Parkinsonian deficits in context-dependent regulation of standing postural control

This study explored whether patients with Parkinson's disease alter the regulation of upright standing according to constraints imposed by the environmental context. The provision of context-dependent adaptations was inferred from the presence of adjustments to standing postural control that would serve to reduce fall risk when balance was challenged by a threatening environmental context. Participants were asked to stand as still as possible in two environmental context conditions that differed in the level of imposed postural threat: LOW threat and HIGH threat. Eight levodopa dependent patients with Parkinson's disease (PD) and eight age-matched control subjects (CTRL) provided the subject sample. PD patients were tested following a 12-h withdrawal of anti-Parkinsonian medications and approximately 1 h post-medication. The CTRL group showed altered postural control in the HIGH threat condition, in a manner that was indicative of appropriate context-dependent regulation of standing. PD patients, in the non-medicated or medicated states, did not modify stance regulation when the environmental context heightened postural threat. Our results extend the current understanding of Parkinsonian deficits in the context-dependent regulation of postural control to include upright standing.