Abstract
Background: Behavioral evidence for cortical involvement in reactive balance control in response to environmental perturbation is established, however, the neural correlates are not known. This study aimed to examine the neural mechanisms involved in reactive balance control for recovery from slip-like perturbations using mental imagery and to evaluate the difference in activation patterns between imagined and observed slipping. Methods: Ten healthy young participants after an exposure to regular walking and slip-perturbation trial on a treadmill, performed mental imagery and observation tasks in the MR scanner. Participants received verbal instructions to imagine walking (IW), observe walking (OW), imagine slipping (IS) and observe slipping (OS) while walking. Results: Analysis using general linear model showed increased activation during IS versus IW condition in precentral gyrus, middle frontal gyrus, superior, middle and transverse temporal gyrus, parahippocampal gyrus, cingulate gyrus, insula, pulvinar nucleus of the thalamus, pons, anterior and posterior cerebellar lobes. During IS versus OS condition, there was additional activation in parahippocampus, cingulate gyrus, inferior parietal lobule, superior temporal, middle and inferior frontal gyrus. Conclusion: The findings of the current study support involvement of higher cortical and subcortical structures in reactive balance control. Greater activation during slipping could be attributed to the complexity of the sensorimotor task and increased demands to maintain postural stability during slipping as compared with regular walking. Furthermore, our findings suggest that mental imagery of slipping recruited greater neural substrates rather than observation of slipping, possibly due to increased sensory, cognitive and perceptual processing demands. New and Noteworthy: The behavioral factors contributing to falls from external perturbations while walking are better understood than neural mechanisms underlying the behavioral response. This study examines the neural activation pattern associated with reactive balance control during slip-like perturbations while walking through an fMRI paradigm. This study identified specific neural mechanisms involved in complex postural movements during sudden perturbations, to particularly determine the role of cortical structures in reactive balance control. It further highlights the specific differences in neural structures involved in regular unperturbed versus perturbed walking.