101
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Song W, Raza HK, Lu L, Zhang Z, Zu J, Zhang W, Dong L, Xu C, Gong X, Lv B, Cui G. Functional MRI in Parkinson's disease with freezing of gait: a systematic review of the literature. Neurol Sci 2021; 42:1759-1771. [PMID: 33713258 DOI: 10.1007/s10072-021-05121-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Freezing of gait (FOG), a common and disabling symptom of Parkinson's disease (PD), is characterized by an episodic inability to generate effective stepping. Functional MRI (fMRI) has been used to evaluate abnormal brain connectivity patterns at rest and brain activation patterns during specific tasks in patients with PD-FOG. This review has examined the existing functional neuroimaging literature in PD-FOG, including those with treatment. Summarizing these articles provides an opportunity for a better understanding of the underlying pathophysiology in PD-FOG. METHODS According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a literature review of studies using fMRI to investigate the underlying pathophysiological mechanisms of PD-FOG. RESULTS We initially identified 201 documents. After excluding the duplicates, reviews, and other irrelevant articles, 39 articles were finally identified, including 18 task-based fMRI studies and 21 resting-state fMRI studies. CONCLUSIONS Studies using fMRI techniques to evaluate PD-FOG have found dysfunctional connectivity in widespread cortical and subcortical regions. Standardized imaging protocols and detailed subtypes of PD-FOG are furthered required to elucidate current findings.
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Affiliation(s)
- Wenjing Song
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Hafiz Khuram Raza
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Li Lu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Zuohui Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Jie Zu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Wei Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Liguo Dong
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Chuanying Xu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Xiangyao Gong
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Bingchen Lv
- Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, People's Republic of China.
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102
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Dong J, Hawes S, Wu J, Le W, Cai H. Connectivity and Functionality of the Globus Pallidus Externa Under Normal Conditions and Parkinson's Disease. Front Neural Circuits 2021; 15:645287. [PMID: 33737869 PMCID: PMC7960779 DOI: 10.3389/fncir.2021.645287] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
The globus pallidus externa (GPe) functions as a central hub in the basal ganglia for processing motor and non-motor information through the creation of complex connections with the other basal ganglia nuclei and brain regions. Recently, with the adoption of sophisticated genetic tools, substantial advances have been made in understanding the distinct molecular, anatomical, electrophysiological, and functional properties of GPe neurons and non-neuronal cells. Impairments in dopamine transmission in the basal ganglia contribute to Parkinson's disease (PD), the most common movement disorder that severely affects the patients' life quality. Altered GPe neuron activity and synaptic connections have also been found in both PD patients and pre-clinical models. In this review, we will summarize the main findings on the composition, connectivity and functionality of different GPe cell populations and the potential GPe-related mechanisms of PD symptoms to better understand the cell type and circuit-specific roles of GPe in both normal and PD conditions.
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Affiliation(s)
- Jie Dong
- Laboratory of Neurogenetics, Transgenic Section, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Sarah Hawes
- Laboratory of Neurogenetics, Transgenic Section, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Junbing Wu
- Child Health Institute of New Jersey, Rutgers University, New Brunswick, NJ, United States
| | - Weidong Le
- Liaoning Provincial Center for Clinical Research on Neurological Diseases & Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Medical School of University of Electronic Science and Technology of China, Institute of Neurology, Sichuan Provincial Hospital, Sichuan Academy of Medical Science, Chengdu, China
| | - Huaibin Cai
- Laboratory of Neurogenetics, Transgenic Section, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
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103
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D'Cruz N, Vervoort G, Chalavi S, Dijkstra BW, Gilat M, Nieuwboer A. Thalamic morphology predicts the onset of freezing of gait in Parkinson's disease. NPJ Parkinsons Dis 2021; 7:20. [PMID: 33654103 PMCID: PMC7925565 DOI: 10.1038/s41531-021-00163-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/14/2021] [Indexed: 11/08/2022] Open
Abstract
The onset of freezing of gait (FOG) in Parkinson's disease (PD) is a critical milestone, marked by a higher risk of falls and reduced quality of life. FOG is associated with alterations in subcortical neural circuits, yet no study has assessed whether subcortical morphology can predict the onset of clinical FOG. In this prospective multimodal neuroimaging cohort study, we performed vertex-based analysis of grey matter morphology in fifty-seven individuals with PD at study entry and two years later. We also explored the behavioral correlates and resting-state functional connectivity related to these local volume differences. At study entry, we found that freezers (N = 12) and persons who developed FOG during the course of the study (converters) (N = 9) showed local inflations in bilateral thalamus in contrast to persons who did not (non-converters) (N = 36). Longitudinally, converters (N = 7) also showed local inflation in the left thalamus, as compared to non-converters (N = 36). A model including sex, daily levodopa equivalent dose, and local thalamic inflation predicted conversion with good accuracy (AUC: 0.87, sensitivity: 88.9%, specificity: 77.8%). Exploratory analyses showed that local thalamic inflations were associated with larger medial thalamic sub-nuclei volumes and better cognitive performance. Resting-state analyses further revealed that converters had stronger thalamo-cortical coupling with limbic and cognitive regions pre-conversion, with a marked reduction in coupling over the two years. Finally, validation using the PPMI cohort suggested FOG-specific non-linear evolution of thalamic local volume. These findings provide markers of, and deeper insights into conversion to FOG, which may foster earlier intervention and better mobility for persons with PD.
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Affiliation(s)
- Nicholas D'Cruz
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group, B-3000, Leuven, Belgium.
| | - Griet Vervoort
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group, B-3000, Leuven, Belgium
| | - Sima Chalavi
- KU Leuven, Department of Movement Sciences, Movement Control & Neuroplasticity Research Group, B-3000, Leuven, Belgium
| | - Bauke W Dijkstra
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group, B-3000, Leuven, Belgium
| | - Moran Gilat
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group, B-3000, Leuven, Belgium
| | - Alice Nieuwboer
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research Group, B-3000, Leuven, Belgium
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104
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Michiels E, Rousseau F, Schymkowitz J. Mechanisms and therapeutic potential of interactions between human amyloids and viruses. Cell Mol Life Sci 2021; 78:2485-2501. [PMID: 33244624 PMCID: PMC7690653 DOI: 10.1007/s00018-020-03711-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/21/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
The aggregation of specific proteins and their amyloid deposition in affected tissue in disease has been studied for decades assuming a sole pathogenic role of amyloids. It is now clear that amyloids can also encode important cellular functions, one of which involves the interaction potential of amyloids with microbial pathogens, including viruses. Human expressed amyloids have been shown to act both as innate restriction molecules against viruses as well as promoting agents for viral infectivity. The underlying molecular driving forces of such amyloid-virus interactions are not completely understood. Starting from the well-described molecular mechanisms underlying amyloid formation, we here summarize three non-mutually exclusive hypotheses that have been proposed to drive amyloid-virus interactions. Viruses can indirectly drive amyloid depositions by affecting upstream molecular pathways or induce amyloid formation by a direct interaction with the viral surface or specific viral proteins. Finally, we highlight the potential of therapeutic interventions using the sequence specificity of amyloid interactions to drive viral interference.
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Affiliation(s)
- Emiel Michiels
- VIB Center for Brain and Disease Research, Leuven, Belgium
- Switch Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Frederic Rousseau
- VIB Center for Brain and Disease Research, Leuven, Belgium.
- Switch Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
| | - Joost Schymkowitz
- VIB Center for Brain and Disease Research, Leuven, Belgium.
- Switch Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
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105
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Tian W, Chen S. Neurotransmitters, Cell Types, and Circuit Mechanisms of Motor Skill Learning and Clinical Applications. Front Neurol 2021; 12:616820. [PMID: 33716924 PMCID: PMC7947691 DOI: 10.3389/fneur.2021.616820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/18/2021] [Indexed: 02/02/2023] Open
Abstract
Animals acquire motor skills to better survive and adapt to a changing environment. The ability to learn novel motor actions without disturbing learned ones is essential to maintaining a broad motor repertoire. During motor learning, the brain makes a series of adjustments to build novel sensory–motor relationships that are stored within specific circuits for long-term retention. The neural mechanism of learning novel motor actions and transforming them into long-term memory still remains unclear. Here we review the latest findings with regard to the contributions of various brain subregions, cell types, and neurotransmitters to motor learning. Aiming to seek therapeutic strategies to restore the motor memory in relative neurodegenerative disorders, we also briefly describe the common experimental tests and manipulations for motor memory in rodents.
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Affiliation(s)
- Wotu Tian
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengdi Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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106
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Ferrazzoli D, Ortelli P, Volpe D, Cucca A, Versace V, Nardone R, Saltuari L, Sebastianelli L. The Ties That Bind: Aberrant Plasticity and Networks Dysfunction in Movement Disorders-Implications for Rehabilitation. Brain Connect 2021; 11:278-296. [PMID: 33403893 DOI: 10.1089/brain.2020.0971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Movement disorders encompass various conditions affecting the nervous system. The pathological processes underlying movement disorders lead to aberrant synaptic plastic changes, which in turn alter the functioning of large-scale brain networks. Therefore, clinical phenomenology does not only entail motor symptoms but also cognitive and motivational disturbances. The result is the disruption of motor learning and motor behavior. Due to this complexity, the responsiveness to standard therapies could be disappointing. Specific forms of rehabilitation entailing goal-based practice, aerobic training, and the use of noninvasive brain stimulation techniques could "restore" neuroplasticity at motor-cognitive circuitries, leading to clinical gains. This is probably associated with modulations occurring at both molecular (synaptic) and circuitry levels (networks). Several gaps remain in our understanding of the relationships among plasticity and neural networks and how neurorehabilitation could promote clinical gains is still unclear. Purposes: In this review, we outline first the networks involved in motor learning and behavior and analyze which mechanisms link the pathological synaptic plastic changes with these networks' disruption in movement disorders. Therefore, we provide theoretical and practical bases to be applied for treatment in rehabilitation.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Paola Ortelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy.,Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, NYU School of Medicine, New York, New York, USA.,Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital (SABES-ASDAA), Merano-Meran, Italy.,Department of Neurology, Christian Doppler Medical Center, Paracelsus University Salzburg, Salzburg, Austria
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
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107
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De Oliveira GS, Pinheiro GS, Proença IC, Blembeel A, Casal MZ, Pochmann D, Tartaruga L, Martinez FG, Araújo AS, Elsner V, Dani C. Aquatic exercise associated or not with grape juice consumption-modulated oxidative parameters in Parkinson disease patients: A randomized intervention study. Heliyon 2021; 7:e06185. [PMID: 33644467 PMCID: PMC7887390 DOI: 10.1016/j.heliyon.2021.e06185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/26/2020] [Accepted: 01/29/2021] [Indexed: 12/23/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder with significant motor disabilities and cognitive decline. Importantly, the imbalance of oxidative stress is related to PD physiopathology and progression. This study aimed to evaluate the impact of grape juice consumption associated with an aquatic exercise protocol on oxidative stress parameters and cognitive function in individuals with PD. The participants were randomized into two groups: grape juice group (GJG) and control group (CG) and were submitted to 4 weeks of an aquatic intervention (twice a week, approximately 60 minutes/session). The GJG also consumed 400 ml of grape juice per day (integral and conventional) during this period. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCa) questionnaire. For the analysis of oxidative stress markers, specifically lipid oxidative damage (TBARS), proteins (Carbonil), acid uric and the activity of antioxidant enzymes (superoxide dismutase, glutathione peroxidase and catalase), blood collection were done before and after intervention. No changes were observed in cognitive function after intervention in both groups. Regarding biomarkers, a reduction of antioxidant enzymes, thiobarbituric acid reactive substances (TBARS) and uric acid was observed in both groups. However, only the GJG showed a significant reduction on protein oxidation levels after intervention. In conclusion, the consumption of grape juice associated with an aquatic exercise protocol might be consider an effective alternative to reduce the oxidative damage in PD, reinforcing the importance of this intervention in promoting beneficial impact in this population.
