Dynamic balance deficit and the neural network in Alzheimer's disease and mild cognitive impairment

Background: Patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) exhibit balance deficits. Although only a few studies have evaluated the relationship between the brain images and balance indices. In this study, we measured balance indices, including the index of postural stability (IPS) and assessed the relationship between the brain images and their clinical motor and cognitive functional features. Methods: The study included patients with MCI (N = 14) and patients with AD (N = 19). The primary outcome was IPS under a visual block condition and/or a proprioception block condition. In addition, 9 MCI and 8 AD patients underwent a 1.5-Tesla (1.5-T) Magnetic Resonance Imaging (MRI) scan, and the relationships between the MRI parameters and the balance indices were evaluated. Results: The IPS score was significantly lower in the AD group than the MCI group, but only under the closed eyes/hard surface condition. In terms of MRI, there was a significant positive correlation between the IPS and the regional betweenness centrality in the left hippocampal region. Conclusions: The finding of a significantly lower IPS score under the closed eyes/hard surface condition in AD than in MCI cases suggests that the vestibular and/or proprioceptive systems were more severely impaired in AD than MCI cases. The results suggest that a dynamic balance disturbance due to deficits of the vestibular hippocampal pathway may be a useful marker for the diagnosis of MCI and detection of disease progression from MCI to AD.

Automated summary

This study found that AD patients had significantly lower IPS scores than MCI patients under closed eyes/hard surface condition, indicating more severe impairment of the vestibular and/or proprioceptive systems in AD. The results suggest that dynamic balance disturbance caused by deficits in the vestibular hippocampal pathway may serve as a useful marker for the diagnosis of MCI and detection of disease progression from MCI to AD.