Theoretical discrimination index of postural instability in Amyotrophic Lateral Sclerosis

12^th International Conference on Central Nervous System

October 07, 2022 | Webinar

Jean Noel Vallee

Paris Nanterre University, France

Posters & Accepted Abstracts: J Neurol Clin Neurosci

Abstract :

Objective: To assess the usefulness of a theoretical postural instability discrimination index (PIth) in amyotrophic lateral sclerosis (ALS). Methods: Prospective regression analyzes were performed to identify the biomechanical determinants of postural instability unrelated to lower limb motor deficits from gait initiation factors. PIth was constructed using a logit function of biomechanical determinants. Discriminatory performance and performance differences were tested. Results: Backward displacement of the pression center (APAamplitude) and active vertical braking of the mass center (Brakingindex) were the biomechanical determinants of postural instability. PIth = - 0.13 x APAamplitude – 0.12 x Braking-index + 5.67, (P < 0.0001, RSquare = 0.6119). OR(APAamplitude) and OR(Braking-index) were 0.878 and 0.887, respectively, i.e., for a decrease of 10 mm in APAamplitude or 10% in Braking-index, the postural instability risk was 11.391 or 11.274 times higher, respectively. PIth had the highest discriminatory performance (AUC 0.953) with a decision threshold value ≥ 0.587, a sensitivity of 90.91%, and a specificity of 83.87%, significantly increasing the sensitivity by 11.11%. Conclusion: PIth, as objective clinical integrator of gait initiation biomechanical processes significantly involved in dynamic postural control, was a reliable and performing discrimination index of postural instability with a significant increased sensitivity, and may be useful for a personalized approach to postural instability in ALS. Recent Publications 1. Alexandre Vallée, Yves Lecarpentier, and Jean-Noël Vallée (2022). WNT/β-catenin pathway and circadian rhythms in obsessivecompulsive disorder. Neural Regen Res. 2022 Oct;17(10):2126-2130 2. Alexandre Vallée, Yves Lecarpentier, and Jean-Noël Vallée (2021) Cannabidiol and the Canonical WNT/β-Catenin Pathway in Glaucoma. Int. J. Mol. Sci. 2021, 22, 3798 3. Alexandre Vallée, Jean-Noël Vallée, Yves Lecarpentier (2021) Parkinson’s Disease: Potential Actions of Lithium by Targeting the WNT/ β-Catenin Pathway, Oxidative Stress, Inflammation and Glutamatergic Pathway. Cells. 2021 Jan 25;10(2):230