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Affiliation(s)
| | - Gislaine S. Pinheiro
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - Isabel C.T. Proença
- Programa de Pós-Graduação em Biociências e Reabilitação, Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Amanda Blembeel
- Programa de Pós-Graduação em Biociências e Reabilitação, Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - Marcela Z. Casal
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daniela Pochmann
- Programa de Pós-Graduação em Biociências e Reabilitação, Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - Leonardo Tartaruga
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flavia G. Martinez
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alex Sander Araújo
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Viviane Elsner
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Biociências e Reabilitação, Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Caroline Dani
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Biociências e Reabilitação, Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
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108
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Nodehi Z, Mehdizadeh H, Azad A, Mehdizadeh M, Reyhanian E, Saberi ZS, Meimandi M, Soltanzadeh A, Roohi-Azizi M, Vasaghi-Gharamaleki B, Parnianpour M, Khalaf K, Taghizadeh G. Anxiety and cognitive load affect upper limb motor control in Parkinson's disease during medication phases. Ann N Y Acad Sci 2021; 1494:44-58. [PMID: 33476067 DOI: 10.1111/nyas.14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/15/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
Anxiety is among the most debilitating nonmotor symptoms of Parkinson's disease (PD). This study aimed to determine how PD patients with low and high levels of anxiety (LA-PD and HA-PD, respectively) compare with age- and sex-matched controls at the level of motor control of reach-to-grasp movements during single- and dual-task conditions with varying complexity. Reach-to-grasp movement kinematics were assessed in 20 LA-PD, 20 HA-PD, and 20 sex- and age-matched healthy controls under single- as well as easy and difficult dual-task conditions. Assessment of PD patients was performed during both the on- and off-drug phases. The results obtained during dual-task conditions reveal deficits in both reach and grasp components for all three groups (e.g., decreased peak velocity and delayed maximum hand opening). However, these deficits were significantly greater in the PD groups, especially in the HA-PD group. Although dopaminergic medication improved reach kinematics, it had no effect on grasp kinematics. The results of our study indicated that high levels of anxiety may enhance the inefficiency of upper limb motor control in PD patients, especially during high demanding cognitive conditions, and should, therefore, be considered in the assessment and planning of interventions for upper limb function in these patients.
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Affiliation(s)
- Zahra Nodehi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hajar Mehdizadeh
- Department of Neurosciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Mehdizadeh
- Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Reyhanian
- Department of Electrical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Zakieh Sadat Saberi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Meimandi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akbar Soltanzadeh
- Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Roohi-Azizi
- Rehabilitation Research Center, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Behnoosh Vasaghi-Gharamaleki
- Rehabilitation Research Center, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Kinda Khalaf
- Department of Biomedical Engineering, Health Engineering Innovation Center, Khalifa University of Science, Abu Dhabi, UAE
| | - Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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109
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Attentional focus modulates automatic finger-tapping movements. Sci Rep 2021; 11:698. [PMID: 33436938 PMCID: PMC7804157 DOI: 10.1038/s41598-020-80296-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 12/17/2020] [Indexed: 11/08/2022] Open
Abstract
The majority of human behaviors are composed of automatic movements (e.g., walking or finger-tapping) which are learned during nurturing and can be performed simultaneously without interfering with other tasks. One critical and yet to be examined assumption is that the attention system has the innate capacity to modulate automatic movements. The present study tests this assumption. Setting no deliberate goals for movement, we required sixteen participants to perform personalized and well-practiced finger-tapping movements in three experiments while focusing their attention on either different component fingers or away from movements. Using cutting-edge pose estimation techniques to quantify tapping trajectory, we showed that attention to movement can disrupt movement automaticity, as indicated by decreased inter-finger and inter-trial temporal coherence; facilitate the attended and inhibit the unattended movements in terms of tapping amplitude; and re-organize the action sequence into distinctive patterns according to the focus of attention. These findings demonstrate compelling evidence that attention can modulate automatic movements and provide an empirical foundation for theories based on such modulation in controlling human behavior.
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110
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Romagnolo A, Zibetti M, Lenzi M, Vighetti S, Pongmala C, Artusi CA, Montanaro E, Imbalzano G, Rizzone MG, Lopiano L. Low frequency subthalamic stimulation and event-related potentials in Parkinson disease. Parkinsonism Relat Disord 2020; 82:123-127. [PMID: 33321451 DOI: 10.1016/j.parkreldis.2020.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND High frequency (130 Hz) subthalamic Deep-Brain-Stimulation (STN-DBS) optimally improves cardinal motor symptoms in Parkinson disease (PD). Low stimulation frequencies (60-80 Hz) improve axial symptoms in some patients and, according to preliminary evidences, may also have a beneficial effect on the cognitive component of motor planning. OBJECTIVE To analyze the configuration of the P300 component of cortical event-related auditory potentials (ERPs), a reliable index of attentive cognitive functions, at different stimulation frequencies in STN-DBS in PD patients. METHODS 12 PD patients underwent ERPs recordings using a standard oddball auditory paradigm with STN-DBS at 60 Hz, 80 Hz, 130 Hz, and OFF-stimulation, applied in a randomized double-blind sequence. ERPs analysis considered the peak amplitude and latency of the P300 components at midline electrode positions (Fz, Cz, Pz). RESULTS P300 latency over Cz and Pz electrodes significantly increased with STN-DBS at 130 Hz compared to OFF-stimulation. P300 latency was also significantly increased, though to a lesser degree, over Pz electrode with stimulation at 80 Hz. No significant P300 latency modifications were detected at 60 Hz stimulation compared to OFF-stimulation condition. P300 amplitude did not change significantly for any of the stimulation conditions tested. CONCLUSIONS Low frequency STN-DBS is associated with minor modifications of P300 latency compared to conventional stimulation at 130 Hz, possibly suggesting that 60 and 80 Hz may have less interference with attentive and cognitive processes in PD patients.
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Affiliation(s)
- Alberto Romagnolo
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
| | - Marco Lenzi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Sergio Vighetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Chatkaew Pongmala
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Elisa Montanaro
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Gabriele Imbalzano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Mario Giorgio Rizzone
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
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111
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Changes in Step Characteristics Over a Known Outdoor Surface Transition: The Effect of Parkinson Disease. J Appl Biomech 2020; 37:59-65. [PMID: 33285513 DOI: 10.1123/jab.2020-0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/12/2020] [Accepted: 09/08/2020] [Indexed: 11/18/2022]
Abstract
The factors that contribute to the difficulties persons with Parkinson Disease (PwPD) have when negotiating transitions in walking surfaces are not completely known. The authors investigated if PwPD adjusted their step characteristics when negotiating a familiar outdoor surface transition between synthetic concrete and synthetic turf. Force plate and motion capture data were collected for 10 participants with mild to moderate Parkinson disease and 5 healthy older control participants ambulating bidirectionally across the transition between synthetic concrete and synthetic turf. Between groups, PwPD had a significantly higher minimum toe clearance (P = .007) for both directions of travel compared with the healthy control group. Within groups, PwPD significantly increased their hip (P < .001) and ankle (P = .016) range of motion walking from concrete to turf, while the healthy control participants significantly increased their minimum toe clearance (P = .013), margin of stability (P = .019), hip (P < .001) and ankle (P = .038) range of motion, and step length (P < .001). Walking from turf to concrete, both the Parkinson disease group (P = .014) and the healthy control group (P < .001) increased their knee range of motion. Both groups adjusted their step characteristics when negotiating known surface transitions, indicating that surface transitions result in step changes regardless of health status. However, PwPD exhibited overcompensations, particularly in their minimum toe clearance.
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112
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Jang JH, Park S, An J, Choi JD, Seol IC, Park G, Lee SH, Moon Y, Kang W, Jung ES, Cha JY, Kim CY, Kim S, Jung IC, Yoo H. Gait Disturbance Improvement and Cerebral Cortex Rearrangement by Acupuncture in Parkinson's Disease: A Pilot Assessor-Blinded, Randomized, Controlled, Parallel-Group Trial. Neurorehabil Neural Repair 2020; 34:1111-1123. [PMID: 33198568 DOI: 10.1177/1545968320969942] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Parkinson's disease (PD) leads to impaired mobility and limited independence. OBJECTIVE We investigated the effects of acupuncture on gait disturbance and analyzed hemodynamic changes caused by acupuncture in the cerebral cortex of patients with PD. METHODS Participants (n = 26) with gait disturbance due to PD were randomly assigned to the intervention (acupuncture twice a week for 4 weeks + conventional therapy) or control (conventional therapy) groups. We analyzed gait parameters using the GAITRite system and hemodynamic responses in the cerebral cortices using functional near-infrared spectroscopy, Unified Parkinson's Disease Rating Scale (UPDRS) scores, neurotransmitter levels, as well as the immediate effects of acupuncture in patients with PD. RESULTS The participants tended to walk with hypometric gait (high cadence, short steps) overground. After acupuncture treatment, those in the intervention group showed a significant reduction in cadence and the UPDRS scores involving "walking and balance" compared with those in the control group (P = .004 and P = .020, respectively); the stride, swing, and single support times were significantly increased (P = .006, P = .001, and P = .001, respectively). Oxyhemoglobin levels in the intervention group while walking on a treadmill were significantly increased in the prefrontal and supplementary motor areas. The oxyhemoglobin levels in the prefrontal cortex and swing time revealed significant positive correlations. CONCLUSIONS Our findings indicated that acupuncture tended to improve hypometric gait and rearranged activation of the cerebral cortex. Thus, acupuncture may be a useful complementary treatment for gait disturbance, including hypometric gait, in patients with PD. Trial Registration Number. Clinical Research Information Service (KCT0002603), https://cris.nih.go.kr/cris/index.jsp.
