Higher cortical beta oscillatory power before balance perturbations is associated with worse balance in older adults with Parkinson's Disease, but not in age-matched older adults

Elevated beta activity is hypothesized to reflect reduced flexibility in updating motor and sensory states, which may impair the rapid integration of sensory information required for balance. Therefore, we predicted that higher cortical beta power immediately before balance perturbations would be associated with poorer clinical balance performance, particularly in individuals with Parkinson's Disease (PD). Seventeen individuals with PD (median Hoehn & Yahr = 2) and eighteen neurotypical older adults stood on a translating platform while 32-channel electroencephalography was recorded. For each participant, the cortical component contributing most strongly to the perturbation-evoked N1 response, a balance-related cortical response localized to the supplementary motor area, was identified. Oscillatory beta power (13-30 Hz) during the one-second period immediately preceding perturbation onset was extracted from this N1-related cortical source and parameterized using Fitting Oscillations and One-Over-F (FOOOF). Balance ability was assessed using the Mini-Balance Evaluation Systems Test (Mini-BESTest). Beta power derived from this N1-related source did not differ between groups; however, within individuals with PD, higher pre-perturbation beta power was associated with lower Mini-BESTest scores, a relationship not observed in neurotypical older adults. A subset of older adults exhibited an additional, higher-frequency beta peak absent in PD, suggesting heterogeneity in cortical beta dynamics with aging. These findings suggest that elevated cortical beta oscillations immediately preceding balance perturbations are linked to clinically meaningful balance impairment in PD, supporting beta activity as a potential cortical biomarker of balance dysfunction in this population.