Abstract
Mobility deficits, including gait disturbance, balance impairments and falls, are common features of Parkinson's disease (PD) that negatively impact quality of life. Mobility deficits respond poorly to dopaminergic medications, indicating a role for additional neurotransmitters. Due to the critical role of cortical input to gait and balance, acetylcholine-an essential neurotransmitter system for attention-has become an area of interest for mobility. This review aimed to identify the role of cholinergic function on gait, balance, and falls in PD using three techniques; pharmacological, imaging, and electrophysiological. Studies supported the role of the cholinergic system for mobility in PD, with the most promising evidence indicating a role in falls. Imaging studies demonstrated involvement of anterior cholinergic (basal forebrain) systems in gait, and posterior (brainstem) systems in balance. However, this review identified a small number of studies which used varying protocols, making comparisons difficult. Further studies are warranted, measuring comprehensive gait and balance characteristics as well as gold standard falls detection to further quantify the relationship between ACh and mobility in PD.
Citations
Feb 12, 2020·JAMA : the Journal of the American Medical Association·Melissa J Armstrong, Michael S Okun
Apr 8, 2020·Age and Ageing·Danielle S AbrahamAllison W Willis
Aug 25, 2020·Movement Disorders : Official Journal of the Movement Disorder Society·Samuel StuartMartina Mancini
Oct 6, 2020·Frontiers in Neurology·Douglas N MartiniFay Horak
Aug 7, 2019·The European Journal of Neuroscience·Philipe Souza CorrêaFernanda Cechetti
Jul 30, 2020·Journal of Neurology·W Alex DalrympleMatthew J Barrett
May 10, 2020·International Journal of Molecular Sciences·Marcella RealeBiancamaria Guarnieri
Mar 7, 2020·Acta Pharmacologica Sinica·John L Waddington
Mar 24, 2020·Acta Pharmacologica Sinica·Xue-Chu Zhen, Hong-Yuan Chu
Nov 17, 2020·Frontiers in Aging Neuroscience·Joanna WilsonBrook Galna
Jan 1, 2021·Movement Disorders : Official Journal of the Movement Disorder Society·Joanna WilsonLynn Rochester
Dec 1, 2020·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Douglas N MartiniFay B Horak
Apr 5, 2021·Parkinsonism & Related Disorders·Rodrigo VitorioMartina Mancini
May 13, 2021·Annals of Neurology·Roger L AlbinWilliam T Dauer
Jul 6, 2021·Aging and Disease·Dipali NemadeVikram Shivkumar
Dec 23, 2020·Brazilian Journal of Physical Therapy·Paulo H S PelicioniStephen R Lord
Sep 1, 2021·Expert Review of Medical Devices·Hilmar P SigurdssonAlison J Yarnall
Sep 1, 2021·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Andrea L RossoCaterina Rosano