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Affiliation(s)
- Jung-Hee Jang
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea.,Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sangsoo Park
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Jinung An
- Convergence Research Center for Wellness, Digist R4-814, Dalseong-Gun, Daegu, Republic of Korea
| | - Jong-Duk Choi
- College of Health & Medical Science, Graduate School, Daejeon City, Republic of Korea
| | - In Chan Seol
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Gunhyuk Park
- Korea Institute of Oriental Medicine, Naju-si, Jeollanam-do, Republic of Korea
| | | | - Young Moon
- College of Health & Medical Science, Graduate School, Daejeon City, Republic of Korea
| | - Weechang Kang
- Daejeon University, Dong-gu, Daejeon City, Republic of Korea
| | - Eun-Sun Jung
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Ji-Yun Cha
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Chan-Young Kim
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Siyeon Kim
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - In Chul Jung
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
| | - Horyong Yoo
- Dunsan Korean Medicine Hospital, Seo-gu, Daejeon, Republic of Korea
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113
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Vitorio R, Stuart S, Mancini M. Executive Control of Walking in People With Parkinson's Disease With Freezing of Gait. Neurorehabil Neural Repair 2020; 34:1138-1149. [PMID: 33155506 DOI: 10.1177/1545968320969940] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Walking abnormalities in people with Parkinson's disease (PD) are characterized by a shift in locomotor control from healthy automaticity to compensatory prefrontal executive control. Indirect measures of automaticity of walking (eg, step-to-step variability and dual-task cost) suggest that freezing of gait (FoG) may be associated with reduced automaticity of walking. However, the influence of FoG status on actual prefrontal cortex (PFC) activity during walking remains unclear. OBJECTIVE To investigate the influence of FoG status on automaticity of walking in people with PD. METHODS Forty-seven people with PD were distributed into 2 groups based on FoG status, which was assessed by the New Freezing of Gait Questionnaire: PD-FoG (n = 23; UPDRS-III = 35) and PD+FoG (n = 24; UPDRS-III = 43.1). Participants walked over a 9-m straight path (with a 180° turn at each end) for 80 seconds. Two conditions were tested off medication: single- and dual-task walking (ie, with a concomitant cognitive task). A portable functional near-infrared spectroscopy system recorded PFC activity while walking (including turns). Wearable inertial sensors were used to calculate spatiotemporal gait parameters. RESULTS PD+FoG had greater PFC activation during both single and dual-task walking than PD-FoG (P = .031). There were no differences in gait between PD-FoG and PD+FoG. Both groups decreased gait speed (P = .029) and stride length (P < .001) during dual-task walking compared with single-task walking. CONCLUSIONS These findings suggest that PD+FoG have reduced automaticity of walking, even in absence of FoG episodes. PFC activity while walking seems to be more sensitive than gait measures in identifying reduction in automaticity of walking in PD+FoG.
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Affiliation(s)
| | - Samuel Stuart
- Oregon Health & Science University, Portland, OR, USA.,Northumbria University, Newcastle upon Tyne, UK
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114
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Chang HC, Chen CC, Weng YH, Chiou WD, Chang YJ, Lu CS. The efficacy of cognitive-cycling dual-task training in patients with early-stage Parkinson's disease: A pilot study. NeuroRehabilitation 2020; 47:415-426. [PMID: 33136071 DOI: 10.3233/nre-203090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recent studies have suggested that cognitive-motor dual-task (DT) training might improve gait performance, locomotion automaticity, balance, and cognition in patients with Parkinson's disease (PD). OBJECTIVE We aimed to investigate the efficacy of cognitive-cycling DT training in patients with early-stage PD. METHODS Participants were scheduled to perform cognitive tasks simultaneously with the cycling training twice per week for eight weeks for a total of 16 sessions during their on-states. Clinical assessments were conducted using the unified Parkinson's disease rating scale (UPDRS), modified Hoehn and Yahr stage, Timed Up and Go (TUG) test, gait and cognitive performances under dual-task paradigm, the new freezing of gait questionnaire, Schwab and England Activities of Daily Living scale, 39-item Parkinson's disease questionnaire, and cognitive performance. RESULTS Thirteen eligible patients were enrolled in the study. The mean age was 60.64±5.32 years, and the mean disease duration was 7.02±3.23 years. Twelve PD patients completed 16 serial cognitive-cycling sessions for two months. After 16 sessions of training (T2), the UPDRS III scores improved significantly in both the off- and on-states, and TUG were significantly less than those at pretraining (T0). During both the single-task and the DT situations, gait performance and spatial memory cognitive performance significantly improved from T0 to T2. CONCLUSION The present study demonstrated that cognitive-cycling DT training improves the motor functions, gait and cognitive performances of PD patients.
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Affiliation(s)
- Hsiu-Chen Chang
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Professor Lu Neurological Clinic, Taoyuan, Taiwan
| | - Chiung-Chu Chen
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsin Weng
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wei-Da Chiou
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Rehabilitation, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Ya-Ju Chang
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Song Lu
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Professor Lu Neurological Clinic, Taoyuan, Taiwan
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115
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Jung SH, Hasegawa N, Mancini M, King LA, Carlson-Kuhta P, Smulders K, Peterson DS, Barlow N, Harker G, Morris R, Lapidus J, Nutt JG, Horak FB. Effects of the agility boot camp with cognitive challenge (ABC-C) exercise program for Parkinson’s disease. NPJ PARKINSONS DISEASE 2020; 6:31. [PMID: 33298934 PMCID: PMC7608677 DOI: 10.1038/s41531-020-00132-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 09/10/2020] [Indexed: 01/03/2023]
Abstract
Few exercise interventions practice both gait and balance tasks with cognitive tasks to improve functional mobility in people with PD. We aimed to investigate whether the Agility Boot Camp with Cognitive Challenge (ABC-C), that simultaneously targets both mobility and cognitive function, improves dynamic balance and dual-task gait in individuals with Parkinson’s disease (PD). We used a cross-over, single-blind, randomized controlled trial to determine efficacy of the exercise intervention. Eighty-six people with idiopathic PD were randomized into either an exercise (ABC-C)-first or an active, placebo, education-first intervention and then crossed over to the other intervention. Both interventions were carried out in small groups led by a certified exercise trainer (90-min sessions, 3 times a week, for 6 weeks). Outcome measures were assessed Off levodopa at baseline and after the first and second interventions. A linear mixed-effects model tested the treatment effects on the Mini-BESTest for balance, dual-task cost on gait speed, SCOPA-COG, the UPDRS Parts II and III and the PDQ-39. Although no significant treatment effects were observed for the Mini-BESTest, SCOPA-COG or MDS-UPDRS Part III, the ABC-C intervention significantly improved the following outcomes: anticipatory postural adjustment sub-score of the Mini-BESTest (p = 0.004), dual-task cost on gait speed (p = 0.001), MDS-UPDRS Part II score (p = 0.01), PIGD sub-score of MDS-UPDRS Part III (p = 0.02), and the activities of daily living domain of the PDQ-39 (p = 0.003). Participants with more severe motor impairment or more severe cognitive dysfunction improved their total Mini-BESTest scores after exercise. The ABC-C exercise intervention can improve specific balance deficits, cognitive-gait interference, and perceived functional independence and quality of life, especially in participants with more severe PD, but a longer period of intervention may be required to improve global cognitive and motor function.
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116
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Fearon C, Butler JS, Waechter SM, Killane I, Kelly SP, Reilly RB, Lynch T. Neurophysiological correlates of dual tasking in people with Parkinson's disease and freezing of gait. Exp Brain Res 2020; 239:175-187. [PMID: 33135132 DOI: 10.1007/s00221-020-05968-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 10/21/2020] [Indexed: 11/24/2022]
Abstract
Freezing of gait in people with Parkinson's disease (PwP) is associated with executive dysfunction and motor preparation deficits. We have recently shown that electrophysiological markers of motor preparation, rather than decision-making, differentiate PwP with freezing of gait (FOG +) and without (FOG -) while sitting. To examine the effect of locomotion on these results, we measured behavioural and electrophysiological responses in PwP with and without FOG during a target response time task while sitting (single-task) and stepping-in-place (dual-task). Behavioural and electroencephalographic data were acquired from 18 PwP (eight FOG +) and seven young controls performing the task while sitting and stepping-in-place. FOG + had slower response times while stepping compared with sitting. However, response times were significantly faster while stepping compared with sitting for controls. Electrophysiological responses showed no difference in decision-making potentials (centroparietal positivity) between groups or conditions but there were differences in neurophysiological markers of response inhibition (N2) and motor preparation (lateralized readiness potential, LRP) in FOG + while performing a dual-task. This suggests that the addition of a second complex motor task (stepping-in-place) impacts automatic allocation of resources in FOG +, resulting in delayed response times. The impact of locomotion on the generation of the N2 and LRP potentials, particularly in freezers, indirectly implies that these functions compete with locomotion for resources. In the setting of multiple complex tasks or cognitive impairment, severe motor dysfunction may result, leading to freezing of gait.
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Affiliation(s)
- Conor Fearon
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland.
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland.
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, 57 Eccles Street, Dublin 7, Ireland.
| | - John S Butler
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland.
- School of Mathematical Sciences, Technological University Dublin, Kevin Street, Dublin, Ireland.
- School of Medicine, Trinity College, The University of Dublin, Dublin 2, Ireland.
| | - Saskia M Waechter
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
| | - Isabelle Killane
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Mechanical and Design Engineering, Technological University Dublin, Bolton Street, Dublin, Ireland
| | - Simon P Kelly
- School of Electrical and Electronic Engineering, University College Dublin, Dublin 4, Ireland
| | - Richard B Reilly
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Medicine, Trinity College, The University of Dublin, Dublin 2, Ireland
| | - Timothy Lynch
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, 57 Eccles Street, Dublin 7, Ireland
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117
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Individuals With Parkinson's Disease Retain Spatiotemporal Gait Control With Music and Metronome Cues. Motor Control 2020; 25:33-43. [PMID: 33075748 DOI: 10.1123/mc.2020-0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/14/2020] [Accepted: 08/22/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to determine the difference in spatiotemporal gait measures induced by stepping to the beat of a metronome and to music cues of various frequencies in individuals with Parkinson's disease. Twenty-one participants with Parkinson's disease were instructed to time their steps to a metronome and music cues (at 85%, 100%, and 115% of overground cadence). The authors calculated cadence, cadence accuracy, and step length during each cue condition and an uncued control condition. The music and metronome cues produced comparable results in cadence manipulation, with reduced cadence accuracy noted at slower intended frequencies. Nevertheless, the induced cadence elicited a concomitant alteration in step length. The music and metronome cues produced comparable changes to gait, but suggest that temporal control is more limited at slower frequencies, presumably by the challenge of increasing the step length.
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118
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Miranda-Domínguez Ó, Ragothaman A, Hermosillo R, Feczko E, Morris R, Carlson-Kuhta P, Nutt JG, Mancini M, Fair D, Horak FB. Lateralized Connectivity between Globus Pallidus and Motor Cortex is Associated with Freezing of Gait in Parkinson's Disease. Neuroscience 2020; 443:44-58. [PMID: 32629155 PMCID: PMC7503210 DOI: 10.1016/j.neuroscience.2020.06.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 01/26/2023]
Abstract
Freezing of gait (FoG) is a brief, episodic absence or marked reduction of forward progression of the feet, despite the intention to walk, that is common in people with Parkinson's disease (PD). We hypothesized that not only motor, but higher level cognitive and attention areas may be impaired in freezers. In this study, we aimed to characterize differences in cortical and subcortical functional connectivity specific to FoG. We examined resting state neuroimaging and objective measures of FoG severity and gait from 103 individuals (28 PD + FoG, 36 PD - FoG and 39 healthy controls). Inertial sensors were used to quantify freezing severity and gait. Groups with and without FoG were matched on age, disease severity, cognitive status, and levodopa medication. MRI data was processed using surface-based registration. High-quality imaging data were used to characterize differences in connectivity specific to FoG using a pre-defined set of Regions of Interest (ROIs) and validated using whole-brain connectivity analysis. Associations between functional connectivity and objective measures of FoG were determined via predictive modeling using hold-out cross validation. We found that connectivity between the left globus pallidus (GP) and left somatosensory cortex and between two brain areas in the default and insular/vestibular networks exhibited significant differences specific to FoG and were also strong and significant predictors of FoG severity. Our findings suggest that the interplay among motor, default and vestibular areas of the left cortex are critical in the pathology of FoG.
