Association Between Balance and the Integrity of Cerebellar White Matter Tracts in a Healthy Population

The Catholic University of Korea22 enrolled

Overview

The cerebellum is involved in regulating balance and walking and plays a crucial role in the locomotor adaptation and learning processes. This study aims to investigate the association between balance and the integrity of the cerebellar white matter tracts in a healthy population. Healthy participants will undergo four weeks of balance training. The investigators will analyze changes in the microstructural integrity of the cerebellar white matter tract before and after four weeks of balance training.

The cerebellum is involved in regulating balance and walking and plays a crucial role in the locomotor adaptation and learning processes. The cerebellum's intermediate zone, which receives afferent stimuli from the sensorimotor cortex (via the cortico-ponto-cerebellar tract) and peripheral muscles (via the dorsal spinocerebellar tract), contributes to maintaining body posture and regulating walking. Proprioceptive information from the peripheral muscles passes through the dorsal spinocerebellar tract, enters the ipsilateral cerebellar hemisphere via the inferior cerebellar peduncle, and finally projects to the contralateral motor cortex through the cerebello-thalamo-cortical pathways. Diffusion tensor imaging (DTI) enables microstructural evaluation of the white matter tracts. Both diffusion tensor tractography, to determine the structural connectivity of the whole tract, and DTI-derived parameters, to determine the microstructural organization, can represent the integrity of the cerebellar white matter tracts. The investigators will evaluate the motor-related white matter tracts, including the corticospinal tract, the cortico-ponto-cerebellar tract, the dorsal spinocerebellar tract, and the dentato-rubro-thalamo-cortical tract. Healthy participants will perform the four weeks of balance training, and DTI will be acquired before and after exercise. The investigators will analyze the DTI-derived parameters of the relevant white matter tracts and analyze the longitudinal changes. The investigators hypothesized that the four weeks of balance training would enhance the integrity of the cerebellar white matter tracts.

Study Type

INTERVENTIONAL

Allocation

Purpose

BASIC_SCIENCE

Masking

Conditions

Balance Cerebellum

Interventions

Balance and Proprioceptive TrainingBEHAVIORAL

* Step-by-step training (5 levels) * 30 minute per training * 3 times per week * Four weeks

Eligibility

Sex: ALLMin age: 20 YearsMax age: 74 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Mini-mental state examination \>=26 * Independent outdoor ambulator Exclusion Criteria: * Men/women with any metal implants in their body * A prior history of psychopathology or a neurological disorders * A prior history of osteoporosis, advanced osteoarthritis (K-L grade \>=3), surgical history of hip or knee arthroplasty * If any structural abnormalities are detected on their scan

Locations (1)

Yeouido St. Mary's Hospital

Seoul, Yeongdeungpo-gu, South Korea

Outcomes

Primary Outcomes

Fractional anisotropy of the cerebellar white matter tracts

Measurement of the change of DTI-derived parameters before and after balance and proprioceptive training 1. Tracts of interest * Corticospinal tract (CST) * Cortico-ponto-cerebellar tract (CPCT) * Dentato-rubro-thalamo-cortical tract (DRTCT) * Dorsal spinocerebellar tract (DSCT) 2. Measurement of DTI-derived parameter * Fractional anisotropy (FA) values of the CST, CPCT, DRTCT, and DSCT 3. Units and scoring of the Measurement * FA * No unit. * The measurement ranges from 0 to 1 * Higher scores indicate better microstructural integrity.

Time frame: Four weeks

Community Balance & Mobility Scale

Performance measure before and after balance and proprioceptive training 1. Measurement * 13 domain * Unilateral stance, Tandem walking, 180° tandem pivot, Lateral foot scooting, Hopping forward, Crouch and walk, Lateral dodging, Walking \& looking, Running with controlled stop, Forward to backward walking, Walk look and carry, Descending stairs, Step-ups x 1 step 2. Scoring of the Measurement * No units. * The measurement ranges from 0 to 96 * Higher scores indicate better postural balance and mobility.

Time frame: Four weeks

Secondary Outcomes

Mean diffusivity of the cerebellar white matter tracts

Measurement of the change of DTI-derived parameters before and after balance and proprioceptive training 1. Tracts of interest * CST * CPCT * DRTCT * DSCT 2. Measurement of DTI-derived parameter * Mean Diffusivity (MD) values of the CST, CPCT, DRTCT, and DSCT 3. Units and scoring of the Measurement * MD * mm\^2/second * There is no limit on the range (usually ranges 0.00005 - 0.0001 mm\^2/second). * Higher scores indicate worse microstructural integrity.

Time frame: Four weeks

Tract volume of the cerebellar white matter tracts

Measurement of the change of DTI-derived parameters before and after balance and proprioceptive training 1. Tracts of interest * CST * CPCT * DRTCT * DSCT 2. Measurement of DTI-derived parameter * Tract volume (TV) values of the CST, CPCT, DRTCT, and DSCT 3. Units and scoring of the Measurement * TV * mm\^3 * There is no limit on the range. * Higher scores indicate better microstructural integrity.

Data from ClinicalTrials.gov

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