view of PD as a predominantly single-system neurodegenerative disease.

Original languageEnglish
Pages (from-to)549-555
Number of pages7
JournalReviews in the Neurosciences
Volume27
Issue number5
DOIs
Publication statusPublished - 1 Jul 2016
Externally publishedYes

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