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Affiliation(s)
- Óscar Miranda-Domínguez
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Anjanibhargavi Ragothaman
- Department of Biomedical Engineering, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Robert Hermosillo
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Eric Feczko
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Rosie Morris
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Patricia Carlson-Kuhta
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - John G Nutt
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Martina Mancini
- Department of Biomedical Engineering, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Damien Fair
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Advanced Imaging Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States
| | - Fay B Horak
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Biomedical Engineering, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States.
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119
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Chung CLH, Mak MKY, Hallett M. Transcranial Magnetic Stimulation Promotes Gait Training in Parkinson Disease. Ann Neurol 2020; 88:933-945. [PMID: 32827221 DOI: 10.1002/ana.25881] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine whether priming with 1 or 25Hz repetitive transcranial magnetic stimulation (rTMS) will enhance the benefits from treadmill training up to 3 months postintervention in people with Parkinson disease (PD), and to evaluate the underlying changes in cortical excitability. METHODS This randomized double-blind, placebo-controlled trial was conducted between October 2016 and December 2018. Fifty-one participants with PD were randomized to receive 12 sessions of rTMS (25Hz, 1Hz, or sham) followed by treadmill training. All participants were assessed at baseline and 1 day, 1 month, and 3 months postintervention. Primary outcome was fastest walking speed, and secondary outcomes were timed up-and-go test (TUG), dual-task TUG (DT-TUG), motor section of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III), and electrophysiological evaluation of cortical excitability by TMS. RESULTS The 1 and 25Hz rTMS groups produced a greater improvement in fastest walking speed at 1 day and 3 months postintervention than the sham group. Only the 1 and 25Hz rTMS groups sustained the improvements in TUG, and had a significant improvement in DT-TUG and MDS-UPDRS-III for up to 3 months. Behavioral improvements correlated with increased cortical silent period and short-interval intracortical inhibition in both groups receiving real rTMS. INTERPRETATION Priming with 1 and 25Hz rTMS can augment the benefits of treadmill training and lead to long-term motor improvement up to 3 months postintervention. The motor improvement at follow-up was associated with a normalization of cortical excitability, which in turn suggests an alteration of the homeostatic plasticity range. Rebalancing cortical excitability by rTMS appears critical for plasticity induction. ANN NEUROL 2020;88:933-945.
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Affiliation(s)
- Chloe Lau-Ha Chung
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Margaret Kit-Yi Mak
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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120
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Weiss D, Schoellmann A, Fox MD, Bohnen NI, Factor SA, Nieuwboer A, Hallett M, Lewis SJG. Freezing of gait: understanding the complexity of an enigmatic phenomenon. Brain 2020; 143:14-30. [PMID: 31647540 DOI: 10.1093/brain/awz314] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/07/2019] [Accepted: 08/16/2019] [Indexed: 12/15/2022] Open
Abstract
Diverse but complementary methodologies are required to uncover the complex determinants and pathophysiology of freezing of gait. To develop future therapeutic avenues, we need a deeper understanding of the disseminated functional-anatomic network and its temporally associated dynamic processes. In this targeted review, we will summarize the latest advances across multiple methodological domains including clinical phenomenology, neurogenetics, multimodal neuroimaging, neurophysiology, and neuromodulation. We found that (i) locomotor network vulnerability is established by structural damage, e.g. from neurodegeneration possibly as result from genetic variability, or to variable degree from brain lesions. This leads to an enhanced network susceptibility, where (ii) modulators can both increase or decrease the threshold to express freezing of gait. Consequent to a threshold decrease, (iii) neuronal integration failure of a multilevel brain network will occur and affect one or numerous nodes and projections of the multilevel network. Finally, (iv) an ultimate pathway might encounter failure of effective motor output and give rise to freezing of gait as clinical endpoint. In conclusion, we derive key questions from this review that challenge this pathophysiological view. We suggest that future research on these questions should lead to improved pathophysiological insight and enhanced therapeutic strategies.
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Affiliation(s)
- Daniel Weiss
- Centre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Anna Schoellmann
- Centre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Michael D Fox
- Berenson-Allen Center, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical Center, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Nicolaas I Bohnen
- Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA; Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA
| | - Stewart A Factor
- Department of Neurology, Emory School of Medicine, Atlanta, GA, USA
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia
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121
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Droby A, Maidan I, Jacob Y, Giladi N, Hausdorff JM, Mirelman A. Distinct Effects of Motor Training on Resting-State Functional Networks of the Brain in Parkinson’s Disease. Neurorehabil Neural Repair 2020; 34:795-803. [DOI: 10.1177/1545968320940985] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background. Nigrostriatal dopaminergic loss is a hallmark of Parkinson’s disease (PD) pathophysiology, leading to motor Parkinsonism. Different intervention protocols have shown that motor and cognitive functions improvement in PD occur via the modulation of distinct motor and cognitive pathways. Objective. To investigate the effects of two motor training programs on the brains’ functional networks in PD patients. Methods. Thirty-seven PD patients were prospectively studied. All enrolled patients underwent either treadmill training (TT) (n = 19) or treadmill with virtual reality (TT + VR) (n = 18) for 6 weeks. Magnetic resonance imaging (MRI) scans (3 T) acquiring 3-dimensional T1-weighted and resting-state functional MRI (rs-fMRI) data sets were performed at baseline and after 6 weeks. Independent component analysis (ICA) was conducted, and functional connectivity (FC) changes within large-scale functional brain networks were examined. Results. In both groups, significant post-training FC decrease in striatal, limbic, and parietal regions within the basal ganglia network, executive control network, and frontal-striatal network, and significant FC increase in the caudate, and cingulate within the sensorimotor network (SMN) were observed. Moreover, a significant time × group interaction was detected where TT + VR training had greater effects on FC levels in the supplementary motor area (SMA) and right precentral gyrus within the SMN, and in the right middle frontal gyrus (MFG) within the cerebellar network. These FC alterations were associated with improved usual and dual-task walking performance. Conclusions. These results suggest that TT with-and-without the addition of a VR component affects distinct neural pathways, highlighting the potential for beneficial neural plasticity in PD. Such distinctive task-specific pathways may foster the facilitation of interventions tailored to the individual needs of PD patients. Registered at Clinicaltrials.gov number: NCT01732653.
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Affiliation(s)
- Amgad Droby
- Labratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement Cognition and Mobility (CMCM), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
- Sagol School for Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Inbal Maidan
- Labratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement Cognition and Mobility (CMCM), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
- Sagol School for Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yael Jacob
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nir Giladi
- Labratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement Cognition and Mobility (CMCM), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
- Sagol School for Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M. Hausdorff
- Labratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement Cognition and Mobility (CMCM), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
- Sagol School for Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Rush University Medical Center, Chicago, IL, USA
| | - Anat Mirelman
- Labratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement Cognition and Mobility (CMCM), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
- Sagol School for Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Florio TM. Stereotyped, automatized and habitual behaviours: are they similar constructs under the control of the same cerebral areas? AIMS Neurosci 2020; 7:136-152. [PMID: 32607417 PMCID: PMC7321770 DOI: 10.3934/neuroscience.2020010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/18/2020] [Indexed: 11/19/2022] Open
Abstract
Comprehensive knowledge about higher executive functions of motor control has been covered in the last decades. Critical goals have been targeted through many different technological approaches. An abundant flow of new results greatly progressed our ability to respond at better-posited answers to look more than ever at the challenging neural system functioning. Behaviour is the observable result of the invisible, as complex cerebral functioning. Many pathological states are approached after symptomatology categorisation of behavioural impairments is achieved. Motor, non-motor and psychiatric signs are greatly shared by many neurological/psychiatric disorders. Together with the cerebral cortex, the basal ganglia contribute to the expression of behaviour promoting the correct action schemas and the selection of appropriate sub-goals based on the evaluation of action outcomes. The present review focus on the basic classification of higher motor control functioning, taking into account the recent advances in basal ganglia structural knowledge and the computational model of basal ganglia functioning. We discuss about the basal ganglia capability in executing ordered motor patterns in which any single movement is linked to each other into an action, and many actions are ordered into each other, giving them a syntactic value to the final behaviour. The stereotypic, automatized and habitual behaviour's constructs and controls are the expression of successive stages of rule internalization and categorisation aimed in producing the perfect spatial-temporal control of motor command.
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Affiliation(s)
- Tiziana M Florio
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
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123
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Wang X, Li L, Wei W, Zhu T, Huang GF, Li X, Ma HB, Lv Y. Altered activation in sensorimotor network after applying rTMS over the primary motor cortex at different frequencies. Brain Behav 2020; 10:e01670. [PMID: 32506744 PMCID: PMC7375128 DOI: 10.1002/brb3.1670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/20/2020] [Accepted: 05/07/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) can modulate brain activity both in the stimulated site and remote brain areas of the sensorimotor network. However, the modulatory effects of rTMS at different frequencies remain unclear. Here, we employed finger-tapping task-based fMRI to investigate alterations in activation of the sensorimotor network after the application of rTMS over the left M1 at different frequencies. MATERIALS AND METHODS Forty-five right-handed healthy participants were randomly divided into three groups by rTMS frequency (HF, high-frequency, 3 Hz; LF, low-frequency, 1 Hz; and SHAM) and underwent two task-fMRI sessions (RH, finger-tapping with right index finger; LH, finger-tapping with left index finger) before and after applying rTMS over the left M1. We defined regions of interest (ROIs) in the sensorimotor network based on group-level activation maps (pre-rTMS) from RH and LH tasks and calculated the percentage signal change (PSC) for each ROI. We then assessed the differences of PSC within HF or LF groups and between groups. RESULTS Application of rTMS at different frequencies resulted in a change in activation of several areas of the sensorimotor network. We observed the increased PSC in M1 after high-frequency stimulation, while we detected the reduced PSC in the primary sensory cortex (S1), ventral premotor cortex (PMv), supplementary motor cortex (SMA), and putamen after low-frequency stimulation. Moreover, the PSC in the SMA, dorsal premotor cortex (PMd), and putamen in the HF group was higher than in the LF group after stimulation. CONCLUSION Our findings suggested that activation alterations within sensorimotor network are dependent on the frequency of rTMS. Therefore, our findings contribute to understanding the effects of rTMS on brain activation in healthy individuals and ultimately may further help to suggest mechanisms of how rTMS could be employed as a therapeutic tool.
