Nervous System Damage Indicative of Poor Posture Control in Multiple Sclerosis

Patients with MS show damage to the pyramidal system had diminished posture control.

A recent study has found that posture difficulties may be associated with certain areas of the nervous system most damaged by multiple sclerosis.

Posture control requires multiple areas of the nervous system to work together, but damage from multiple sclerosis may cause difficulties that can lead to posture problems, and falling.

In a study published by Plos One, investigators examined neurological functional systems and how they affect posture and incidence of falls in these patients.

Posture is controlled by multiple systems: the pyramidal system is composed of nerve fibers that start in the brain and stops in the brainstem; the cerebellar system is responsible for coordination; the sensory system allows the brain to interpret signals.

Included in the study were 342 patients who were placed into groups based on the scores for each neurological functional system based on the Expanded Disability Status Scale. Approximately 83.6% of patients had pyramidal system damage, 50.3% had cerebellar impairment, and 52.6% had sensory system impairment, according to the study.

Few patients had damage to only 1 of the systems, but 63.2% had damage to 2 or 3 systems. Patients with damage only to the pyramidal system had less postural stability compared with patients who had other damage.

Patients with damage to only a single neurological system had more stable posture compared with those who had impairment of multiple systems. However, sensory system impairments were not seen to impact posture control in patients with damage to the pyramidal system.

Investigators then determined how these impairments impacted falling. There were 166 patients considered fallers, and these patients had higher disability scores compared to non-fallers.

Approximately 44.3% of fallers had damage to the pyramidal system, 33.3% had damage to the cerebellar, and 19.5% had damage to the sensory system, according to the study.

Patients who had changes to all of the systems composed 65% of fallers. These findings indicate that the different impairments impact postural control, and may lend a hand in creating targeted treatments for patients with different types of impairments.

“Future research studies should investigate whether balance (and fall reduction) interventions, tailored according to the level of involvement of the pyramidal, cerebellar and sensory systems, are more beneficial than traditional rehabilitation,” the study concluded.