Associations between proprioceptive neural pathway structural connectivity and balance in people with multiple sclerosis

Brett W. Fling, Geetanjali Gera Dutta, Heather Schlueter, Michelle H. Cameron, Fay B. Horak

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Mobility and balance impairments are a hallmark of multiple sclerosis (MS), affecting nearly half of patients at presentation and resulting in decreased activity and participation, falls, injuries, and reduced quality of life. A growing body of work suggests that balance impairments in people with mild MS are primarily the result of deficits in proprioception, the ability to determine body position in space in the absence of vision. A better understanding of the pathophysiology of balance disturbances in MS is needed to develop evidence-based rehabilitation approaches. The purpose of the current study was to (1) map the cortical proprioceptive pathway in vivo using diffusion-weighted imaging and (2) assess associations between proprioceptive pathway white matter microstructural integrity and performance on clinical and behavioral balance tasks. We hypothesized that people with MS (PwMS) would have reduced integrity of cerebral proprioceptive pathways, and that reduced white matter microstructure within these tracts would be strongly related to proprioceptive-based balance deficits. We found poorer balance control on proprioceptive-based tasks and reduced white matter microstructural integrity of the cortical proprioceptive tracts in PwMS compared with age-matched healthy controls (HC). Microstructural integrity of this pathway in the right hemisphere was also strongly associated with proprioceptive-based balance control in PwMS and controls. Conversely, while white matter integrity of the right hemisphere’s proprioceptive pathway was significantly correlated with overall balance performance in HC, there was no such relationship in PwMS. These results augment existing literature suggesting that balance control in PwMS may become more dependent upon (1) cerebellar-regulated proprioceptive control, (2) the vestibular system, and/or (3) the visual system.

Original languageEnglish (US)
Article number814
JournalFrontiers in Human Neuroscience
Issue numberOCT
StatePublished - Oct 20 2014


  • Diffusion tensor imaging
  • Diffusion tensor tractography
  • Proprioception
  • Somatosensory cortex
  • Somatosensory disorders
  • White matter pathways

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Behavioral Neuroscience


Dive into the research topics of 'Associations between proprioceptive neural pathway structural connectivity and balance in people with multiple sclerosis'. Together they form a unique fingerprint.

Cite this