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Affiliation(s)
- Xiaoyu Wang
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Lingyu Li
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.,Shandong Huayu University of Technology, Dezhou, China
| | - Wei Wei
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Tingting Zhu
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Guo-Feng Huang
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Xue Li
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Hui-Bin Ma
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China.,Integrated Medical Research School, Jiamusi University, Jiamusi, China
| | - Yating Lv
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
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The Effects of Task Prioritization on Dual-Tasking Postural Control in Patients With Parkinson Disease Who Have Different Postural Impairments. Arch Phys Med Rehabil 2020; 101:1212-1219. [DOI: 10.1016/j.apmr.2020.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/12/2020] [Accepted: 02/24/2020] [Indexed: 11/19/2022]
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125
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Human brain connectivity: Clinical applications for clinical neurophysiology. Clin Neurophysiol 2020; 131:1621-1651. [DOI: 10.1016/j.clinph.2020.03.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/12/2022]
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126
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Ehgoetz Martens KA, Peterson DS, Almeida QJ, Lewis SJG, Hausdorff JM, Nieuwboer A. Behavioural manifestations and associated non-motor features of freezing of gait: A narrative review and theoretical framework. Neurosci Biobehav Rev 2020; 116:350-364. [PMID: 32603716 DOI: 10.1016/j.neubiorev.2020.06.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022]
Abstract
Over the past decade, non-motor related symptoms and provocative contexts have offered unique opportunities to gain insight into the potential mechanisms that may underpin freezing of gait (FOG) in Parkinson's disease (PD). While this large body of work has informed several theoretical models, to date, few are capable of explaining behavioural findings across multiple domains (i.e. cognitive, sensory-perceptual and affective) and in different behavorial contexts. As such, the exact nature of these interrelationships and their neural basis remain quite enigmatic. Here, the non-motor, behavioural evidence for cognitive, sensory-perceptual and affective contributors to FOG are reviewed and synthesized by systematically examining (i) studies that manipulated contextual environments that provoke freezing of gait, (ii) studies that uncovered factors that have been proposed to contribute to freezing, and (iii) studies that longitudinally tracked factors that predict the future development of freezing of gait. After consolidating the evidence, we offer a novel perspective for integrating these multi-faceted behavioural patterns and identify key challenges that warrant consideration in future work.
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Affiliation(s)
| | - Daniel S Peterson
- College of Health Solutions, Arizona State University, Arizona, USA; Phoenix Veterans Affairs Medical Centre, Arizona, USA
| | - Quincy J Almeida
- Movement Disorders Research & Rehabilitation Centre, Laurier University, Waterloo, ON, Canada
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, New South Wales, Australia
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Dept of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Alice Nieuwboer
- Department of Rehabilitation Science, University of Leuven, Leuven, Belgium
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Bonnet CT, Delval A, Singh T, Kechabia YR, Defebvre L. New insight into Parkinson's disease-related impairment of the automatic control of upright stance. Eur J Neurosci 2020; 52:4851-4862. [PMID: 32558964 DOI: 10.1111/ejn.14870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
Parkinson's disease (PD) affects the automatic control of body movements. In our study, we tested PD-related impairments in automatic postural control in quiet upright stance. Twenty PD patients (mean age: 60 ± 8 years; Hoehn and Yahr: 2.00 ± 0.32, on-drug) and twenty age-matched controls (61 ± 7 years) were recruited. We studied interrelations between center-of-pressure movements, body movements (head, neck, and lower back), eye movements and variability of pupil size. Participants performed two fixation tasks while standing, during which they looked at: (a) a cross surrounded by a white background; and (b) a cross surrounded by a structured visual background (images used: rooms in houses). PD patients exhibited stronger and weaker correlations between eye and center-of-pressure/body movement variables than age-matched controls in the white and structured fixation tasks, respectively. Partial correlations, controlling for variability of pupil size showed that PD patients used lower and greater attentional resources than age-matched controls to control their eye and center-of-pressure/body movements simultaneously in the white fixation and structured fixation tasks, respectively. In the white fixation task, PD patients used attentional resources to optimize visuomotor coupling between eye and body movements to control their posture. In the structured fixation task, the salient visual stimuli distracted PD patients' attention and that possibly affected postural control by deteriorating the automatic visuomotor coupling. In contrast, age-matched controls were able to use surrounding visual background to improve the automatic coupling between eye and center-of-pressure movements to control their posture. These results suggest that cluttered environments may distract PD patients and deteriorate their postural control.
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Affiliation(s)
- Cédrick T Bonnet
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Arnaud Delval
- Unité INSERM 1172, Service de Neurophysiologie Clinique, CHRU Lille, Hôpital Salengro, Lille, France
| | - Tarkeshwar Singh
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Yann-Romain Kechabia
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Luc Defebvre
- CHRU Lille, Unité INSERM 1172, Service de Neurophysiologie Clinique, Hôpital Salengro, Lille, France
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128
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Hoppe M, Chawla G, Browner N, Lewek MD. The effects of metronome frequency differentially affects gait on a treadmill and overground in people with Parkinson disease. Gait Posture 2020; 79:41-45. [PMID: 32344358 DOI: 10.1016/j.gaitpost.2020.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Treadmills and rhythmic auditory cueing can influence stepping rhythm for individuals with Parkinson disease (PD). Of concern, however, is that auditory cueing directly addresses the temporal features of gait, whereas adjusting step length may be more important for people with PD. Stepping to a faster cadence when walking overground may increase gait speed, but without requiring an increased step length. Furthermore, given the potentially valuable role of walking on a treadmill for individuals with PD, we are concerned that increasing cadence with rhythmic auditory cueing while walking at a constant treadmill speed will induce even shorter steps. RESEARCH QUESTION What is the effect of different metronome cue frequencies on spatiotemporal gait parameters when walking overground compared to walking on a treadmill in people with PD? METHODS Using a repeated-measures design, 21 people with PD (stage 1-3) walked overground and on a treadmill with and without metronome cues of 85 %, 100 %, and 115 % of their baseline cadence frequency for one minute each. We assessed step length, and cadence during all conditions. Gait speed was assessed during overground gait. RESULTS An interaction effect between cue frequency and walking environment revealed that participants took longer steps during the 85 % condition on the treadmill only. When walking overground, metronome cues of 85 % and 115 % of baseline cadence yielded decreases and increases, respectively, in both cadence and gait speed with no associated change in step length. SIGNIFICANCE These data suggest that people with PD are able to alter spatiotemporal gait parameters immediately when provided the appropriate metronome cue and walking environment. We propose to target shortened step lengths by stepping to the beat of slow frequency auditory cues while walking on a treadmill, whereas the use of fast frequency cues during overground walking can facilitate faster walking speeds.
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Affiliation(s)
- Madelon Hoppe
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Guneet Chawla
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nina Browner
- Department of Neurology University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael D Lewek
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Orcioli-Silva D, Vitório R, Nóbrega-Sousa P, da Conceição NR, Beretta VS, Lirani-Silva E, Gobbi LTB. Levodopa Facilitates Prefrontal Cortex Activation During Dual Task Walking in Parkinson Disease. Neurorehabil Neural Repair 2020; 34:589-599. [DOI: 10.1177/1545968320924430] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background. Although dopaminergic medication improves dual task walking in people with Parkinson disease (PD), the underlying neural mechanisms are not yet fully understood. As prefrontal cognitive resources are involved in dual task walking, evaluation of the prefrontal cortex (PFC) is required. Objective. To investigate the effect of dopaminergic medication on PFC activity and gait parameters during dual task walking in people with PD. Methods. A total of 20 individuals with PD (69.8 ± 5.9 years) and 30 healthy older people (68.0 ± 5.6 years) performed 2 walking conditions: single and dual task (walking while performing a digit vigilance task). A mobile functional near infrared spectroscopy system and an electronic sensor carpet were used to analyze PFC activation and gait parameters, respectively. Relative concentrations of oxygenated hemoglobin (HbO2) from the left and right PFC were measured. Results. People with PD in the off state did not present changes in HbO2 level in the left PFC across walking conditions. In contrast, in the on state, they presented increased HbO2 levels during dual task compared with single task. Regardless of medication state, people with PD presented increased HbO2 levels in the right PFC during dual task walking compared with single task. The control group demonstrated increased PFC activity in both hemispheres during dual task compared with single task. People with PD showed increases in both step length and velocity in the on state compared with the off state. Conclusions. PD limits the activation of the left PFC during dual task walking, and dopaminergic medication facilitates its recruitment.
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Affiliation(s)
- Diego Orcioli-Silva
- Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (UNESP), Rio Claro, Brazil
- Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Rodrigo Vitório
- Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (UNESP), Rio Claro, Brazil
- Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Priscila Nóbrega-Sousa
- Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (UNESP), Rio Claro, Brazil
- Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Núbia Ribeiro da Conceição
- Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (UNESP), Rio Claro, Brazil
- Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Victor Spiandor Beretta
- Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (UNESP), Rio Claro, Brazil
- Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Ellen Lirani-Silva
- Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (UNESP), Rio Claro, Brazil
- Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Lilian Teresa Bucken Gobbi
- Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), São Paulo State University (UNESP), Rio Claro, Brazil
- Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
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130
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Hirata K, Hattori T, Kina S, Chen Q, Ohara M, Yokota T. Striatal Dopamine Denervation Impairs Gait Automaticity in Drug‐Naïve Parkinson's Disease Patients. Mov Disord 2020; 35:1037-1045. [DOI: 10.1002/mds.28024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kosei Hirata
- Department of Neurology and Neurological ScienceGraduate School of Medical and Dental Sciences and Center for Brain Integration Research, Tokyo Medical and Dental University Tokyo Japan
| | - Takaaki Hattori
- Department of Neurology and Neurological ScienceGraduate School of Medical and Dental Sciences and Center for Brain Integration Research, Tokyo Medical and Dental University Tokyo Japan
| | - Satoko Kina
- Department of Neurology and Neurological ScienceGraduate School of Medical and Dental Sciences and Center for Brain Integration Research, Tokyo Medical and Dental University Tokyo Japan
| | - Qingmeng Chen
- Department of Neurology and Neurological ScienceGraduate School of Medical and Dental Sciences and Center for Brain Integration Research, Tokyo Medical and Dental University Tokyo Japan
| | - Masahiro Ohara
- Department of Neurology and Neurological ScienceGraduate School of Medical and Dental Sciences and Center for Brain Integration Research, Tokyo Medical and Dental University Tokyo Japan
| | - Takanori Yokota
- Department of Neurology and Neurological ScienceGraduate School of Medical and Dental Sciences and Center for Brain Integration Research, Tokyo Medical and Dental University Tokyo Japan
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Gennaro F, Maino P, Kaelin-Lang A, De Bock K, de Bruin ED. Corticospinal Control of Human Locomotion as a New Determinant of Age-Related Sarcopenia: An Exploratory Study. J Clin Med 2020; 9:E720. [PMID: 32155951 PMCID: PMC7141202 DOI: 10.3390/jcm9030720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia is a muscle disease listed within the ICD-10 classification. Several operational definitions have been created for sarcopenia screening; however, an international consensus is lacking. The Centers for Disease Control and Prevention have recently recognized that sarcopenia detection requires improved diagnosis and screening measures. Mounting evidence hints towards changes in the corticospinal communication system where corticomuscular coherence (CMC) reflects an effective mechanism of corticospinal interaction. CMC can be assessed during locomotion by means of simultaneously measuring Electroencephalography (EEG) and Electromyography (EMG). The aim of this study was to perform sarcopenia screening in community-dwelling older adults and explore the possibility of using CMC assessed during gait to discriminate between sarcopenic and non-sarcopenic older adults. Receiver Operating Characteristic (ROC) curves showed high sensitivity, precision and accuracy of CMC assessed from EEG Cz sensor and EMG sensors located over Musculus Vastus Medialis [Cz-VM; AUC (95.0%CI): 0.98 (0.92-1.04), sensitivity: 1.00, 1-specificity: 0.89, p < 0.001] and with Musculus Biceps Femoris [Cz-BF; AUC (95.0%CI): 0.86 (0.68-1.03), sensitivity: 1.00, 1-specificity: 0.70, p < 0.001]. These muscles showed significant differences with large magnitude of effect between sarcopenic and non-sarcopenic older adults [Hedge's g (95.0%CI): 2.2 (1.3-3.1), p = 0.005 and Hedge's g (95.0%CI): 1.5 (0.7-2.2), p = 0.010; respectively]. The novelty of this exploratory investigation is the hint toward a novel possible determinant of age-related sarcopenia, derived from corticospinal control of locomotion and shown by the observed large differences in CMC when sarcopenic and non-sarcopenic older adults are compared. This, in turn, might represent in future a potential treatment target to counteract sarcopenia as well as a parameter to monitor the progression of the disease and/or the potential recovery following other treatment interventions.
