Neuroimaging and cognitive correlates of postural control in Parkinson's disease: a systematic review.
Patrick Tait, Lisa Graham, Rodrigo Vitorio and 5 others
PMID 39920722WHAT IT FOUND
Poorer cognition, especially executive function, is linked to worse balance in Parkinson's.
Brain scans show patients rely more on conscious cortical control for posture. However, protocols varied widely, so no single test or intervention is proven.
Key findings
01Executive function and attention are the cognitive domains most consistently associated with postural control performance.
02People with Parkinson's show increased cortical activity during balance tasks, likely compensating for subcortical damage.
03Study protocols were highly variable, making it difficult to compare findings or draw firm conclusions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
High variability in study protocols, including different cognitive tests, balance measures, and imaging devices, prevents direct comparison and meta-analysis. Many studies had small sample sizes. Medication status (ON/OFF) was inconsistent across studies, which can affect both cognitive and motor performance. The review did not differentiate between Parkinson's disease subtypes (e.g., postural instability/gait difficulty vs. tremor-dominant). Most included studies were cross-sectional, so causal relationships between cognitive decline and balance impairment cannot be established.
Declared interests
Not reported in the provided text.
The easy way to misread this
Do not interpret the increased cortical activity as a sign of a 'better' or 'stronger' brain. It is likely a compensatory mechanism for subcortical damage, which may be fragile and easily disrupted by cognitive load or fatigue.