Neurological Sciences

, Volume 33, Issue 6, pp 1215–1223 | Cite as

The neurobiology of falls

  • Alfonso Fasano
  • Meir Plotnik
  • Francesco Bove
  • Alfredo Berardelli
Review Article

Abstract

Falling is a major clinical problem; especially, in elderly population as it often leads to fractures, immobilization, poor quality of life and life-span reduction. Given the growing body of evidences on the physiopathology of balance disorders in humans, in recent years the approach of research on falls has completely changed and new instruments and new definitions have been formulated. Among them, the definition of “idiopathic faller” (i.e. no overt cause for falling in a given subject) represented a milestone in building the “science of falling”. This review deals with the new determinants of the neurobiology of falling: (1) the role of motor impairment and particularly of those “mild parkinsonian signs” frequently detectable in elderly subjects, (2) the role of executive and attentive resources when coping with obstacles, (3) the role of vascular lesions in “highest level gait disorder” (a condition tightly connected with senile gait, cautious gait and frailty), (4) the role of the failure of automaticity or inter-limbs coordination/symmetry during walking and such approach would definitely help the development of screening instrument for subjects at risk (still lacking in present days). This translational approach will lead to the development of specific therapeutic interventions.

Keywords

Falls Postural instability Parkinsonism Automaticity Cognition Freezing of gait High-level gait disorder 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Alfonso Fasano
    • 1
    • 2
    • 3
  • Meir Plotnik
    • 4
    • 5
    • 6
    • 7
  • Francesco Bove
    • 1
  • Alfredo Berardelli
    • 8
    • 9
  1. 1.Department of NeurologyCatholic UniversityRomeItaly
  2. 2.Department of NeuroscienceAFaR-Fatebenefratelli HospitalRomeItaly
  3. 3.Istituto di NeurologiaRomeItaly
  4. 4.Advanced Technologies CenterRehabilitation Hospital, Sehba Medical CenterTel HashomerIsrael
  5. 5.Department of Neurological RehabilitationSheba Medical CenterTel HashomerIsrael
  6. 6.Department of Physiology and PharmacologySackler School of Medicine, Tel Aviv UniversityTel AvivIsrael
  7. 7.Gonda Brain Research CenterBar Ilan UniversityRamat GanIsrael
  8. 8.Department of Neurology and PsychiatrySapienza University of RomeRomeItaly
  9. 9.Neuromed Institute (IRCSS)Pozzilli (IS)Italy

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