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Affiliation(s)
- Federico Gennaro
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, 8093 Zurich, Switzerland; (K.D.B.); (E.D.d.B.)
| | - Paolo Maino
- Pain Management Center, Neurocenter of Southern Switzerland, Regional Hospital of Lugano, 6962 Lugano, Switzerland;
| | - Alain Kaelin-Lang
- Neurocenter of Southern Switzerland, Regional Hospital of Lugano, 6900 Lugano, Switzerland;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Medical faculty, University of Bern, 3008 Bern, Switzerland
| | - Katrien De Bock
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, 8093 Zurich, Switzerland; (K.D.B.); (E.D.d.B.)
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, 8093 Zurich, Switzerland; (K.D.B.); (E.D.d.B.)
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
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Ferrazzoli D, Ortelli P, Cucca A, Bakdounes L, Canesi M, Volpe D. Motor-cognitive approach and aerobic training: a synergism for rehabilitative intervention in Parkinson's disease. Neurodegener Dis Manag 2020; 10:41-55. [PMID: 32039653 DOI: 10.2217/nmt-2019-0025] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) results in a complex deterioration of motor behavior. Effective pharmacological or surgical treatments addressing the whole spectrum of both motor and cognitive symptoms are lacking. The cumulative functional impairment may have devastating socio-economic consequences on both patients and caregivers. Comprehensive models of care based on multidisciplinary approaches may succeed in better addressing the overall complexity of PD. Neurorehabilitation is a highly promising non-pharmacological intervention for managing PD. The scientific rationale beyond rehabilitation and its practical applicability remain to be established. In the present perspective, we aim to discuss the current evidence supporting integrated motor-cognitive and aerobic rehabilitation approaches for patients with PD while suggesting a practical framework to optimize this intervention in the next future.
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Affiliation(s)
- Davide Ferrazzoli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Paola Ortelli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy.,The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, Department of Neurology, NYU School of Medicine, New York, NY 10017, USA
| | - Leila Bakdounes
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
| | - Margherita Canesi
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
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Polskaia N, St-Amant G, Fraser S, Lajoie Y. A functional near-infrared spectroscopy (fNIRS) examination of how self-initiated sequential movements become automatic. Exp Brain Res 2020; 238:657-666. [PMID: 32030471 DOI: 10.1007/s00221-020-05742-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/27/2020] [Indexed: 12/11/2022]
Abstract
The neural mechanisms underlying movement automaticity have been investigated using PET and fMRI and more recently functional near-infrared spectroscopy (fNIRS). As fNIRS is an emerging technique, the objective of the present study was to replicate the functional magnetic resonance imaging-related motor sequence findings as reported by Wu et al. (J Neurophysiol 91:1690-1698, https://doi.org/10.1152/jn.01052.2003, 2004) using fNIRS. Seventeen right-handed participants practiced self-initiated sequential finger movements of two lengths (4 and 12) until a level of automaticity was achieved. Automaticity was evaluated by performing a visual-letter-counting task concurrently with the sequential finger movements. Our data were unable to replicate the pre-to-post-practice decrease in cortical activity in the left dorsolateral prefrontal cortex for both motor sequence tasks. The findings did reveal increased contribution from the right hemisphere following learning. The observed lateralization is suggestive of explicit learning and the involvement of working memory in motor sequence production.
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Affiliation(s)
- Nadia Polskaia
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, 125 University Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Gabrielle St-Amant
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, 125 University Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Sarah Fraser
- Faculty of Health Science, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Yves Lajoie
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, 125 University Avenue, Ottawa, ON, K1N 6N5, Canada.
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134
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Hsiu-Chen C, Chiung-Chu C, Jiunn-Woei L, Wei-Da C, Yi-Hsin W, Ya-Ju C, Chin-Song L. The effects of dual-task in patients with Parkinson's disease performing cognitive-motor paradigms. J Clin Neurosci 2020; 72:72-78. [PMID: 31952973 DOI: 10.1016/j.jocn.2020.01.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/05/2020] [Indexed: 11/29/2022]
Abstract
Patients with Parkinson's disease (PD) exhibit impaired dual-task (DT) performance. A recent meta-analysis confirmed that dual tasking severely affects walking performance in PD patients. However, one report indicated that a cycling DT paradigm has facilitative effects on cognition. We investigated the effects of dual tasking by using walking and cycling as motor tasks and revealed the clinical determinants associated with DT performance. Twenty-seven eligible participants were enrolled for clinical, cognitive-walking, and cognitive-cycling DT paradigm investigations. The mean age and age at onset of the patients were 59.87 ± 6.3 and 53.11 ± 8.4 years, respectively. Both the off- and on-state akinesia subscores were worse on the more-affected side than on the less-affected side. However, the DT effects on the cycling and gait outcomes on both the more-affected and the less-affected side showed no significant differences. The DT effect on the two motor tasks and cognitive performance during a concurrent walking task declined. Nevertheless, the DT effect on cognition improved during cycling. The present study also revealed that the levodopa equivalent daily dosage was highly associated with cognitive-cycling performance and that the akinesia subscore was the most relevant factor that contributed to cognitive-walking performance. In conclusion, DT facilitation or interference might be mediated by the type of motor task applied. The cognitive-cycling DT paradigm had a facilitative effect on cognition. Cycling exercise may diminish motor dysfunction has been investigated. We suggest that cognitive-cycling DT training is a potential adjuvant therapeutic strategy for patients with PD to promote motor and cognitive functions.
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Affiliation(s)
- Chang Hsiu-Chen
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taiwan; School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Professor Lu Neurological Clinic, Taoyuan, Taiwan
| | - Chen Chiung-Chu
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Liaw Jiunn-Woei
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Mechanical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Chiou Wei-Da
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Physical Rehabilitation, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Weng Yi-Hsin
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Chang Ya-Ju
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taiwan; School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Lu Chin-Song
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taiwan; Professor Lu Neurological Clinic, Taoyuan, Taiwan.
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135
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Yaffe JA, Zlotnik Y, Ifergane G, Levy-Tzedek S. Implicit task switching in Parkinson's disease is preserved when on medication. PLoS One 2020; 15:e0227555. [PMID: 31935247 PMCID: PMC6959575 DOI: 10.1371/journal.pone.0227555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 12/20/2019] [Indexed: 02/08/2023] Open
Abstract
People with Parkinson's disease have been shown to have difficulty switching between movement plans. In the great majority of studies, the need to switch between tasks was made explicitly. Here, we tested whether people with Parkinson's disease, taking their normal medication, have difficulty switching between implicitly specified tasks. We further examined whether this switch is performed predictively or reactively. Twenty five people with Parkinson's disease continuously increased or decreased the frequency of their arm movements, inducing an abrupt-but unaware-switch between rhythmic movements (at high frequencies) and discrete movements (at low frequencies). We tested whether that precipitous change was performed reactively or predictively. We found that 56% of participants predictively switched between the two movement types. The ability of people with Parkinson's disease, taking their regular medication, to predictively control their movements on implicit tasks is thus preserved.
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Affiliation(s)
- Jacob A. Yaffe
- Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yair Zlotnik
- Neurology Department, Soroka University Medical Center, Beer-Sheva, Israel
| | - Gal Ifergane
- Neurology Department, Soroka University Medical Center, Beer-Sheva, Israel
| | - Shelly Levy-Tzedek
- Recanati School for Community Health Professions, Department of Physical Therapy, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany
- * E-mail:
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136
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Multimodal Training Reduces Fall Frequency as Physical Activity Increases in Individuals With Parkinson's Disease. J Phys Act Health 2019; 16:1085-1091. [PMID: 31648204 DOI: 10.1123/jpah.2018-0595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 08/05/2019] [Accepted: 08/19/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Parkinson's disease (PD) results in a global decrease in information processing, ultimately resulting in dysfunction executing motor-cognitive tasks. Motor-cognitive impairments contribute to postural instability, often leading to falls and decreased physical activity. The aim of this study was to determine the effects of a multimodal training (MMT) versus single-modal (SMT) training on motor symptoms, fall frequency, and physical activity in patients with PD classified as fallers. METHODS Individuals with PD were randomized into SMT (n = 11) or MMT (n = 10) and completed training 3 times per week for 8 weeks. The SMT completed gait and cognitive training separately, whereas MMT completed gait and cognitive training simultaneously during each 45-minute session. Physical activity, 30-day fall frequency, and PD motor symptoms were assessed at baseline, posttreatment, and during a 4-week follow-up. RESULTS Both groups exhibited significant (P < .05) improvements in clinical ratings of motor function, as symptoms improved by 8% and 15% for SMT and MMT, respectively. Physical activity significantly increased (P < .05) for both groups from baseline (mean steps 4942 [4415]) to posttreatment (mean steps 5914 [5425]). The MMT resulted in a significant 60% reduction in falls. CONCLUSIONS Although SMT and MMT approaches are both effective in improving physical activity and motor symptoms of PD, only MMT reduced fall frequency after the intervention.
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137
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The Two Minute Walk Test Overground and on a Self-Paced Treadmill Detects Dual Task Deficits in Individuals With Parkinson's Disease. J Aging Phys Act 2019; 27:843-847. [PMID: 31034314 DOI: 10.1123/japa.2018-0264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this project was to 1) evaluate the potential of the Two Minute Walk Test (2MWT) to detect declines in gait velocity under dual task conditions, and 2) compare gait velocity overground and on a self-paced treadmill in Parkinson's disease (PD). Twenty-three individuals with PD completed the 2MWT under single and dual task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single to dual task conditions overground (1.32±.22 m/sec to 1.10±.25 m/sec, p <.001) and on the self-paced treadmill (1.24±.21 m/sec to 1.05±.25 m/sec, p <.001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2MWT coupled with a cognitive task provides an effective model of identifying dual task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.
