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The Effects of Levodopa and Visual Information on The Complexity of Postural Control in Parkinson’s Disease Patients With and Without Freezing of Gait Through a Multiscale Entropy Approach

Authors :

Kiarash Banan Motarjem¹ َAmirhassan Khalouzadeh Mobarakeh² Aria Behroozi³ Elham Shirzad Araghi⁴

1- دانشگاه تهران 2- دانشگاه تهران 3- دانشگاه تهران 4- دانشگاه تهران

Keywords :

Complexity،Freezing of Gait،Levodopa،Multiscale Entropy،Parkinson’s Disease،Postural Control

Abstract :

The nuanced effects of levodopa on postural control in Parkinson's disease (PD), particularly under challenging sensory conditions, remain a critical area of investigation. This work analyzed postural sway complexity using a multiscale entropy (MSE) approach in 32 individuals with PD, with and without Freezing of Gait (FoG), across both ON and OFF medication states and with eyes open or closed. A primary finding revealed that levodopa significantly reduced medial-lateral postural complexity when visual input was absent (eyes closed) compared to the unmedicated state. While the presence of FoG did not emerge as a significant factor for complexity in this quiet standing task, the results highlight a crucial paradox: standard dopaminergic therapy may inadvertently diminish the adaptability of the postural control system. These findings underscore the complex interplay between pharmacology and sensory integration, suggesting that therapeutic approaches should account for how medication modulates balance in varied environments.