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138
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Letter regarding the article "Which cognitive dual-task walking causes most interference on the Timed Up and Go test in Parkinson's disease: a controlled study". Neurol Sci 2019; 41:1281-1282. [PMID: 31754874 DOI: 10.1007/s10072-019-04125-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
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139
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Franzén E, Johansson H, Freidle M, Ekman U, Wallén MB, Schalling E, Lebedev A, Lövdén M, Holmin S, Svenningsson P, Hagströmer M. The EXPANd trial: effects of exercise and exploring neuroplastic changes in people with Parkinson's disease: a study protocol for a double-blinded randomized controlled trial. BMC Neurol 2019; 19:280. [PMID: 31718583 PMCID: PMC6849188 DOI: 10.1186/s12883-019-1520-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) affects many physiological systems essential for balance control. Recent studies suggest that intensive and cognitively demanding physical exercise programs are capable of inducing plastic brain changes in PD. We have developed a highly challenging balance training (the HiBalance) program that emphasizes critical aspects of balance control through progressively introducing more challenging exercises which incorporates dual-tasking. Earlier studies have shown it to be effective in improving balance, gait and dual-tasking. The study design has thereafter been adjusted to link intervention-induced behavioral changes to brain morphology and function. Specifically, in this randomized controlled trial, we will determine the effects of the HiBalance program on balance, gait and cognition and relate this to task-evoked functional MRI (fMRI), as well as brain-derived neurotrophic factor (BDNF) in participants with mild-moderate PD. METHODS One hundred participants with idiopathic PD, Hoehn & Yahr stage 2 or 3, ≥ 60 years of age, ≥ 21 on Montreal Cognitive Assessment will be recruited in successive waves and randomized into either the HiBalance program or to an active control group (the HiCommunication program, targeting speech and communication). Both interventions will be performed in small groups, twice a week with 1 h sessions for 10 weeks. In addition, a 1 h, once a week, home exercise program will also be performed. A double-blinded design will be used. At the pre- and post-assessments, participants will be assessed on balance (main outcome), gait, cognitive functions, physical activity, voice/speech function, BDNF in serum and fMRI (3 T Philips) during performance of motor-cognitive tasks. DISCUSSION Since there is currently no cure for PD, findings of neuroplastic brain changes in response to exercise would revolutionize the way we treat PD, and, in turn, provide new hope to patients for a life with better health, greater independence and improved quality of life. TRIAL REGISTRATION ClincalTrials.gov: NCT03213873, first posted July 11, 2017.
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Affiliation(s)
- Erika Franzén
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. .,Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden. .,Stockholms Sjukhem, R&D unit, Stockholm, Sweden.
| | - Hanna Johansson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden
| | - Malin Freidle
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Urban Ekman
- Stockholms Sjukhem, R&D unit, Stockholm, Sweden.,Department of Neurobiology, Care sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Medical Psychology, Stockholm, Sweden
| | - Martin Benka Wallén
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Ellika Schalling
- Department of Clinical Science, Intervention and Technology, CLINTEC, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Speech and Language Pathology, Stockholm, Sweden
| | - Alexander Lebedev
- Department of Neurobiology, Care sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Martin Lövdén
- Department of Neurobiology, Care sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Staffan Holmin
- Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden.,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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140
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Koh SB, Park YM, Kim MJ, Kim WS. Influences of elbow, shoulder, trunk motion and temporospatial parameters on arm swing asymmetry of Parkinson's disease during walking. Hum Mov Sci 2019; 68:102527. [PMID: 31689575 DOI: 10.1016/j.humov.2019.102527] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/26/2019] [Accepted: 09/26/2019] [Indexed: 11/19/2022]
Abstract
Arm swing asymmetry is commonly observed in early Parkinson's disease (PD) and has been found to be useful for early diagnosis. However, there are uncertainties about the nature of its relationships with gait parameters, especially shoulder and elbow motions. Therefore, this study explored how these relationships are different between PD and controls. Forty one early PD and 23 controls were included. Participants walked at self-selected speed for 3D motion analysis. Arm swing at the wrist (AS), temporospatial parameters and kinematics in elbow, shoulder and trunk were obtained. Amplitudes and asymmetries of these variables were compared between PD and control groups. PD group showed increased AS asymmetry, compared to controls. Multiple hierarchical regression analysis on AS asymmetry was conducted in order to investigate how PD influences on the relationship between AS asymmetry and other variables. In pooled data (PD and control group), asymmetries in elbow and shoulder range of motion (RoM) were significant predictors for AS asymmetry but walking speed and asymmetries in temporospatial parameters were not significant. Group effect (PD effect) was significantly mediated by only elbow RoM asymmetry. Interaction between group and elbow RoM asymmetry was statistically significant, indicating that group was an effect modifier for elbow RoM asymmetry effect on AS asymmetry. Conclusively, arm swing asymmetry measured at the wrist represents the involvement of PD effect on the unilateral and distal upper limb in early stage. These findings are helpful for future researches related to clinical applications and mechanisms of arm swing asymmetry in PD.
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Affiliation(s)
- Seong-Beom Koh
- Department of Neurology & Parkinson's Disease Center, Guro Hospital, Korea University, 148 Gurodong-ro, Guro-gu, Seoul, Republic of Korea.
| | - Young-Min Park
- Department of Neurology & Parkinson's Disease Center, Guro Hospital, Korea University, 148 Gurodong-ro, Guro-gu, Seoul, Republic of Korea; Department of Neurology, Dobong Hospital, 720 Dobong-ro, Dobong-gu, Seoul, Republic of Korea
| | - Mi-Jung Kim
- Department of Neurology & Parkinson's Disease Center, Guro Hospital, Korea University, 148 Gurodong-ro, Guro-gu, Seoul, Republic of Korea; Department of Neurology, Bobath Memorial Hospital, 155-7, Daewangpangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Woo-Sub Kim
- Department of Physical Medicine and Rehabilitation, Guro Hospital, Korea University, 148 Gurodong-ro, Guro-gu, Seoul, Republic of Korea.
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141
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Malling ASB, Morberg BM, Wermuth L, Gredal O, Bech P, Jensen BR. Associations of Motor Symptom Severity and Quality of Life to Motor Task Performance in Upper and Lower Extremities Across Task Complexity in Parkinson's Disease. Motor Control 2019; 23:445-460. [PMID: 30827179 DOI: 10.1123/mc.2018-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2023]
Abstract
The authors examined the associations between the performance of upper- and lower-extremity motor tasks across task complexity and motor symptom severity, overall disease severity, and the physical aspects of quality of life in persons with Parkinson's disease. The performance was assessed for three lower-extremity tasks and two upper-extremity tasks of different levels of complexity. The motor symptoms and overall disease severity correlated significantly with all motor tasks with higher correlation coefficients in the complex tasks. Thus, the strength of the association between disease severity or severity of motor symptoms and motor performance is task-specific, with higher values in complex motor tasks than in simpler motor tasks. Mobility-related and activity-of-daily-living-related quality of life correlated with lower-extremity tasks of low and medium complexity and with the complex upper-extremity task, respectively; this suggests that Parkinson's Disease Questionnaire-39 is capable of differentiating between the impact of gross and fine motor function on quality of life.
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Affiliation(s)
| | - Bo M Morberg
- University of Southern Denmark
- Odense University Hospital
| | - Lene Wermuth
- University of Southern Denmark
- Odense University Hospital
| | - Ole Gredal
- The Danish Rehabilitation Centre for Neuromuscular Diseases
| | - Per Bech
- University Hospital of Copenhagen
| | - Bente R Jensen
- University of Southern Denmark
- Odense University Hospital
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142
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Hu B, Chomiak T. Wearable technological platform for multidomain diagnostic and exercise interventions in Parkinson's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 147:75-93. [PMID: 31607363 DOI: 10.1016/bs.irn.2019.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Physical activity and exercise have become a central component of medical management of chronic illness, particular for the elderly who suffer from neurodegenerative disorders that impair their cognition and mobility. This chapter summarizes our recent research showing that a new generation of wearable technology can be adopted as diagnostic and rehabilitation tools for people living with Parkinson's disease. For example, wearable device-enabled 6-min walking test can be automated to eliminate human supervision and many other technical factors that confound the results with conventional testing. With reduced cost and increased test standardization, the technology can be adopted for population-based screening of cardiovascular fitness and gait rehabilitation training efficacy associated with many medical conditions. The Ambulosono platform for multidomain exercise intervention, in particular, has the potential to deliver lasting clinical benefits in slowing PD progression. The platform, through the integration of brisk walking with behavioral shaping strategies such as contingency reinforcement, anticipatory motor control and musical motivational stimulation, creates a home exercise regime that can transform monotonous walking into a pleasurable daily activity and habit.
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Affiliation(s)
- Bin Hu
- Division of Translational Neuroscience, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Taylor Chomiak
- Division of Translational Neuroscience, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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143
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Belluscio V, Stuart S, Bergamini E, Vannozzi G, Mancini M. The Association between Prefrontal Cortex Activity and Turning Behavior in People with and without Freezing of Gait. Neuroscience 2019; 416:168-176. [PMID: 31330231 PMCID: PMC7778469 DOI: 10.1016/j.neuroscience.2019.07.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/08/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
Abstract
Turning elicits Freezing of Gait (FoG) episodes in people with Parkinson's disease (PD) and is thought to require higher cortical control compared to straight ahead gait. Functional near infrared spectroscopy (fNIRS) has been used to examine prefrontal cortex (PFC) activity while walking, but the relationship between PFC activity and turn performance remains unclear. The aim of this pilot study was to examine PFC activity during turning in PD and healthy controls, and to investigate the association between PFC activity and turning. Thirty-two subjects, 15 freezers (PD + FoG) and 17 non-freezers (PD - FoG), and 8 controls were asked to perform a 2-min turning-in-place test under single-task (ST) and dual-task (DT) conditions. Each participant wore an fNIRS system to measure changes in oxyhemoglobin, as measure of PFC activity, and inertial sensors to quantify turning. Our results show a significant group (p = .050), task (p = .039), and interaction (p = .047) for the PFC activity during turning. Specifically, PD + FoG show higher PFC during turning compared to the other groups; PFC activity during DT is overall different compared to ST with an opposite trend in PD + FoG compared to controls and PD - FoG. In addition, higher PFC is associated with worse FoG in PD + FoG (r = 0.57, p = .048) and with lower number of turns in PD - FoG (r = -0.70, p = .002). The increased PFC activity in PD and the association between higher PFC activity and poorer turning performance may be a sign of poor movement automaticity in PD. Although further investigations are required, these pilot findings may guide development of personalized treatments to improve motor automaticity in PD.
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Affiliation(s)
- Valeria Belluscio
- Universita' degli Studi di Roma Foro Italico, Roma, Italy; Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Samuel Stuart
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | | | | | - Martina Mancini
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.
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144
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Hidalgo-Balbuena AE, Luma AY, Pimentel-Farfan AK, Peña-Rangel T, Rueda-Orozco PE. Sensory representations in the striatum provide a temporal reference for learning and executing motor habits. Nat Commun 2019; 10:4074. [PMID: 31501436 PMCID: PMC6733846 DOI: 10.1038/s41467-019-12075-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 08/18/2019] [Indexed: 12/25/2022] Open
Abstract
Previous studies indicate that the dorsolateral striatum (DLS) integrates sensorimotor information from cortical and thalamic regions to learn and execute motor habits. However, the exact contribution of sensory representations to this process is still unknown. Here we explore the role of the forelimb somatosensory flow in the DLS during the learning and execution of motor habits. First, we compare rhythmic somesthetic representations in the DLS and primary somatosensory cortex in anesthetized rats, and find that sequential and temporal stimuli contents are more strongly represented in the DLS. Then, using a behavioral protocol in which rats developed a stereotyped motor sequence, functional disconnection experiments, and pharmacologic and optogenetic manipulations in apprentice and expert animals, we reveal that somatosensory thalamic- and cortical-striatal pathways are indispensable for the temporal component of execution. Our results indicate that the somatosensory flow in the DLS provides the temporal reference for the development and execution of motor habits. The authors combine anatomical mapping, electrophysiological recordings, lesions, and pharmacological and optogenetic manipulations in rats to examine the role of forelimb somatosensory flow in the dorsolateral striatum in the learning and execution of motor habits.
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Affiliation(s)
- Ana E Hidalgo-Balbuena
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, UNAM, Campus Juriquilla, Boulevard Juriquilla No. 3001, Querétaro, 76230, Mexico
| | - Annie Y Luma
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, UNAM, Campus Juriquilla, Boulevard Juriquilla No. 3001, Querétaro, 76230, Mexico
| | - Ana K Pimentel-Farfan
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, UNAM, Campus Juriquilla, Boulevard Juriquilla No. 3001, Querétaro, 76230, Mexico
| | - Teresa Peña-Rangel
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, UNAM, Campus Juriquilla, Boulevard Juriquilla No. 3001, Querétaro, 76230, Mexico
| | - Pavel E Rueda-Orozco
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, UNAM, Campus Juriquilla, Boulevard Juriquilla No. 3001, Querétaro, 76230, Mexico.
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145
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Clark BC, Woods AJ, Clark LA, Criss CR, Shadmehr R, Grooms DR. The Aging Brain & the Dorsal Basal Ganglia: Implications for Age-Related Limitations of Mobility. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2019; 1:e190008. [PMID: 31497780 PMCID: PMC6731027 DOI: 10.20900/agmr20190008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The capacity to move is essential for independence and declines with age. Limitations in mobility impact ~35% of adults over 70 and the majority of adults over 85. These limitations are highly associated with disability, dependency, and survival. More than 25-years ago the term "sarcopenia" was coined to highlight the age-related loss of muscle mass and strength with the assumption being that sarcopenia led to limitations in mobility. However, contrary to expectations, recent findings clearly indicate these variables only modestly explain limitations in mobility. One likely reason the current sarcopenia variables of muscle mass and strength do not discriminate, or predict, mobility limitations well is because they are heavily influenced by musculoskeletal mechanisms and do not incorporate measures reflective of the central neural control of mobility. Unfortunately, the precise central neural changes associated with aging that lead to decreased mobility are poorly understood. This knowledge gap has hampered the development of effective interventions for mobility limitations and the subsequent reduction of major functional disability for older adults. Here, we discuss the potential role of the motor control circuit of the dorsal basal ganglia as well as dopaminergic function in age-related reductions in mobility.
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Affiliation(s)
- Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH 45701, USA
- Department of Biomedical Sciences, Ohio University, Athens, OH 45701, USA
- Division of Geriatric Medicine, Ohio University, Athens, OH 45701, USA
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL 32610, USA
| | - Leatha A. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH 45701, USA
- Department of Biomedical Sciences, Ohio University, Athens, OH 45701, USA
| | - Cody R. Criss
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH 45701, USA
- Heritage Fellow, Translational Biomedical Science Program, Ohio University, Athens, OH 45701, USA
| | - Reza Shadmehr
- Laboratory for Computational Motor Control, Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MA 21218, USA
| | - Dustin R. Grooms
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH 45701, USA
- Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH 45701, USA
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146
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Alvar AM, Lee J, Huber JE. Filled Pauses as a Special Case of Automatic Speech Behaviors and the Effect of Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:835-843. [PMID: 31306603 DOI: 10.1044/2018_ajslp-msc18-18-0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose In Parkinson's disease (PD), there are significant changes in the basal ganglia, a structure known to be important for controlling automatic responses to cues. Changes to the basal ganglia in PD impair an individual's ability to trigger a behavior in response to cues, but more so in response to internal cues more than external ones. Filled pauses are considered a subconscious or automatic speech response to an internal cue that there are difficulties with ongoing communication. Typical speakers use filled pauses (such as uh or um) to mark silent pauses. The purpose of this study was to examine how automatic speech responses are impacted in PD by looking at filled and silent pausing behaviors, extending our understanding of the role of the basal ganglia in automatic behaviors. We hypothesized that individuals with PD would use fewer filled pauses and longer silent pauses. We also hypothesized that longer pauses would be more likely to be marked with filled pauses and that this relationship would be weaker in speakers with PD. Method Speech samples were collected via a story-retelling task from 15 individuals with PD and 18 age-matched controls. Duration and frequency of filled and silent pauses were measured using spectrographic analysis. Number and duration of marked silent pauses (those consecutive with 1 or more filled pauses) were measured. The t tests and analyses of variance were used to test our hypotheses. Results There was no significant difference in the number of silent pauses between groups, but the duration of silent pauses was significantly greater for individuals with PD. Despite this, individuals with PD produced significantly fewer filled pauses and fewer marked silent pauses. For both groups, longer silent pauses were more likely to be marked by filled pauses, but individuals with PD marked a smaller percentage of silent pauses at longer durations than controls. Conclusions Producing fewer marked silent pauses, coupled with longer silent pauses, reduces natural cues to discourse and puts people with PD at greater risk of sounding unnatural and losing their communicative turn. These results suggest that automatic responses regarding speech production difficulties are impaired by PD. This interpretation fits with nonspeech literature where automatic responses have been demonstrated to be impaired in PD.
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Affiliation(s)
- Ann M Alvar
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Jiyeon Lee
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Jessica E Huber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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147
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Rosenfeldt AB, Penko AL, Streicher MC, Zimmerman NM, Koop MM, Alberts JL. Improvements in temporal and postural aspects of gait vary following single- and multi-modal training in individuals with Parkinson's disease. Parkinsonism Relat Disord 2019; 64:280-285. [DOI: 10.1016/j.parkreldis.2019.05.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/30/2019] [Accepted: 05/12/2019] [Indexed: 10/26/2022]
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148
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Gilat M, Dijkstra BW, D'Cruz N, Nieuwboer A, Lewis SJG. Functional MRI to Study Gait Impairment in Parkinson's Disease: a Systematic Review and Exploratory ALE Meta-Analysis. Curr Neurol Neurosci Rep 2019; 19:49. [PMID: 31214901 DOI: 10.1007/s11910-019-0967-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Whilst gait impairment is a main cause for disability in Parkinson's disease (PD), its neural control remains poorly understood. We performed a systematic review and meta-analysis of neuroimaging studies of surrogate features of gait in PD. FINDINGS Assessing the results from PET or SPECT scans after a period of actual walking as well as fMRI during mental imagery or virtual reality (VR) gait paradigms, we found a varying pattern of gait-related brain activity. Overall, a decrease in activation of the SMA during gait was found in PD compared to elderly controls. In addition, the meta-analysis showed that the most consistent gait-related activation was situated in the cerebellar locomotor region (CLR) in PD. Despite methodological heterogeneity, the combined neuroimaging studies of gait provide new insights into its neural control in PD, suggesting that CLR activation likely serves a compensatory role in locomotion.
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Affiliation(s)
- Moran Gilat
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium.
| | - Bauke W Dijkstra
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium
| | - Nicholas D'Cruz
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium
| | - Alice Nieuwboer
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium
| | - Simon J G Lewis
- Brain and Mind Centre, University of Sydney, Sydney, Australia
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149
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Repetitive Transcranial Magnetic Stimulation Does Not Improve the Sequence Effect in Freezing of Gait. PARKINSONS DISEASE 2019; 2019:2196195. [PMID: 31275542 PMCID: PMC6589230 DOI: 10.1155/2019/2196195] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/17/2019] [Accepted: 04/28/2019] [Indexed: 11/18/2022]
Abstract
Introduction The sequence effect (SE) is a reason contributing to freezing of gait (FOG) in Parkinson's disease (PD) patients. There is no effective treatment for the SE. The objective of the current study is to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the SE in PD patients with FOG. Methods 28 PD patients with FOG received either real or sham 10-Hz rTMS over the supplementary motor area (SMA). The effects of rTMS on the SE, FOG, and some gait parameters were evaluated. Results rTMS did not improve the SE. Real rTMS had beneficial effects on FOG and some gait parameters, and this effect lasted for at least four weeks. Conclusions High-frequency rTMS over the SMA cannot alleviate the SE in PD patients with FOG. rTMS has a long-lasting beneficial effect on FOG; however, this effect is not achieved by improving the SE but may be through improving some other gait parameters.
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150
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A novel single-sensor-based method for the detection of gait-cycle breakdown and freezing of gait in Parkinson's disease. J Neural Transm (Vienna) 2019; 126:1029-1036. [PMID: 31154512 DOI: 10.1007/s00702-019-02020-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 05/22/2019] [Indexed: 12/14/2022]
Abstract
Objective measurement of walking speed and gait deficits are an important clinical tool in chronic illness management. We previously reported in Parkinson's disease that different types of gait tests can now be implemented and administered in the clinic or at home using Ambulosono smartphone-sensor technology, whereby movement sensing protocols can be standardized under voice instruction. However, a common challenge that remains for such wearable sensor systems is how meaningful data can be extracted from seemingly "noisy" raw sensor data, and do so with a high level of accuracy and efficiency. Here, we describe a novel pattern recognition algorithm for the automated detection of gait-cycle breakdown and freezing episodes. Ambulosono-gait-cycle-breakdown-and-freezing-detection (Free-D) integrates a nonlinear m-dimensional phase-space data extraction method with machine learning and Monte Carlo analysis for model building and pattern generalization. We first trained Free-D using a small number of data samples obtained from thirty participants during freezing of gait tests. We then tested the accuracy of Free-D via Monte Carlo cross-validation. We found Free-D to be remarkably effective at detecting gait-cycle breakdown, with mode error rates of 0% and mean error rates < 5%. We also demonstrate the utility of Free-D by applying it to continuous holdout traces not used for either training or testing, and found it was able to identify gait-cycle breakdown and freezing events of varying duration. These results suggest that advanced artificial intelligence and automation tools can be developed to enhance the quality, efficiency, and the expansion of wearable sensor data processing capabilities to meet market and industry demand.
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